Better Breathing Summer 2022

My breathing story

Oli Bell and his mum Kelly share their story with asthma and how help from his local respiratory nurse changed his life.

asthma, understanding how asthma medication works is essential.

Pg4.ReaduponCanBreatheandhow they’verecentlycelebrated50years.

Zoe Manderson has to say about the benefits of Pumonary Rehabiliation classes.

Our Team In this issue...

3. Respiratory Community News

CanBreathe, Canterbury’s asthma society, celebrates 50 years serving the community and we meet a generous young man who turned his 21st into a fundraiser for the Foundation. 5.

You can also read this magazine online

Just head to issuu.com /betterbreathing

basics on asthma medication and outline the current recommended treatment for those over 12 years old.

12. Understanding Bronchiolitis

Your Questions

Answered Our experts answer your questions about chronic obstructive pulmonary disease (COPD).

6. Respiratory News

Find out the latest in respiratory news from New Zealand and the world, and catch up on our top tips for summer.

8. How’s Your Asthma

Take our quick quiz and learn about your asthma control.

9. My Breathing Story

Meet Oli Bell and his mum Kelly who share his story with asthma, and Kawerau swim coach Annette Reece who tells us about her experience with COPD.

10. Know Your Asthma Medications

Preventers, relievers, puffers, inhalers –what to take and when… It can all get a bit confusing. In this article we give you the

Thank you to our Friends of the Foundation for supporting our ongoing initiatives.

Bronchiolitis is a common childhood illness that affects the small breathing tubes in the lungs. This article answers your questions including what to expect if your child develops this condition.

13. Managing

Breathlessness Respiratory physiotherapist Zoe Manderson explains the benefits of Pulmonary Rehabilitation classes.

15. Asthma Societies

Find out more about the Nelson Asthma Society and get the details of your local asthma society or support group.

... Leave a leagcy for future generations

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

Please recycle this material after use. This material has been printed with vegetable oil-based/mineral-free inks. The paper used comes from sustainable forests.

Here we are already at the end of 2022! It’s been a busy, few months at the Foundation so I know the team and I are looking forward to enjoying a bit of down time over the festive season – as well as the celebrations!

With the easing of COVID restrictions, we were thrilled to get our live Sailor the Pufferfish asthma education shows back on the road recently. In September, Sailor travelled to Palmerston North, Whanganui and Tairāwhiti, to share important asthma information with students and teachers.

Our English language version of the show was performed at 12 schools and Early Childhood Centres in the ManawatuWhanganui region. This included a special show at Love & Learn Care and Education Centre in Whanganui with our Friends of the Foundation sponsor, eHaus. This was a fantastic opportunity for tamariki and our sponsors to learn more about asthma.

In Tairāwhiti our te reo show Heremana te Kōpūtōtara was performed to six enthusiastic groups at Te Kura Reo Rua o Waikirikiri in Gisborne. A big thank you to our wonderful performers Chris Lam Sam and Hinerongonui Kingi who bring our Sailor shows to life!

A huge thank you also to everyone who got behind our annual fundraising campaign Breathe Better September! We raised nearly $14,500 over the month, an incredible achievement. I want to give a special shout out to Comfortech, a silver sponsor in our Friends of the Foundation programme who raised $5000. A big thank you also to Pulse Energy, one of our gold sponsors, whose CEO Sharnie Warren walked 10,000 steps each day during the month, earning a total of $820.

There were some outstanding efforts from other challengers. The Skelton-Morris whānau raised $1,390 through their daily Jump Jam fundraiser, and fellow ‘jammers’ at Twizel Area School raised an impressive $826. All money raised from Breathe Better September will go towards the Foundation’s education, research and advocacy work.

Advocacy work is often the ‘invisible’ work of charities. The Foundation works tirelessly behind the scenes with government agencies, partner organisations, and all with the voluntary support of our Scientific Advisory Board, and Vaping Educational Advisory Group. You might have seen me recently being interviewed on the topic of youth vaping. The Foundation is continuing to strongly push for tighter regulations and controls around vaping, and our efforts have made a difference. However there is still more mahi to do such as restricting the nicotine levels in vape products and capping the number of stores where vapes can be sold. The Government recently indicated it would look at reducing nicotine levels in vaping products, which are currently allowed at very high levels.

It always great to get out and about and see what is happening at the grassroots. In October, Joanna, the Foundation’s Research and Education Manager and I were invited to present to the Horowhenua Breathe Easy Support group based in Levin. It was wonderful to share the Foundation’s news with this group, hear their stories and learn about their work in the wider region. Community organisations like this one, provide such important practical support for people living with respiratory conditions. If you are ever keen for a visit to your community group or Society, please get in touch!

