Better Breathing Winter 2020

Winter 2020

Better Breathing What does my inhaler do?

Getting to know your asthma & COPD medicine

COVID-19 Response What we have been up to and how we have helped

Missing out on your CPD points?

Register now for the NZ Respiratory Conference, 5-6 Nov!

Check out our first Pasifika resource!

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Pg 10 Winter ha s arrived, find ou t how to stay well this season.

Our Team Chief Executive Letitia Harding Research and Education Manager Joanna Turner Office Administrator Catherine Fell Donor Relations Coordinator Ruby Parker Grants and Fundraising Manager Harriet Cartwright Marketing and Communications Team Leader Brian McDonald Marketing & Communications Coordinator Victoria Fairweather Marketing and Partnerships Advisor Grant Steere Medical Director Dr Stuart Jones, MBChB, PhD, FRACP Chief Cultural Advisor –­­ Māori Sir John Clarke, KNZM, CNZM Level 2, The Woolstore, 262 Thorndon Quay, Wellington 6011 PO Box 1459, Wellington 6140 04 499 4592 ARFNZ.org.nz asthmaandrespiratoryfoundation asthmafndation asthmaandrespiratoryfoundation

ISSN 2703-4127

Pg 2 Check out the first of our Pasifika resources; avail able now!

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In this issue...

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Community News See what Nelson Asthma Society has been up to, read about our first Pasifika resource, and check out Sailor’s new look.

3

Our COVID-19 Response What a year we have has so far! See what the Foundation has been up to for the past few months during lockdown.

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Health Professional News The updated asthma guidelines are almost here; get in quick and register for the NZ Respiratory Conference to find out more!

5

NZ Respiratory Conference COVID, vaping, and guidelines; learn about what’s on the programme for this year’s respiratory conference.

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What Does My Inhaler Do? Curious about how your inhaler works? We break down every inhaler available in New Zealand and how they work for you.

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World Asthma Day Round Up Did you tune in to watch our World Asthma Day livestreams? If not, read all about it here!

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Understanding Bronchiectasis What used to be an often misdiagnosed disease is now becoming more common. But what is BX?

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10 Tips for Winter Wellness Winter has arrived, and so have some new challenges in managing respiratory illness. We have compiled some helpful tips to help you manage these this season.

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Build a Healthy Home with DRIDEX® Often overlooked, roofing can play a huge role in the healthiness of your home. Check out how DRIDEX® can help.

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Resource Review We have collated our expanding range of bilingual resources and reviewed these for quick reference.

Coming up...

29 June - 3 July World Allergy Week 1 Sept Breathe Better September launches 7 Sept Māori Language Week 21 Sept World Sign Language Week 5 - 6 Nov NZ Respiratory Conference 18 Nov World COPD Day

Did you realise you can also read this magazine online?

Head to the link below to view every issue of Better Breathing Magazine! issuu.com/betterbreathing

Letitia’s Message W

ell, we’re certainly living in interesting times!

Of course, the COVID-19 pandemic has affected us all enormously. We’ve all been working from home and keeping things going, but it’s certainly good to be back in the office now.

Our thoughts are with all of our respiratory whānau, and we hope that you managed to get through the pandemic healthy and well. It has been a challenging time, and the team here at ARFNZ have worked incredibly hard to bring you the latest information on what the different alert levels would mean to you and your family.

Earlier in the month, the Smoke Free Environments and Regulated Products (Vaping) Amendment Bill entered into public consultation (again, remotely), and appears to be a good fit

with the Foundation’s goals. Importantly, the Bill will not penalise those using vaping for smoking cessation, but introduces strong regulations around youth uptake and advertising.

This legislation is about 95% of what we wanted to see from a respiratory health perspective. However, if these products are intended to help people quit smoking, there should be robust support systems in place to accomplish this, and these must be delivered at the point of sale. We’re still interested in how safety standards will be set and regulated, and how 18+ sales will be monitored online, but these issues won’t be solved overnight.

Our shared goal is better respiratory health for all New Zealand, and we need to work together to achieve this.

Following the Bill, we also celebrated World Asthma Day in lockdown; our annual awareness campaign to educate Kiwis about one of New Zealand’s most prevalent respiratory diseases.

With our plans cancelled due to COVID, the team and I certainly had to think fast on our feet to make changes to the way we were going to engage this World Asthma Day. After numerous ‘Zoom’ brain storming meetings we embarked on our first entirely digital campaign, and I am pleased to say that this was a great success.

Thanks to the team at De’Longhi NZ, we were able to give away a brand new Magnifica S Smart coffee machine to one lucky donor this World Asthma Day!

The new online pivoted campaign consisted of a series of livestream videos, broadcasted

ARFNZ CE, Letitia Harding

throughout World Asthma Day on May 5th.

This included a Sailor the Puffer Fish Asthma Musical with Chris Lam Sam, a crafting session with Kikorangi the Asthma Fairy, and a live Q&A session with our asthma and respiratory expert, Dr James Fingleton.

Each year, World Asthma Day provides a wonderful opportunity to promote awareness, and encourage self-management of asthma. Lockdown made traditional outreach challenging, but we are pleased that the variety in the World Asthma Day content allowed for people to learn more about asthma, even if they wouldn’t usually consider it a priority.

