greatest gift of all Every year 130 New Zealanders receive a new kidney, with the majority of donors being sons, daughters, parents, siblings or friends
Exercise for anyone No matter what your age or stage, activity is the spice of life
Celebrity trends Imitating the rich and famous might offer a quick retail fix, but like chocolate, the high doesnâ€™t last long and you risk landing with a bump
Power to the people As energy consumption rises and oil levels lower, what are our options?
Four steps to improve your health Simple daily changes do make a difference
News | Events | Life | Health & Wellness | Sustainability | Initiatives | Interviews
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IF YOU’D SIGNED THIS PETITION 6 MONTHS AGO, I MIGHT STILL BE ALIVE. Christie Marceau, 18, died on 7th November 2011 in her mother’s arms. The person charged with her murder was a 19 year old male. We can only refer to him as ‘the accused’. The accused was granted interim aname suppression until 18th April 2012. He was on bail at the time and was facing charges for kidnapping Christie just a couple of months before her death. The judge gave the accused bail after what he had done, despite strong police opposition. It is said that the police showed the judge a Google map to illustrate he was placing the accused just 350m from Christie’s home. Christie was terrified for her life. It is alleged that when he turned up to Christie’s home early that morning, the accused brutally stabbed her. Christie bled to death in her mother’s arms. The shock of Christie’s murder has resulted in an unprecedented public response and community action. Since her death, Christie’s devastated parents, Tracey and Brian Marceau have been working with friends and the Sensible Sentencing Trust to launch the petition. Christie’s Law petition was launched earlier this week on Monday, outside the High Court in Auckland. Over 1,000 people gathered to show their support. Unfortunately, we can’t turn the clock back, but imagine if this petition had been around 6 months ago and we had got 500,000 signatures. The politicians and judges would have sat up and listened to the voice of the people. Imagine if there was a public outcry because our bail laws have failed so many, like Augustine Borelle and Aalyagh Morrissey who was just a toddler. They too were murdered by violent offenders who were granted bail. Let us not forget Vanessa Pickering. The man who killed Vanessa was not long out of prison when he raped a woman only to be granted bail. And now, there’s Christie. Christie’s alleged killer has been charged with her murder, however Garth McVicar believes the judge’s decision placed the accused right back into our community and subsequently cost Christie her life. The judge has never been held responsible for his actions. Our petition aims to change that and make judges accountable for their actions. Judges are not above the law. We believe New Zealanders have the right to be safe. The vulnerable have the right to be protected. Did you know that 5,082 people were convicted for failing to answer Court bail orders in 2007? These are the latest figures supplied by the Minister of Justice after an Official Information Request. 1,313 of those people committed another crime while on bail. Christie is the latest victim. If you believe something needs to be done about our failed bail laws, here is your chance, for Christie’s sake.
So what can you do to help? MAKING CHANGES TO BAIL We are asking that police be given the power to appeal a judge’s decision to grant bail. This would automatically move the application to a higher court. We want you to support making the following amendments to the Bail Act: • No bail for defendants with a criminal history for an offence involving violence, which attracts a sentence of two years or more linked to; • No bail for any person accused of an offence involving serious violence as defined in the three strikes legislation. We also want you to support the reintroduction of meaningful bail bonds (not the current NO bond system that’s costing the tax payer over $300m per year): • NO bond, NO bail. • An automatic and immediate inquiry after every serious bail breach, similar to a police inquiry after a police shooting. • The views of the victims of any violent offence are given paramount consideration. MAKING CHANGES TO JUDICIARY At present, judges are a law unto themselves. There is no monitoring of them and they are not accountable for their decisions. This petition calls for an annual, publicly available performance review of judges, with the right of public recall on those proven to be consistently below par or found guilty of exposing the public to undue risk.
5 ways to help Christie’s Law mean something 1. Sign the Christie’s Law Petition in the coupon. 2. Talk to your friends, business colleagues and talk to your children and family about Christie’s Law. 3. Like our Facebook page at facebook.com/christieslaw 4. Please visit the site and download the petition and ask your staff to sign it. Lead the way by signing it yourself. 5. Donate to Christie’s Law (see box below).
Please donate $20 to Christie’s Law. Simply call 0900 72 33 69 and your $20 donation will be made automatically – Thank you for your support and effecting change. HSE 2350 Christie FP Today Mags.indd 1
CHRISTIE’S LAW Petition Help us change the Bail Act
PLEASE PRINT CLEARLY By signing this petition we call on the House of Representatives to enact the following: Name: 1. Immediately amend bail legislation Signature: to help prevent similar tragedies from ever occurring again and Address: ensure public safety is of paramount consideration at all times. 2. Instigate an annual performance Email: review of judges with the right of public recall for those who expose Name: the public to undue risk.
Make your signature count 1. Fill out all sections on the petition. 2. Photocopy petition or download it online at www.christieslaw.co.nz if you need more. 3. Free post completed petitions to
Dr. Jackie Blue Member of Parliament FREE POST Parliament Buildings WELLINGTON
Email: Name: Signature: Address:
This advertisement has been authorised by Garth McVicar of the Sensible Sentencing Trust. P.O. Box 701 Napier 4140. 5/03/12 1:50 PM
Issue 5 Autumn 2012
greatest gift of all Every year 130 New Zealanders receive a new kidney, with the majority of donors being sons, daughters, parents, siblings or friends
Exercise for anyone
6 The Greatest Gift
No matter what your age or stage, activity is life’s elixir
Every year about 130 New Zealanders receive a new kidney, with the majority of donors being sons, daughters, parents, siblings or friends
Celebrity trends Imitating the rich and famous might offer a quick retail fix, but like chocolate, the high doesn’t last long and you risk landing with a bump
Power to the people As energy consumption rises and oil levels lower, what are our options?
Four steps to improve your health Simple daily changes do make a difference
News | Events | Life | Health & Wellness | Sustainability | Initiatives | Interviews
5 Going nuts It's not just apples keeping the doctor away
5 Exercise for any age or stage No matter what your age or stage, activity is life's elixir
7 Power to the people As power consumption inexorably rises, and oil levels steadily lower, what are our energy options?
8 Celebrity trends
PO Box 1879
Imitating the rich and famous might offer a quick retail fix, but like chocolate, the high doesn’t last long and you risk landing with a bump
9 The crying game
GENERAL MANAGER Rebecca Harris
12 Nature's Harvest
ADMINISTRATION Kylie Moore
Beauty products that are making the most of honey's natural goodness
Kelly Clarke Judy Slater Kimberley Wells Tayla Brown
SALES & ADVERTISING Lynne Puddy-Greenwood
14 Pete's Lemonade A project which began in a Wakefield man’s kitchen with a few buckets and some fruit has evolved into a thirst-quenching phenomenon
The call for couples to act sooner when conceiving proves problematic
Examining a few facts and implementing some simple changes each day will make a difference
Clive Greenwood PUBLICATION MANAGER
15 Four simple ways to improve your health
Grief affects children and teenagers in different ways to adults
A place in the sun and living the high life
16 Managing Menopause Where to get support and taking the natural route
NEWSROOM Jonathon Taylor EDITOR
18 Eden Sleep A simple solution for a better night’s rest
20 Getting a fibre rich diet How do you get enough fibre to stay healthy and how much do you really need?
21 Coping with cold sores
Symptoms, signs, causes and care
Bridget Gourlay Kayte John
26 Contemplating surgery for morbid obesity
Putting the focus on healthy skin
Phone: 03 961 5050
The importance of early diagnosis
Fax: 0800 555 054
29 Bowel health
24 Migraines Migranes affect almost 20 percent of women and eight percent of men and have a major impact on people's lives.