Finally, you’ll notice a few changes to this issue of Better Breathing. This is in response to our recent readers’ survey, which had some useful suggestions on how to make our magazine more informative and readable. We hope you like the updates.

ora mai Letitia Harding Chief Executive

Noho

Kia ora koutou and Meri Kirihimete!

Letitia presents to the Horowhenua Breathe Easy Support Group.

The Comfortech team get ready for Breathe Better September.

Twizel Area School fundraises for Breathe Better September.

CANBREATHE CELEBRATES 50 YEARS

The Canterbury respiratory community gathered in November to mark the 50th anniversary of CanBreathe, which started life as the Canterbury Asthma Society in 1972.

CanBreathe Acting Nurse Manager Teresa Chalecki says the event was a chance to celebrate the past, present and future of the organisation and its survival over 50 years. “The fact that we are still operating, stronger than ever, and just as relevant, is a real testament to the commitment of people who have been involved over the years. From board members, to our volunteers and dedicated staff, it’s all those people who had that extra drive to improve respiratory health in our community.”

She says innovation has also been key to the Society’s survival. “The health system has changed dramatically over 50 years, but the need for support for those with respiratory conditions in our community has not,” she says. “We’ve had to be flexible and creative to find new ways to deliver services.”

Teresa says this innovation was visible early in CanBreathe’s history with establishment of an asthma helpline, before that was common practice, and regularly held summer camps and swimming lessons at a time when children with asthma were discouraged from exercising. It has continued today with resources like the ‘Baxter Bear kit’ which was developed as a play therapy to help young children and their parents use inhalers and spacers, and regular asthma clinics held at local high schools.

FUNDRAISING RUN CELEBRATES LIFE

After a near-fatal asthma attack as a child, Aucklander Taumata O Te Ra Nga Hau E Wha o Te Motu Lowe knew he wanted to do something special to celebrate reaching his 21st birthday.

He was inspired to both challenge himself and give back to others living with asthma by organising a 21km fundraising run for the Foundation.

“I’ve had asthma my whole life and had some bad experiences. I was fortunate not to die, and so I felt like running 21kms for 21 years was a fitting way to give back and help others,” he explains.

Taumata rallied family and friends for the run, which started off at Red Hill in Papakura. They raised more than $600, with Taumata and two others running the full distance and other supporters joining for parts of the course.

For a confessed ‘non-runner’, Taumata knew the event would be a bit of a slog. “I do cross-fit and weights, but I knew this was going to be a challenge and it went as well as I expected! But I felt really grateful to be able to do it.”

Taumata experienced a severe asthma attack when he was seven years old. “I remember coming home from school and not feeling that good and the next minute I was waking up later in hospital. They told me I’d been resuscitated in the ambulance.”

While that experience was terrifying for Taumata and his family, he found that learning more about his condition, understanding the symptoms and getting a good grasp of how to manage his asthma, allowed him to get on with an active life.

“I found my asthma got better as I got fitter. But even now, it can flare up. The start of spring can be a difficult time,” he says.

The greatest challenge of the past 50 years has been securing funding. “While some of our services are funded, we still need to fundraise to meet our needs. It’s been an uphill battle, as, unfortunately, respiratory health is not seen as a priority by some. However, if you can’t breathe, then not much else matters,” Teresa says.

CanBreathe provides free support to everyone in their community who needs it. “We have removed all barriers to access. There’s no cost, no referral needed, and we will travel to people who need it.”

The Society supports over 1000 Cantabrians every year and offers one on one consultations, educational sessions to schools and community groups, training masterclasses for health professionals and spirometry services.

After the success of the run, Taumata is planning on organising a bigger fundraising event in the future. “It’s such a good thing to be able to do and it would be awesome to do it again.”

Glen Rutherford and Pamela O’Brien with current President Lydia Matthews at the 50th celebration.

The Foundation hosted a webinar called Living well with COPD on World COPD Day, 16 November. We had three expert speakers: Dr James Fingleton (respiratory physician and Foundation Medical Director), Nicola Corna (nurse practitioner) and Pauline Mohi, who has lived with COPD for the past 11 years. Here are a few of the questions asked by attendees with edited answers from our panel.

What is the top advice you would give for people to live well with COPD?

Pauline:

For me it is to do the Better Breathing (Pulmonary Rehabilita tion) courses, which are available all-around New Zealand and when you really progress with that, keep it up by joining an ex ercise and coffee group. You’re joining with likeminded people. You share your experiences and learn from each other. It not only helps your physical health, it helps your mental health as well.