We also have to say a huge thank you to our sponsor DeLonghi – who donated a Magnifica S Smart coffee machine for our ‘Donate your Coffee’ draw. Over 800 people entered the competition, raising over $3,000!

Lastly, I am pleased to announce that the Foundation was recognised as a major leader in the field of asthma during lockdown, and was invited to be a GINA (Global Initiative for Asthma) advocate for a 3 year term from May 2020. This appointment highlights the calibre and esteem which the Foundation is held in, and we thank those Foundation team members who have come before us since 1964 in paving the way.

Letitia Harding

Better Breathing

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Respiratory Community News Building healthy homes with Pro Clima Our Sensitive Choice partner Pro Clima visited Nelson as part of their CUBE Seminar Series earlier in the year, where they met up with Nelson Asthma Society for a joint presentation.

Pro Clima’s ‘Cube’ is a converted shipping container that has been travelling across the country presenting to building professionals over the past few months. The Cube educates those in the construction sector around improving the performance of buildings in New Zealand, and demonstrates building technology which aims to benefit the health of all Kiwis.

Manager of Nelson Asthma Society , Sue Alsop (pictured right) joined Pro Clima in a recent demonstration. Sue provided insight from a respiratory health perspective, and gave free advice and resources on how to keep homes warm, dry, and pollution free.

Celebrating Samoan Language Week

New look for asthma education website

To celebrate Samoan Language Week this year, the Foundation is pleased to announce the first of our Samoan asthma resources.

The Foundation is pleased to announce that our Sailor the Pufferfish asthma education website has been given a much needed face lift!

The Tausiaina o le ma’i sela o lau tama (Managing your Child’s Asthma) handbook is now available to order or download - the first of many Pasifika languages we hope to translate to.

Complementing the Sailor the Pufferfish asthma musical that educates classrooms across New Zealand on asthma management, the Sailor Asthma Education website takes this education further with its interactive website content.

The booklet covers everything you need to know to care for a child who has asthma, from identifying triggers, to caring for a spacer.

The booklet can be downloaded from our website as a free downloadable PDF, or ordered through our online store. To find out more, visit arfnz.org.nz/resources.

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A key highlight of the upgrade is the brand new asthma themed colouring game, where children can learn about asthma triggers and management through digital art.

The Foundation hopes to continue to expand these digital resources over the coming year. Check it out at sailorasthmashow.co.nz.

ARFNZ COVID-19 RESPONSE Over the past three months, the Foundation has worked hard to support our respiratory community through these unprecedented times. Here is an overview of what we have been up to:

STAYING INFORMED The Foundation began its COVID-19 coverage back in February; before New Zealand’s first confirmed case. This was followed with a dedicated COVID-19 webpage specifically addressing the concerns of those with respiratory illness;.

The content on this page has been continually updated and verified by members of our Scientific Advisory Board as New Zealand moved through the different alert levels . This page has now had over 26,000 visits since inception, and is one of the leading New Zealand sources of COVID-19 information for those with respiratory disease.

ANSWERING COMMUNITY CONCERNS As the number of COVID-19 cases increased in New Zealand, we were inundated with calls and emails from our respiratory community. Throughout this time, we answered over 1,000 enquiries from emails, phone calls, and social media; assisting those with chronic respiratory conditions on how to stay safe and reduce their risk of transmission.

BUILDING ONLINE COMMUNITIES Despite closing our office throughout Level 3 and 4 lockdown, the Foundation continued to work from home, and transitioned to operating entirely remotely. Throughout this time, we saw a massive spike in digital engagement from our respiratory community; with a record number of people interacting with the Foundation through our online channels. This resulted in over 17,000 likes, comments and shares of our online content, and over 100,000 clicks on our posts. We also saw a large increase in traffic to our other channels, with over 175,000 visits to our website, 600 downloads of the My Asthma App, and 10,000 opens of our e-newsletters.

TAKING OUR CAMPAIGNS ONLINE Traditionally, our World Asthma Day campaign is celebrated throughout primary schools across New Zealand, however, this year we needed to move this to be an online only event. With some quick thinking from the team, we launched World Asthma Day ‘Live from your living room,’ where we educated and entertained our respiratory community with a series of livestream video broadcasts on Facebook. Alongside this campaign, we also launched our first online raffle, where over 800 wonderful donors donated the cost of their coffee towards World Asthma Day.

SUPPLYING RESOURCES TO THOSE IN NEED With many medical practices closed for face to face visits, accessing new spacers proved difficult for those who needed them. To meet this need, the Foundation provided free spacers through an easy online ordering system to anyone who required one over the lockdown period. Additionally we also used this time to translate the first of our Samoan language resources ‘Tausiaina o le ma’i sela o lau tama ‘ which is now available as a free downloadable PDF from our website.

SUPPORTING POLICY CHANGE At the beginning of lockdown, the Foundation provided a submission towards the Smokefree Environments and Regulated Products (Vaping) Amendment Bill, which the Foundation’s CE presented in person via Zoom to the Health Select Committee. This has now reached its second reading in parliament, and we are pleased to see that some of our suggestions have been considered.

