Better Breathing Magazine - Summer 2021

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Spring 2021 2020 Summer

Better Breathing top tips for summer

Teens & vaping fighting the new addiction

Anxiety, stress & the breath Breathe Better

September wrap-up Understanding vasomotor rhinitis

Find out more about this surprisingly common condition


s from result rming ent vaping la a e th tud . Read gest s Pg 6-7 aland’s lar ey e v r Z u s New

Pg 8. Summer is the time for ad ventures. See our tips for keeping your as thma at bay

Our Team Chief Executive Letitia Harding Research and Education Manager Joanna Turner Office Administrator Dunia Cullingford Grants and Fundraising Manager Harriet Duncan PR and Comms - Head of Marketing Kate Davidson Marketing & Communications Advisor Sam Treseder Corporate Sponsorship and Engagement Advisor David Barclay 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

ISSN 2703-4127

Pg 9. Anxiety, str ess and

In this issue...

the breath

on’s Dys ist for a an kl checl and cleis coo ome th r h me sum 12 p.

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Did you know that the Foundation is now a chosen charity of the Good Registry? Find out more about what this means and how you can get involved.

Respiratory physiotherapist Tania Clifton-Smith shares useful insights on reducing the stress of ‘over-breathing’.

Community news

Anxiety, stress and the breath

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Health professional news We’re proud to say that we have had our key respiratory resources translated into Tongan. Find out more about what’s on offer for the Tongan community.

Breathe Better September wrap up Catch up on some highlights from our recent fundraising and awareness month, including the remarkable 24-hour run by our star fundraiser Nick Ashill!

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Respiratory research bulletin We bring you the latest respiratory research from Australia and New Zealand, including a new University of Otago trial to study the impact of COPD on Māori.

Understanding vasomotor rhinitis

Vasomotor rhinitis affects many New Zealanders – so what’s it all about and how can it be managed?

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Dyson’s checklist for a cool, clean home

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Teens and vaping - Fighting the new addiction A new report from the Foundation and the Secondary Principals’ Association of NZ found that rates of vaping and nicotine addiction among teenagers are alarmingly high. What’s the full story?

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Top tips for summer Make sure you’re fully prepared to manage your respiratory condition through the warmer months and the holiday season. Thanks to the Foundation’s sponsors for supporting our ongoing initiatives

Keep your living space in tip top shape this summer with advice from our Friends of the Foundation, Dyson.

Top Picks.. Page 3. Read about schoolboy Joe May’s brilliant asthma invention. Page 5. Kiwi scientists make a major tuberculosis breakthrough. Page 12. Dyson’s advice on keeping your home cool, clean and healthy this summer.

Did you know you can also read this magazine online? Head to the link below to view every issue of Better Breathing Magazine! issuu.com/betterbreathing


ARFNZ CE, Letitia Harding

Letitia’s Message Hi everyone, well it is nice to see the summer days finally arrive, in what seems to have been a long and challenging year for Aotearoa. The Foundation whānau had an amazing Breathe Better September this year, with the biggest highlight being the 24-hour run by Nick Ashill. You can see more of what Nick did, and others who raised money for the Foundation, on page 10, including our competition winners. It was lovely to hear the feedback from our winners, especially those who won the heat pump and air ventilation system. We are so glad we could help. The money raised by Breathe Better September goes towards helping the 1 in 7 New Zealanders affected by a respiratory illness, and allows us to continue providing asthma and COPD resources to health professionals and the public free of charge. The BBS donation website is open until the end of the year, so if you missed out, and still want to donate you can go to breathebetterseptember.co.nz. Speaking of free resources, we are pleased to announce that our resources have now been translated into Tongan. Find more on page 4. Summer can be a difficult time for people who suffer with hay fever or seasonal rhinitis. We have some allergy tips on page 8, and an article on vasomotor rhinitis on page 11. Here in New Zealand, around 20% of the adult population live with allergic rhinitis, so it is important to know what to do to keep symptoms under control. We are also privileged to have Tania CliftonSmith, Respiratory Physiotherapist advisor to the Foundation, sharing her thoughts on how anxiety and stress can impact on your

breathing. These are stressful times for those with a respiratory condition, and it’s so important to be conscious of our breath and avoid anxiety-induced over breathing. Tania shares some really useful and practical tips we can all use to breathe more freely. There is always something new and exciting happening in respiratory research, and here at the Foundation we try to share the latest information with you. On page 5, we share details of a study aiming to help Māori living with lung disease, and a major tuberculosis breakthrough by Kiwi scientists.

A major piece of research conducted by the Foundation was ‘The ARFNZ/SPANZ vaping in NZ youth survey’, initiated in partnership with the Secondary Principals’ Association of NZ (SPANZ). This survey was carried out in response to growing concerns from parents, teachers and schools around the epidemic of teen vaping. Over 19,000 students in Years 9-13 were asked about their vaping and smoking habits and we found that: • 26% of students reported vaping and 15% reported smoking cigarettes in the past week • Nearly 20% of students are vaping daily or several times a day, the majority with high nicotine doses. • Over half of those vaping were vaping more frequently and at higher nicotine

doses than last year. The results of this survey support concerns raised in the World Health Organisation 2021 report on the global tobacco epidemic, which emphasised that Electronic Nicotine Delivery Systems (ENDS)/vapes are addictive and not without harm, and that they should be strictly regulated. The WHO report also stated that children and adolescents need to be protected from these products, which can double their risk of smoking cigarettes. The Foundation has been actively involved in combatting the rise in youth vaping since 2017, and we are pleased that teachers and parents now have the evidence to show others that this is a very real problem, and we need to address it. Read more on page 6. Remember the DGSI website, dontgetsuckedin.co.nz, has a huge amount of information on vaping to help you become informed, and also to broach the subject with your teen if you are concerned. Finally, as always, we hope that you continue to support and value what the Foundation does. Please provide us with feedback, the positive and the negative, as we welcome engagement from you – our readers. The Foundation can only do what we do through the generous support of our Friends of the Foundation sponsors, our donor whānau, and the community grants that we are always so thankful to receive. Noho ora mai

Letitia Harding Chief Executive

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Respiratory Community News A Good result The Good Registry is a brilliant organisation that offers people the chance to create gift registries or buy gift cards to benefit a good cause. In October, the Foundation was delighted to become one of the Good Registry’s chosen charities. Instead of buying yet more unnecessary stuff as the festive season approaches, you can give a gift that makes a real difference for the one in seven New Zealanders living with a respiratory disease! If you’d like to learn more, buy a gift card or set up a registry for your event, visit thegoodregistry.com.

Thank you Sue Nelson Asthma Society Manager Sue Alsop is leaving the Society for new and exciting opportunities for her and her family. Sue began as Manager in 2015, when the Society was looking for someone with new skills and vision. Sue had a strong background of working with a “green prescription” so already knew what it was to work “one on one” with participants in a team environment. “There have been many changes for the Society over the past 6+ years, and many of those changes can be attributed to Sue’s drive and determination to get the job done and do it well,” says Rosalie Adamson, Chairperson of the Society. “Sue has lifted the profile of the organisation, providing a much higher level of support to our community in a professional and safe way.” Both Pulmonary Rehabilitation courses and Better Breather classes saw big increases in numbers. What’s more, Sue put professional standards in place, contracting trainers to deliver the courses, choosing the venues, and ensuring everything ran smoothly. She managed to make it a fun environment where laughing is high on the agenda. Sue started a Better Breather Circuit Class for members, with most participants having completed Pulmonary Rehabilitation courses and needing a regular class to attend afterwards. She also managed to secure funding to run a Bronchiectasis Brunch, an information session with the Society’s respiratory specialist as the main speaker, which was a great success. Sue oversaw the development of the Society’s website, which has been hugely successful and lifted its profile in the community, along with informative newsletters. Finally, Sue networked with other asthma managers around the country, meeting them at the Asthma and Respiratory Foundation Conference, gleaning new ideas and information and putting them into practice. “We wish Sue the best for her future and thank her for making us the successful organisation that we are today,” says Rosalie. Pictured: Nelson Asthma Society manager Sue Alsop, right, presents Birchwood School principal Chris Herrick, left, with an Asthma Emergency Kit

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Featured Fundraisers World COPD Day On 17 November, the Foundation celebrated World COPD Day. This international day is about raising awareness around Chronic Obstructive Pulmonary Disease, or COPD. For 2021, the theme was “Healthy Lungs – Never More Important”. This year’s aim was to highlight that the burden of COPD remains, in spite of the ongoing global COVID pandemic. COPD continues to be a leading cause of death worldwide, and there is never a more important time to focus on lung health. Keeping your lungs healthy can include avoiding cigarettes, air pollution or occupational exposure, as well as staying active through regular physical activity or pulmonary rehabilitation. To mark World COPD Day, respiratory physician and co-author of our COPD Guidelines Dr Stuart Jones answered questions from our audience about COPD in a Facebook video. You can watch it on the Asthma and Respiratory Foundation Facebook page.

Sailor goes online In October, the Foundation launched the Sailor Digital Classroom, a brand-new free online tool to teach primary school children about asthma. Children can join Sailor the Pufferfish and his friend Jelly on a quest to find out about what asthma is, asthma triggers, how to treat asthma, and what to do in an asthma emergency. “The Sailor Digital Classroom uses a different platform to open up access to asthma education, delivering the key educational elements of the ‘live’ Sailor the Pufferfish show, to every primary school in New Zealand,” says Joanna Turner, Research and Education Manager at ARFNZ.

Joe’s amazing asthma invention

The Digital Classroom was proudly suppported by Pub Charity Ltd.

While the Digital Classroom will not replace our Sailor live show, it will mean that schools can receive asthma education faster, and regardless of the COVID traffic light setting. We can also engage with more children in schools throughout New Zealand than ever before, particularly those in rural communities, and schools who have hosted a live show can update their asthma knowledge by completing the digital classroom refresher. Schools can register their interest at digital.sailorasthmashow.co.nz

Marlborough schoolboy Joe May came up with a smart idea for his recent Science Fair project – the Puff’n’Go inhaler carry case! Joe, who has severe asthma, always needs to have his inhaler on him. But he found that the carry cases currently on the market aren’t ideal, because he has to carry them in his hands and they’re not waterproof. This is a real problem for running, cycling and playing sports. So Joe came up with a wearable and waterproof inhaler carrier, which you can strap onto your arm to carry your medication easily whatever activity you’re doing. His brilliant invention won the whole Marlborough Science Fair for the intermediate age group! “I use my invention every day now for carrying around my inhaler and spacer,” says Joe, who is in Year 8 at Renwick School. “It’s so helpful for me and makes it easy to keep my inhaler with me at all times.”

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New health resources for Tongan community The Foundation is proud to announce that we have translated our Child Symptom Diary and Asthma Action Plan, COPD Action Plan and Adult Asthma Action Plans (AIR, 3 Stage and 4 Stage) to Tongan. Translating the Foundation’s resources into Pasifika languages demonstrates our commitment to improving health literacy and access to targeted information. This is imperative to reduce health inequity in the Pacific population. Pacific communities can be hard to reach, and they suffer a great respiratory disease burden. By providing targeted resources, the Foundation hopes to support Tongan people to manage their respiratory conditions and get the support they need. Our key resources are also available in Samoan, as well as te reo Māori and Simplified Chinese.

COPD Guidelines talks coming soon Early next year, the Foundation will be running three COPD education events for health professionals around the country. The events will be based around the Foundation’s COPD Guidelines, and will cover what’s changed, what’s new, and the management of patients with COPD in a New Zealand context. We will have a different expert speaker for each event: Wellington: Dr James Fingleton, Medical Director of the Foundation and COPD Guidelines author. Auckland: Dr Stuart Jones, lead COPD Guidelines author Christchurch: Professor Bob Hancox, lead COPD Guidelines author These are free events, and they also include a free registration for the Asthma and COPD Fundamentals eLearning Course (valued at $180). The course is endorsed by the College of Nurses Aotearoa for 12 CPD hours. Watch this space for more details. We look forward to welcoming you!

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Health Professional News


Respiratory Research Bulletin

New research to study impact of COPD in Māori A new trial led by University of Otago Professor Dr Sue Crengle, along with the Waitematā DHB, will test more than 500 people who are most at risk of lung cancer. The purpose of the trial will be to determine who in this group has COPD. COPD is more common amongst the Māori community than other ethnic groups, and has historically been severely underdiagnosed and undertreated. Those participating in the trial will take part in low-dose CT scans to detect any abnormalities and, with consent, will be assessed for COPD by blowing into a spirometer device to test their lung capacity. The aim is to assess who has the disease in the hope of making sure it’s treated properly, and outcomes are improved. The trial will investigate ways to improve the number of diagnoses for COPD and ways to reduce the rate of hospitalisations amongst Māori communities.

Kiwi scientists make major tuberculosis breakthrough Tuberculosis (TB) is a deadly lung disease that is still one of the world’s biggest killers. A team of scientists from the University of Otago have made a huge breakthrough that could lead to its elimination. Professor Kurt Krause and Professor Greg Cook are part of an international collaboration with Nobel Prize winner Professor Hartmut Michel, of Germany’s Max Planck Institute of Biophysics. Together, they have determined the atomic structure of a protein called bd oxidase. The bd oxidase protein lives in the cell membrane of the TB bacterium, and helps it breathe in the low oxygen conditions that occur in infected lungs. Knowing the structure of the protein will speed up the process of designing and discovering small molecules to block bd oxidase function and rapidly kill TB germs. This breakthrough will serve as an important template for producing fast-acting TB drugs. A rapid cure could lead to world-wide elimination, which would have an enormous health impact.

Family violence increases asthma risk Researchers at Australia’s Murdoch Children’s Research Institute have found that exposure to family violence greatly increases children’s risk of being diagnosed with asthma. The decade-long study tracked over 1,500 Victorian mothers, who were questioned in the first, fourth and tenth years of their child’s life. Exposure to violence in the first four years of life was found to put children at three times higher risk of developing asthma and language difficulties before the age of 10. The researchers say the findings highlight the urgency of effective intervention, with health outcomes for children greatly improving when they received support early or were taken out of a family violence situation before they turned five.

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Teens and vaping fighting the new addiction

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ast month, the Foundation released the results of one of the largest ever surveys looking at the vaping habits of secondary school students. The survey was undertaken in response to growing concerns raised by parents, teachers and schools around the epidemic of teen vaping and the harms associated with it. To carry out the survey, the Foundation partnered with the Secondary Principals’ Association of NZ (SPANZ). Over 19,000 students in Years 9-13 were asked about their vaping and smoking habits, and participation was anonymous and voluntary.

What the survey found: • 27% of those surveyed reported vaping and 15% reported smoking traditional cigarettes in the past week. • 75% of those vaping, or 20% of total respondents, are vaping daily or several times a day, and the majority are vaping with high nicotine doses. • Over half of those vaping reported that they were vaping more frequently and at higher nicotine doses compared to last year. • 86% of students who were vaping more than once a day reported that they were addicted to vaping and 57% felt that it was having an adverse effect on their health. • The most common source of supply for students was from dairies.

Is teen vaping on the rise? Yes. The results of the survey show a major increase in vaping rates compared with surveys which collected data two years ago. It’s clear that many young people are picking up high nicotine vapes without ever having smoked a cigarette, and swiftly becoming addicted to nicotine.

Where do teens get their vapes? The survey showed that the majority of young people are buying their vapes at dairies, despite the fact that sale to under18s is prohibited. It is hoped that the recent regulations introduced under the Smokefree Environments and Regulated Products Act 1990, including limiting the vape flavours that can be sold by general retailers like dairies, will help to curb this trend.

What are the risks of vaping? While vapes might be less harmful than combustible cigarettes, they still expose users to toxic substances that have been shown to adversely affect the heart and lungs. New evidence is emerging regularly about the harms caused by e-cigarettes. What’s more, vaping carries specific risks for adolescents, whose brains and bodies are still developing. Many young people perceive vaping as harmless, but this is far from the truth; there is increasing evidence showing significant health risks. For example, vaping with nicotine has been consistently associated with depression, ADHD and conduct disorders

in adolescents, and nicotine exposure has been shown to impact learning and memory.

What needs to change? The Foundation has made some recommendations to try to combat the problem of teen vaping. These include: 1. Introducing regulations to limit the content of nicotine available in vaping products sold in New Zealand to a maximum of 20mg. 2. Raising the legal age to purchase vape products to 21 years. 3. Banning in-front-of-store window advertising and product display by retailers. 4. Preventing the sale of vaping products within a one-kilometre radius of any school by retailers. 5. Emphasising Aotearoa educational campaigns aimed at youth, and focused on the health harms that vaping can cause. 6. Conducting further surveys to investigate the impact of the new regulations introduced under the Smokefree Environments and Regulated Products Act 1990.

Has your teen been sucked in? The Foundation’s vaping education site, Don’t Get Sucked In, offers a wealth of information and resources for teenagers about vaping. It informs and educates young people about the risks of vaping and encourages them not to try it in the first place.

Visit dontgetsuckedin.co.nz and get educated about vaping. Knowledge is power!

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Top tips for summer W

ith international travel off the cards for now, many of us will once again be hitting the road for Kiwi adventures this summer. Here are some tips to keep your asthma and allergies at bay while enjoying the warmer months.

1. Have a plan in place Before you travel, make sure that you have an up-to-date asthma action plan. Having a self management plan helps you to identify when your symptoms are worsening and what to do when this happens. You can download a free asthma action plan on the Resources tab of the ARFNZ website – asthmafoundation.org.nz

2. Know your triggers

and drink plenty of water. Try to plan your outdoor activities for first thing in the morning or later in the day when it’s cooler.

6. Stay hydrated While this tip may seem obvious, it’s so important to drink plenty of water and stay hydrated in the summer heat. Whether you’re making a pit stop in a rural town or driving long distances, we suggest you always keep a good supply of water with you.

7. Know where the nearest medical facility is If you’re going away, be aware of where the nearest GP, hospital or after-hours medical facility is, so you’re well prepared should you need to seek medical attention.

A trigger is something that makes your asthma symptoms flare up. Pollen and hot, humid weather can both be triggers, and both are more common in summer. If you know what your triggers are, you can try to avoid those things and reduce the chance of an asthma exacerbation.

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

If pollen is one of your triggers, it’s a good idea to stay indoors if the pollen count is high or if it’s very windy. You can also keep windows and doors closed to limit exposure.

With the My Asthma App you can have your asthma action plan with you no matter where you are – even with no internet connection!

3. Have your medication handy Make sure you keep taking your asthma medication as prescribed while you’re on holiday, and always have your reliever inhaler on hand should you need it. Check you have enough medication to see you through the holiday period. This is especially important if you’re going away, as it may not be easy to access asthma medication if you need it suddenly.

4. Store your medication safely Keep your medication in a cool, dry place that you can reach easily. Don’t leave it in direct sunlight or in the car, as this can cause it to overheat.

5. Stay cool If heat triggers your asthma, stay indoors or somewhere cool

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My Asthma app

The My Asthma App means all your asthma management information is at your fingertips, with customisable action plans, information on triggers, and steps to follow in an asthma emergency.

Download the My Asthma App free today from the App Store or Google Play


Anxiety, stress and the breath By Tania Clifton-Smith MPNZ (Hon) Respiratory-Musculo Physiotherapist

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eviewing the effects of prolonged stress on the body and soul is a good starting point to help restore normal physiologically sound calm breathing. Breathing is mostly automatic. While we work, sleep or play, our breathing takes care of itself. But we also have conscious control over our breathing, unlike other body systems such as the heart, kidneys or liver. Yet all these systems depend on breathing to deliver the goods – oxygen – to the tissues for healthy function, and of equal importance, to remove carbon dioxide. When we become aware of our breathing – under stress with aftershocks or dealing with storm damage for instance – it’s due to moving too much air through the chest for the body to deal with. All our body systems suffer, not because we lack oxygen but because too much carbon dioxide has been breathed out. Adrenalin pours into the system, heart rates increase, shoulders tense and muscles ache. Air becomes locked high in the chest. Jaws and face muscles tense up along with clenched abdominals and diaphragm. Upper chest breathing takes over. Not enough blood gets to the muscles and organs. You feel exhausted and irritable, sleep is disturbed. Your body is on ‘red alert’, shaky and tense. Sound familiar? Not a pleasant scenario, but this is played out daily – probably hourly – in many post-disaster zones. All that adrenalin literally turns on major stress responses. And to make matters worse, breathing patterns adapt. Upper chest breathing becomes ‘normal’. Overbreathing becomes chronic. The circle is complete. Over-breathing itself becomes a major stressor. You, a loved one or colleague, could be a chronic over-breather. An effective way of reducing the stress of ’over breathing’ is to understand how and why to breathe well. Make it the first step. If you’re experiencing frequent sighing or yawning, feel anxious and jumpy, achy and tired, this could be what’s happening to you.

A basic checklist to help re-balance your breathing: • “When in doubt, breathe out”. BradCliff Breathing ™ (Focus on the gentle out breath) • Try the BradCliff: Stop Drop Flop ™ Stop – relax your upper chest and nose breathe Drop – release both shoulders Flop – relax all over -- sit back and take 2 minutes time out/ breathe out • Avoid or reduce coffee and alcohol as too much of either affects sleep • Include a protein hit with every meal – and drink plenty of water ‘Be kind, for everyone you meet is fighting a hard battle’ - Plato

Allergies The allergy season is rife in the southern hemisphere with the month of November having the most pollens in the atmosphere. It’s well documented that disordered breathing, especially overbreathing, increases circulating histamine levels in the blood. This acts as a trigger to asthma and allergies. If you tend to over-breathe this may predispose you to allergies or wheezing. Ensure daily practice of your good breathing techniques. We know that if we are run down and tired we are more susceptible to reacting to whatever our allergy is. Get plenty of sleep and eat regularly. Also: • Take medications as prescribed. • Breathe well to maintain health and a strong immune system, avoid over-production of histamine. • Exercise. • Maintain a low allergy environment

Win a copy of Tania’s new book! Congratulations to Aneela Jeram of Auckland, winner of last issue’s book competition. We have another signed copy of Tania’s latest book, How to Take a Breath, to give away! To be in to win, email your name and address to comms@arfnz.org.nz, and title your email Book Competition. Entries close at 5pm on Sunday 9 January 2022.

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A good run for

Breathe Better September W

hat a month it was! The Foundation’s annual awareness and fundraising campaign Breathe Better September attracted a record 267 Better Breathing Heroes, and raised over $15,000 to support the one in seven Kiwis affected by respiratory disease. Nick Ashill, a marketing professor from Wellington, raised almost $2,500 by taking on an epic 24-hour run around Wellington city. Nick’s friends and colleagues joined him and supported him along the way as he ran a 6km loop around the city from 9am on Friday 24 September to 9am on Saturday 25 September, totalling 157km. An amazing achievement!

Breathe Better September is a campaign which is close to Nick’s heart, having lost his mum to the rare respiratory disease Idiopathic Pulmonary Fibrosis in 2017. As an ultra-marathon runner, he decided that the best way to raise awareness and funds would be to do what he loves best and take on an epic running challenge.

“It was an honour to support the Asthma and Respiratory Foundation,” says Nick. “They do an incredible job at supporting Kiwis with respiratory illness. I look forward to running 48 hours next year!”

Other top fundraisers and teams We’re so grateful to everyone who signed up and donated to the Breathe Better September campaign. A big thank you to Katie Ham, Sarah and Korowai, Aron Chantelau, Steve Williams, Mike Anderson and Olivia Wells, who raised over $500 each. The top teams were both from Assurity Consulting: the Footrot Phalanges raised a whopping $1,980 and Team Amazeballs weighed in at $1,472. RCR’s team managed to raise over $1,000, and LabServilicious Crew clocked in with $990. Stunning efforts all round!

5 and under category winner Caylee Zhao

And the winners are... We had some amazing entries to our children’s art competition, with the theme: ‘What does a healthy home mean to you?’. Thank you so much to everyone who entered! It was a tough choice, but our winners who each received a scooter kindly donated by Micro Scooters, were Caylee Zhao, Daiwik Arora and Rakim Ali. Some of our Better Breathing Heroes took home amazing prizes for their fundraising and donation efforts. A massive thanks to all of our generous Friends of the Foundation and sponsors for donating prizes. The winners were Steve Williams, Doug Ashley-Miller, Eamon McCreesh, Sarah Giffney and Susan McIvor.

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9-13 category winne r Rakim Ali

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A huge thanks to our Breathe Better September prize sponors...

ne gory win 6 -8 cate ra ro A Daiwik


Understanding

vasomotor rhinitis R

hinitis is inflammation and swelling of the mucous membrane of the nose, which causes a runny nose and stuffiness. “Vaso” means blood vessels and “motor” refers to the nerves. Vasomotor rhinitis (VMR) is chronic rhinitis, characterised by intermittent episodes of sneezing, watery nasal drainage (rhinorrhea), and blood vessel congestion of the nasal mucus membranes. It is sometimes referred to as idiopathic non-allergic rhinitis.

What causes VMR? People with VMR have a hypersensitive response to stimuli like a dry atmosphere, air pollutants, spicy foods, alcohol, strong emotions, and some medications. Any particulate matter in the air, including pollens, dust, mould, or animal dander can bother people with VMR, even if they are not actually allergic to these things. VMR seems to be an exaggeration of the normal nasal response to irritation, occurring at levels of exposure which don’t bother most people. It’s important to understand that VMR is a non-specific response to virtually any change or impurity in the air, as opposed to allergic rhinitis (or hay fever), which involves a response to a specific protein in pollen, dust, mould, or animal dander.

What are the symptoms? This depends, because people with VMR fall into two general groups. There are “runners”, who have “wet” rhinorrhea, and “dry” sufferers, with symptoms of nasal congestion and blockage to airflow, but minimal runny nose.

How is VMR diagnosed? Your doctor will take a careful history and examine your nose and throat closely. Allergy testing should also be done to make sure there is no allergic basis for some of the symptoms, since this would affect how it should be treated.

What are the treatment options? Saline nasal rinses can be helpful. In terms of drugs, it depends on

your symptoms. Antihistamines seem to help a few patients whose main symptom is runny nose, but usually only when the rhinitis is mixed vasomotor and allergic. Univent (ipratromium bromide) nasal spray is effective in patients who have runny nose as their main symptom. For congestion, you can opt for an over-the-counter decongestant. Tablets containing phenylephrine are an option, but should not be used if you have heart problems; high blood pressure; diabetes; prostate problems; glaucoma; an overactive thyroid gland; are taking a monoamine oxidase inhibitor (for depression); are pregnant or breastfeeding; or are under six years old. Oxymetazoline (Drixine) and xylometazoline (Otrivin) nasal sprays are another option, but can only be used for three days continuously, otherwise they cause a condition known as ‘rebound congestion’. Corticosteroid nasal sprays help with congestion, runny nose, and sneezing. While they do not start working immediately, when they do, they seem to control all the symptoms. Some adverse effects can be nasal dryness, smell and taste disturbances, irritation of the nose and throat, or nosebleeds. Always speak to your doctor, pharmacist or nurse before taking any medicines, to determine whether it is safe and appropriate for you, or the person you are buying it for, to use. In very rare cases, where the VMR doesn’t respond to medication, surgery can be considered.

How many people have VMR? Up to 10% of the population suffer from VMR. Most VMR patients seem to be older than the typical patients with hay fever.

Are there other conditions that cause similar symptoms? Yes – nasal polyps, previous trauma to the nose, and structural abnormalities in the nose can cause similar symptoms, so it’s important to get a proper diagnosis from a medical professional.

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Dyson’s checklist for a cool and clean home this summer

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e spend as much as 90% of our time indoors1 and the air we breathe contains microscopic particles which are invisible to the human eye. The cleanliness of your house has a direct correlation to your indoor air quality and wellbeing. Less dust and allergens in your home means there is less in the air you breathe. At Dyson, we have over 25 years of experience and expertise in HEPA filtration and filter media and have our own in-house microbiology lab, armed with the sort of equipment usually associated with hospital laboratories. Professor of Global Environmental Health, Sotiris Vardoulakis, at the Australian National University says: “We’re often exposed to many different types of both indoor and outdoor air pollution and the health effects of different pollutants can depend on the individual. Certain groups may be particularly sensitive to the effects of air pollutants, including young children, pregnant women, the elderly and one in nine Australians who suffer from respiratory health conditions such as asthma, hay fever or bronchitis.”

been redesigned to be 20% quieter while maintaining purification performance for more peaceful nights.4

Reduce heat sources at home Electronic devices can generate excess heat, contributing to the ambient temperature of the room. Traditional lightbulbs for example use up to 90% of their energy generating heat, with only 10% being converted to visible light.5 Choose energy efficient lights and get into the habit of turning off and unplugging all electronic devices that are not being used. Cooking in a pan or oven can also increase indoor temperatures, so opt for a lighter meal or one that can be cooked outside such as a barbecue. This may have the added benefit of reducing indoor levels of PM2.5, which is often generated through combustion while cooking.

Use HEPA purifiers when cooking

Head of Environmental Care at Dyson, Evan Stevens, shares tips for maintaining a healthy home and staying cool this summer.

Burning fuels such as wood, gas or oil can release volatile organic compounds (VOCs), as well as tiny particulates called PM2.5, which are emitted during combustion. Despite the pleasant smells coming from the kitchen, it’s possible that, as a result, the air contains some of these unwanted pollutants. Opening the window while you cook or using mechanical ventilation like a purifying fan will filter out the pollutants, helping reduce your exposure to them.

Close curtains and shutters

Vacuum often to reduce dust and pet hair

Keep the windows, curtains or shutters closed during the day to minimize the amount of sunlight entering the home. Night-time is when summer temperatures tend to dip, so make a habit of opening windows at night to allow cooler air to enter. Then be sure to close them in the morning before temperatures rise.

Keep your carpets, hard floors, upholstery and surfaces free of dust and pet hair – most effectively by vacuuming often. These items can harbour not only large debris but also dust mites, skin flakes and other allergens such as pollen and food allergens. 1 Klepeis NE, Nelson WC, Ott WR, et al. The National Human Activity Pattern Survey (NHAPS): a resource for

Beat heat with cooling airflow The World Health Organization (WHO) suggests that environmental stressors, such as noise or temperature, can impact sleep quality and quantity.2 With temperatures rising, staying cool can be a real challenge on hot summer nights. Using Dyson Air Multiplier™ Technology, the machine can project purified air to every corner of the room.3 The Dyson Purifier Cool ™ has also

12 Better Breathing

assessing exposure to environmental pollutants. J Expo Anal Environ Epidemiol 2001;11:231-52 2 US Department of Energy. “https://www.energy.gov/energysaver/design/windows-doors-and-skylights/ update-or-replace-windows” 3 In maximum setting. Tested for air projection (DTM 801) and purification coverage in a 81m3 room (TM003711). 4 20% quieter than Dyson’s predecessor machine, applies to Dyson Pure Cool only. 5 How Incandescent Bulbs Are Inefficient — Scientific Lights


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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.