Nicola: Learn a bit more about your condition, and how it affects you. If you’re smoking, stop and kick the guilt in the teeth. It’s a waste of time and energy. Get exercising, join a local Better Breathing programme and meet people in a similar position to you because you’ll find that more than anything else it is just really supportive and encouraging.

James:

From a medication point of view, don’t be afraid to ask us how to use an inhaler. There are different inhalers, so if you’re find ing the inhaler fiddly, talk to your health practitioner about if

there is one that could work better for you. Feel free to bring in a list of questions when you visit us, so we can talk about what you want to know.

How do you get an accurate diagnosis with COPD?

James:

You make the diagnosis with COPD with a clinician taking a history, doing an examination and then confirming the diag nosis with breathing tests. We need to do the breathing tests to confirm what is going on because there are other lung conditions that have some of the same symptoms but cause different patterns on the breathing test.

How long can you live with COPD?

James:

People can live to a ripe old age with COPD. The important thing is that we try and stop or slow any decline. So that might mean if someone is smoking, we support them to stop smoking. This can be hugely challenging but makes a real difference to how fast the lungs get worse, and likewise removing any exposure to industrial causes of COPD. Then it’s about keeping people healthy as much as possible both with medications and with exercise. Those things set people up to live well with COPD, even though the condition can be life-changing.

What type of exercise is good for COPD?

Nicola:

Any! Just keep moving. On the Foundation website there is a section with a list of available Pulmonary Rehabilitation classes throughout New Zealand. You can contact them or ask to be referred to them, to find out more about what exercise you should be doing.

Pauline: Also, I would say that if you stop exercising, boy do you notice it and it is so hard to bring yourself up to that point again. It’s about simply keeping up that exercise all the time. It’s amazing what it a difference it makes.

How do you deal with the anxiety that comes with COPD?

Nicola:

It comes down to understanding what’s happening in your lungs and having the knowledge and the confidence that you know what to do, to be OK. If you have the confidence to do that it will decrease your anxiety dramatically. Learning to manage your breathlessness, will help you deal with your anxiety.

The full webinar can be viewed at: www.asthmafoundation.org.nz/news-events/2022/worldcopd-day-webinar-living-well-with-copd

Check out the list of Pulmonary Rehabilitation (Better Breathing) classes available around New Zealand here: www.asthmafoundation.org.nz/about-us/ support-groups

Respiratory News

CHILD RESOURCES NOW INTERACTIVE

CHILD RESOURCES NOW INTERACTIVE

The Foundation has released its Child Asthma Action Plans and Child Asthma Symptom Diaries as interactive documents (available in English, Maori, Samoan and Ton gan). The plans can now be filled in digitally by health practitioners during an appointment and then emailed to families via Manage My Health to save to their phone or other device for later reference. These digital plans can be saved as a document and easily shared with other family members, school and sports coaches – so that everyone has this important life-saving infor mation.

The Foundation has released its Child Asthma Action Plans and Child Asthma Symptom Diaries as interactive docu ments (available in English, Maori, Samoan and Tongan). The plans can now be filled in digitally by health prac titioners during an appointment and then emailed to families via Manage My Health to save to their phone or other device for later reference. The best thing is that digital plans can be saved as a document and easily shared with other family members, school and sports coaches – so that everyone has this important life-saving information.

Pill for hay fever

Australian researchers believe they have developed a pill that could protect people against hay fever and thunderstorm asthma. The ‘pollen pill’ contains tiny amounts of grass pollen and works by reprogramming people’s immune system. Early testing has found the pill had a 92% success rate in reducing symptoms, but more testing is needed. It is expected that the pill will eventually be available as a prescription-only medicine.

Air pollution’s link to lung cancer

Scientists have identified how small particles of pollutants could trigger lung cancer in people who have never smoked. The particles, which are usually found in vehicle exhaust and smoke from fossil fuels, can trigger inflammation in the lungs and cause lung cells with pre-existing mutations to start forming a tumour. While the risk of lung cancer from air pollution is lower than from smoking, the researchers said it is a growing problem as more people are being exposed to unsafe levels of air pollution.

Mānuka honey to help in treating lung infections

A new treatment that combines mānuka honey with a widely used drug, can be used to treat a serious lung infection commonly expe rienced by people with cystic fibrosis or bronchiectasis. Research found that mānuka honey, which has long been known to have antimicrobial activity, can be used to kill a drug-resistant bacterial infection, and greatly reduce the serious side effects of a drug cur rently used in treatments.

New asthma drug available in NZ for severe asthma

Pharmac is now funding a new asthma drug (benralizumab) for treatment of severe eosinophilic asthma (EA) in New Zealanders aged 12 years and over. In this subtype of asthma, people have too many eosinophils – a type of white blood cell - in the airways of their lungs, which causes inflammation and greatly increases the severity of asthma symptoms. The drug is administered as an injection and will be available to patients who meet specific criteria. Pharmac estimates that about 40 people will benefit in the next year.

Healthy Homes Initiative to go national

New Zealand’s Healthy Home Initiative set up nine years ago, is to be rolled out nation-wide. The initiative was set up to improve living conditions for low-income families with young children and pregnant women. A recent report found that 31,000 children were warmer and healthier thanks to the initiative which has seen new beds, bedding, curtains, heating and in some cases new homes, provided to those in vulnerable communities.

Second-hand smoke a generational risk

Children are more likely to develop asthma if their father was exposed to second-hand smoke as a child, according to new re search from the University of Melbourne. The researchers found that the risk of non-allergic asthma in children increased by 59% if their fathers had been exposed to smoking as children. If these men went on to become smokers, then the risk of their children developing asthma increased to 72%. Scientists think this intergenerational damage may be caused by environmental factors, like smoking, interacting and changing genetics.

Why should I use an asthma action plan?

If you have ever been in the situation when your asthma was flaring up, but you’ve forgotten how many puffs of your inhaler you need to take and how often – then you’ll understand why asthma action plans are important.

An asthma action plan is a written or digital record that outlines what to do if your asthma starts to worsen. It is completed by your health practitioner and needs to be reviewed regularly. This is a resource that you can refer to as needed and share with family and friends.

The Foundation has digital and downloadable action plans available on our website.

These are free to use and make a real difference to managing your asthma well, so you are in control when your asthma isn’t.

With the sum mer holidays now only a few short weeks away, many Kiwis are looking for ward to well-deserved time off. Routines often relax over the holidays, but it’s important to keep up managing your condition and staying aware of triggers. Here are a few tips to help you enjoy your summer.

Be prepared

If you are travelling away from home, remember to take all your medications and any treatment action plans. Keep your reliever in haler on you at all times. You may want to check in with your health practitioner before you head away, to ensure that your asthma or COPD action plan is up to date. It is also a good idea to know where to find medical centres along your travel route and at your final destination.

Know the conditions

If your symptoms are triggered by pollen or temperature changes – then make sure you check out the forecasts for the day ahead. As well as temperature forecasts, the Metservice website has information on estimated pollen levels which you can find here: www.metservice.com.

If the conditions look risky for you, then plan a day of indoor activities instead. If pollen levels are very high, you might want to consider closing windows and doors and using an air conditioner to stay cool.

Be the early bird

If you want to get out and about, then aim to do outdoor activities in the morning when the air quality is best and before temperatures increase.

Dust mites

December is the beginning of dust mite breeding season with warm, humid conditions causing them to thrive. Dust mites are a common trigger for respiratory symptoms. You can limit their impact by regularly airing out bedding and blankets, and cleaning often with a vacuum that contains a HEPA filter. It is a good idea to vacuum mattresses, sofas and chairs regularly to eliminate dust mites.

IS

Count

If you answered with four ‘a’s then, your asthma is most likely well-controlled. Remember to check with your health practitioner if you experience any changes to your symptoms.

If you answered with one or two ‘b’s then it is likely that your asthma is partially-controlled. It’s a good idea to have a check-up with your health practitioner and get advice on your current treatments.

If you answered with three or four ‘b’s then it is likely that your asthma is poorly-controlled. Make an appointment with your health practitioner and ask them to review your current asthma action plan.

Our Breathing Story: Kelly & Oliver Bell

“Our diagnosis was a long journey of a cough that went undiagnosed. We were in and out of the doctors until Oliver was three years old. We tried everything; antihistamines because they thought it was allergies, saline drops, putting him the shower with lots of steam, liquid Vicks. But it just wasn’t working. He barely slept and he would sometimes cough so hard that he would vomit.”