PRODUCTION MANAGER Ian Knott Carolynne Brown ASSISTANTS
Kirsty Opie DESIGNERS Jarred Shakespeare Janelle Pike
30 In circulation Understanding varicose veins
Phone: 03 961 5050 Fax: 0800 555 054 Email: email@example.com
Disclaimer: This publication is provided on the basis that A-Mark Publishing is not responsible for the results of any actions taken on the basis of information in these articles, nor for any error or omission from these articles and that the firm is not hereby engaged in rendering advice or services. A-Mark Publishing expressly disclaim all and any liability and responsibility to any person in respect of anything and of the consequences of anything done, or omitted to be done, by any such a person in reliance, whether wholly or partially upon the whole or any part of the contents of this publication. Advertising feature articles are classified as advertising content and as such, information contained in them is subject to the Advertising Standards Authority Codes of Practice. Contents Copyright 2010 by A-Mark Publishing (NZ) Ltd. All rights reserved. No article or advertisement may be reproduced without written permission.
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4 | Autumn 2012 www.awarenesstoday.co.nz
Going nuts A daily intake of nuts can reduce cholesterol levels and improve heart health. An analysis of 25 studies conducted by a team at the US Loma Linda University in California has concluded that eating nuts may help to lower the risk of heart disease by positively influencing blood lipids (fats) and lowering cholesterol. The research reported that an average intake of 67 grams of nuts every day resulted in an average reduction of individual’s LDL (‘bad’) cholesterol of 7.4 percent. The studies ranged from three to eight weeks in duration. ABC Nutrition director, Angela Berrill says this study reinforces the important role nuts can play when included as part of a healthy, balanced everyday diet, particularly in relation to their impact on heart health.
“We have seen significant results from these types of studies that supports the idea that nuts can help to reduce the risk of heart disease by favourably improving blood lipid levels. However, while daily consumption of nuts may be beneficial for your heart, it’s best to choose nuts which are not roasted, salted or sugar-coated.”
In 2003 the US Food and Drug Administration (FDA) recommended a daily intake of 42.5 grams of good nuts in order to reduce the risk of heart disease. “Including nuts into our daily diets is one way Kiwis can get on board to help protect themselves,” Angela says. With one in five people believing all fats are bad, and 20 percent mistakenly cutting all fat from their diet, education around the benefits of good fats is essential for making people aware of how diet can affect the health of their heart. "Nuts contain mostly polyunsaturated and monosaturated fats rather than saturated fat, and because they contain fibre and protein, nuts can help you feel fuller for longer." The New Zealand Heart Foundation says heart health should be a focus for every Kiwi, young or old. Most people don’t realise cardiovascular disease – including heart disease and stroke – kills more New Zealanders than any other. “A healthy and nutritious diet, including plenty of fruit and vegetables, whole grains, and good fats from a balanced amount of nuts and seeds is an easy and simple way Kiwis can look after their heart health and get the most out of life,” it says.
for any age and any stage
Every one of us needs exercise. Whether you’re naturally thin, or pregnant, or recovering from illness, there’s very few cases where you shouldn’t do some kind of a work-out at all. But everyone’s needs are dependant on their age and stage. Sam Hall, a local fitness guru, has worked with people of all shapes and sizes in his career and he spoke to Bridget Gourlay.
base exercises and never fall below that,” Hall advises.
“Children should exercise daily – exercise for them should develop fine motor skills, so games with balls and bats that teach balance and co-ordination are important.” Hall stresses children must see exercise as something fun.
Even though technically you’re past you aerobic peak, people in their 40s can still be very fit – many complete the Coast to Coast. “Exercise is important for women at this age as it aids the start of menopause. Weightbearing exercise can prevent osteoporosis in later years. Keep going, because you’ll want to be able to play with the kids or grandkids in your 40s and 50s without doing your back in.”
Teenagers “This is quite a difficult one,” Hall says, “Because co-ordination deteriorates for them for awhile! Don’t make them do exercise which makes them look goofy in front of other teens.” Hall says it’s very important for teens to start base strength training – ie being able to do a certain amount of push-ups and sit-ups and squats. This is called ‘pre-hab’ and if you start this in your teens and continue into your 20s, you’re less likely to get injured throughout your life whatever sport you play or activity you do. Pre-hab also has an aerobic element – for example, you should be able to go for a 20 minute walk without puffing.
20 somethings “In their 20s, people are often in gyms, or doing social sport. A game of indoor netball a week is not going to maintain strength, so keep going with pre-hab - set yourself five
30 somethings Believe it or not, this is the age a lot of studies say humans hit their aerobic peak. That’s why so many top marathon runners are in their 30s. So there’s no reason to take a step back from physical activity.
50 somethings At this age, there’s an emphasis on social aspects of exercise – there are walking groups, gardening tours and trips overseas which involve a lot of walking. At 50, Hall says it’s common for people to go back to sports they played when they were younger - but there’s a higher risk of injury if they haven’t exercised properly in years. “Work at flexibility – seek advice from physios and personal trainers. If you go all out you could get injured very quickly. Prepare your body. But there’s no reason why you can’t play rugby or tennis as long as you’ve got that strength base.”
60 somethings For people 60 and over, Hall recommends low-impact non weight-bearing exercise,
such as walking, cycling and aqua-jogging. “Listen to your body,” he advises. “Niggles are there to tell you something’s not quite right.” But being at retirement age is no reason to give up exercising. Unless a doctor has told you not to, Hall believes you should exercise, according to your ability, until you die.
Pregnant First and foremost, Hall stresses, you should always ask your midwife, G.P or specialist if it is ok for you to start or continue an exercise plan. You should check with them before your second and third trimester as well. There are many things which may prevent you exercising as your baby grows such as your blood pressure and weight, your baby’s position and heart rate, and water retention. But if you’ve got the all clear, then light aerobics, walking, pregnancy yoga and swimming are good. Exercise during pregnancy can boost your energy, improve your sleep, reduce constipation and relieve back pain. It can also lead to a faster birth and help with post-natal recovery.
After giving birth Again, Hall says you must be given the all clear from your midwife or doctor before starting back on an exercise routine. However, once you are good to go, exercise is a great way of helping you bounce back. Hall recommends taking it slowly and listening to your body instead of throwing yourself back into the intense work-out you did pre-pregnancy.
Recovering from illness Hall says not to exercise when you are ill – it will take away from your immune system’s efforts. He says it is much more important to rest, eat nutritious food and make sure you
are getting the necessary vitamins and antioxidants. When you do recover, Hall recommends listening to your body about how much exercise to do. If it’s only a short walk instead of your usual run, then so be it.
Never exercised before For people who have never exercised before, Hall says finding a work-out they enjoy is key. “If exercise is a chore, then you’re less likely to do it. There’s so much out there – if you hate running or going to the gym it doesn’t matter.” Again, he recommends pre-hab to prevent injury.
Overweight/obese people For overweight and obese people, Hall recommends not trying to do what a person with a healthy BMI would do. “For people carrying 30 kilograms of extra weight, a 20 minute session moving and doing squats etc is a big workout. My clients ask me - is that all? But as they get fitter they can do more. Overweight people need exercise that doesn’t put too much pressure on their knees as this can be really painful.
Sam Hall has a Bachelor of Sports Coaching, a Certificate in Fitness Consultancy, and a Les Mills Body Trainer Certificate. He runs his own fitness consultancy ‘Work Ya Bum Off’ which runs private one-on-one and small group sessions. For more information, visit www.wybo.co.nz.
www.awarenesstoday.co.nz Autumn 2012 | 5
The greatest gift of all All Black great Jonah Lomu's transplanted kidney has failed. This leaves him needing intensive dialysis and another new kidney to survive. Lomu has had to spend time in hospital and is now 30kg lighter than when he launched the Rugby World Cup in September last year. Kidney disease forced him to have a transplant eight years ago, but in October that organ - donated by his friend and radio host Grant Kereama - stopped working. Lomu, 36, revealed in the New Zealand Woman's Weekly that he was ill again and the transplanted kidney had not responded to treatment. "We were hoping to see some improvement but nothing has made any difference, so the next step is to try to find a donor." Lomu's immune system is so low that an ankle injury got infected so badly he couldn't walk and wound up in hospital. He told the magazine he was having dialysis for seven hours, three nights a week. But he was focusing on spending as much time as possible with his family. Kidney Health New Zealand education manager Carmel Gregan-Ford says the Thank You T-shirts were designed for kidney and other organ transplant recipients to wear during the second week of March, including World Kidney Day, as a way to recognise the gift they have been given and to say thank you to those who have supported them.
The gift of a better quality of life was also a gift economically, she says. Not only did an unwell person feel better and be able to contribute more to their families and communities, but each transplant saved the health system tens of thousands of dollars a year in treatment costs for people with diabetes and other kidney diseases. With only three transplant units in the country (Auckland, Wellington and Christchurch) and supply not meeting demand, some patients were waiting between six months and five years for a transplant. "Last year there were 479 people on the waiting list for a kidney alone." Because of the wide range of medical tests required, it could take up to a year before the live transplant could go ahead and donors were given plenty of time to think through their decision. "Of the 110 who had a kidney transplant last year, 60 of them were from living donors. We are hoping more live donors will come forward. They are our main source [of kidneys] now.”
There are a number of reasons why there are The Thank You day, which included planting fewer deceased donors, modern medical Freesia bulbs as a symbol of new life, aimed to technology, safer vehicles etc. The important recognise the people and their families that thing to remember is to talk to your family have donated organs. and tell them your wishes. Every year, about 130 New Zealanders There were more than 2500 people on receive a new kidney, with 60 percent of dialysis in New Zealand. Symptoms were the organs provided by live donors; usually vague and could indicate a myriad of other sons, daughters, parents, siblings or friends. issues. It had been estimated 3000 more Every sympathy is justifiably with the patients people might not be aware they have kidney who have, in many cases, endured years of disease, Gregan-Ford says. kidney disease and uncomfortable, lifestyle "Kidney disease is a silent killer. People don't cramping dialysis. usually realise until they have got 20 percent But, putting the risk of organ rejection aside, capacity left," she said the procedure is usually more of a threat for the live donor, a healthy person who has deliberately made themselves sick, to give the For more information or donations call patient a gift of life. 0800KIDNEY / 0800543639, or visit www.kidneys.co.nz Removing a kidney is usually a straightforward procedure that can be done by keyhole surgery. "But, generally, they have the feeling of giving a gift, which is great," she says.
Above: Rob Johnson, whose son Richie gave him his kidney last year, with Malia, who had been on dialysis since the age of two until she received a kidney two years ago. They are planting Freesia's at the Boatshed in Christchurch as a symbol of new life in Canterbury.
Line artery to vein pump Tubing made of a selectvely permeable membrane
Line from apparatus to vein
Fresh dialysing solution
Used dialysing solution (with urea and excess salts)
Artificial Kidney - Dialysis 6 | Autumn 2012 www.awarenesstoday.co.nz
News a year or so and my opinion is New Zealand needs to do this pretty quickly before the economic situation really kicks in.” However, some people find wind farms ugly and noisy. Care has to be taken that wind farms don’t ruin iconic or culturally significant views.
Hydro “The combination of wind and hydro is particularly beneficial as water can be stored in the lakes when the wind is blowing and used to generate power when it is not,” Lloyd says. Hydro power is already the basis for much of New Zealand’s energy, but environmentalists and animal lovers say large scale hydro wrecks eco-systems. Rivers are also loved by outdoors people such as kayakers and anglers. Since New Zealand is susceptible to dry rivers, we can’t have an over-reliance on hydro, but it is an option. The Green party’s energy policy is to only encourage small hydro developments, where they can be built without significant damage to ecology or public values.
Power to the people Last year, protesters tried to block oil exploration off the East Cape. In 2010, thousands took to the streets and told the Government to keep its hands off our national parks, which it intended to mine further. All around the country words like ‘fracking’ and ‘lignite’ are making headlines, as greenies fight to make the phrase ‘100% Pure’ more than just a marketing slogan.
We think of wood as a way of heating our houses, but it can be much more than that. Waste wood from plantation forests can be used in co-generation plants to provide process heat and electricity for industry, with some power exported to the national grid. People become concerned, about wood, when it isn’t farmed sustainably and eco-systems are wiped out, and because in places like Christchurch open fires create smog. But when those problems are addressed, wood offers the potential to be a sustainable power source as well as a job creator here in New Zealand
Environmentalists are desperately worried that burning our fossil fuels will accelerate global warming. But how would they power New Zealand sustainably? Bridget Gourlay finds out the options.
One thing that has everyone excited is geothermal. Unlike other countries, New Zealand has a high concentration of them. High temperature geothermal fields are principally located in the Taupo Volcanic Zone, with another high temperature field at Ngawha in Northland. Moderate to low and very low temperature systems are more widely scattered. When properly developed and managed, geothermal electricity is a clean, abundant, and reliable source of renewable energy that isn’t affected by the weather – making it very reliable.
Wind is a popular green solution to New Zealand’s situation. Dr Bob Lloyd, associate professor of physics at the University of Otago, is a fan.
Although ‘nuclear’ is a dirty word in New Zealand, in other countries it is hailed as a clean way to get energy – if the issue of what to do with the waste is neatly sidestepped. Up until March 2011, many countries were using nuclear power
“The easiest option for New Zealand is wind – you can buy and install wind turbines within
enthusiastically. Possibilities of a melt-down were dismissed; the Chernobyl disaster was blamed on an inefficient developing country, with poor safety controls. The fact that nuclear power plants could be a terrorist threat were downplayed. Fukashima changed that. Countries all around the world are now re-thinking nuclear options. Angela Merkel has ordered all German nuclear power plants to be turned off by 2022. In New Zealand, otherwise known as the ‘shaky isles’ a nuclear power plant would be threatened by earthquakes, the expense of building and maintaining it and deepseated anti-nuclear feelings. As Dr Lloyd says, nuclear power doesn’t have a solution for getting rid of nuclear waste safely. Instead it is problematic for about 250,000 years. “The basic thing is that human kind has to work out solutions where we don’t rely on future generations to bear the problems.”
Wave, tides and currents The benefits of wave, tide or currents as power sources show promise but have not properly researched. Given New Zealand’s long coastline if this seed bears fruit it could be a game-changer for us, but sadly this technology has not been widely commercialised.
Everyday savings Of course, environmentalists all agree limiting the amount of energy we use to begin with is vitally important. Good public transport, using bicycles and walking takes away our reliance on cars. So does growing our own vegetables and buying local produce instead of shopping at supermarkets. With today’s technologies, it is possible to create buildings which drastically reduce a typical structure’s carbon footprint. Take the new Geyser building in Parnell, Auckland. Meeting the extremely difficult standard to achieve 6 star’s with the Green Building Council, the complex uses cutting edge design technology to naturally heat and cool itself. The building has its own rainwater harvesting system to store and supply water to low flush toilets and irrigation systems. It uses only 27 percent of the energy and half the water of a typical office of its size. When it comes to being green, it seems thinking differently and outside of the square is how problems get solved.
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By Kayte John
addictive or depressing?