UPDATING BEST PRACTICE FOR HEALTH PROFESSIONALS With our updated Asthma guidelines, and the brand new COPD guidelines nearing publication, work is now underway to update the Foundation’s Asthma and COPD Fundamentals e-Learning series to reflect the updated guideline content. These guidelines will reform asthma and COPD best practice in New Zealand, with this year’s upcoming NZ Respiratory Conference also offering in depth presentations on how these can be applied in both primary and secondary care. To find out more about how to enrol in the Fundamentals course visit bit.ly/2mUlVgo.

Health Professional News Registrations now open for NZRC 2020 The New Zealand Respiratory Conference (NZRC) will take place this 5-6 November, at Te Papa, Wellington.

This year’s theme is ‘Building the Foundation for Better Breathing’ as we work towards releasing the 2020 Adolescent and Adult Asthma Guidelines, the revised Child Asthma Guidelines, and New Zealand’s first ever COPD Guidelines. This year’s event has also been endorsed by The Royal New Zealand College of General Practitioners (RNZCGP) for 10 CME credits.

This year’s programme will focus on topical presentations, including asthma management in the digital realm, vaping and Smokefree 2025, air pollution, COVID-19, and healthy housing. These presentations will translate the latest research and findings into relevant and actionable material, to promote clinical best practice and wrap around care for patients and their whānau.

The NZRC is the largest gathering or hui for professionals with an interest in respiratory health in New Zealand. Delegates from a variety of professions join us each year, including GPs, nurses, pharmacists, specialists, educators and researchers. To register for this year’s conference, go to NZRC2020.com. For more information on sponsorship opportunities email joanna@arfnz.org.nz.

Dr Stuart Jones presenting at the 2018 NZRC

Asthma & COPD Guidelines Update The much anticipated NZ Adolescent and Adult Asthma Guidelines will be published in the New Zealand Medical Journal shortly, followed by the New Zealand’s first Chronic Obstructive Pulmonary Disease (COPD) Guidelines, scheduled to be published in a few months time.

The NZ Adolescent and Adult Asthma Guidelines have been re-developed by a multidisciplinary group of respiratory health experts, under the leadership of Professor Richard Beasley of the University of Otago, and are designed to aid health professionals in delivering asthma care to their patients, providing simple, practical, and evidence-based guidance. These guidelines will provide a framework for the diagnosis and treatment of asthma for those 12 years and over; and into adulthood.

The brand new NZ COPD Guidelines have been led by Professor Bob Hancox from the University of Otago, and provide evidence-based recommendations for the diagnosis, assessment, and management of COPD - a condition often under-diagnosed in New Zealand.

The NZ Adolescent and Adult Asthma Guidelines (previously Adult Asthma Guidelines) were last updated in 2016, while the NZ COPD Guidelines will be a New Zealand first. The new guidelines will join the revised NZ Child Asthma Guidelines, and will align the latest research with specific information for the New Zealand context. These documents will also be used to form asthma action plans and resources for patients, as well as training courses and tools for health professionals.

To reflect the new guidelines’ framework, we will be publishing new asthma resources including additional COPD resources

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Once published, all respiratory guidelines will be readily available to download or print at nzrespiratoryguidelines.co.nz

Building the Foundation for better breathing

NZ Respiratory Conference 2020 Programme T

he New Zealand Respiratory Conference 2020 will take place this 5-6 November at Te Papa, Wellington. The conference will be hosting nine plenary sessions across two days, focussing on this year’s theme of ‘Building the Foundation for Better Breathing.’ These sessions range from health practice and documentation, to personal experience. Read on to find out what’s in store for this year’s programme.

Laying the Foundation for Asthma Management Join Professor Richard Beasley as he discusses what’s new in the NZ Adolescent and Adult Asthma Guidelines, and why the changes happened.

Following this, Dr David McNamara will talk about the revision of the Child Asthma Guidelines, and how to implement these into best practice.

Launching COPD best practice, and learnings from our online world Chronic Obstructive Pulmonary Disease (COPD) affects almost 15% of the New Zealand population over the age of 45. Dr Stuart Jones will discuss how this influenced the creation of the brand new NZ COPD Guidelines, while Betty Poot will talk how these guidelines are translated into the Asthma & COPD Fundamentals E-Learning series. Later, Dr Amy Chan will present on Asthma Management in the Digital Realm, and how asthma is represented and discussed on social media.

Are you up to date? The latest in immunisation and respiratory medicine The world of respiratory health is a fast-moving one, and this session aims to fill in any gaps of knowledge. Dr Adrian Trenholme will give an update on immunisation and RSV, followed by PHARMAC’s Logan Heyes who will be discussing the ins and outs of respiratory medicine funding in New Zealand.

Te Whare Tapa Whā In this session, Lady Tureiti Moxon and Dr Matire Harwood will discuss the Māori health framework. This is followed by Keri Brown, who will discuss COVID-19 and how this has revealed cracks in our healthy housing system.

The Importance of a Healthy Environment Healthy environments are vital to respiratory hygiene. In this session, Dale Bailey discusses a new healthy home initiative ‘Mr Humfreez’ and how he’s helping Kiwi families understand the importance of warm dry homes.

Following this, Dr Guy Coulson of NIWA will speak about air pollution and its connection to respiratory health.

Building towards a Smokefree 2025 With Smokefree 2025 quickly approaching, Professor Hayden McRobbie will discuss the role of electronic nicotine delivery services (ENDS) to quit smoking, while Professor Philip Pattemore asks if youth use of ENDS is on the increase, and is it really displacing cigarettes?

Improving Patient Care and Promoting Self-Management The pathway for COPD patients from secondary care to primary care is the topic of Susan Ward’s presentation, while changing sedentary lifestyles are a health priority for Sarah Mooney. Lastly, Susan Jones will discuss barriers to good asthma care, and how to overcome them.

My Respiratory Story This session features personal stories from respiratory patients. First up, we have Peter Atkins’ talking about living with COPD, followed

by Tomairangi Brown as she discusses her journey with asthma & bronchiectasis.

A year in review, where to from here?

The last session looks at the past year, and the future, with Dr Michelle Balm sharing lessons learned from the COVID-19 pandemic, followed

by Foundation President John Knight wrapping up the year that was.

Earlybird available now!

There are two registration options for this year’s conference. These are; the full two day conference pass, or for a Day Delegate Pass.

Please note, the below early bird pricing is only available until 27 August 2020. To register please visit NZRC2020.com.

All passes include • Access to conference sessions and medical exhibition • Entry to the Cocktail Function on Thursday 5 November • Lunch and refreshment breaks Full Conference Pass (5 & 6 November) A full conference pass provides you access to both days of the conference. This registration is for all health professionals. $420.00 incl GST One Day Delegate Pass (5 OR 6 November) This registration is for one day only, on either the Thursday OR Friday of the NZ Respiratory Conference. $285.00 incl. GST We are pleased to offer a reduced rate for a full conference pass to all regional societies wishing to attend. For more information on this, or to register as an exhibitor please contact : holly@limeandsoda.co.nz

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What does my S

ometimes, it can seem overwhelming at just how many different inhalers there are. It is quite common to be on one type of inhaler, but your friend or family member is on another. ‘Puffer’ inhalers (also called metered dose inhalers or MDIs) are the most common inhaler and these are generally used with a spacer. However, there are also other types of inhaler devices depending on which inhaler medication you have been prescribed. We sat down with Joanna Turner, Research and Education Manager for ARFNZ, to put together a helpful guide, which breaks down what types of inhalers are available in New Zealand, and what they are used for.

Preventer Inhalers

ICS (Inhaled Corticosteroid) Inhaled corticosteroids are an anti-inflammatory maintenance medicine (preventer) for asthma. They prevent asthma symptoms by reducing inflammation in the airways. In addition, they reduce the amount of mucus produced by the bronchial tubes and help to reduce long-term damage. ICS medicines are the core treatment for asthma control and maintenance, and need to be taken every day, even when feeling well.

Preventer ICS inhalers are usually orange, brown or yellow. Current ICS medications available in New Zealand are: • Budesonide (Pulmicort® Turbuhaler) • Fluticasone (Flixotide® MDI and Accuhaler, Floair® MDI) • Beclomethasone dipropionate (Beclazone® MDI, Qvar® MDI)

Reliever Inhalers

SABA (Short-Acting Beta2 Agonist) This medication provides quick relief of shortness of breath and wheezing. SABAs work by relaxing the muscles around the narrowed airways, and are delivered via a metered dose inhaler or a turbuhaler.

Unlike long-acting beta2-agonists (LABAs) which are used on a daily basis, SABAs are only used “as needed” to provide fast relief of asthma symptoms or for use in an asthma emergency, with the effects wearing off after 4-6 hours. Overuse, or over reliance on this type of inhaler is a sign that your asthma is not well controlled, and we would recommend that you discuss this with your doctor or healthcare provider.

These inhalers are usually blue or green. Current SABA medications available in New Zealand are: • Salbutamol (Ventolin® MDI, Respigen® MDI, SalAir® MDI) • Terbutaline (Bricanyl® turbuhaler) SAMA (Short-Acting Muscarinic Antagonist) Like SABAs, SAMAs provide relief of symptoms, but take a little longer to have an effect (up to 30 minutes). This medication is typically used for COPD. Current SAMA medication available in New Zealand is: • Ipratropium (Atrovent® MDI) Combination SABA/SAMA This medication is a combination of both a short-acting beta2 agonist and a short-acting muscarinic antagonist, which helps to relieve the symptoms of asthma.

Current SABA/SAMA medication available in New Zealand is: • Salbutamol + Ipratropium (Duolin HFA® MDI)

Long Acting Symptom Controllers

LABA (Long-Acting Beta2 Agonist) This medication is prescribed to control the symptoms of COPD, or for asthma symptoms where preventer treatment alone is not effective. LABAs should never be used alone for the management of asthma. LABAs last longer than SABAs, with effects that last for up to 12 hours. LABA medication relaxes the muscles around the narrowed airways to help keep them open. When used regularly, you should begin to experience fewer symptoms. LABAs should not be used in an emergency; therefore it is important to always have a short-acting reliever inhaler (i.e. a SABA inhaler) on hand.

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Current LABA medications available in New Zealand are: • Salmeterol (Serevent® MDI and Accuhaler®, Meterol® MDI) • Indacaterol (Onbrez Breezhaler®) • Formoterol fumarate (Oxis® turbuhaler) • Formoterol fumarate dihydrate (Foradil® powder for inhalation caps, used with Aerolizer® device)

y inhaler do?

LAMA (Long-Acting Muscarinic Antagonist) LAMAs are similar to LABAs and are prescribed for the management of COPD. However, there are people with severe asthma, who are under specialist care, who may also be prescribed a LAMA. Like LABAs, LAMAs must not be used in an emergency situation Current LAMA medications available in New Zealand are: • Tiotropium (Spiriva Respimat®) • Umeclidinium (Incruse Ellipta®) • Glycopyrronium (Seebri Breezhaler®) Combination LABA/LAMA This medication is a combination of both a long-acting beta2 agonist and a long-acting muscarinic antagonist, to help control COPD symptoms. Current LABA/LAMA medications available in New Zealand are: • Gycopyrronium + Indacterol (Ultibro Breezhaler®) • Umeclidinium + Vilanterol (Anoro Ellipta®) • Oldaterol + Tiotropium bromide (Spiolto Respimat®)

Types of Inhalers in New Zealand

Accuhaler®

Metered Dose Inhaler (MDI)

Combination Inhalers

ICS/LABA (Inhaled Corticosteroid /Long-Acting Beta2 Agonist) This medication contains both a preventer medicine and a long-acting reliever medicine. Depending on the combination inhaler that you are prescribed, you will also need to have a fast-acting reliever inhaler for use in an asthma flare-up, or asthma emergency, with the exception of Symbicort® turbuhaler.

Symbicort® is a unique inhaler which contains a quick onset, long-acting reliever, and can be used for the immediate or emergency relief of asthma symptoms.

Current ICS/LABA medications available in New Zealand are: • Fluticasone + Salmeterol (Seretide® MDI and Accuhaler®, RexAir® MDI) • Budesonide + Formoterol (Symbicort® turbuhaler, Vannair® MDI) • Fluticasone furoate + Vilanterol (Breo Ellipta®)

Ellipta® Aerolizer®

Using a Spacer

A spacer is a clear plastic cylinder, designed to make metered dose inhalers (MDIs) easier to use. The spacer helps deliver the medicine directly into the lungs, instead of the mouth and throat. Spacers are designed to deliver up to twice the amount of medication to the lungs. Order your free spacer from our website at arfnz.org.nz.

Respimat® It is important to regularly check in with your health care professional about the medications you are taking at least once a year, to make sure that these are still working effectively.

Please note, some of the medications listed above are not fully funded in New Zealand and part charges may apply. The medications listed as available are current as of 1 June 2020.

Breezhaler®

Turbuhaler Better Breathing

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World Asthma Day

LIVESTREAM

Wrap up World Asthma Day is the Foundation’s annual education campaign for one of New Zealand’s most prevalent respiratory illnesses: asthma. Each year, the campaign takes place on the second Tuesday of May, with this year’s campaign being held on May 5th.

Usually, our World Asthma Day campaign consists of educational activities which are sent to schools across New Zealand. However, this year presented some rather unique challenges, so we decided to go digital with a day of online events to engage our respiratory community stuck at home during lockdown.

As part of the Foundation’s ‘World Asthma Day - Live from your Living Room’ event, the Foundation hosted a range of Facebook livestream videos throughout May 5th, with over 500 people signing up to take part.

The day started with a live broadcast of the Foundation’s educational asthma musical, Sailor the Pufferfish, performed by educator and

entertainer Chris Lam Sam. This was followed by a crafting tutorial from the Foundation’s resident Asthma Fairy, Kikorangi, who demonstrated a few respiratory related arts and crafts. After this, the Foundation hosted a livestream Q&A session with respiratory specialist Dr James Fingleton, who answered real-time asthma related queries from our online respiratory community. Lastly, there was a live prize draw for the campaign’s ‘Donate my Coffee’ competition, which concluded the day’s events.

The Foundation’s World Asthma Day online event was overwhelmingly well-received by the online respiratory community, with the livestream videos having been viewed over 10,000 times since airing. The Foundation is proud to have been able to provide a day of education and entertainment, and highlight the importance of asthma management, entirely remotely through our digital channels. Most importantly, we were able to have this message reach those who need it most, despite the unfortunate circumstances of COVID-19.

Introducing Kikorangi the Asthma Fairy During lockdown, the Foundation introduced Kikorangi the Asthma Fairy, a new initiative to engage children with their respiratory health in a fully digital space. This enabled us teach kids about their asthma while maintaining lockdown restrictions, and helped to entertain the young ones for a short time to give their parents and caregivers a break!

Below are some of the results from Kikorangi’s crafting sessions that were sent in to our Facebook page. The full crafting with Kikorangi series of videos are available to view on demand on the Asthma and Respiratory Foundation Facebook page.

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Understanding Bronchiectasis B

ronchiectasis is a lung condition where the breathing tubes in the lungs (bronchi) have been damaged, enlarged and scarred – primarily due to infection. This causes mucus to build up in the extra space. Over time, the airways’ ability to clear out mucus and to transport oxygen is reduced. This can lead to worsened lung scarring and other health problems.

Bronchiectasis is usually caused by a severe chest infection needing hospital admission often at a young age, or by repeated more mild chest infections.

Typically, in healthy lungs, the mucus gets cleared up by tiny hairs called cilia that line the breathing tubes so that it’s easily coughed out. However, when these hairs are not working properly, mucus gets stuck in the breathing tubes. This allows bacteria to grow in the excess mucus, causing further lung infections which damage the airway walls.

How is it treated?

Bronchiectasis often is treated with medicines, hydration, and chest physical therapy (CPT).

Antibiotics, bronchodilators, expectorants, or mucus-thinning medicines can be used to treat bronchiectasis. As bronchiectasis can cause repeated lung infections, oral antibiotics can treat these issues. For more difficult infections, antibiotics may be given through an IV, to ensure that the medicine gets to where it needs to go. Other medicines can be used to thin and loosen mucus (expectorants) in the lungs; making it easier to cough up.

Drinking plenty of water is an easy way to help bronchiectasis, and can help to thin mucus and prevent it from becoming an ordeal to cough up.

As a result, the breathing tubes become baggy, and holes form in the lungs. However, bronchiectasis is often preventable, or even reversible, if diagnosed early enough.

Chest Physical Therapy, or CPT, is a more physical way of aiding those with bronchiectasis. This involves tapping or pounding the chest or back to physically loosen mucus. This should only be done by a medical professional or a trained carer, as amateur attempts can cause serious damage if done incorrectly.

Signs and symptoms

Living with Bronchiectasis

Most people with bronchiectasis have a chronic, mucus-producing cough. Other symptoms may include coughing up blood, bad breath, wheezing chest, recurring lung infections and a decline in general health.

The main symptom of bronchiectasis is a wet or rattling cough which produces a lot of sputum or phlegm. While older children and adults can cough this up, it is more difficult for younger children, and the cough may sound more rattling.

If you or your child has coughed every day for more than six weeks, or if your child has had three or more stays in hospital with chest problems, consult a health professional and ask about bronchiectasis.

How is it diagnosed?

To diagnose bronchiectasis, your doctor will need to take a complete medical history, ask about childhood diseases, and investigate recent chest infections. Following this, a physical examination is carried out; which includes listening to the chest. If there are symptoms of bronchiectasis, a chest x-ray will be recommended, and a CT scan of the lungs if essential (this is a painless examination and is similar to an x-ray). Blood and sputum tests are also required to detect and identify any bacteria or fungi that are infecting the lungs or breathing passages.

Living a healthy lifestyle is possible with bronchiectasis, and helps to minimise the impact it has on your life. Simple things like avoiding smoking, keeping physically active, drinking plenty of water, and even avoiding dairy can help to keep your mucus under control.

People with chronic lung diseases also often experience mental health problems such as anxiety or depression. Addressing these issues is just as important as addressing the physical aspects of bronchiectasis. Support groups, therapy, or medication can help improve your quality of life and keep you happy and healthy.

Do you, or someone you know have Bronchiectasis?

Alongside the Asthma and Respiratory Foundation NZ, the Bronchiectasis Foundation has a range of resources and information to help those with bronchiectasis as well as those who care for them.

These include action plans and advice for schools and pre-schools.

Check out their website at bronchiectasisfoundation.org.nz for more information.

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10 Tips for Winter Wellness inter can bring about a raft of triggers for those with asthma and allergies. We have compiled a list of helpful tips to help manage your asthma during these colder months.

W

Flu Vaccine The flu vaccine is available FREE to those with a chronic respiratory condition and appointments are prioritised for these people.

Frequent Hand Wash Although we are now back to Alert Level 1, hand washing is still incredibly important to help reduce other virally transmitted disease like colds and flu. Make sure you wash your hands regularly throughout the day for at least 20 seconds with soap and water to help reduce your exposure. Another alternative is to use hand sanitiser with a high alcohol percentage to eliminate any bacteria or virus on your hands.

Take Your Medications Ensure you are taking your medication, as prescribed and directed by your healthcare provider. It is important to make sure you take your maintenance medication (if prescribed) even when you are feeling well, as this will reduce your reliance on your reliever medication.

Take Care of Your Mental Health Some asthmatics find that different emotions cause their asthma to flare up, and with the compounding lack of sunshine during the W] winter months, this can often contribute to depression. Remember that it is just as important to take care of your mental well-being as well as your physical well-being. If you find yourself struggling to balance your emotions, speak to your GP who will be able to help or refer you to appropriate organisations.

Healthy Eating It is important to fuel your body with vitamins and nutrients. Fruits and vegetables are rich in both these and will help boost your immune system. Try to buy seasonal vegetables that are high in fibre and nutrients. Drinking eight glasses of water a day is also very beneficial for your heath. You can also add flavour to your water with hot or cold fusion herbal teas. Water has been found to thin the mucus in your lungs, so your body is able to remove it easier.

Light Exercise Indoors Exercise is good for your body and mental health, but exercising outdoors in winter can trigger asthma in some people. For those with respiratory conditions, it is recommended to perform light exercise indoors so the harsh, cold air does not irritate or inflame your lungs.

10 Better Breathing

Avoid Your Triggers If you know your triggers, try to avoid these if possible, or take steps to reduce their impact. Pollen, animal fur, and smoke are common triggers for many people. Help reduce your exposure to pollen by staying indoors when it’s windy, keep your windows closed at night and early morning, and avoid high pollen areas such as parks, farms, and golf courses.

Wear a Scarf Wearing a scarf around your mouth is helpful when you are outside in the cold, to help prevent asthma symptoms. As the cold air evaporates, the thin layer of fluid that lines your airways dries faster than it can be replaced. Dry airways become irritated and swollen which worsen asthma symptoms. If you breathe through your nose, this may also help as it helps warm up the air before it enters the lungs.

Clean Frequently Triggers such as dust, mould and animal fur can linger around your household and contribute to asthma flare-ups. To help combat this, try to clean your home as often as you can with asthma and allergy sensitive products. It is also advised to vacuum regularly to remove indoor allergens with a HEPA filtered vacuum, wash bed sheets and blankets in hot water to get rid of dust mites, and replace filters on heat pumps and air conditioners frequently. Check out Sensitive Choice for more information on products and services which offer a benefit to those with asthma and allergies at sensitivechoice.com.

Build a healthy home with DRIDEX® M

ould is a common issue in housing across New Zealand. Due to the lightweight properties of water vapour, it has a tendency to find its way into the ceiling cavity which is why the ceiling is often the first place you will find mould, a known trigger of asthma.

Damp and mould are both huge problems for your home and its inhabitants; luckily, we’ve got some tips on how to help.

As we enter the colder, wetter months, there is an increased possibility of dampness, mildew, and mould. These can negatively affect your breathing, affecting allergies, asthma, and even causing pneumonia or bronchitis.

Improper ventilation and bad drainage are some of the main culprits that cause a damp home. Also, with some older houses, there could be plumbing issues that leave a lot of water where you might not expect it.

Prevention is the best cure, and so avoiding dampness in your home in the first place is the best way to deal with it.

Drawing the curtains (and cleaning them once in a while) can be helpful, as can opening the windows and letting in some fresh air. This can be hard as the days get colder, but it’s well worth it to prevent mould and mildew.

If your home is already damp, the above will stop it getting worse, but you may want to fix what’s already been done too.

Simplest solutions often work best; open the windows, and leave them open. There are also damp absorbing crystals that can be purchased in tubs and left in key areas, like the wardrobes or under your bed, which can help if you don’t want to buy a dehumidifier for every room.

Unfortunately, the fostering of mould can also be encouraged through poor design. Traditional roofing underlays are designed to be vapour permeable but, in reality, they act as a significant barrier – leaving many Kiwis with the task of fighting household mould.

Historically, HVAC units and dehumidifiers have been used in the struggle against mould. However, COLORSTEEL® offers a new innovation to combat the growth of mould in New Zealand households COLORSTEEL® DRIDEX®.

COLORSTEEL® DRIDEX® consists of a unique anti-condensation layer of fleece adhered to the reverse side of COLORSTEEL® roofing products.

This anti-condensation fleece helps to keep the roof dry by absorbing water and negating the need for traditional roofing underlay. When roof temperatures rise, the condensation evaporates, escaping out the roof cavity into the exterior environment.

Ensuring that you have good insulation is key; especially under floor insulation, as it stops any water under your house rising up through the floor.

COLORSTEEL® DRIDEX® is an innovative roofing solution that delivers superior condensation absorption and allows for enhanced ventilation creating drier and healthier homes.

If you have further questions or concerns about your breathing being affected by dampness, speak to your doctor or healthcare provider.

For more information on DRIDEX® or to find out other ways you can make your home more asthma and allergy friendly, visit sensitivechoice.com.

ABOUT COLORSTEEL DRIDEX COLORSTEEL® DRIDEX® creates drier and healthier internal environment for your home. Available in two grades, DRIDEX® is recommended for moderate environments and DRIDEX+® is recommended for severe environments (determined by your property’s proximity to the coast, geothermal areas and industrial environments).

KEY FEATURES • Layer of anti-condensation fleece on the underside of each sheet • Keeps the roof dry by absorbing water into the fleece • Reduces mould and other pollutants associated with asthma, and other respiratory tract inflammations and allergies • Available in a range of COLORSTEEL® colours.

Better Breathing 11

Respiratory Resource Review

To celebrate the launch of our first Pasifika resource, we have reviewed a selection of our translated resources for easy reference. These resources can all be ordered from our online store at: bit.ly/2Ta1CsM (excl. shipping), or download as a free PDF from arfnz.org.nz/resources.

Te Reo Child Symptom Diary

This brochure is an asthma action plan for healthcare professionals to complete and give to their patients. Action plans help patients understand when their symptoms are worsening and which medication to take. Te Reo Action Plans are available in 3 Stage 4 Stage, and COPD.

The Symptom Diary brochure is for healthcare providers to give to their child patients and their parents/caregivers, and is used in conjunction with the Child Asthma Plan to track and identify key aspects of a child’s asthma. Ā Tū wh ro ina ro

Te Reo Asthma Action Plans

H U A NG Ō Huaina

Uruora

Āwhina

Ngāngā

Oranga

Ka pai

Hoatu kia ono pahu i te ngongo kikorangi.

Me ka pau ana te ono miniti, ā, kāore e pai te haere, waeatia te Waka Tūroro 111.

Kia kaha te hoatu i te ngongō kikorangi kia 6 pahu i te 6 miniti, tae rawa mai he āwhina.

Ngāwari Hēmanawa, ngae, maremare, umu ita.

Kino He kaha te ngae, hā uaua, kōrero poto noa.

Taumaha Āwangawanga, hā pupuha, he uaua te kōrero kia rua ngā kupu, kikorangi te waha.

Mē he taumaha te huangō, he mataku rānei te tūroro, waea te Waka Tūroro 111.

Me whakanohotū te tūroro, ka noho ki tōna taha.

Mē he kino, hoatu kia rua pahu i te ngongo whakaoraora.

Ngā tohumate kino, taumaha rānei Haere ki te tīwae whai ake.

Kia whai kauhanga tēnei momo ngongo. Kainga kia kotahi te pahu rongoā i ia wā.

Kia ono hā ki te pahu kotahi.

Me ka pau te ono miniti, ā, ka pai me aroturuki haere tonu.

Ki te tino āhei, tukuruatia ngā pahu i te ngongō kikorangi.

Kia maumahara • Kia 6 ngā pahu rongoā • Kia 6 ngā hā ki te pahu kotahi • Kia 6 miniti te tatari Mā te pēnei kāore e taea te tūroro te pota rawa i a koe e hoatu ana i te ngongo i ia ono meneti.

Me tikiake te taupānga Taku Huangō mō ngā mōhiohio huangō, te whakaora ohotata, me tētahi Mahere Mahi Huangō tāhiko! E wātea ana i Google Play, Apple App Store rānei.

Kia mutu te ngae, te maremare, te hēmanawa rānei, e hoki ki tētahi mahi mārire.

Ki te hoki mai ēnei tohumate, tukuruatia te maimoatanga, ā, ka whakatā.

Me maumahara Me haere kia kite i tō tākuta whai muri i te pāngia ki te mate huangō.

Taupānga KOREUTU

asthmaandrespiratory.org.nz

Te Reo First Aid Poster An A4 poster with six steps for asthma first aid, using the word huangō (asthma) as an acronym to make it easier to remember and follow. This multi-purpose poster can be used in a variety of circumstances, from sick bays to staff rooms.

Managing your Child’s Asthma Booklet (Te Reo and Samoan) This 35-page booklet teaches parents and children about asthma.

Content includes how to help prevent an asthma attack, how to use an inhaler, and how to clean your spacer. This resource is paired with the additional online learning website learnaboutlungs.org.nz.

Te Reo COPD Action Plan

12 Better Breathing

This is a brochure containing a chronic obstructive pulmonary disease (COPD) Action Plan for healthcare providers to complete together with their patients. It includes actions to take for different levels of symptoms for COPD – from well, worsening, severe to emergency.

Endorsed for 10 CME credits!

5-6 November 2020 Te Papa, Wellington

The NZRC has been endorsed by The Royal New Zealand College of General Practitioners (RNZCGP) for up to 10 CME credits for the General Practice Educational Programme (GPEP) and Continuing Professional Development (CPD) purposes.

Earlybird closes: August 27th NZRC2020.com

Find your local Society!

Did you know that ARFNZ is affiliated with many asthma societies across New Zealand who are here to provide you with support, rehabilitation and nursing assistance with your respiratory condition?

Horowhenua Breathe Easy Group iandlmckenzie@xtra.co.nz LEVIN 0279521439 06 3688069

MahiTahi Hauora 28-30 Rust Avenue WHANGAREI 09 438 1015 MahiTahi Hauora 182 Commerce Street KAITAIA 09 408 3142

Asthma & Respiratory Management BOP reception@asthmabop.org.nz www.asthmabop.org.nz 254 Chadwick Road TAURANGA 0800 276 267

Eastern Bay of Plenty & COPD Support Group COPD@drct.co.nz Disabilities Resource Centre 141 King Street WHAKATANE 0800 227 363

Asthma Waikato info@asthmawaikato.org.nz www.asthmawaikato.org.nz 18 Claudelands Road HAMILTON 07-838 0851 Manawatū Breathe Easy sjorgi64@gmail.com Palmerston North 0272420669

Gisborne & East Coast Asthma Society lynlolohea@hotmail.com 14 Kennedy Street GISBORNE 06-868-9970

Nelson Asthma Society asthma.nelson@xtra.co.nz 9 Cambridge Street RICHMOND 03 544 1562

Breathe Hawke’s Bay admin@breathehb.co.nz www.breathehb.co.nz 199 Dickens Street NAPIER 06-835-0018

Asthma Marlborough Inc asthma.marlborough@xtra.co.nz Marlborough Community Health Hub 22 Queen Street BLENHEIM 03-579-1609 Southland Asthma Society southlandasthma@xtra.co.nz Federated Farmers 70 Forth Street INVERCARGILL 03 214 2356

Tu Kotahi Māori Asthma Trust anne@kokiri-hauora.org.nz 7-9 Barnes Street Seaview LOWER HUTT 0800 939 462

CanBreathe office@canbreathe.org.nz www.canbreathe.org.nz 196 Hills Road, Edgeware CHRISTCHURCH 03-386-0278

Asthma Otago otagoasthma@xtra.co.nz Dunedin Community House Cnr Moray Place & Gt King Street DUNEDIN 03-471-6167

North Otago Asthma sec.noasthma@gmail.com 0277535711

About ARFNZ Asthma and Respiratory Foundation NZ is the national authority for respiratory illness within New Zealand. ARFNZ develops and supports respiratory health best practice through partnering, research, training and education, and continually works towards increasing awareness of respiratory illness within New Zealand.