“One night, it was really bad, and I just knew it wasn’t right, so I called an ambulance. He got taken to hospital and put on a nebuliser. His oxygen level had dropped really low. Fi nally, at that point, the paediatrician referred us to the paediatric respiratory health clinic in Hastings where we met Nora (the clinical nurse specialist). She listened to that cough and said ‘Oh, he’s got asthma’ and everything changed for us then. That diagnosis changed his life. Once he was put on a preventer inhaler, he went from pretty much 0% sleep

several hours at a time which was huge for our whole family. He had this really bad postnasal drip which made his cough so much worse when he was lying down. “

“Nora worked with us to develop this amaz ing asthma plan which makes sure that his asthma never gets off the ground. That plan is like our gold handbook! Thanks to Nora, we know now what tools we need if his asthma ramps up and we feel like experts on his asthma now. Nora filled in that asthma knowledge gap. We feel safe now, whereas before we didn’t feel safe at all."

“It took a bit of time to find the medication and dosage that works best for him. Nora really went the extra mile to help us. I could text her when I needed, and she provided emergency scripts to help us during lock downs.”

“I look at Oliver now and I know that he can

do whatever he wants in his future. We were at the hot pools the other day and he was able to jump in and out of the water, and I didn’t need to worry about the temperature change affecting his asthma because it’s under control.”

“My advice to other parents would be get your GP to refer you to your local respiratory clinic and get educated. Find out how to use your inhaler properly, ask lots of questions and utilise all the resources available to you. If you are worried about a cough, then make sure you check it out.”

Annette’s COPD Story

Annette Reece is an active member of the Kawerau community, a well-known swim coach, an umpire for outdoor bowls, a volunteer for multiple community groups, an avid knitter for charity, and she lives with the respiratory condition COPD.

The 81-year old has lived with asthma her entire life, but was diagnosed with COPD nearly 12 years ago after experiencing an increase in breathlessness symptoms. “I found I couldn’t walk the length of the hallway, which was very frustrating for me,” she recalls.

She has found her background as a swimming coach, to be an advantage in learning to manage her condition. “When you learn to swim, you learn diaphragmatic breathing, and this breathing is also really helpful when managing breathlessness. They say you can’t

teach an old dog new tricks, but you definitely can. Learning breathing techniques really helps, as does knowing when and how to take medication.”

With her condition managed, Annette is able to continue with her many community commitments including volunteering at the local op shop, driving other locals to hospital appointments and calling the weekly bingo sessions. However, when she is unwell, the impact of COPD is more evident. “I had a bad flu three months ago and it took me three weeks to recover, when usually it would have been a week.”

enrol now learn.asthmafoundation.org.nz

Annette is a regular attendee at the Kawerau COPD group and says the companionship and support from this group has been very helpful in learning to live with the condition.

Photo: Rotorua Daily Post/ Andrew Warner

If you or your loved ones have asthma, understanding how asthma medication works is essential. It will allow you to better manage your asthma and to live a full and active life. Asthma medication is usually delivered by an inhaler, also called a “puffer”. Having a good inhaler tech nique and using your inhaler as directed is really important in getting your asthma under control. Here are answers to some commonly asked questions about asthma inhalers.

What is an inhaler?

An inhaler, sometimes called a “puffer”, is a small plastic device that holds asthma medicine. It delivers the medica tion directly into your lungs. There are two main types of asthma inhalers:

A metered dose (or aerosol) inhaler contains medicine in a gas form. This type of inhaler needs to be shaken imme diately before use to ensure the medicine is mixed with the gas propellent before you use it. When you push down on the inhaler, it releases the medicine from the cannister con tained inside the plastic case. Metered dose inhalers are best used with spacers, as using a spacer can increase the amount of medicine delivered to the lungs by up to 50%. If your metered dose inhaler contains a preventer medicine (corticosteroid), then you should rinse your mouth and spit out after each dose.

A dry powder inhaler contains medicine in a powder form. It doesn’t need to be shaken before use. The medication is breathed in directly from the mouthpiece. Types of dry powder inhalers include the Accuhaler, Breezhaler, Ellipta, Spiromax and Turbuhaler. If you are using a dry powder inhaler that contains a corticosteroid medicine then you should rinse your mouth and spit out after each dose.

What is a spacer?

A spacer is a clear plastic tube. The inhaler fits at one end of the spacer, and the other end has a mouthpiece. A mask can be fitted onto the mouthpiece, if needed for younger children. All metered dose inhalers should be used with a spacer. Spacers ensure that as much medicine as possible goes down into the lungs.

Using a spacer means that medicine is less likely to get stuck at the back of your mouth or breathed out again. If you are not sure how to use an inhaler or spacer, ask your doctor, nurse or pharmacist to demonstrate the correct

technique so that you get the most benefit from your medicine.

What are the different medicines inside my inhalers?

There are three main types of asthma medications that do different things inside your lungs: preventers, relievers and combination inhalers. Many New Zealanders use both preventer and reliever inhalers to manage their asthma. The recommended treatment for asthma in people over the age of 12 years is a combination inhaler containing budesonide/ formoterol. This medicine is available in New Zealand as a dry powder inhaler with the brand name Symbicort Turbu haler or DuoResp Spiromax.

Preventer medications, also known as maintenance medications, treat the underlying inflammation in the lungs that causes asthma. These inhalers are meant for daily use; they reduce the amount of mucus produced in the airways and reduce the long-term damage to the lungs. Preventer inhalers are usually orange, brown or yellow in colour, and include the brand names Flixotide®, Pulmicort®, Beclazone ® and Qvar®.

Reliever medications, also known as bronchodilators, relax the muscles of the airways which tighten when asthma starts to worsen. These inhalers provide immediate relief from the symptoms of asthma, but do not address under lying inflammation. They are used ‘as needed’ to relieve symptoms. If you are using your reliever inhaler more than twice a week, this indicates that your asthma is not wellcontrolled. Reliever inhalers are usually blue or white. Some of these medications currently available in New Zealand are Ventolin®, Respigen®, SalAir® and Bricanyl®.

For anyone over the age of 12 years, reliever inhalers, on their own, are not a recommended treatment for asthma. Overuse or over-reliance on reliever inhalers can cause your asthma to get worse.

Combination inhalers contain both preventer and reliever medications. There are a few different combination inhal ers available, but the budesonide/formoterol combina tion inhaler (Symbicort or DuoResp Spiromax ) is now the recommended asthma treatment for people aged 12 years and over.

The budesonide/formoterol inhaler is currently available in New Zealand as a dry powder inhaler, under the brand name Symbicort or DuoResp Spiromax. This medicine works by opening up the airways quickly and delivering a dose of anti-inflammatory at the same time to address the underly ing cause of asthma. It has been shown to be extremely ef fective in asthma management and reduces asthma attacks.

For mild asthma, the budesonide/formoterol inhaler can be used as a reliever only. As you get a regular dose of

preventer with each dose, a separate preventer inhaler is not needed. This is known as AIR therapy.

For moderate to severe asthma, the budesonide/formoterol inhaler is used both daily as a preventer and as a reliever when needed. This is also called SMART therapy.

What other kinds of asthma medication are available?

For severe episodes of asthma, you may be prescribed shortterm corticosteroid tablets. This medication works slowly over several hours to reverse the swelling of airways.

Another medication that comes in tablet form is the antiinflammatory asthma treatment, Montelukast. Montelukast is taken regularly and cannot be used in an acute attack of asthma.

A newer form of treatment available in New Zealand for those with severe asthma are the biologics, medicines which target specific types of inflammation in asthma. These are administered by injection and can only be prescribed by specialists to people who meet certain funding criteria.

Understanding childhood bronchiolitis

Childhood bronchiolitis (pronounced brong-kee-oh-LIE-tiss) is a chest infection caused by a virus that affects bronchioles, the small breathing tubes in the lungs. It is a common infection in the first year of life, and especially in babies under six months of age.

It causes babies and small children to cough, wheeze and have trouble breathing. It is important to note that having bronchiolitis as a baby does not mean your child will go on to develop asthma.

What is the difference between bronchiolitis and bronchitis?

Bronchitis affects larger tubes in the lungs called bronchi, while bronchiolitis affects smaller tubes called bronchioles.

What causes bronchiolitis?

Bronchiolitis is usually caused by a viral infection. Many viruses can cause the illness with the most common being RSV (respiratory syncytial virus). It is very infectious and is usually caught from a close contact who has a cold or cough. It can make babies sick for three to seven days, and the cough can last for several weeks.

How is bronchiolitis treated?

Most babies do not require any special medical treatment and will get better by themselves. They can be looked after at home if they are feeding well, do not look sick and are not having problems with breathing. Some babies may have trouble feeding, and will need to rest and drink little and often.

As bronchiolitis is caused by a virus, antibiotics will not help (antibiotics are only effective against bacterial infections). Asthma puffers will not help babies with bronchiolitis, and giving your baby a blue reliever inhaler may make their breathing worse.

How do I take care of my child with bronchiolitis?

Most babies can be cared for at home. Offer your child small feeds of breast milk or infant formula and ensure they are warm, but not too hot. Allow your baby as much rest as possible and do not smoke in the house or around your baby. Try to keep baby’s nose clear, if their nose is blocked or crusty you can use saline nose drops (which can be bought from a pharmacy). Clearing the nose can often also help with feeding problems.

You may give your baby paracetamol to help with discomfort, but be sure to use the correct dose.

Try to stay at home if you can, so your baby is not exposed to too many temperature changes. It is also important to keep your child away from other children, as bronchiolitis is very contagious for three to eight days.

Babies with more serious bronchiolitis may need to be admitted to hospital if they have trouble breathing or feeding, or if they are not able to get enough oxygen. Treatment may involve delivering oxygen via a small, soft plastic tube through your baby’s nose.

When should I go to my health practitioner?

You should visit your health practitioner if your child:

• is under three months old

• is breathing fast, has noisy breathing and is using extra effort to breathe.

breathe

• looks pale and unwell

• is taking less than half of their normal feeds

• is vomiting

• has not had a wet nappy for six hours

• is giving you cause to worry or is getting worse

Call 111 and ask for an ambulance if your child:

• has severe difficulty breathing or has periods of stopping breathing

breathing

• has blue lips or tongue

• is becoming very sleepy and not easy to wake up

• Is pale or floppy

• has irregular breathing or pauses in their breathing

Even if you have already seen a health professional, if your baby’s breathing difficulties get worse, or you are worried, go back again.

How do I prevent my child getting bronchiolitis?

Keep your home smoke-free and do all you can to keep your home warm and dry. Breastfeeding your child beyond four months old can also boost their immune system and provide protection from viruses.

PULMONARY REHABILITATION

INFORMATION FROM RESPIRATORY

PHYSIOTHERAPIST ZOE MANDERSON

In 2021, the New Zealand COPD Guidelines were released. They recommend that pulmonary rehabilitation should be offered to all people with COPD. But what is pulmonary rehabilitation and why is it so important?

What is Pulmonary rehabilitation?

Pulmonary rehabilitation is a supervised exercise pro gramme for people with respiratory conditions, including COPD. Along with exercise, there is also usually an education component regarding self-management of symptoms. In New Zealand, most programmes are eight weeks long and are run by a respiratory physiotherapist and/or nurse. The programmes are run out of hospitals, community gyms or halls and even, in this COVID-era, online.

What are the benefits of Pulmonary rehabilitation?

Pulmonary rehabilitation has been shown to reduce breath lessness, improve quality of life, and reduce depression in people with COPD. Of course, participants also gain im proved strength and exercise capacity. It can be hard to know where to start if you are new to exercise, but that is the benefit of attending an organised programme where you can get guidance regarding the right exercise for you. Par ticipants also enjoy the camaraderie of exercising alongside others with medical conditions similar to themselves.

How fit do I need to be to do Pulmonary rehabilitation?

Any level of fitness is appropriate for pulmonary rehabilita tion and no prior gym or exercise experience is necessary. People who get breathless with exercise may feel reluctant to attend an exercise programme, but in fact the people who benefit most from pulmonary rehabilitation are those who are most breathless.

How do I join a class?

Ask your GP to make a referral or check out what is available in your region. There is a list of regional classes available on the Foundation’s website: https://www.asthmafoundation. org.nz/about-us/support-groups

About the author

Zoe Manderson is a respiratory physiotherapist in Taranaki for Te Whatu Ora and a member of the Asthma and Respiratory Foundation’s Scientific Advisory Board .

eHaus Whanganui District hosts Sailor the Pufferfish

eHaus was thrilled to be part of the Foundation’s Sailor the Pufferfish asthma education tour in Whanganui and Manawatu this September.

Local eHaus licensee Simon Penn Building sponsored a performance of the show at the Love & Learn Care and Education Centre in Whanganui. Both the tamariki at Love & Learn and the eHaus team enjoyed learning about asthma during the lively and engaging show performed by Sailor and his friend Chris Lam-Sam.

eHaus director and founder Baden Brown joined the audience for the show. “It was great to see first-hand how the Foundation is sharing vital asthma education to children and teachers, and to see how our sponsorship is ben efitting the community,” he says.

eHaus was one of the first organisations to sign up to the Friends of the Foundation corporate sponsorship programme. “We got on board because we saw that our values really aligned with the Asthma and Respiratory Foundation and we also understood the importance how well-designed and built homes can aid respiratory health,” explains Baden.

eHaus was started in Whanganui and came in direct response to co-founder Jon Iliffe’s experience of living in a cold, damp New Zealand house. “Jon’s son had asthma which was significantly impacted by his living environment. That experience drove Jon to want to design and build the healthiest, comfiest and highest performing homes in New Zealand. I shared that vision of wanting Kiwi families to live in homes that were actually good for their health,” Baden says.

The company uses the PassivHaus design and build principles to create homes that are good for people and the environment. The eHaus team is spread across 19 regions in New Zealand and has designed over 100 beautiful homes to this exceptional standard of performance.

“The fabric of the build is totally protected, which means no mould and damp can get established in your home. A warm, dry, healthy eHaus is not only good for you, but the environment too and it will still be standing in 100 years from now,” Baden explains.

Sailor the Pufferfish performer Chris Lam Sam pictured with with eHaus franchisee Simon Penn and eHaus founder Baden Brown.

Asthma New ZealandAuckland

Monday-Friday, 9am-5pm 09 623 0236

0800 227 328 anz@asthma.org.nz 581 Mt Eden Road, Auckland www.asthma.org.nz

Asthma Waikato

Monday-Friday, 9am-4pm 07 838 0851 info@asthmawaikato.org.nz

18 Claudelands Road, Hamilton East, Hamilton www.asthmawaikato.org.nz

Asthma and Respiratory Management BOP Inc

Monday-Friday, 9am-4pm 07 577 6738

0800 ARM BOP or 0800 276 267 reception@asthmabop.org.nz

254 Chadwick Rd, Gate Pa, Tauranga 3112 www.asthmabop.org.nz

Asthma New ZealandRotorua

Monday-Friday, 9am-5pm 07 347 1012

rotorua@asthma.org.nz 1290 Eruera Street, Rotorua 3010 www.asthma.org.nz

Eastern BOP Asthma and COPD support group 07 307 1447 or 0800 227 363 copd@drct.co.nz

C/O Karen Couchman, Disabilities Resource Centre Trust, 141 King Street, Whakatane 3120

Gisborne and East Coast Asthma Society (Inc) 06 868 9970 lynlolohea@hotmail.com 14 Kennedy Street, Gisborne 4010

Breathe Hawke’s Bay

Monday-Friday, 8.30am-3pm 06 835 0018 admin@breathehb.co.nz 199 Dickens Street, Napier www.breathehb.co.nz

Tu Kotahi Maori Asthma Trust Lower Hutt

Monday-Friday, 8.30am-5pm 04 939 4629 / 0800 939 462 anne@kokiri-hauora.org.nz 7-9 Barnes St, Seaview, Lower Hutt 5010

Asthma New ZealandWellington

Monday-Friday, 9am-5pm 04 237 4520 wellington@asthma.org.nz Level 2, 120 Featherston Street, Wellington 6011 www.asthma.org.nz

Marlborough Asthma Society Any messages will be responded to during office hours Monday to Friday. 03 579 1609 0272057244 asthma.marlborough@xtra.co.

Nelson Asthma Society

Monday, Tuesday, Wednesday and Friday, 9am-2pm 03 544 1562

asthma.nelson@xtra.co.nz 9 Cambridge Street, Richmond, Nelson 7020 nelsonasthma.co.nz

CanBreathe Canterbury Monday-Friday, 9am-4pm 03 386 0278 office@canbreathe.org.nz 196 Hills Road, Edgeware, Christchurch 8013 www.canbreathe.org.nz

Otago Asthma Society

Monday-Friday, 9am-12pm 03 471 6167, 027 471 6162 otagoasthma@xtra.co.nz Dunedin Community House, 1st Floor, Cnr Moray and Great King Street, Dunedin 9016

Southland Asthma Society Monday-Friday, 10am-3pm 03 214 2356 / 0800 800 249 southlandasthma@xtra.co.nz C/O Federated Farmers, 70 Forth Street, Invercargill 9810

Everyone is welcome at the Nelson Asthma Society’s Richmond base, says new manager Jess Quinney. “We operate an open-door policy. We want our office to be a warm and welcoming place where anyone with a respiratory condition can come for free information and support.”

This Society offers a range of services including eight-week Pulmonary Rehabilitation Courses, regular Better Breathing exercise classes for those living with respiratory conditions, educational sessions for community groups and schools, an asthma resource centre and a telephone helpline.

Jess is also looking at re-starting services that had to be suspended during COVID-19 restrictions, including a respiratory support group and the Sing Your Lungs Out choir for people with respiratory conditions. “We are also looking at how we can extend our services further into more rural parts of the Nelson region,” she says.

She says one of the most popular services they offer is the Better Breathing exercise class. “The benefits from these classes are life-changing, both physical and social. People find it an amazing support network, with no judgment from others who understand what you are going through.”

Find out more at: nelsonasthma.co.nz

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