Fashion can be great; it makes us feel good and gives us that extra bit of confidence. But the everincreasing celebrity trends and endless high-street labels are making women competitive. This new addiction to look immaculate 24/7 is invading our lives and our wardrobes. A close friend of mine recently bought a $600 black bag; it was the most expensive fashion item she had ever brought. When I asked her about it she replied she would do anything to look good. She also confessed that Kim Kardashian had a similar one. Normally my friend buys handbags that would cost less than a beaten-up-bicycle and not her last foreign holiday. The following day I went shopping paying great attention to the selection of bags on offer, some were so expensive. I wanted one and it wasn’t fair. It’s been a long time since a bag has inspired such envy in me, however women like my friend seem to buy anything to make them look and feel like a celebrity. Fashion has and will always be around. It’s a statement that is also becoming an obsession, to look good, be up-to-date with trends and sadly for most women, falling into debt. Size is also a crucial component too. During the last few years, it’s begun to look like an assembly line - Kate Middleton, Nicole Richie, and Lindsay Lohan. Their drapey gowns clinging to their non-existent hips, long tendrils of hair falling over their matchstick-thin arms - thinness seem to be essential. It might look like this trend is blowing through Hollywood as we flick through our glossy magazines, but it is affecting New Zealand women too. Women who feel the pressure to look as good as these so called celebrities we call ‘role models,’ are dramatically losing weight. Is this going to be how women live? If so where have the real women gone? I’m talking about the curvy Marilyn Monroe types. Celebrities should start pilling on a few pounds and start showing off some
healthy curves. Song writer, Adele has been constantly criticised in the tabloids about her larger frame, however she recently hit back saying she was proud of her body because she represented the ‘every-day woman’.
and back-stabbers. Fashion is competitive and to a size six and seriously fell into depression women are competing. because of the high competitiveness that came with modelling.” Every woman does it though - you pick it up at school, when you start mixing with other Sadly, many girls like Nicole fall into this females. I’m talking about the dirty look. trap every year; they feel the pressure The retail industry in New Zealand has started Sometimes it is an ocular movement so slight of needing to be immaculate 24/7. This to grow; more high-street stores cater for you may not even know you have delivered it. obsession is causing underweight, insecure everyone as their clothes become similar Sometimes it is about as subtle as a brick-full women, who live their life by deciding to what celebrities wear - we just get them on. Staying ahead of the game and looking what they will wear tomorrow. cheaper. Even K-Mart and The Warehouse are trendy or just very ‘now’ entails a never ending With all this said, I think I’ll leave that bag I getting the latest trends for its customers. game of ‘one-up woman-ship’. had my eye on after all. But a lot of women seem to want the best of I was on the receiving end of a ‘look’ the other everything and this comes at a high cost. night. I went out, straight after work to meet Luxury goods seem to have added value. some friends for a meal. Afterwards, we ended for the person buying them-they are up at bar, where a fashion maven gave my buying something they think is high status. outfit a withering once-over. By choosing and wearing something She added the evil twist of turning to her exclusive, they are getting what they think is friends for shared, knowing smiles. I admit that admiration, praise and celebrity status. going out wearing jeans and jandles with a What is it about fashion though? It seems non-statement belt marked me out as a new we want to be better than everyone harassed mother, which I am not. The look is a else. Our society is based on image and challenge and I was forced to give the fashion first appearances. People like to express maven’s dress-sense a return match. My eyes themselves - they want to look good. But said it all, as I looked her over with a smile, ‘You what lies behind this compulsion? Is it an may well own a bit of Gucci love, but your look exaggeration or must-have society? An has one mismatched colour too many.’ increasing pressure to be better than our All of this bitchiness is a sure sign of neighbours, colleagues and friends? A insecurity. What happens though, when growing need to succeed? women are so insecure they fall into debt or Society is becoming far more materialistic; depression? people are often replacing relationships Nicole, aged 24 from Christchurch, moved to with people, to relationships with goods and Sydney with the aspirations of becoming a services. We live in a branded environment, model. To look the part she went shopping even adolescents know this – it has become with her credit cards. Eight failed auditions part of their everyday lives. and six months down the line, Nicole Fashion can also be a bitchy industry and ended up with $14,000 worth of debt. She many people are willing to get on that career embarrassedly confessed, “It was all on ladder and join in with the feuds, betrayals clothes, I didn’t even eat. I went from a size 10
8 | Autumn 2012 www.awarenesstoday.co.nz
Grief She suggests having a ceremony, where a prayer is said, a candle lit or a balloon released. She knows of a case where a memorial scholarship for a child who died of cystic fibrosis was given to a student who always tried their hardest. One school built a biketrack in memory of a student. “Harness that stress and anger and turn it into something positive,” Hendry advises. “Provide opportunity to keep talking,” she says. “Don’t say at a certain point that’s it - we move on. Issues keep coming up.”
Have a plan
The crying game
By Bridget Gourlay
High School is a bit of a blur and I don't remember exact details about Year 11. I can't remember the marks I got, or what music was in, but I do remember, as clearly as if it was yesterday, my classmate's funeral. I remember the shock of seeing a teacher cry. I remember the painful eulogies. And most of all, I remember the sob her mother made at the end of the funeral when her coffin was carried away. It was the saddest thing I have ever heard and I hope I never hear it again as long as I live.
Grief affects children and teenagers in different ways to adults. For many, the passing of a classmate may be the first time they have experienced death.
Continued care Grief does not end a few weeks after a death, rather it is an ongoing process. Tricia Hendry from Skylight, a trust which gives people resources in how to deal with grief, says continuing to remember the student is important and helps with the grief process.
Hendry says it is vitally important to pre-think the issue of a student death and to have a strategy. “Do some planning for how you will handle this event. It’s a horrible thing to plan for but it is necessary. Make sure one reaction isn’t radically different to another – there should be no favourites in death.” She also advises training yourself in advance about loss and grief - perhaps having a staff meeting about it. “Understand nobody grieves in same way, and be respectful of styles. Don’t underestimate the lack of concentration children and young people will have – can you even teach a grieving child? They will be exhausted at school then will go home to more grief. It might even hit them much later. I know of a teenager who had been through a serious family loss and seemed to bounce back. When her cat was hit and killed five months afterwards she was then inconsolable. Obviously, it wasn’t just about the cat. Grief is unpredictable. There are no rules, no timetable.”
It’s not a lesson teachers would ever want to give, but helping students cope with grief and develop healthy outlets for it could be one of the most important things they ever learn at school.
Do • Have a process planned for when a student dies • Be honest and give students information immediately, to prevent rumours • Have ongoing counselling available • Remember the student with something appropriate to them and their culture • Be familiar with the different ways children and young people grieve Don’t • Expect students to ‘get over it’ within a certain timeframe • Expect only the deceased’s close friends and family to be upset. Many others will be feeling emotional too • Only address deaths within the school. Students may be greatly upset when a former pupil or student from a neighbouring school dies too
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www.awarenesstoday.co.nz Autumn 2012 | 9
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Nature’s harvest It’s drawn up by bees, stored in their stomachs, regurgitated, dehydrated then covered in wax – but don’t be fooled by its unappetising method of creation – honey, the by-product of this process has numerous health benefits. Natural antibiotics A Blenheim based beauty products company has taken advantage of honey’s natural goodness in its products. The Honey Collection, as it is aptly called, uses Active Manuka Honey with the Unique Manuka Factor (UMF) as its key ingredient. UMF certification guarantees that the honey contains high levels of the beneficial anti-bacterial and antibiotic properties, which gives the honey its special qualities. Company general manager Georgia Devlin, says as a member of the UMF group its products are guaranteed.
Skin health As a company, The Honey Collection prides itself on manufacturing a high quality range of skin products at an affordable price. “Our range markets from $5-$55,” Georgia says. “All ingredients are selected to compliment and aid the beneficial effects of honey, to repair and revitalise skin tissue, help reduce ageing and over exposure to wind and sun.” Georgia recommends in particular, its biggest selling products, remedial creams, for people with eczema, cracked heels, leg ulcers, acne, psoriasis and wounds. “It’s good for improving skin and it helps reduce scarring. We have had a lot of positive feedback.”
A home-grown company Georgia says it is the company’s personal touch that has made it the success it is today. “Our wonderful products are handmade, a lot of care is gone into them and because the products work it has kept our business going.”
The Honey Collection range was first developed by founder, Jean Coombe, 20 years ago in her Auckland kitchen. Jean, who is now 84, began to develop these products using natural ingredients to combat her own sensitive skin. After seeing the tremendous benefits the creams had on her skin, she branched out, selling the products within the small craft market clientele. Her son, Nick Coombe, took over the reins in 1996 and when it out-grew its Auckland base they moved to Blenheim in 2002. Today he continues to run the company while manufacturing all its products himself. But though Jean handed the reins over to her son, Georgia says she is still fully involved with the business, in particular with the development of new products. “She’s our guinea pig,” she jokes. Though there is truth in her words as the company prides itself on animal-free testing of its products.
An expanding export market It’s a company which despite its small beginnings has out-grown the New Zealand market, with deals as far afield as America, Europe and Asia. “We estimate sales of around 500k a year with our new Korean distributors,” Georgia says. “I’m constantly being approached by potential buyers.”
Claim to fame Three years ago the company also began experimenting with bee venom, which is said to be a wonder-drug for arthritis and wrinkles. It’s an intricate process, which requires giving the bee a tiny electric shock, sufficient enough to stimulate it into giving half a sting – rather than a full fatal sting.
The Honey Collection has done its own take on the widely popular Bee-venom cream which has been linked to The Duchess of Cambridge. Georgia says, as they go from success to success the future for the company has simply opened up, “It’s unlimited!”
Honey properties at a glance • moisturising • anti-aging • anti-oxidising
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12 | Autumn 2012 www.awarenesstoday.co.nz
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Why is fertility treatment
becoming more common?
By Dr Andrew Murray, Fertility Associates
The reasons for this are not hard to understand. More women are participating in tertiary education, many couples need double incomes, and to a certain extent we have been giving women the message from an early age “Girls can do anything!” We are also living in a society where the norm has been to save for the house deposit, establish the career, and then have the kids “when I’m financially secure”. Dr Andrew Murray of Fertility Associates agrees girls can do anything, but sometimes it comes at a cost. “On an almost daily basis the women I meet are shocked to see how their fertility declines significantly with age,” he says. “All too often their partners are also blissfully unaware how fertility declines.”
It is estimated that within the next five to 10 years there will be one child in every classroom born through IVF. “Girls can do anything… except make more eggs,” explains Dr Murray.
compensate for age. Your chance of success at 41 years of age is half what it is at 36.”
“Career planning needs to include family planning. We need to make work places more accepting of part time roles, be breast feeding friendly, and if possible provide more readily accessible childcare.
preferred partner, who will be able to offer and continue to support a high level of care. Dr Phillipson says that the transition will be seamless for patients and referrers. “We Fertility Associates are thrilled with this outcome and want to assure patients that it will be business as now in Christchurch Fertility Associates Ltd is pleased to announce usual,” he says. that they will be taking over the Repromed For more information visit Fertility Associate’s fertility business in Christchurch following website www.fertilityassociates.co.nz Repromed Australia’s decision to withdraw
“Even with these changes it is a biological certainty that as women leave it later in life to have their children, a larger number of perfectly healthy women are going to need help because their eggs are fewer and of poorer quality.” If you are having trouble getting pregnant, the good news is that fertility clinics like Fertility Associates are in the best position to help you. But you need to take action sooner rather than later to ensure a greater your chance of success.
The call for couples to act sooner
New Zealand couples may be taking too long to seek fertility advice, according to leading This rapid decline in fertility is highlighted in fertility expert, Dr Mary Birdsall. Given that the table below which shows the monthly the average age of New Zealand women chance of getting pregnant versus age: seeking treatment is close to 37, many are In particular you can see how the chance of beyond the optimum age for treatment. If a baby drops dramatically in your mid 30’s. treatment is necessary, a younger start will Why? It’s all about the eggs. Egg quantity and mean a better chance of success. egg quality. The average fertility patient in Europe, where “The most eggs a woman ever has are most IVF studies are based, is often under before she is born. About half way through 35 years. “This will significantly increase the her own gestation she will have seven chances of conception,” says Dr Birdsall. million eggs, but from there it’s all down“The leading clinical and scientific studies all hill,” explains Dr Murray. support early intervention, which can often “By birth she will have one million eggs, by mean less invasive and more importantly, puberty 300,000, and by her mid 30’s maybe more successful treatments.” 25,000 left. Still sounds like a lot I know, but Fertility Associates conducted a recent review the other issue is that you tend to ovulate on more than 750 patients. It showed that your best eggs when you are younger. The only a third of patients saw a doctor after 12 older women get, the greater the chance of months of unsuccessfully trying to conceive a genetic problem in the egg. This largely - which is the widely accepted indicator of explains the numbers shown in the table.” potential infertility issues. Another third of Fertility treatments try to overcome this by patients are waiting more than two years increasing the chances of an egg and sperm which is well beyond what is recommended. getting together. This could start with some Many patients see fertility treatment as the thing as simple as Clomiphene (a tablet last back-stop. “Seeking help earlier may well designed to help women release more eggs), mean less invasive treatment; more than through to IVF where egg and sperm are half of our patients are on our less complex brought together in the lab, and subsequent treatments which don’t involve IVF at all,” Dr embryo quality can be examined, leading Birdsall says. to selection of the strongest most viable “Further, early advice can make all the embryo. The average chance of a baby from difference,” Dr Birdsall says. “IVF can’t one cycle of IVF is now 45 percent.
Women's Age 34 or younger 35-37 38-39 40-41 42 or older
Monthly chance of Pregnancy 26% 22% 17% 12% 8%
It is not known why New Zealand couples may take longer to seek help, but Dr Birdsall notes that starting to try for a family later in life and the long wait for public fertility treatment in New Zealand - waits of over 18 months – compounds the problem.
from the New Zealand market. Repromed invited Fertility Associates, New Zealand’s leading provider of fertility services, to buy its business which was completed on September 16 last year. Patients and referrers will not notice any immediate difference in the service and care they receive other than some benefits that New Zealand’s leading fertility provider can bring. Fertility Associates is doctor-led and is a wholly New Zealand-owned business. The principals of the Christchurch practice, including Dr Greg Phillipson, the Medical Director of the Christchurch clinic, approached Fertility Associates as a
Above: Dr VP Singh, Dr Andrew Murray and Dr Mary Birdsall Medical Directors of Fertility for Associates for Hamilton, Wellington and Auckland
With you every step of the way
Whether you are planning to start a family or are trying to conceive, we can help you. As New Zealand’s leading provider of fertility diagnosis, support and treatment, Fertility Associates understand each step towards starting your new family. We offer both public and privately funded consultations, with treatments that start from as low as $295. Take the first small step today by calling 0800 10 28 28 or visit www.fertilityassociates.co.nz
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When parents of Generation X, the so-called “Baby Boomers”, started having children in the late 1960’s to early 70’s, the average fertility rate was around three children per couple, and the average age of mothers was 24. Now Gen X is having the kids and the fertility rate is less than two children per couple with the average age of mothers between 30 and 35.
www.awarenesstoday.co.nz Autumn 2012 | 13
Naturally refreshing A project which began in a Wakefield man’s kitchen with a few buckets and some fruit has evolved into a thirstquenching phenomenon which has the likes of Al Brown and Simon Gault singing its praises. For lemonade brewer Pete Blommaert the quest started while going about his usual business one day. It popped into his head that his new project would be making homemade lemonade. True to his philosophy, and many of those around the world today, Pete wanted to make his lemonade from the best local products and as healthily and naturally as possible. He called the company Pete’s Natural to reflect this. So it was his experimentation began. Pete’s partner and sales and marketing manager Marlene Suy says the first part of the process proved to be a “little hectic” at times. “There would be buckets all over the kitchen and garage. Whenever someone came to visit they would get a sample to try.” It was a completely new venture. The couple are bakers by trade, with more than 21 years of owning bakeries around the world. “We just did it [lemonade production] on the side, but after a year we had to make the decision to either go on with the bakery, or put all our efforts into the lemonade.” The lemonade was the winner and it has worked out well with the couple now doubling their sales in the past year. “At the start we were bottling 3000 bottles at a time. Now we make bigger batches and bottle 15,000 or 30,000 at a time,” Marlene says. After getting the lemonade perfected, Pete then developed two further flavours, Pete’s Natural Currant Crush and Orange Berry Fusion.
The drinks are still made from their property at Wakefield, however, there have been some changes. It is no longer made in the kitchen and the domestic lemon squeezer, on which they would laboriously squeeze up to 80kg of fruit a day, has now been replaced with an automatic fruit squeezer imported from Italy. The business has expanded so much, they are now looking for investors to take it even further.
Only the finest products The fruit is sourced only from New Zealand. Lemons come locally from Upper Moutere or Golden Bay, blackcurrants are from Tapawera (right from Pete and Marlene's back yard) and oranges are picked from the orchards of Gisborne. All the fruits are spray free. There are no artificial flavours, concentrates, chemicals, reconstituted juices, preservatives or colours; in fact the lemonade is made from water, freshly squeezed lemon juice, Fair Trade organic sugar, vinegar and natural flavours. It is this mixture of natural ingredients combined with the authentic homemade
process which Marlene believes makes the drinks not only taste good but also provides added benefits.
also served in some of New Zealand's best restaurants; The Depot in Auckland, Fleur's in Moeraki and Riverstone Kitchen near Oamaru.
From the kitchen to the market
Who’s drinking it?
The product was first introduced at markets and festivals around the countryside. For the couple the best advertisement is getting people to drink it. “Once they have tasted, they buy it,” Marlene says. Up untill now they have still used this philosophy in marketing the product to shops and cafes, with frequent trips around New Zealand, cold-calling on prospective customers who they hope will select their product to put on their shelves or menus. However, they have now found a prospective distributor for the South Island and Hamilton and are looking to find another two to tout their products elsewhere in the North Island. Pete’s Natural drinks are now available at selected bakeries, cafes, New World, Four Square and Fresh Choice supermarkets and Pete and Marlene will continue to visit markets and festivals. The lemonade is
She reported her nausea immediately subsided and there was no nasty aftertaste. “That was amazing for us, we were really quiet that day. We just really were blown away with what had happened,” Marlene says.
Recipe Pete’s Natural Lemonade Large glass
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Chef Simon Gault confesses to loving the lemonade; “if only all Kiwi inspiration was as good. Clearly you shot for the moon and landed amongst the stars." But it is the praise of one very special customer which perhaps holds the most satisfying reward for the couple. A woman receiving chemotherapy wrote to them with her thanks after drinking the lemonade after her treatment.
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Pete’s Natural lemonade has received some high praise from perhaps some of New Zealand’s sternest taste buds. Celebrity chef Al Brown describes the lemonade as “delicious, refreshing and honest” and says it is a mainstay in his fridge, adding it is often used for cocktails.
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14 | Autumn 2012 www.awarenesstoday.co.nz
Loads of ice Chopped mint Lime Slices Fill glass with ice. Add chopped mint and a couple of lime slices. Pour over Pete’s Natural Lemonade and leave for a few minutes to let the mint and lime infuse – a refreshing thirstquencher for any time of the year. www.peteslemonade.co.nz
4 Simple ways
By Fleur Hupston
to improve your health
A new year is viewed by millions as a time for new resolutions, new schedules and a clean start. These resolutions are often made impulsively, with little thought given to long-term goals, which means they are usually short-lived. Examining a few health facts and implementing some simple lifestyle changes each day will make a difference to overall health.
Meditation minimises disease Meditation is a phenomenal way to instantly take control of your health. Studies indicate that a mere 20 minutes of quiet time a day can halve one's risk of heart attack or stroke by reducing high blood pressure and cholesterol. In countries such as India and China, meditation has been used for centuries as a way to lower stress levels and improve concentration. Scientists have found that transcendental meditation, which promotes deeper relaxation through mantras, is even more beneficial for the mind and body. Tests show that sufferers of atherosclerosis were able to reduce their risk of a fatal heart attack or stroke by 47 percent, compared to those who simply followed a healthy diet and exercise program.
Replace hazardous laundry detergents Certain liquid laundry detergents contain cancer-causing chemicals. Research shows that these harmful cleaning aids contain around 25 volatile compounds, which may make people sick. Fumes from washing machines and dryers release harmful chemicals, such as acetaldehyde, into the atmosphere, which may also find their way into the water supply. Shop for safer, less dangerous detergents which will help your health and the environment too.
Juice your own fruits and vegetables for better health Buying a carton of juice from the store can be hazardous to your health. Just because the label says "100% pure" or "freshly squeezed" does not mean it is true. In processing orange juice, for example, most manufactures remove all the oxygen molecules from the liquid, which allows the juice to be stored for up to a year. As this process strips the juices of their flavors, juice companies then add fragrance and flavor additives to the product. Avoid processed, stored products and take the time to juice your own fruits and vegetables as a great kick-start to better health.
Reduce beer consumption and drink alcohol in moderation Heavy beer drinkers risk liver damage and a bigger beer belly. According to experts who studied the health of more than 500,000 people between the ages of 35 to 70, it was found that those who drank 30g of pure alcohol a day from beer had a massive 75 percent increased risk of developing stomach cancer. Worse still, heavy beer drinkers with a particular gene variant in the cluster of three genes that metabolize alcohol have an even greater chance of getting stomach cancer, according to the American Association for Cancer Research. Ideally, all alcohol should be taken with food, such as a glass of wine with a meal, and spirits should be enjoyed in moderation.
About the author Fleur Hupston is a professional freelance writer. She is passionate about natural, healthy living and is currently studying to be a naturopath. She divides her time between studying, writing and home-schooling her children. Article kindly provided courtesy of NaturalNews.com
www.awarenesstoday.co.nzâ€ƒâ€ƒ Autumn 2012 |15
" The transition of menopause is the beginning of a new phase of life with fewer family obligations, greater freedom and new opportunities.
Do you, or does someone you know suffer from the often debilitating symptoms of menopause? You're not alone. Roughly 70 percent of all women between the ages of 40 and 55 experience menopause symptoms; some are mild, others can be extremely distressing - yet they all have one thing in common; they’re triggered by a progressive drop in hormone levels. Until now many women have struggled to get support and advice on what this change in life means and how to deal with it. The NZ Menopause Support forum allows you to seek support and advice not only from other members, but also from New Zealand based Menopause experts. If this sounds like it might be helpful, simply visit www.menopause.org.nz to find out more. It has been estimated that by the year 2015, nearly 50 percent of women in the United States will be menopausal. It’s not a strange affliction, a nasty disease or a freaky condition. It is a natural and necessary change in every woman’s life. The transition of menopause is the beginning of a new phase of life with fewer family obligations, greater freedom and new opportunities. The term menopause specifically refers to the one year since a woman’s last menstrual period, with or without symptoms. The average age is 51, but changes can begin to occur as early as 40 years of age. During perimenopause, erratic hormone levels may cause irregular cycles and hot flashes and other symptoms, the pattern and intensity of which can vary greatly. Other menopause symptoms include skin changes, vaginal dryness, fatigue, decreased
libido, mood swings and sleep disturbance, most occur within the first four years and improve over time. There are some things women can do naturally which can help manage symptoms and prevent conditions associated with menopause. Homeopathy, nutritional support, exercise, acupuncture, mediation practices, herbal medicine, natural hormones and other therapies can help stabilise, support and nourish the body during a time of change.
Natural treatment Victoria University lecturer professor Shaun Holt has been the principal investigator in more than 50 clinical trials and appeared in more than 80 medical literature publications. An honorary research fellow at the Medical Research Institute of New Zealand, an advisor to the Asthma Foundation and Natural Products NZ, Holt has also written five books including the bestseller ‘Natural Remedies That Really Work’. “I try not to focus on whether something's a pharmaceutical drug or natural,” Holt says, adding that many pharmaceuticals derive from natural medicines or contain natural properties. “So, it’s not such a massive distinction. People do think natural means safer and better, or they want to manage a condition themselves – so there are reasons people want to try them.” For many conditions, including menopause, there are effective natural remedies to fight the symptoms, Holt says. For menopause, he says, the main one is black cohosh.
16 | Autumn 2012 www.awarenesstoday.co.nz
Black cohosh is a herb with powerful action when used as a relaxant and a normaliser of the female reproductive system. A natural supplier of oestrogen, it may be used to combat painful or delayed menstruation and ovarian cramps.
Other natural medicines can also be successfully used to counteract other symptoms of menopause, such as St Johns Wort for depression.
With all the books and internet information on natural therapies, some women choose “It’s a perennial plant which has been used for to self prescribe supplements. A woman many years for women’s hormonal problems; that solely relies on self-treatment may be managing symptoms such as hot flushes and PMT and menopause, conditions where mood swings, but not addressing long-term hormones are all over the place.” health concerns and will miss having her Another natural product proven to relieve health monitored over time. hot flushes, although not to the same level Additionally, certain symptoms associated is vitamin E and Holt says the recommended with menopause may actually be signs of dose is 400 IU (international unit). another illness such as thyroid disease or The plant product, maca, is also strongly clinical depression. Make sure you see your recommended. “This works well for hot GP initially for diagnosis. flushes, night sweats and heart palpitations. “It’s a non-HRT (hormone replacement therapy) way to reduce symptoms and can be taken in a capsule or tablet.”
A place in the sun Santorini Fantastic, fabulous, unforgettable Santorini deserves all the superlatives it gets. Every traveller succumbs to the beauty of this surreal, postcard landscape. Santorini is a relic of what was probably the biggest volcanic eruption in recorded history. If you want to experience the full dramatic impact of Santorini, it’s worth arriving by a slower ferry with open decks, rather than by enclosed catamaran or hydrofoil. Santorini is famous for its spectacular sunsets. The village of Oia, on the northern tip of the island, is a hugely popular sunset viewing site because there is an uninterrupted view of the sun as it finally sinks below the horizon. Further south the last of the setting sun can be obscured by the islands of Nea Kameni and Thirasia. Santorini has a wide variety of accommodation to choose from. Many are nestled and built in high among the cliff tops. Spiliotica Villas offers stunning views down over the ocean. Check out: www.avatonresort.com or www.anastasisapartments.com
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This package includes one night in a luxury tree house, a bottle of wine on arrival, dinner and breakfast. Whether you are looking for relaxation, nature, excitement, art, history and culture, or fine wines and cuisine, Kaikoura offers it all. For more information visit: www.hapukulodge.com
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Bushman gels are highly concentrated, just apply a thin layer to all exposed skin.
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www.awarenesstoday.co.nz Autumn 2012 | 17
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z z z Nuisance or Serious Health Problem? zz z z z z z z DO YOU:
• Snore? • Wake feeling unrefreshed? • Struggle to stay awake during the day? • Wake with a dry mouth? • Wake sweating? • Wake with a bad taste in your mouth? • Wake with headaches? • Regularly wake to use the bathroom? • Wake gasping for air? DO YOU ALSO HAVE: • High Blood Pressure? • Type 2 Diabetes? • Heart Failure? • Asthma/COPD? If the answer is yes to any of these questions then you could have a sleep problem that may impact on your health. Although humans can spend one third of their lives sleeping, we do not tend to consider the impact of sleep disorders on our overall general health and wellbeing, yet tiredness and poor sleep is a common complaint heard in general practice. It is now a well-researched fact that poor sleep costs the economy hundreds of millions of dollars a year, through lost productivity, associated health costs, work based and motor vehicle accidents. There are around 70 diagnosable sleep disorders, but the most common one by far is snoring. Without a doubt we all know someone who snores. We treat it as an embarrassment or the butt of jokes, but unfortunately snoring can be far from amusing for sufferers or bed partners. Jez Morris of Edensleep New Zealand states that probably the most common reason for someone to attend or contact his clinic is their bed partner. “The actual snorer has little insight into the severity of their snoring as they are fast asleep. As well as this they may be embarrassed by the noise, especially if they are single or travel with friends or colleagues.” The snorer may also report they suffer from increasing sleepiness during the day as a result of poor-quality sleep. They wake unrefreshed despite long periods of sleep, short term memory can be poor along with poor concentration, they have a tendency to
be short tempered or irritable with possible symptoms of depression.
Sleepiness is also likely to increase the likelihood of work based and motor vehicle accidents, as a result of slowed reaction times and increased risk taking. Other annoying symptoms include the increased need to go to the toilet at night; indigestion or reflux at night, depression as a result of fatigue, reduced libido and a dull headache in the morning. When assessing a patient it is important to also consider two other main areas in the patient’s relationship - the bed partner who is affected and also the medical team or GP responsible for the snorer’s long term health. Whilst snoring can impact on the ability of the bed partner to sleep (and often other household members), it can also significantly affect the quality of their sleep. Snoring can be extremely loud with quite a number of partners comparing it to a jet taking off; which is not a bad comparison as noise levels can reach up to 90db! The impact of this on a relationship can be significant with bed partners often moving to another room. It is not only the noise that concerns the partner, but also the long pauses that can accompany severe snoring (Sleep Apnoea), or the tiredness that results in the sufferer falling asleep frequently, impacting on personal and family relationships. “It used to be that Sleep Apnoea was the main thing we looked for, but with emerging scientific evidence we encompass all sleep breathing issues; from snoring to Obstructive Sleep Apnoea under the one umbrella of Sleep Disordered Breathing (SDB).” It is now a well-recognised fact that SDB is associated with significant medical complications. It is for this reason that clinics such as Edensleep New Zealand are seeing increasing referrals from primary care providers such as General Practitioners. Sleep Disordered Breathing used to require overnight stays in hospital-based sleep laboratories where leads are placed literally all over the patient; up to 20 head electrodes, electrodes on the eyes, jaw and legs as well as bands around the chest, abdomen and probes on the finger. Patients are then instructed to fall asleep, while being watched on camera; not exactly “homely” conditions! Edensleep New Zealand specialises in homebased sleep studies which quite often do not require clinic attendance. Advanced diagnostic equipment can be programmed and couriered to individuals to use at home; questionnaires are used to look at aspects of the patient's sleep health. This process is rapid and can quickly identify patients at risk. Sleep Disordered Breathing has a number of significant relationships with other medical conditions.
18 | Autumn 2012 www.awarenesstoday.co.nz
A better sleep
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Snoring can be extremely loud with quite a number of partners comparing it to jet taking off; which is not a bad comparison as noise levels can reach up to 90dB!
HIGH BLOOD PRESSURE (Hypertension) The most common physiological impact of Sleep Disordered Breathing is on blood pressure. The lack of airflow during an apnoea causes a “collapse” of the upper airway, in much the same way as a wet paper straw collapses. This collapse occurs on breathing in. Patients then make repeated attempts to breathe in against the blocked airway. This may cause, among other things, oxygen levels to fall and the patient's sleep is momentarily “lightened” to restore normal breathing. This can cause a surge in blood pressure to levels as high as 240/140 mmHg (normal being around 120/80). These surges
can occur frequently during the night resulting in high daytime blood pressure requiring medication. If Sleep Disordered Breathing is involved, but not addressed in patients on blood pressure medication, it can often lead to patients requiring higher and higher doses to manage their blood pressure.
TYPE 2 DIABETES Recent research identifies a significant relationship between type 2 diabetes and Obstructive Sleep Apnoea (OSA), the most common form of Sleep Disordered Breathing. It is estimated that up to 50 percent of people with type 2 diabetes will have OSA. There is compelling evidence that OSA is a significant risk factor for cardiovascular disease and
A better sleep
HEART FAILURE Developing as a result of coronary heart disease, heart failure (HF) can also result from hypertension cardiomyopathy, rheumatic heart disease and other cardiac diseases. Mortality rates are high within HF patients. Studies have shown that in Sleep Disordered Breathing can increase the risk of heart problems in men 40-70 years old by as much as 68 percent. The incidence of Sleep Disordered Breathing in systolic heart failure has been studied repeatedly and these studies suggest that the incidence of Sleep Disordered Breathing in patients with heart failure is between 40 to 80 percent, which is a significantly higher incidence than the general population. Given the serious consequences of untreated sleepdisordered breathing in heart failure patients, there is sound justification to screen for sleep apnoea in all patients diagnosed with heart failure. Subsequent treatment of those patients with sleep apnoea can significantly improve their quality of life, reduce hospital admissions and can decrease their mortality.
Treatment options include:
Mandibular Advancement Splint (MAS)
The only “guaranteed” way of treating Sleep Disordered Breathing (especially in patients with other medical problems) and where there is severe OSA, or other related breathing issues, is with Continuous Positive Airway Pressure. CPAP involves wearing a mask over the nose and/or mouth. This allows a constant gentle positive pressure of air to keep the throat open.
This device fits over both upper and lower teeth and holds the lower jaw and therefore the tongue, forward. This increases the area at the back of the throat decreasing pressure of breathing, and in some cases eliminating snoring.
Suppliers of CPAP therapy such as ResMed have also developed equipment to manage more complex Sleep Breathing Disorders associated with diabetes and heart failure.
Above: A Mandibular Advancement Splint (MAS)
ProVent Therapy This new product uses little plaster-like devices that cover the nostrils. In the plasters are small holes that increase the pressure of air in the upper nose, splinting open the breathing passages. New plasters are used every night and cost around the price of a cup of coffee. Both methods may prevent snoring and control mild to moderate Sleep Disordered Breathing
Fortunately, treatments for both snoring and Sleep Disordered Breathing are easily available once a diagnostic test has been carried out. Lifestyle changes can assist in managing simple snoring. Weight loss is the first and most obvious place to start, although this can be extremely difficult if the snorer is significantly tired due to poor sleep quality. Not only does this reduce the motivation to exercise, but there is also an increased desire to eat high-calorie foods. Surgery in adults can help, most commonly if the snorer has enlarged tonsils, or a severely blocked nose. Reducing alcohol intake prior to bed will also assist.
Before treatments can be properly assessed, an overnight sleep test and examination are necessary. Effective and appropriate treatment can be extremely rewarding for both the snorer, and bed partner, in terms of improved quality of sleep resulting in cognitive, physical and emotional benefits. Long term health can also be supported with effective therapy.
mortality. There is ever mounting research that suggests that OSA is also independently associated with alterations in glucose metabolism and places patients with OSA at an increased risk of the development of type 2 diabetes.
Fortunately, treatments for both snoring and Sleep Disordered
Breathing are easily available once a diagnostic test has been carried out.
" Above: ProVent Therapy
Below: CPAP Therapy
www.awarenesstoday.co.nz Autumn 2012 | 19
• Fibre helps your digestive system to process food and absorb nutrients • Fibre can help to lower blood cholesterol • Fibre makes you feel fuller and so helps to control your appetite.
We all need fibre in our diet and we all know it's good for us. But how do we get enough fibre to keep us healthy and how much do we really need?
Here are some easy ways to increase the fibre content of your breakfast without changing it completely. Just a few additions and adjustments can increase the fibre content dramatically.
There are two types of fibre: insoluble and soluble. The fact that much fibre passes through us from top to bottom is the basis of one of its important functions - this fibre is known as insoluble, acting like a human bottlebrush, picking up waste along the way.
• Start by making sure you have breakfast – it's a good meal for fibre-rich foods
Its accomplice, soluble fibre, soaks up water, making waste material larger, softer and easier to move through the system.
• Add fresh fruit; whatever is in season
To work at their best, soluble and insoluble fibre need water, in any form – tea, coffee, juice or water-containing foods, as well as water itself.
in your diet
Fibre-rich tips for breakfast
Fibre used to be defined as the plant material that passed through the body undigested. While this is still largely true, it does fibre a bit of a disservice, implying it is inert and possibly unimportant.
The latest dietary recommendations in New Zealand and Australia suggest women should be eating 25g of fibre a day, men 30g, and even higher to reduce long-term illnesses such as heart disease and some cancers. On average, New Zealand women consume 18g a day, men 23g, falling below our recommendations.
Fibre is a vital component of a healthy balanced diet. We get fibre from plant-based foods, but it's not something the body can absorb. This means fibre is not a nutrient and contains no calories or vitamins.
But what do these recommendations mean in terms of food? Are we faced with eating loaves of wholemeal bread, or will just an apple a day suffice? Rest assured there are plenty of high-fibre foods to choose from.
• Top breakfast cereals or porridge with stewed fruit or fruit compote
• Mix high- and low-fibre cereals together if you find a high-fibre one too much first thing in the morning • Try one of the high-fibre white breads if you don't enjoy wholemeal • Add peanut butter as a high fibre spread; marmalade and jam contain very little fibre, despite the peel and pips • Try a bran muffin instead of a chocolate one • If you avoid gluten or wheat, fruit salad is a great high-fibre way to start the day.
All women experience the menopause and it needn’t be distressing. If flushes, sweats and sleep disturbances are bothering you ask your doctor if Utrogestan, natural micronised progesterone, is right for you. It could be part of the solution for you.
Utrogestan: Progesterone capsules 100mg; is a PRESCRIPTION MEDICINE. Use strictly as directed. If symptoms continue or you have side effects see your doctor, pharmacist or healthcare professional. What Utrogestan is used for: It contains a hormone called progesterone and is to be used with another medicine called oestrogen. The combination of Utrogestan and oestrogen belongs to a group of medicines called hormone replacement therapy (HRT). Utrogestan is used to reduce the symptoms of the menopause (change of life). It is used only in women who still have a womb (uterus). It is not a contraceptive. Do not take Utrogestan if you: are allergic (hypersensitive) to peanuts or soya. Utrogestan contains peanut oil (arachis oil) and soya lecithin; are allergic (hypersensitive) to progesterone or any of the other ingredients of Utrogestan; have severe liver disease; have ever had breast cancer; have porphyria (an illness which makes your urine and skin an unusual colour); have unexpected and unexplained bleeding from your vagina (and it is not due to your normal monthly period). have ever had cancer of your sex organs; have had blood clots, bleeding of the brain, or a stroke. A small increased risk of breast cancer may be associated with HRT use. Check with your doctor or pharmacist before taking this medicine if you have: high blood pressure or heart problems; kidney or liver problems; epilepsy, diabetes, migraine or asthma; ever had depression; skin that is sensitive to light (photo-sensitivity). Do not take Utrogestan with food. Pregnancy and breast-feeding: Do not take Utrogestan if you are pregnant or might become pregnant. Talk to your doctor before taking this medicine if you are breast-feeding. Possible side effects: Like all medicines, Utrogestan can cause side effects, although not everybody gets them. