Better Breathing Magazine - Autumn 2022

Autumn 2022

Better Breathing Omicron & asthma

Understanding Pertussis

what you need to know

(Whooping Cough)

top tips for autumn How technology is helping to transform asthma management

Nick Runs America - The Return 2022 Nick Ashill returns to the US to complete his incredible journey

n ing ru upcom arathons ’s k ic N -m about e’s 21 half an . Read Pg 8-9 US, and Sh eeks. w s the in 21 acros

Pg 10. Check ou

t our tips on sta ying healthy as the we ather cools off.

Our Team Chief Executive Letitia Harding

In this issue...

2. Community news

Research and Education Manager Joanna Turner

We profile the NZ Bronchiolitis and Child Respiratory Support Group, and share a great birthday gift idea!

Office Administrator Dunia Cullingford

3. Health professional news

Grants and Fundraising Manager Harriet Duncan PR and Comms - Head of Marketing Kate Davidson Marketing & Communications Advisor Sam Treseder Corporate Sponsorship and Engagement Advisor Amy-Rose Todd Medical Director Dr James Fingleton, BM, PhD, FRACP Chief Cultural Advisor –­­ Māori Sir John Clarke, KNZM, CNZM

Ground Floor, 85 The Terrace, Wellington 6011 PO Box 1459, Wellington 6140 04 499 4592 asthmafoundation.org.nz asthmaandrespiratoryfoundation asthmafndation asthmaandrespiratoryfoundation

Pg 12 - Omicron and asthma – wh at you need to know

The Foundation’s Fundamentals eLearning is going from strength to strength, with more and more health professionals signing up... and we’re lowering the price for good!

4. Respiratory research bulletin

There is some fascinating research taking place in New Zealand in the respiratory space. Read about a new study on how cannabis affects the lungs, and a groundbreaking allergy discovery.

5.

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om to issuu.c Just head reathing /betterb

8-9. Running for good

We are lucky enough to have two remarkable athletes completing epic running challenges to raise money for the Foundation. Read about Nick’s upcoming run across the US, and Shane’s 21 half-marathons in 21 weeks.

10. Top tips for Autumn

As the seasons change, it’s important to be on top of what this means for our respiratory health.

Check out our tips on staying healthy as the weather cools off.

11.

Understanding Pertussis (Whooping Cough) Pertussis can be a serious threat to babies and young children. Find out about the disease, and how best to manage the risk to your family.

12.

Home ventilation: just what the doctor ordered?

Omicron and asthma – what you need to know

Our Friend of the Foundation HRV offers some great solutions to make the air in your home cleaner and fresher. Read about their ventilation options and how they could work for your home.

With Omicron in the New Zealand community, it’s important that those of us with asthma and other respiratory conditions are well prepared. In this article, we offer some useful advice and tips.

6-7. The Digital Life

Passive House the antidote for asthma sufferers?

Dr Amy Chan, Senior Clinical Research Fellow at the University of Auckland and Lead Pharmacist Clinical Research at Auckland DHB, shares her insights on how technology is helping to transform asthma management.

ISSN 2703-4127 Thanks to the Foundation’s sponsors for supporting our ongoing initiatives

13.

John Iliffe, director of our Friend of the Foundation eHaus, shares his experience of living in a passive house.

Thank you to Pub Charity for their continued support of the Foundation, and allowing us to provide Better Breathing magazine free of charge to the respiratory and healthcare communities.

ARFNZ CE, Letitia Harding

Letitia’s Message N

gā mihi o te tau hou, greetings everyone.

Let’s start off with some good news!

The Foundation was fortunate enough to be chosen to join the Good Registry, which helps people to gift to charities in times of personal celebration such as a birthday. You can read more about the Good Registry and their support on page 2, and all the ‘Good’ that they do as a social enterprise business.

Supporting each other is important, especially in these financially challenging times, which is why we want to use the Foundation’s voice to bring attention to the Bronchiolitis and Child Respiratory support group. This is an online support network for New Zealand parents and caregivers who have had a little one who has been hospitalised AND diagnosed with bronchiolitis, bronchiectasis, pneumonia, bronchitis, asthma, viral induced wheeze, a confirmed case of COVID-19 or RSV, or other respiratory conditions. On page 2 you can find out more information on how to connect with this group, and what they do.

Now for some inspiration!

The amazing run across America by Nick Ashill (who did our 24hr run challenge for Breathe Better September) kicks off in May. Victoria University marketing professor Nick is returning to Columbus, Ohio, where in 2017 he was critically injured in a hit-and-run incident while completing an epic run across the US. After making an amazing recovery, he is ready to complete his mission, running the final 922km of the 5,400km journey to help raise funds for the Foundation. You can see more about Nick and his run on page 8.

Another amazing runner who is asthmatic himself, is Shane Ross. This year Shane ran 21 half marathons in 21 weeks, to raise funds for the Foundation and to celebrate losing 16kg and regaining his fitness! Read about Shane’s mission on page 9.

We are so thankful to these fantastic fundraisers, who really have gone ‘the extra mile’ for the Asthma and Respiratory Foundation.

Now of course we must mention COVID-19 and how Omicron is going to affect our most at-risk communities. The COVID-19 virus does affect your lungs, so for our readers who have a respiratory disease and compromised lung function, or have loved ones who do, then being prepared is paramount. On page 12, find out how you can be prepared for Omicron if you live with a respiratory condition.

In these rapidly changing times, we also see an abundance of new health technologies emerge. On page 6, Dr Amy Chan talks about innovative technologies that are specifically relevant to asthma.

In this ever more digital and mobile era, being able to tap into health technologies which are accessible via your mobile phone will become more important than ever.

For our parents and caregivers of wee ones out there, we also have a highly informative article on page 11 on understanding whooping cough; its incidence in New Zealand, the symptoms,

the vaccination and what you can do to avoid it.

Speaking of online resources. I am pleased to say that our ever-popular Fundamentals eLearning course will stay at its current list price of $135.00... permanently. We know that times are tough financially, and prices seem to be going up everywhere – which is why the Foundation wants to reward our nurses and other allied health professionals working at the respiratory coalface with this online 12 CPD-approved hours training at its current low price. You are important to us, and if we can make things a little easier for you, then we will. Please check out the website at learn. asthmafoundation.org.nz. If you have any questions about the course, don’t hesitate to contact Joanna our Research and Education Manager, joanna@arfnz.org.nz.

Now I will leave you all with our top tips for autumn on page 10. Please stay safe and keep supporting the respiratory community and the Foundation. These are challenging times, and we can only do what we do through your generous support and engagement, our Friends of the Foundation sponsors, our donor whānau, and the wonderful community grants that we are always so thankful to receive.

Noho ora mai

Letitia Harding Chief Executive

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Respiratory Community News Bronchiolitis and Child Respiratory Support Group

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he Bronchiolitis and Child Respiratory Support Group NZ is a Facebook-based support group for parents and caregivers of children living with respiratory conditions. Melissa Patterson (pictured, top, with her children) created the group in 2015, after her son James suffered multiple bouts of bronchiolitis as an infant and toddler, hospitalising him many times. The journey she went through when James was little was isolating and created serious anxiety.

The group now has over 1,300 members, mostly from NZ but some from Australia, UK and the US. There are three group admins as well as Melissa: Andrea Bennett, April Mihare, and Rachel Crump (pictured, bottom, with her daughter). All three have children with serious respiratory conditions and know what it’s like to live in and out of hospital. Here, Rachel shares her perspective.

“I joined the group when my daughter Chloe was 3, and had been getting constantly sick with bronchiolitis, wheeze and chest infections. Multiple hospital admissions resulted in a bronchiectasis diagnosis just before she turned 4. Now 9, Chloe still lives with the implications of the conditions she has daily. Six months ago, she had a portacath placed in her chest to make IV treatments more accessible, since her veins had all collapsed from PICC lines. She also got caught up the RSV outbreak and was in and out of hospital from July to September.

“It’s particularly scary watching your child struggling to breathe, always getting sick and feeling helpless about the situation. Our group is a village. Many members have been through traumatic experiences with their own kiddos and understand the anxiety that comes with this journey.

“The group hears people’s concerns and shares experiences, from navigating certain hospitals to tips to get kids to take inhalers and spacers, and even ideas to help Bronchiectasis (BX), CSLD, and CF kids comply with their daily chest physio.

“More often than not we are an ear for that tired, emotional parent who is at their child’s bedside in hospital or has been up for what might feel the hundredth night with a coughing, wheezing kiddo, or who has just been rushed to hospital with their child and needs some love and calming words. With Covid in our communities now too, we are all on edge.

“Members often say they wish they had found the group earlier. We see many people doubting themselves about when to seek medical attention because they have been dismissed before. There’s a lack of follow-up and ongoing care with clear advice for parents about when to present to hospital with their child or when to see a doctor. Many don’t have asthma action plans and haven’t been shown the correct way to use a spacer and inhaler. This is where we help direct parents to useful resources such as ARFNZ or local asthma clinics.”

If you’d like to join the group, search for ‘Bronchiolitis & Child Respiratory Support Group NZ’ on Facebook.

Looking for a meaningful birthday gift?

The Foundation is delighted to be a chosen charity of the Good Registry, a brillliant organisation that gives people the chance to create gift registries or buy gift cards to benefit a good cause.

If you’re looking for a gift for that tricky-to-buy-for person in your life, and want to make a real difference for the 700,000 Kiwis with respiratory conditions, why not give with the Good Registry? Visit thegoodregistry. com.

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We have a winner!

Huge congratulations to Phillippa Brosnahan of Wellington, who was the lucky winner of a signed copy of Tania CliftonSmith’s new book, How to Take a Breath. Happy reading, Phillippa!

Health Professional News Demand for Fundamentals eLearning higher than ever The Foundation has been seeing an increase in demand for the Asthma and COPD Fundamentals eLearning course for health professionals. In fact, registrations for the course have risen by over 100% between 2020 and 2021!

The Fundamentals course provides up-to-date education for all registered health professionals including nurses, occupational therapists, pharmacists, physiotherapists and GPs. Updated in February 2021 to align with the new NZ Asthma and COPD best practice guidelines, the course incorporates the latest research with specific information for the New Zealand context, such as recently funded medications, treating Māori and Pacific peoples, and best practice health literacy. The course consists of four online modules, in which a ‘flipped classroom‘ provides a contemporary and enjoyable approach to professional development.

“There’s a huge demand for online education among health professionals, especially in this time of COVID-19,” says Joanna Turner, ARFNZ’s Research and Education Manager. “Not only is an up-to-date knowledge of respiratory health issues like COPD and asthma more important than ever in the time of the pandemic – having the option to learn online and at your own pace rather than in person is also really beneficial.”

In recognition of tough financial times, we‘ve decided to reward our nurses and other allied health professionals working at the respiratory coalface by keeping our prices low. We’ll be making the summer special price of $135 our permanent price point, down from $180. Health professionals can enrol at: learn.asthmafoundation.org.nz “With Omicron now on our shores and in our communities, there’s never been a more important time for health professionals to get up to speed on common, chronic respiratory conditions,” says Foundation Chief Executive Letitia Harding. “There are 700,000 Kiwis living with respiratory diseases, and it’s vital that they get the best possible treatment and advice. The Fundamentals course gives health practitioners the tools and knowledge to offer this, and we want to make it as accessible as possible for everyone.”

Feedback from participants has been excellent, with one paediatric community nurse saying, “This was a well-structured update very relevant to my work... The COPD information and learning is important too, when talking with parents about smoking and reasons to quit.”

“I think an excellent job has been done here as everything is clearly explained in a range of ways that make it interesting to complete,” said another participant.

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Health Respiratory Professional Research News Bulletin T

he research into respiratory health that takes place in New Zealand and overseas plays a vital role in helping us to understand, diagnose and treat respiratory conditions. In this issue, we share some cutting-edge research from Aotearoa and beyond.

Groundbreaking allergy discovery in NZ Wellington’s Malaghan Institute of Medical Research has made an important discovery about a missing link between the skin and the development of allergies. It is being referred to as the most significant immunological breakthrough in New Zealand in 20 years.

For the past decade, immunologists have been aware that exposure to allergens through the skin can affect someone’s predisposition to food allergies. Now, Malaghan researchers have found a molecule constantly present in the skin that favours allergic reaction.

Vaping can exacerbate COVID symptoms, study finds Another recent study from the Mayo Clinic in Rochester, Minnesota, looked at the effects of vaping on COVID-19 symptoms. Some 290 COVID-positive vapers aged 18 and older were compared with similar-aged people who had COVID-19 but didn’t vape. The study found that those who vaped were more likely to report chest pain, chills, headaches, muscle aches, nausea, vomiting, diarrhoea and the loss of smell or taste. These patients also reported higher rates of laboured breathing.

Research into breast milk’s impact on asthma risk A Hungarian scientist who is newly arrived at the Liggins Institute, University of Auckland, is investigating links between the kind of milk a baby gets and how this affects their gut and the creation of T-cells.

The discovery of the IL-13 molecule shows why the skin might be primed to allergic response. It helps to explain why children can develop allergies to foods they’ve only been exposed to through their skin.

Dr Gergely Toldi’s study, which is awaiting final approval, will involve analysing cord blood from the placentas of newborn babies in Auckland. Additional blood samples and stool samples will be collected three weeks after birth.

The discovery will have a positive impact on the development of immunotherapies to target inflammatory and allergic conditions.

Dr Toldi plans to define how different types of milk affect the production in a baby’s gut of short chain fatty acids which, in turn, may be linked to the production and function of regulatory T-cells. These T-cells are thought to be associated with a reduced risk of asthma, obesity, and autoimmune diseases. The planned study would include around 25 fullterm and 25 pre-term babies, as well as ten healthy adults.

The human microbiome is mostly established in the first months after birth and is affected by the type of milk a baby receives. Bacteria called Veillonella and Gemella, which support the function of regulatory T-cells, are more abundant in the guts of breastfed babies.

How cannabis smoking affects the lungs A new University of Otago study has found that prolonged cannabis use led to over-inflated lungs and increased the resistance to airflow to a greater extent than tobacco.

ARFNZ Scientific Advisory Board Member and study coauthor Professor Bob Hancox says: “Although the effects of cannabis were detrimental, the pattern of lung function changes was not the same as in tobacco use. This study also found that cannabis use may impair the ability of the lungs to extract oxygen from the breath. This is a known consequence of smoking tobacco but has not been demonstrated with cannabis until now.”

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Dr Toldi hopes that the research will not only highlight the health benefits of breastfeeding but could also potentially help the manufacturers of baby formula to optimise their products.

Home ventilation: just what the doctor ordered?

In Victorian times they believed there was little that couldn’t be cured by a good dose of fresh air – and the colder the better!

These days, medical science has moved on a bit, but there are still plenty of reasons why fresh, clean air could be good for you and your family. That goes double if you’re one of the many New Zealanders living with asthma or another respiratory condition.

Throwing the windows open or going for a walk on the beach is one way to get a dose of fresh air, but that isn’t always an option – especially in the colder months.

Enter HRV. Our partner HRV has been delivering drier, fresh, filtered air to New Zealand homes since 2003, which is why we’re so pleased to be working together with them.

HRV home ventilation works by drawing air from your home’s roof space – where’s it’s naturally drier and often warmer – filtering it, then delivering it via ducts to your living areas.

As the fresh air enters, it drives stale, damp air out. As anyone who’s woken to wet windows knows, everyday living creates a lot of moisture!

Cooking, showering, laundry and even breathing all play their part, creating ideal conditions for mould and mildew, and exacerbating some respiratory conditions.

With HRV home ventilation on the job 24/7, moisture levels are reduced and allergy-causing pollen and mould spores are filtered too. And here’s a bonus: that drier air is easier to heat. That means quicker heating and less energy used, no matter what sort of heating you have.

The health risks of an inadequately heated home are well known, so HRV offers a range of heating options to keep everyone cosy. Efficient, modern heat pumps are fast becoming the number one choice for New Zealand families but HRV GM of Marketing, Product and Insights Chris Masterson says there are other options. “For simple, fast heating of small areas or rooms, our Nobo electric panel heaters are really popular,” says Chris. “We can even help open fire or woodburner fans get more from their heating.”

An HRV heat transfer kit (sold as a standalone installation or together with HRV home ventilation) takes surplus warm air from a well-heated room like a lounge, then delivers it via ducting to bedrooms or other areas that need it.

HRV home ventilation has benefits beyond health and comfort. Enjoying great ventilation while being able to leave doors and windows closed is great for security, especially at night. And if street noise is keeping you awake, keeping windows closed can help on that front.

So maybe the Victorians were right! Fresh air, delivered high-tech style via HRV home ventilation, could be just what the doctor ordered.

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The Digital Life Using technology to improve asthma and respiratory management

By Dr Amy Chan PhD, BPharm(Hons), MPS, RegPharmNZ Senior Clinical Research Fellow (University of Auckland) and Lead Pharmacist – Clinical Research (Auckland DHB) ‘Beep beep beep’. The familiar yet annoying sound of my phone alarm going off in the morning for work cuts through my sleep.

Bleary-eyed, I sleepily click it off as I get ready for another day at work.

Rain – low 17 degrees, high 26, windy conditions expected from 14:00 – 20:00. High pollen counts expected, likely to trigger asthma. High risk of asthma worsening. Click to review plan.

A push notification pops up on my phone. I click to review my plan on my asthma management app, which has helpfully checked the weather and my triggers for me for today. It reminds me to take my preventer before I head out to work, and asks if I want to book an appointment for my asthma review with my GP in two weeks. I push yes to send off the appointment request and throw in a request for a repeat prescription of my inhalers – something I had been meaning to do for weeks but had been slipping down my to-do list. Thank you phone, what would I do without you?

Digital technology use – the current landscape This seamless integration of digital health apps and technologies into our daily lives may have seemed impossible in the past – yet now, in 2022, it is very much a tangible reality. I still recall the first mobile phone I had in high school – a phone the size of a cordless phone complete with antennae. Other than playing ‘snake’ and using it for the odd text or two (due to the extortionate costs of SMS messages back then), it served very little purpose even for telecommunications, let alone for management of health.

Fast forward two decades, and smartphones and smart devices such as watches are one of the most commonly used and owned pieces of technology. Global data estimates that the current number of smartphone users in the world is over 6.6 billion, meaning at least 84% of the

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world’s population own a smartphone. Even in lowmiddle income countries, mobile phone penetration has surpassed 90% in recent years, though internet connectivity still lags. This has provided unique opportunities to revolutionise the way healthcare is being delivered; the costs of mobile technologies are becoming increasingly affordable, enabling most people around the world to benefit.

Mobile phones are also user friendly and generally do not need much literacy or technological proficiency to use. In New Zealand, the often quoted ‘digital divide’ between Māori and non-Māori is closing, at least when it comes to owning or having access to a mobile phone: data from Te Puni Kōkiri shows equivalent rates between Māori and non-Māori, with high usage particularly in young Māori. A survey from 2015 reports 91% of New Zealanders use their smartphone every day, and 86% use their smartphone to look for reference information, with the most common use of apps being for referencing or information (79% of respondents).

These data highlight the great potential for using common digital devices such as smartphones to manage our health, both as a country and globally for humanity. If anything, the coronavirus pandemic has only served to accelerate the development of digital health technologies and heighten the importance of using technology in our lives – not only for communication, but for health management and accessing information.

Technology innovations in respiratory health There are a variety of digital technologies that have been developed for respiratory health. Apps have been around since the early 2000s, with health apps becoming commonplace thereafter. Apps for respiratory health can serve a range of functions: • informing (providing information); • instructing (providing instructions to the user); • recording (capturing user-entered data); • displaying (graphically showing data); • guiding (providing guidance based on user-entered information such as recommending treatment or medical care); • reminding (alerts or reminders to the user); and • communication (such as communication with a with a healthcare provider or links to support networks).

These apps have shown benefits for improving asthma control; though what affect the app has will depend on the functionalities on the app. Beyond smartphone apps, there are also medical devices that support asthma and respiratory self-management such as smart inhalers, smart peak flow meters and even smart spacers.

Smart inhalers have existed since the 1980s, but have only become more developed for everyday use since the late 2000s. These devices attach onto asthma inhalers and can give reminders for when doses are due, feedback on inhaler technique, and reports on medication-taking trends based on dosing records. Some of the devices can sync with an app or portal, and integrate with medical records so health providers and individuals with asthma can make decisions about treatment based on a review of medication use. Use of smart inhalers with an audiovisual reminder function was shown to improve asthma medication taking by 50% in a 2015 study in New Zealand, with improvement in overall asthma control.

Smart peak flow devices were developed more recently in 2017, with the primary function of recording peak flow readings digitally. The meters can also give the user reminders, live feedback and recording of their peak flow, with a digital animation on-screen to encourage optimal peak flow, and motivational messages, rewards or challenges to encourage regular peak flow monitoring.

The device can link to a computer or mobile phone so users can keep track of their peak flow measurements and patterns in the context of their personal best scores, and share their readings with their healthcare team. The impact of smart peak flow on asthma management has not yet been fully explored.

Other digital innovations include ‘smart’ or intelligent spacers, which can record medication-taking and whether the inhaler had been shaken before, activated soon after shaking, and if a sufficient volume had been inhaled from it. How these spacers can help with asthma management is currently the topic of research studies overseas. There has also been increasing interest in the use of smart spirometers and smartwatches in recent years to monitor and manage asthma – both innovations to watch for in this space.

What are some things to consider with digital technologies?

The advent of digitisation provides great opportunities. However, with great opportunities also comes great responsibility. Data governance, privacy and confidentiality and the effect on health inequities require consideration.

There is a need for robust processes to be developed to safeguard the data and ensure that use of technologies does not worsen inequities due to differences in access between populations.

Despite the increasing innovations available to us at our fingertips, there remains a need to have non-digital systems to support any digital processes.

As with all digital advances, no level of smart technology can completely replace in-person care – as technologies continue to evolve and become more sophisticated, so too should the role that we play as technology users, in managing these innovations.

How can we use these digital advances in our everyday respiratory management?

These digital advances have the potential to support more seamless and timely data transfer between health systems, improved communication to streamline patient care, and sharing of up-to-date information. These innovations can also empower people to take more ownership of their own respiratory health by being able to check and monitor their own asthma status, their medication management, and their own health data.

These technologies are likely to serve as an extra tool to support individual self-management, but are unlikely to replace traditional healthcare completely. In the future, systems may be able to apply artificial intelligence and machine learning to understand and foresee changes in respiratory health.

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RUNNING FOR GOOD The Foundation is so fortunate to have two amazing athletes completing epic running missions to raise funds for us. Ultra-marathon runner Nick Ashill is returning to America to complete his coast-to-coast run, which was cut short by a serious accident four years ago. And fellow Wellingtonian Shane Ross is completing 21 half marathons in 21 weeks, finishing this month.

NICK’S STORY

Nick with family after his accident in 2017

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ou might remember Nick’s inspiring story from our Winter 2021 issue. The ultramarathon runner, who is also a marketing professor at Victoria University of Wellington, went to the United States in 2017 to complete an epic run from Los Angeles to New York. He was nearly 4,000 km into his journey when he was hit by a truck, thrown into a ditch and left for dead.

After an amazing recovery, Nick is returning to the scene of the accident this May, and completing the last 922 km of his run. He will be raising money for the Asthma and Respiratory Foundation and for the Pulmonary Fibrosis Trust in the UK. “I made the decision to return to the US last September, after running 157 km to support the Asthma and Respiratory Foundation. This was my longest run since the accident. I had no idea if my body would be able to do it, but it did me proud and confirmed that returning to the US to finish the run was actually possible.

“I am currently running around 150 km a week and spending time in the gym each day to strengthen my core.

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“I’ve slowed down a bit, and my running gait has changed, but it is amazing how the human body adapts and compensates.

I have developed a strong connection with Mount Victoria, Thorndon Hill and the Brooklyn Wind Turbine, and love the elevation challenge. This will be invaluable when I tackle Pennsylvania, which is more mountainous than Ohio and New Jersey. I plan to remain at 150 km a week through February, but will increase this in March and April. I never believed I would be running these distances 3 years ago.

“The possibility of reaching the Atlantic Ocean five years after I started at the Pacific Ocean really excites me. I never contemplated giving up on the dream after the hit and run, despite the many setbacks and multiple surgeries. I have no idea how I’ll feel on the morning of 30 May, when I start at the site of the hit and run. However, I will be surrounded with so many incredible people. My support crew, Jim and Paul, will be at my side. Doctors and physios who put me back together in 2017 and worked with me to get me walking again will also be running with me at the start. Bringing everyone together at the same time will be an incredible experience and this fills my heart with so much joy.

“I have no doubt that running past the actual site of the hit and run will be hard.

I could never imagine something like this ever happening. But I am grateful for a second chance. Yes, I still get afraid, but I will not let fear stop me. My family and close friends remind me of how far I’ve come, not how many kilometres I have left.

“I believe the reality of what I’m trying to do will hit home on day 4 or 5. In 2017, the novelty of running across the US completely disappeared at the end of the first week and the head games began. I am mentally strong, but it will be so important that I listen to my body. There have been many times over the past few years that I have so wanted to go back and change the beginning of the run and do things differently.

“But I can’t change what happened. I have cried, failed, withdrawn, but I’m not ready to give in.

“I’m looking forward to raising awareness of pulmonary fibrosis, which has always been the primary goal of the run. I am honoured to be working closely with the Pulmonary Fibrosis Trust in the UK and the Asthma and Respiratory Foundation.

Pulmonary fibrosis is a progressive debilitating lung disease with high morbidity.

There’s no cure.

“I’m also excited about reconnecting with many people in America who have supported me over the past 5 years – doctors, nurses, physiotherapists, emergency medical responders, state troopers, and the local community in Columbus, Ohio. I can’t wait to see everyone! Finally, I’m looking forward to a good meal after I run into the Atlantic Ocean in New York!”

To follow Nick’s progress or donate to his campaign, scan the QR code or visit

nickrunsamerica.org.nz

SHANE’S STORY

journey – helping to change those attitudes about people with asthma, how to live with asthma, and treating asthma better. So, my being an asthmatic and running 21 x 21km over 21 weeks is my way of showing that asthmatics can do this – and raising funds to continue the good work the Foundation is doing.

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he ‘why’ is an easy one. Asthma should not be a limiter to life. I’ve been an asthmatic all my life, and I’m 56 years old now. My early memories are several annual trips to the children’s ward at Wellington Hospital. I started with Intal inhaler as a young person, plus all the normal meds (Alupent, Ventolin, Bricanyl, Pulmicort) and the occasional nebulisers.

“I grew up in an era when kids with asthma didn’t do sports. They stayed inside or did activities that didn’t require a lot of exertion. As an example – in third form of college it was easier to say to mum that I had detention for two evenings a week than say I had rugby practice. It was only after my parents came to my first game that they saw I could do it and allowed me to play.

“As I got older, and was able to make my own decisions, I picked up a few sports.

I’ve done the Coast to Coast multisport race twice, have competed in running (including ultra-marathons), road cycling, mountain biking and kayaking events.

For about six years I competed as part of a team in the New Zealand multi-day

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Shane shows off his 16kg weight loss in cheese!

Adventure Racing series. We raced in Australia in their 10-day XPD event.

“I’ve never been a great athlete. I have been a capable one, and occasionally in terms of results a surprising one. I’m mid pack for most major events. If I had followed the norms of my childhood for handling asthma (lots of medicines and minimal exertion) I would never have had the fun and experiences that I have had.

In May last year I did a similar fundraiser for the Foundation. I had turned 56, so I set up a weekend where I wanted to do 56 kms kayaking, 56 kms mountain biking and 56 kms running and trekking within 56 hours. I asked people to sponsor me for every hour under 56 that I did it in. I cut it all out in 29.5 hours and raised $2,000 for the Foundation.

There are plans for a 57 version this May! “Also, from January to March last year, I managed to lose 16kg, mainly through changes to my diet and exercise. The running now is a validation of that physical change, and how I can better manage my asthma as a result. With the return of some element of fitness and no desire to return to racing, a fundraiser seemed the best way to make use of the fitness I was getting back.”

To donate to Shane’s campaign, visit

“The Asthma and Respiratory Foundation has been a key part of my personal

givealittle.co.nz/fundraiser /project-blackjack

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TOP TIPS Top tips for FOR AUTUMN summer A

fter a stunning summer, the weather is starting to cool down, and we’re heading into autumn. Here are some tips for managing your respiratory condition as the seasons change.

safe place, and their teacher knows what to do if symptoms start to worsen. Sharing your child’s asthma action plan with their teacher is a good idea.

Create a healthy environment

Those with respiratory conditions can be at increased risk from the flu and COVID-19. To make sure you are protected, get your annual flu vaccination and your COVID-19 vaccinations. People with respiratory conditions are prioritised for the flu vaccine, and those eligible can receive the vaccine for free. Flu vaccines are usually available in New Zealand from April each year.

One major asthma trigger is mould, and as the weather gets colder and wetter the conditions are perfect for mould to thrive. To help reduce the impact of mould in your home, make sure that you create a warm, dry indoor environment.

This means airing out your home frequently during the day and wiping down any condensation that builds up on your windows. You can also use extractor fans to remove moisture, and consider installing double glazing if you’re replacing your windows.

Avoid smoke

Get immunised

Breathe in through your nose On colder days, try inhaling through your nose, as this will warm up the air before it travels down your lungs, limiting the irritation the cold air can cause.

Many New Zealanders use log burners to keep their homes warm. However, this can be a problem if smoke is one of your asthma triggers. You could consider purchasing an air purifier with a HEPA filter to help improve the indoor air quality of your home. If you don’t have a log burner but your neighbours do, it’s a good idea to keep windows and doors closed when they have log fires burning.

Wash your hands

Stay active

Creating an asthma action plan with your healthcare provider is the best way to manage your asthma, as it provides a clear plan to manage your symptoms when they are getting worse. You can download action plans from our website or use the digital plan on the ‘My Asthma’ app. Having an action plan in place means that you can take control of your asthma and not let it control you. You will also feel more confident in managing triggers that may arise as the weather cools down and we enter a new season.

It’s tempting to stay warm and cosy indoors in the colder months, but remember that exercise is a vital way to keep your lungs healthy and you should stay as active as possible all year round. If you are exercising outdoors, we recommend that you check the outdoor temperature first, as cold, dry air can irritate your lungs. Exercising indoors can be a good alternative on these cooler days. Also, remember to warm up thoroughly prior to exercise. This will help reduce the strain on your lungs during your workout.

Keep your medication on hand Always carry your reliever inhaler with you (if prescribed) and make sure it is readily available for fast relief of symptoms. If you’re relying on your reliever inhaler more than usual, you should consult your healthcare provider. It is also important that your child has their reliever inhaler at school, kept in a

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It’s important to emphasise the importance of good handwashing, as this can limit the spread of viruses. With Omicron spreading in our comunities, this is more vital than ever.

Make sure you practice good hand hygiene and regularly wash your hands for at least 20 seconds with soap and warm water.

Chat with your healthcare practitioner

Have your asthma action plan on you at all times with the...

My Asthma app

Download for free from Google Play or the App Store

Understanding

Pertussis (Whooping cough)

W

eating. The final stage is the recovery period. Symptoms get less severe, but the cough continues for weeks or months.

What is pertussis (whooping cough)?

Older children and adults may get a less severe illness, particularly if they have had whooping cough before, but most still have a long-lasting irritating cough.

ith recent reports that New Zealand could be at risk of a whooping cough outbreak, we take a look at what it is, who is vulnerable, and how to stay protected.

Whooping cough is a disease that causes bouts of coughing, and can be very serious in babies and children, especially those under 1 year old or with heart or lung conditions. It’s caused by a type of bacteria called Bordetella pertussis, which damages the lining of the nose, throat and breathing tubes and causes coughing. Pertussis is called whooping cough because of the ‘whoop’ noise some children make after coughing.

Who is most at risk from whooping cough?

The elderly, babies and young children are particularly vulnerable, especially if babies under 6 weeks old have not had all their immunisations, or have a heart or lung condition.

Whooping cough in very young babies is unpredictable and can get worse very quickly.

Whooping cough is less severe in older children and adults, but can still be distressing.

What are the symptoms of whooping cough?

Whooping cough affects people differently depending on their age. The younger your child, the greater the risk of them getting seriously ill. If your child gets sick with whooping cough, you should seek advice from your health professional.

Babies under 6 months old do not usually ‘whoop’. They may be unable to feed because of coughing, vomit after coughing bouts, and get exhausted. In severe cases, they may stop breathing, go blue, or become very sleepy and difficult to rouse, in which case you must dial 111.

In older babies and young children, whooping cough starts with cold-like symptoms for 1-2 weeks. Next, there is an irritating cough, which gets worse over a week or two. They might gasp for air between each bout of coughing and get red in the face. These spells may last many minutes, and they may vomit afterwards. The cough often gets worse with swallowing or

How do I care for my child with whooping cough?

If your child has whooping cough, they should stay away from people outside the family (especially other children) for 3 weeks, to stop the infection spreading. The doctor may prescribe antibiotics, in which case the time the person is infectious goes down to 5 days.

Your child will need rest at the beginning when the bouts of coughing are most intense. They should drink fluids and eat healthy small meals, and they can have paracetamol if the coughing is painful. Cough medicine is not recommended.

If your child is very young or very unwell, or they have any complications, seek medical attention urgently.

Can I prevent my child from getting whooping cough?

Vaccination against whooping cough reduces your child’s risk of catching the disease and makes it less severe if they do. The vaccine is part of the NZ Immunisation Schedule and is given at 6 weeks, 3 months and 5 months. Two booster doses are given at ages 4 and 11.

Most cases of whooping cough in babies are passed on by family members, who can be infectious without realising. People who are around pregnant mums and babies should have a whooping cough vaccination. The protection from vaccination wanes over time, so check with your healthcare provider whether you need a booster injection.

For more information on pertussis, visit our website: www.asthmafoundation.org.nz/your-health/otherrespiratory-conditions/pertussis-whooping-cough

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Omicron and asthma What you need to know W

ith Omicron now in our community, it’s important for all of us to be as prepared as possible, and to know what to do should we test positive. If you have asthma, it’s even more important to have a plan in place. Here are some tips for managing your respiratory condition with Omicron.

To stay protected: Get vaccinated and boosted

Vaccination will greatly decrease your risk of getting severely ill with COVID-19. However, your immunity levels drop over time, and getting a booster has been shown to top them back up. It’s a good idea to get your booster as soon as you’re eligible. If you’re over 18 and it’s been more than three months since your second shot, you can go for your booster now.

While there is no indication that Omicron poses any more threat than previous COVID variants, it is more easily spread. Try to minimise your risk as far as possible through precautions like wearing a mask in enclosed spaces and outdoors where you can’t maintain physical distancing, practicing good hand hygiene, and keeping indoor spaces well-ventilated if possible.

Asthma or Omicron?

Omicron can cause symptoms like shortness of breath and coughing, which can be similar to asthma symptoms. However, there are often additional symptoms, like fever, sore throat, fatigue and changes in taste and smell, which are more indicative of a COVID infection. If you have symptoms of any kind, it’s important to get a COVID test.

If you test positive:

while you have COVID. Bear in mind that your reliever might not help with breathlessness and coughing caused by COVID rather than asthma. If you feel your symptoms getting worse, seek medical assistance.

Follow your Asthma Action Plan

It’s so important to have an Asthma Action Plan in place, and even more so if you’re unwell with a respiratory infection like Omicron. Having your plan up-to-date will help you keep track of your symptoms and medications, and know what to do if your symptoms get worse. You can download a free Asthma Action Plan on the Resources tab of the Foundation’s website – asthmafoundation.org.nz

Will COVID make my asthma worse?

It’s possible that you could feel worse with COVID if you’re already struggling to breathe. However, if your asthma is well controlled, you shouldn’t be at any additional risk from COVID infection. If you do feel your asthma symptoms worsening, you must seek medical attention.

Long COVID and asthma

When you’re recovering from COVID, it’s important to know the difference between your asthma symptoms and your COVID symptoms. Asthma is more likely to cause wheeze, cause a change in your peak flow reading, and respond to your reliever medication. Keep treating your asthma symptoms as usual.

If your COVID symptoms don’t seem to be clearing after a few weeks, speak with your health professional. They’ll be able to assess whether you might have long COVID and determine what care you need going forward.

Stay at home

It’s vital that you self-isolate while you have COVID. This means staying home, and distancing from others in your home as much as possible. You will need to self-isolate for at least 10 days.

Keep taking all your regular medications

Make sure you have a good supply of your medication, and keep taking it as normal. If you have been forgetting to take your preventer inhaler, you should restart taking it. This will help prevent your asthma symptoms from flaring up, and it’s perfectly safe to continue taking your preventer and reliever as normal

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For more information about COVID-19 and asthma, head to our website asthmafoundation.org. nz/your-health/covid-19 or the Ministry of Health website covid19.govt.nz

Passive House the antidote for asthma sufferers Jon Iliffe is a director of eHaus. He has been involved in designing and building the passive house way for over 10 years now with eHaus. He shares his experience of living in a passive house.

The comparison of living in an old, cold villa vs a certified passive house I think my family’s story is typical of many of us here in Aotearoa that have experienced raising families in a cold home; reliant on a wood burner for the main living area and then struggled to heat the rest of the house. This became a huge worry when our babies came along and keeping their rooms warm? We did our best but despite our efforts our first child developed respiratory issues and suffered from asthma because of our cold villa. There is no question that our homes are linked to our health, and this is even more so when thinking about our more vulnerable young and old.

For my family the contrast when we moved to the eHaus was so radical and had such a positive impact on our way of life and of course our son. Basically, the breathing issues that are associated with asthma disappeared, and the inhaler was forgotten about and put away in a drawer.

How do you create a healthy living environment?

There are many contributing factors that create a healthy living environment but the most crucial are the temperature and air quality. This is well documented with the perfect temperature range being between 20 - 25C and a clean dry supply of fresh air that is fully exchanged every 3 hours. It is absolutely no coincidence that these are locked in as key deliverables for every eHaus that we design and build.

How does a certified passive house perform?

We have worked with Auckland University to monitor houses that we have built, and the book Positive Energy Home includes performance data from an eHaus. My own home is using a sophisticated monitoring device that captures the Temperature, Relative Humidity, CO2, TVOC, PM2.5, CO, NO2 and Ozone. Here is a snapshot showing you the figures taken on September 10th 2021.

As you can see all the figures are in green and the overall summary is “Air Quality is great. All parameters are within optimal range, enjoy clean air and keep up the good work”.

The reality is, when living in an eHaus there is no work to do apart from changing the filters on the MHRV once a year, yes it’s that simple!

One in seven children, and one in eight adults have asthma in New Zealand, with unhealthy housing conditions a key contributor to these statistics. These statistics can’t be ignored.

Constructing the healthiest, energy efficient homes is our goal, and the work the Asthma & Respiratory Foundation does is a perfect fit for eHaus. Which is why we are proud to be partnering with them and offering some solutions for the respiratory health of New Zealanders.

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Find your local Society!

Did you know that ARFNZ is affiliated with many asthma societies and groups 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 NZ 581 Mt Eden Rd AUCKLAND 09 623 0236 0800 227 328 anz@asthma.org.nz

Manawatū Breathe Easy sjorgi64@gmail.com Palmerston North 0272420669

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

Southland Asthma Society southlandasthma@xtra.co.nz Federated Farmers 70 Forth Street INVERCARGILL 03 214 2356

Asthma NZ Level 1, Salvation Army 125 Johnsonville Rd JOHNSONVILLE 04 237 4520 0800 227 328

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

North Otago Asthma sec.noasthma@gmail.com 0277535711 Asthma Otago otagoasthma@xtra.co.nz Dunedin Community House Cnr Moray Place & Gt King Street DUNEDIN 03-471-6167

Gisborne & East Coast Asthma Society lynlolohea@hotmail.com

14 Kennedy Street GISBORNE 06-868-9970

Asthma NZ C/- Korowai Aroha 1292 Hinemoa St ROTORUA 07 347 1012 0800 227 328

Nelson Asthma Society asthma.nelson@xtra.co.nz 9 Cambridge Street RICHMOND 03 544 1562 Asthma Marlborough Inc asthma.marlborough@xtra.co.nz Marlborough Community Health Hub 22 Queen Street BLENHEIM 03-579-1609

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

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

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

About ARFNZ Asthma and Respiratory Foundation NZ (ARFNZ) is New Zealand’s principal authority for all respiratory conditions. The Foundation’s purpose is to lead respiratory health knowledge through research, education, and advocacy, with the goal to reduce respiratory related hospitalisations, and improve respiratory health outcomes for all.