Family Health Diary May/June 2014 by Family Health Diary

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familyhealthdiary.co.nz May / June 2014

Smokefree

2025 by

Pipe dream or

emerging reality?

Well I've finally given in and admitted winter is on its way. The younger kids seem to have sprouted hugely since last winter, with the long pants looking not so long anymore, so it’s shopping we go. I wish I had the excuse of still growing – for me it’ll be the ‘same-old same-old’ in my winter wardrobe! For one lucky reader though, it will be a different story, because this month we’re giving away an exclusive shopping experience with leading NZ stylist Nikki Lovrich. See the back page for details. I hear it’s World Smokefree Day on May 31st and from the Kiwi point of view our smoking rates are now down to 15% of adults, which is something to be proud of as a nation. If you’ve contributed to those stats, well done. If you’d like to quit but it’s just fallen into the too-hard basket, or you’ve now found renewed motivation, there’s some help at hand in this edition of Family Health Dairy. Go on, make winter 2014 one to remember for all the right reasons. Whatever the winter months bring your way... stay safe, warm and healthy, and we’ll catch you next time.

In this issue 4 A beauty secret that's stood the test of time 6 Conjunctivitis – now less of a fuss 8 Prevent shingles – get vaccinated 10 Depression – staying with the treatment you're used to 12 Make World Smokefree Day your day to quit 14 Get real control over asthma 16 Haemorrhoids… don't sit on symptoms 18 Treat osteoporosis just once a year 20 Good news for warfarin patients 22 Once-a-day treatment for psoraisis

Editor: Aileen Nakhle Design: Raydar For editorial enquiries write to: editor@familyhealthdiary.co.nz For Family Health Diary advertising enquiries: Please phone sales manager Harinda Singh DDI: 09 306 2344, Email: harinda@brandworld.co.nz

Family Health Diary May/June 2014

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Smokefree by 2025 – pipe dream or emerging reality? The New Zealand Government has a goal to make this country smokefree – meaning less than 5% of the population smoke – by 2025. But is it even possible to achieve this status? How do we get there and how would Kiwis’ attitudes, and everyday lives, need to change? And what about the smokers left behind who just don’t want to quit? This month at www.familyhealthdiary.co.nz we investigate the future of smoking in New Zealand. Here’s a hint of what we found…

Places to smoke There needs to be an extension of smokefree environments for the 2025 goal to be achieved, says Stephanie Erick, director of Action on Smoking and Health (ASH). She believes that if people do want to smoke, the only place should be outside their home, away from children. “We need to support smokers who are trying to quit by making more places smokefree, such as the outdoor areas of pubs.”

Hidden but accessible Stephanie Erick hopes that by 2025 cigarettes will be a lot less accessible, with sellers requiring registration and located away from childcare centres and schools. “There are currently over 7000 places in New Zealand where you can buy cigarettes. The extreme view is that we won’t be selling cigarettes in this country by 2025. If we do still sell them, the hope is for one shop for every 1000 smokers, which means a drop from 7000 outlets to about 160.”

Building on what works Funded by the government, the Centre for Tobacco Control Research has found that permanent success can be helped along by adding a competitive and supportive environment to proven effective cessation methods such as Champix and Quitline. The WERO competition funded by the Ministry of Health is now in action and involves teams of quitters within regions. Participants support each other and have the added incentive of a cash prize that goes to a charity of the winning team’s choice.

To read the full feature story, visit us online Family Health Diary is published by BrandWorld Limited, Auckland. Phone 09 306 2340 Every effort has been made to ensure the contents of this magazine reflect current accepted medical opinion and that it is as up-to-date as possible, but it does not claim to be the last word on any medical matter featured. No medical or health information, however detailed, can ever be considered a substitute for consultation with, or the advice of, a qualified doctor. Though this publication contains information that may be of the greatest importance to your health and well-being, it is not intended to replace your doctor or Seemay back for details discourage you from seeking his or her advice. If anything in Family Health Diary leads you to suppose you bepage suffering from any of the serious conditions described, you are urged to see your doctor without delay. ©2014 Copyright. No part of this publication may be reproduced without the express permission of the publisher. Family Health Diary® is a registered trademark of BrandWorld Limited.

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A little secret, a lot loved When it comes to beauty, it can be tempting to try out new products that promise you a miracle – but all too often we return to those that have stood the test of time. Beauty fads come and go but when a product really delivers, it stays on shop shelves for generation after generation while others disappear. The fact that such products can be found in bathrooms around the world is testament to the fact they work. Palmer’s Cocoa Butter is one of these enduring beauty secrets, with a loyal following in over 80 countries. The key ingredient – cocoa butter – is key to its success, trusted by many as the answer to smooth, youngerlooking skin.

Family Health Diary May/June 2014

Why is cocoa butter so great for skin? Cocoa Butter is nature’s super beauty ingredient. It naturally contains the most powerful blend of antioxidants, including vitamins, flavonoids and the unique Cocoa Mass Polyphenol. Palmer’s Cocoa Butter harnesses the power of natural cocoa butter and delivers it right to your skin. It works in a unique way, melting on contact and matching your skin’s natural oil balance. That’s what makes it so good at fighting the free radicals responsible for ageing.

The Palmer’s Cocoa Butter difference

W he re do es it co m e fro m? Cocoa butt er origin at ca ca o tre e, which on es fro m th e tropics - th e area 20ly grows in th e an d Sout h of th e eq de gree s N orth uato r.

Many moisturisers contain a lot of water, which can evaporate quickly leaving your skin feeling dry. That’s not the case with Palmer’s Cocoa Butter. Enriched with Vitamin E, Palmer’s softens, smoothes and evens out skin tone and texture, leaving skin looking and feeling beautiful.

Aft er dryi ng an d roa bean s are crus hed ansti ng, cocoa extra ct pu re cocoa bu d pressed to Th e bean s are th e tt er. sa m e as th os e us ed to m ak e ch ocol at e.

Discover Palmer’s for yourself If you’re not already familiar with the extensive Palmer’s Cocoa Butter range, test it out and discover why so many women around the world continue to choose Palmer’s.

In supermarkets and pharmacies

Palmer’s Cocoa Butter range Moisturisers harnessing the power of cocoa butter for beautiful skin form the basis of this range. Four favourites are: Body Lotion A luxuriously rich lotion for sexy skin.

Rapid Moisture Spray Delivers the unique Cocoa Butter formula in a refreshing, fast-absorbing spray for people on the go.

Daily Facial Lotion with SPF15 UVA/UVB Protection Designed for the face, this lotion has the added benefits of sun protection to help prevent skin damage.

Intensive Relief Hand Cream A concentrated moisturiser that helps relieve dry to extra dry skin, particularly on the hands.

Palmer’s is a member of The World Cocoa Foundation (www.worldcocoafoundation.org), helping promote a sustainable cocoa economy through economic & social development and environmental stewardship in cocoa-growing communities.

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Open your eyes to convenience Conjunctivitis is easily spread and shouldn’t be ignored, yet most treatment regimes can be difficult to follow through. Over-the-counter conjunctivitis treatments need applying up to five times a day. Applying eye drops can be fiddly at any age so the fewer times a day you need to do it, the better. Fortunately one uniquely formulated product, available on prescription from your doctor, only needs to be used twice a day. It’s called Fucithalmic® and now it’s fully funded. Designed for both adults and children, its ease of use will be welcome relief for both parents and little ones.

Convenient for all the family Its convenience means Fucithalmic® fits better around family commitments, such as work, school, preschool and daycare. For busy parents, being able to apply eye drops in just the morning and evening means it’s easier to follow through with treatment.

Family Health Diary May/June 2014

Ea sy to cat ch M ost ba cte ria that cau se conju nct ivit is are spread throug direct ha nd-to -ey e contact h fro m conta mi nated ha nd e dis eas e ca n be cau ght juss.t Th by tou chi ng som eth ing that wa s ha nd led by a n inf ect ed per son. For thi s rea son, peo ple wh o are dia gn ose d wit h conju nct ivit particula rly children, sho uldis, sta y hom e u ntil tre atm ent ha s sta rte d, to avo id inf ect ing oth ers.

Conjunctivitis – a common problem You may know conjunctivitis as ‘pink eye’ or ‘red eye’. Common symptoms include redness, itching, swelling of the eyelids and a discharge that may cause the lids and lashes to be matted together in the mornings. There can be a scratchy feeling, pain with bright light, or tearing. Conjunctivitis affects approximately 12% of New Zealand’s population and peaks from winter through to springtime. The three most common ways you can get it is through an allergic reaction, from bacteria, or a virus.

Use twice a d ay, n o t f i v e

t i m e s

features AND Benefits • Easier than multiple-application products • Opaque drop turns into clear gel, for clear vision after use • Effective and well-tolerated

Ask your doctor if Fucithalmic® is right for you.

• Used by New Zealanders for over 13 years • Now fully funded (ie. you will not pay for the medicine – only doctor’s and pharmacy fees apply).

Now fully funded conjunctivitis treatment.

Fucithalmic® is a Prescription Medicine for the treatment of bacterial infections of the eye like conjunctivitis. Medicines have risks and benefits. Do not use if you wear contact lenses. Do not drive or operate machinery if vision is blurred after application. Possible side effects: mild stinging and burning in the eye, tearing & blurring of the eyes. Use only as directed. If symptoms persist see your doctor. Fusidic Acid 1%. For further details refer to CMI on www.medsafe.govt.nz, bioCSL (NZ) Ltd, Auckland. Fucithalmic® is a registered trademark of Leo Pharmaceutical Products Ltd A/S. TAPS NA6382 familyhealthdiary.co.nz

Help prevent Shingles, get vaccinated

If you’ve ever had chickenpox, the Shingles virus is already inside you. That means 97% of New Zealand adults are at risk of Shingles, and one in three people will go on to get it. Many health problems may be avoidable and Shingles is an example. Shingles can strike at any time and it can be very painful; sometimes the pain can last months, or even years. One in three people who have had chickenpox will get Shingles, and those over 50 are more at risk. But rather than waiting to get Shingles, you can help prevent it. Now there is a Shingles vaccine available – it is your best defence against Shingles.

Family Health Diary May/June 2014

What is shingles? Shingles is caused by the same virus that causes chickenpox. After your chickenpox blisters heal, the virus that caused them stays in your body, lying dormant in nerve cells. The virus may be there for many years, without causing any problems. But without warning, it can become active again, resulting in a Shingles outbreak.

Symptoms of Shingles Shingles can appear as a painful, blistering rash, that can last weeks.

The rash forms where the nerves from the spinal cord connect with the skin. This area is called a dermatome. Usually the rash will appear along a dermatome located on one side of the body. Because the nerves along the path become inflamed, Shingles can be very painful. Pain that can last for months after the blisters have healed is called post herpetic neuralgia (PHN). As you get older the risk of developing PHN increases. Patients have described PHN as burning, throbbing, stabbing or shooting pain. In some cases, this pain can go on for years.

Who is affected? Anyone who has had chicken pox is at risk. As we age our immune system is less effective at protecting us and that is why two thirds of cases occur in people over 50.

Introducing Zostavax â&#x20AC;&#x201C; the Shingles vaccine Zostavax is a vaccine to help protect you against the acute and chronic pain of Shingles and PHN. You must be 50 years or older to be vaccinated with Zostavax.

How to get Zostavax Zostavax is available from your doctor, and some pharmacists. And yes, you can get it at the same time as the flu vaccine. Zostavax is not funded, so charges will apply.

Ask your doctor or vaccinating pharmacist about the Shingles vaccine THINGS TO KNOW BEFORE USING ZOSTAVAX (zoster virus vaccine, live) 19,400 PFU as 0.65 mL vial for injection: ZOSTAVAX is used in adults 50 years of age and over to prevent Shingles. ZOSTAVAX should not be used in people who are allergic to any of its ingredients including gelatin or neomycin; have a weakened immune system; have untreated tuberculosis; are or may potentially be pregnant. Pregnancy should be avoided for 3 months following vaccination. ZOSTAVAX is not recommended for use in children. Caution is advised in people who have a fever, have HIV, are immunocompromised or are breast-feeding. Common side effects are: headache, localised injection site reactions and pain in the arm or leg. ZOSTAVAX is not funded. There will be a charge for the vaccine, and other medical fees may apply. Cost should be discussed with the health professional. All medicines have risks and benefits, consult your health professional to see if ZOSTAVAX is right for you. If you have side effects, see your health professional. For additional product information, consult the Consumer Medicine Information, available on request from 0800 500 673, or refer to the Medsafe website www.medsafe.govt.nz . Based on data sheet prepared 09/08/2011. Supplied by: Merck Sharp & Dohme (NZ) Limited, Newmarket, Auckland. [MPI-ZST-1] VACC-1101661-0028 First issued April 2014. TAPS NA7055 Zoster Vaccine Live (Oka/Merck)

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Update your approval for Efexor-XR It’s great when you find relief from major depression. So if Efexor-XR is working for you and your doctor feels you should continue treatment, you can stay on it. Just ask your doctor to update your authority number… Read on for details. If you’d like to stay with Efexor-XR and not be given another brand, it’s really important you ask your doctor to check the authority number on your script. It’s a number that appears at the bottom of your script, and you’ll want to be sure it’s not out of date.

Family Health Diary May/June 2014

You see, it’s this number that enables you to receive the EfexorXR capsules you’re used to, and not a tablet alternative.

Fully funded With an up-to-date authority number, Efexor-XR is fully funded, so there is no extra charge other than your usual doctor’s and pharmacy fee. You just need to let your doctor know that you want to stay with Efexor-XR, and ask your pharmacist for Efexor-XR by name.

More about Efexor-XR Efexor-XR is used in the treatment and prevention of relapse of depression and is also prescribed for a range of mood disorders including generalised anxiety, social anxiety and panic disorders. Efexor-XR’s dual-action approach to depression may help resolve a broad range of depression symptoms like constant sadness, trouble sleeping or low energy. Resolving these symptoms can be the first step to helping you control your depression so you can feel like your old self again.

Stay on your treatment as long as prescribed One of the most important things for you to remember is to take your medication as prescribed, and stay on it for as long as your doctor advises. That’s because it’s not uncommon for depression symptoms to return. If you have found a treatment that works for you, and it’s Efexor-XR, then you don’t have to change. You can stay

with what you know, so long as your authority number is up to date.

ent? Wh at is the goa l of treatmgoa l is the ion, In treatin g depress you – ter bet l fee to more tha n just r you all te ina elim d an try wa nt to m the p kee d depression sympto ms an call this the rs cto Do from coming back. ple who remission of sympto ms an d peo less rea ch remission of sympto ms are rn. retu ms like ly to have their sympto ing For you, remission cou ld meanitehav our fav ene rgy again for you r rest in the activities an d ren ewed inte ng. thi ngs you used to love doi you r If you r treatm ent is Efexor-XRag, e an d doctor will know the right dos xorhow lon g you need to sta y on Efe s. t l resu XR to get the best unded For more inform ation on fully-f nz co. r. ize f w.p Efexor-XR, visit ww

Ask your doctor to update your Authority Number and ask your pharmacist for Efexor-XR by name.

EFEXOR-XR (venlafaxine hydrochloride, 37.5 mg, 75 mg, 150 mg) Modified Release capsules. EFEXOR-XR (venlafaxine hydrochloride) is a funded prescription medicine (restrictions apply) for the treatment of depression, panic and anxiety disorders. A pharmacy charge and normal doctor’s fees apply. Do not take EFEXOR-XR if you have an allergy to venlafaxine or any other capsule ingredients. Do not take EFEXOR-XR if you are on monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the last 14 days. Use with caution if you have a history of aggression, restlessness, glaucoma, kidney, liver, blood pressure or heart problems, raised cholesterol, a history of fits, a history or family history of bipolar disorder, abnormal bleeding tendencies, are diabetic, pregnant or breastfeeding. Tell your doctor if you are taking any other medicines. Common side effects include stomach, bowel or urinary tract problems, headache, difficulty sleeping, drowsiness, dizziness, nervousness, confusion, agitation, muscle tremor or weakness, fast heart beat, menstrual problems, weight loss, sweating, hot flushes, hair loss, bleeding or bruising more easily than normal, changes in your eye sight, sexual function problems. If you have any side effects see your doctor. Use strictly as directed. Consult your doctor to see if EFEXOR-XR is right for you. Contains venlafaxine hydrochloride 37.5 mg, 75 mg or 150 mg. Further information on EFEXOR-XR is available from www.medsafe.govt.nz or Pfizer New Zealand Ltd, Auckland. www.pfizer.co.nz Ph. 0800 736 363. V10913. TAPS NA6706 familyhealthdiary.co.nz

More Kiwis going smokefree May 31 marks World Smokefree Day and Kiwis have a good reason to be proud, with thousands of us having quit smoking in recent years. If you’re a smoker, but keen to quit, you could make the 31st your big day. World Smokefree Day is a time when people around the planet join together to support the idea of a healthier lifestyle, with the aim of ultimately saving lives. It’s not just about saving smokers, but also protecting those living around smokers, especially children, and generally working towards a more positive future for friends and whanau.

possible – despite smoking being highly addictive.

What does smokefree mean? A smokefree New Zealand means that less than 5% of New Zealanders will smoke. The goal is that in 2025 there won’t be a ban on smoking, but tobacco will be difficult to sell and supply. We’re well on our way. The last census shows the number of smokers nationwide dropped by nearly a quarter between 2006 and 2013. Associate Minister of Health Tariana Turia says we cannot afford to be too complacent though. “We want to rid our country of this product that kills 13 New Zealanders a day and 5000 each year. I look forward to the day we reach our goal of becoming smokefree.”

For help to quit smoking talk to your local health provider or visit quit.org.nz or aukatikaipaipa.org.nz

Since 2011 the New Zealand Government has been working towards a goal of making Aotearoa Smokefree by 2025. It is achievable, as already smoker numbers have dropped to only 15% nationwide. It’s a fantastic achievement and shows that with encouragement and support, quitting is absolutely

Family Health Diary May/June 2014

Getting the support you need to quit If you do decide to quit smoking on World Smokefree Day, try to have family and friends onboard to help you get through it. In addition, there are plenty of support services: • Face to face (GPs, counsellors, health centres, etc) • Phone (Quitline) • Online/Internet (Goalpost, Smokestop, The Quitblog) • Txt/mobile messages (Txt2Quit) It’s a good idea to talk to your doctor too. He or she can advise you, and may be able to offer you a smoking cessation treatment that can increase your chances of success in the long run. Champix (varenicline) 0.5 mg & 1 mg Tablets Champix (varenicline) is a prescription medicine that helps adults stop smoking. Champix is fully funded under special authority. A pharmacy charge and normal doctor’s fees apply. Do not take Champix if you are allergic to varenicline or any other tablet ingredients. Tell your doctor if you have ever had depression, other mental health problems, kidney problems, have a history of repeated fits, heart problems, are pregnant, intend to become pregnant or are breastfeeding. Some people have had changes in behaviour, mood or thinking including self-harm or harming others. If you or your family notice changes in your behaviour, mood or thinking, stop taking Champix and see your doctor. Some people have had allergic reactions to Champix that can be life threatening. If you get swelling of the face, mouth, throat or a skin rash, stop taking Champix and see your doctor immediately. There have been reports of heart attack and strokes in some people taking Champix. Heart attacks and strokes can also be caused by smoking. If you have had any of these conditions tell your doctor. Common side effects include nausea, constipation, diarrhoea, flatulence, dry mouth, vomiting, headache, toothache, muscle or joint pain, dizziness, difficulty in sleeping and abnormal dreams. If you have other side effects see your doctor. Always read the label and use as directed. Consult your doctor to see if Champix is right for you. Contains varenicline 0.5 mg or 1 mg.

How Champix can help

Champix is a quit-smoking treatment that’s different to gum or patch-based treatments you may have tried. It is a tablet you take twice a day for at least 12 weeks. By the end of the 12-week Champix programme, you’re around four times more likely to have given up, than if you’d taken no medication. Champix is thought to work in two ways. It reduces withdrawal symptoms and blocks the ‘feelgood’ effects of nicotine, so if you do smoke you probably won’t enjoy it as much. Talk to your doctor about Champix as you may be eligible to have the entire 12-week course funded. Normal doctors’ fees and pharmacy dispensing fees apply.

For more advice see your doctor or go to www.champix.co.nz

Further information on Champix is available from www.medsafe.govt.nz or Pfizer New Zealand Ltd, Auckland, www.pfizer.co.nz. Ph. 0800 736 363. P8365 04/14. TAPS CH4007 familyhealthdiary.co.nz

Get real control of asthma 1

It may seem like just a lovely daydream, but a life without the coughing, wheezing and shortness of breath of asthma is actually possible. If you live with asthma, do you assume you have to live with the symptoms too? You might also assume all asthma treatments are pretty much the same. If that’s the case, you might be surprised at what’s out there. At your next doctor’s visit, ask about options that will help you manage your asthma better. One option is Seretide® (fluticasone propionate/salmeterol xinafoate), which can actually help prevent symptoms in the first place.2

Family Health Diary May/June 2014

Leaving symptoms behind In a major New Zealand asthma study, 81% of people thought their asthma was well controlled, yet three-quarters were using their blue reliever at least once daily and the remainder were taking at least 3-4 puffs a day.3 In short, most people overestimated their level of asthma control. The fact is, if you’re using your reliever more than twice a week, chances are your asthma is not as good as it could be.4

Get control of asthma Seretide can help you control your asthma, often to the point where the symptoms don’t bother you at all.1 Control means:4  • No coughing or wheezing • No night-time awakenings  • No emergency visits to your doctor or hospital • Participating in activities you enjoy and not having to avoid them  • Using a blue reliever inhaler less than two times a week and living life more.

How Seretide works Seretide's dual action formula is so good at treating asthma, it can actually help prevent symptoms in the first place. As a result you could have symptom-free days for most of the year.5

Is Seretide right for you? Your doctor is the best person to talk to about your asthma control. The most important thing is to let them know what symptoms you’re experiencing and how often you’re having them. You could also visit www.seretide.co.nz where you’ll find FAQs, as well as tips around nutrition, exercise and daily living with asthma.

Ask your doctor about fully funded6 Seretide – the purple inhaler

Th e Seretid e Accuh ale r® The Seretid e Accuh ale r is a conven ient alte rnative to a2 traditional inh ale r becaus e: n, • It is eas y to use – justt ope shu and ale click, inh • You don ’t need to use a spa cer • It can be used by chil dre n ove r the age of fou r yea rs dos e • It als o com es wit h a ays kno w alw ll ’ you so r nte cou es dos exa ctly how ma ny a re lef t.

1. Bateman ED et al. Am J Respir Crit Care Med 2004;170 (8): 836-844. 2. Seretide Datasheet, GSK New Zealand 3. Holt S. NZ INSPIRE Study Overview. Research Review. 2008:113. 4. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. Updated 2012. Available at http://www.ginasthma.org/ Accessed 10 June 2013. 5. Woodcock A et al. Prim Care Resp J. 2007;16(3):155-161. 6. PHARMAC notification. Available from http://www.pharmac.health.nz/ckeditor_assets/attachments/641/ notification-2013-12- 09-eltrombopag-zanamivir.pdf. Accessed 9 December 2013. Seretide® (fluticasone propionate/salmeterol xinafoate; available as a 50/25, 125/25 or 250/25 micrograms per actuation inhaler, or as a 100/50 or 250/50 micrograms per actuation Accuhaler®) is a Prescription Medicine for the treatment of reversible obstructive airway disease (ROAD) including asthma, and for the treatment of chronic obstructive pulmonary disease (COPD). Seretide is a fully funded medicine. Seretide 250/25 microgram inhaler is a private purchase medicine that you will need to pay for. Use strictly as directed. Seretide is not for relief of acute symptoms. Always carry your reliever inhaler. Do not discontinue Seretide abruptly. Tell your doctor: If you are taking any other medicines or herbal remedies, you have pulmonary tuberculosis (TB), a thyroid problem or a heart problem, or you are having treatment for high blood pressure. Side Effects may include: Headache, 'shaky' feeling, fast heart rate, irritation in the nose and throat. If symptoms continue or you have side effects, see your doctor, pharmacist or health professional. For more information, see Seretide Consumer Medicine Information at www.medsafe.govt.nz. Normal doctor's office visit fees apply. Ask your doctor if Seretide is right for you. Seretide and Accuhaler are registered trade marks of the GlaxoSmithKline group of companies. Marketed by GlaxoSmithKline NZ Limited, Auckland. Adverse events involving GlaxoSmithKline products should be reported to GSK Medical Information on 0800 808 500. TAPS CH3930-14DE. familyhealthdiary.co.nz

Haemorrhoids… don’t sit on symptoms If it feels like no matter what you do, you can’t get rid of haemorrhoids, then there's a good chance you haven't seen your doctor yet.

So what exactly are they? Despite the notoriety, there’s often a lack of understanding about haemorrhoids. Also known as piles, they are inflamed veins in the region of the anus, caused by pressure.

Haemorrhoids are so common, half of us will get them at some point. Both men and women are affected equally.

They can be internal or external, and lead to the following:

They can be painful, stubborn, and in many cases they can keep coming back.

• Pain and itching

But if you think there’s not much more you can do other than ‘put up’ with them, then think again.

• Blood on toilet paper, in stools and the toilet bowl • Painful swelling or hard lumps.

Family Health Diary May/June 2014

What can really make the difference is seeing your doctor: the expert who can also prescribe an expert treatment.

including the pain, itch and inflammation.

Ti ps on preventio n Mod ern lifestyle s invo pe riods of sittin g an lvi ng lon g ha ve cont ribut ed to d in activity in crea sin g nu m be r an Ot he r fa ctors in cl ud of sufferers. e: • Poor eatin g ha bits drin ki ng en ou gh wa/ not te r • Co nstipat ion / di arrh oea • Pre gn an cy • St ra in in g on th e toilet • Obes ity • H ea vy liftin g. As you ag e your weak en s an d st retskchin tissu e so th os e ag ed 40 anes m ore ea sily, m ore lik ely to get ha d olde r are em orrh oids.

Even better, it works fast and is long-lasting too. Ultraproct is also fully funded, so you’ll only have to pay your usual doctor’s and prescription charges. In return, you’ll get targeted treatment that gives long-lasting relief.

DOn’t grin and bear it Just putting up with haemorrhoids and not seeking help can mean you suffer unnecessarily. Don’t sit on symptoms – get along to your doctor instead.

See your doctor and ask about Ultraproct®

Your doctor – key to relief Not everyone wants to talk about haemorrhoids, but unless you see your doctor you might be relying on a bit of guesswork when it comes to treating them. So seeing your doctor is a really important step. They’ll give you a proper diagnosis, so you can be sure it’s haemorrhoids and not something else. Your doctor can also prescribe a treatment called Ultraproct®.

Ultraproct® can help Ultraproct is a unique formulation of active ingredients proven to treat the most troublesome symptoms,

ULTRAPROCT® Ointment and Suppositories (Ointment contains 0.92 mg fluocortolone pivalate, 0.95 mg fluocortolone hexanoate and 5 mg cinchocaine hydrochloride per gram) (Suppositories contain 0.61 mg fluocortolone pivalate, 0.63 mg fluocortolone hexanoate and 1 mg cinchocaine hydrochloride per suppository). ULTRAPROCT is a fully funded prescription medicine. Normal doctor’s fees and pharmacy charges will apply. Do not use ULTRAPROCT in the first trimester of pregnancy. Only use in second and third trimester of pregnancy and breastfeeding when prescribed by your doctor; do not use if you suffer from virus diseases, tuberculosis or syphilitic processes in the area to be treated. Prolonged use (longer than 4 weeks) should be avoided. Care must be taken to ensure ULTRAPROCT does not come into contact with the eyes. Careful hand washing after use is recommended. Tell your doctor if you notice any unwanted effect, or if there is a change in your health that you think might be caused by ULTRAPROCT. Always use ULTRAPROCT strictly as directed by your doctor. Additional consumer medicine information can be obtained from the Medsafe website www.medsafe.govt.nz or from bioCSL (NZ) Ltd, PO Box 62 590 Greenlane, Auckland 1546. Freephone 0800 502 757 or www.biocsl.co.nz ULTRAPROCT® is a registered trademark of Bayer Schering Pharma AG. TAPS CH3932

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Treat osteoporosis just once a year If you’re managing osteoporosis with tablet treatments, there is another option… and you’ll only need it once a year. If you have osteoporosis, you might be treating it with tablets. But you have to remember to take them, constantly, which is easier said than done. If you find that you are missing doses, or struggling to take as directed, your bones may not be getting the protection they need. Fortunately, there is another option that helps protect your bones for a full year. It’s not a tablet. It’s an infusion you have only once a year.

Family Health Diary May/June 2014

Aclasta – once a year With Aclasta, once you have your first infusion – which takes around 15-30 minutes – you don’t need to think about your Aclasta treatment again for another year. If you are on Aclasta, it’s important to get the infusion every year for at least three years. That will help ensure you have ongoing protection for your bones. After three years, your doctor will reassess how often you need this treatment.

Wh at is ost eoporo sis ? Osteoporosis is often refe rred totheas the “sile nt epide mic” becau ses until wa rnin g sign s are not obviou the disease is advan ced. du ally Bones becom e less den se, grabrit tle re mo , ker wea ma kin g the m . ken bro ily an d eas an d Th ere is no cure, but medication som e life style cha nge s help. ar Aclast a is a convenient once-a1-ye 2 for infu sion that protects you months at a tim e. ine if It is also a fully fun ded medicma l nor the ly you qua lify for it. On ly. app s fee ent tm trea doctor’s an d How does Aclasta work? For those in normal health, bone breakdown (resorption) and bone formation take place in close sequence and remain balanced. For those with osteoporosis, there is an imbalance in the bone cycle, resulting in bone loss. This imbalance can occur after menopause in women – when

ovaries stop producing the hormone oestrogen, which keeps bones healthy – and with ageing in both genders. Aclasta works by slowing down bone breakdown, which allows the boneforming cells time to rebuild normally.

Don’t reach breaking point If you are currently putting up with a tiring tablet regime, or about to begin osteoporosis treatment, remember there is another option. Just think Aclasta, once a year. Ask your doctor if Aclasta is right for you. And for ongoing protection, don’t forget to get the infusion yearly.

Help your bones Every day…. • Eat a balanced diet high in calcium • Spend 30 minutes outdoors in sunlight (for vitamin D) • Be physically active for 30 minutes • Limit alcohol to two standard drinks • Don’t smoke.

Ask your doctor if Aclasta is right for you Aclasta® (zoledronic acid 5mg) is a prescription medicine for the treatment and prevention of osteoporosis. Aclasta is an infusion and contains 5mg of zoledronic acid. Check with your doctor to see if Aclasta is right for you. It is important to have an Aclasta infusion each year to ensure you get maximum treatment benefit. Aclasta is fully funded for patients who meet specified criteria. Funding does not include the cost of infusion and normal doctors and prescription charges will apply. Caution while under dental treatment or if dental treatment is planned. Calcium, hydration status and kidney function may be assessed by your doctor before and after you are given Aclasta. Your doctor may recommend that you take regular Calcium and Vitamin D supplements. Adverse effects are usually mild and transient. Common side effects are flu-like symptoms and bone, joint, and/or muscle pain; anaemia; headache; dizziness; transient low blood calcium; gastrointestinal symptoms; renal impairment; breathing difficulty and lethargy. If symptoms persist or you have side effects see your doctor. Aclasta is the registered trademark of Novartis AG. Novartis New Zealand Limited, Auckland. For further information check the Consumer Medicine Information [CMI] at www.medsafe.govt.nz. ACL 0214-259 TAPS CH3923

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On warfarin? Blood testing made easy Here’s some important information for those taking warfarin for anticoagulation (or thinning) of the blood. There’s a new option for managing your INR blood tests that’s more convenient, a lot gentler and much faster.

Working with District Health Boards, doctors and pharmacists are now providing you with an easier and more comfortable way of keeping on top of INR blood testing – which determines if you are taking the correct dose of warfarin. The test checks how long it takes for blood to clot. Up until recently the only option for this important test was to go to the laboratory or doctor’s surgery, wait until you were seen, have a blood sample taken, and then go home to wait. It could take a day until you learned the results from the laboratory and what adjustments your doctor thought were necessary to your warfarin dosage. 20

Family Health Diary May/June 2014

And let’s face it – a needle in the arm is not something many people look forward to either. With the new Community Pharmacy Anticoagulation Management Service (CPAMS) you now have the option of visiting one of more than 100 pharmacies nationwide for immediate, gentle testing and an accurate result in seconds.

How the service works Under CPAMS you are still under the overall responsibility of your GP, but it means your pharmacist and doctor take a shared role in managing your INR blood tests.

When you use the service, a highly skilled pharmacist will take just one drop of blood from a finger tip and an accurate INR test result will be available in seconds – not hours. Warfarin dose changes can be made immediately, and a calendar can also be printed for you with details of what dose to take on every day of the month. Your GP will receive the test results too. At all times they will have a clear picture of your treatment progress and can get involved when necessary. What’s more, if you provide an email address, you can be sent automatic email reminders when the next test is due, and can see your own results via the Internet.

How do you start? To be set up with the service you’ll need to meet with your doctor. After a discussion you can decide if it’s right for you, and your GP can organise a referral as well as advise you of the nearest pharmacy offering the service. You can also help get the ball rolling by getting the appropriate forms from a pharmacy for your doctor to fill out.

Key benefits of the service

Find out more

• Convenient: On-the-spot testing when you call into your pharmacy; instant results; warfarin dose advice given in minutes.

Visit www.anticoagulation.co.nz online for more information and a handy geographical map of the pharmacies involved with the service. There are plans to increase the number of accredited pharmacies – currently about 116 – and growing.

• Professional care: Your doctor and pharmacist work together to monitor your treatment.

It is hoped that every New Zealander on warfarin can get easy access to this convenient, gentle and fast service so that managing the condition is less stressful.

• Gentle testing: Pain-free finger prick test. TAPS NA7056

Visit www.anticoagulation.co.nz for more information

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Once-a-day treatment for psoriasis If you have to live with psoriasis, when it comes to treating it, you might think you've heard it all before. Now your doctor may have good news for you.

Anyone dealing with psoriasis knows how difficult it is to live with, and how equally frustrating it can be to treat. Creams and lotions must be applied repeatedly – many of which are heavy and take time to dry. Even in between flare-ups, maintenance treatment is usually needed to keep the red, inflamed skin from coming back. But in most cases it does come back – angry, itchy and difficult to cover up. So the endless cycle of treatment continues. If you’re familiar with this routine, don’t give up hope. There is now a fully funded treatment that may be different to anything you have tried before.

Family Health Diary May/June 2014

Ask your doctor about Daivobet® Daivobet® is a once-a-day treatment that works fast. It’s an easier way to treat psoriasis, without the need for multiple applications and multiple treatments. If you haven’t spoken to your doctor recently, this could be the time to do so. This fully funded treatment might be the answer you’ve been hoping for.

Daivobet® benefits • Convenient • Only one application a day • Combination treatment • Works fast – most see improvements within seven days • Rapidly absorbed gel provides alternative to ointment when you need fast drying treatment • Fully funded.

How it works

what type of psoriasis?

Daivobet® is a combination treatment containing two products often used separately: this combination of products treats the overactive skin cells that cause psoriasis, and relieves redness, swelling, itching and irritation of the skin.

Daivobet® is available as an ointment and gel to treat plaque psoriasis. Plaques are raised, rough, reddened areas covered with fine, dry silvery scales. About 80% of people with psoriasis have this type.

When a flare-up happens, you only need to apply it once a day. And most people see improvement within seven days.

Daivobet® gel also treats scalp psoriasis. The almost clear gel is alcohol-free, odourless and rapidly absorbed.

While the re is still no cure for pso ria sis, Da ivo bet® mig ht hel you dea l wit h it a lot better. p

Ask your doctor whether Daivobet® Ointment or Gel is right for you. DAIVOBET® is a fully funded prescription medicine. Normal doctor’s fees and pharmacy charges will apply. For the topical treatment of plaque type psoriasis and scalp psoriasis. Tell your doctor if you are taking Calcium or Vitamin D supplements or any medicines. If you have other types of psoriasis, liver or kidney problems, any skin infections, TB, or skin rashes, acne, rosacea, ulcers or broken skin, are pregnant or breastfeeding, or have calcium metabolism disorder. Do not use on face, mucous membranes, or skin folds. Protect treated skin areas from sunlight and UV rays. Side effects may include: skin irritation; rash; worsening of psoriasis; change

in skin colour; headache; sore throat; back pain; sensitivity to light or change in control of diabetes. Tell your doctor or pharmacist if you experience any of these or if you have any other unpleasant side effects. Always use DAIVOBET® strictly as directed by your doctor. Contains 50 mcg/g calcipotriol and 500 mcg/g betamethasone (as dipropionate). Additional consumer medicine information can be obtained from bioCSL (NZ) Ltd, PO Box 62 590 Greenlane, Auckland 1546. Freephone 0800 502 757 or www.bioCSL.co.nz. Daivobet® is a registered trademark of Leo Pharmaceutical Products Ltd. TAPS pp3988

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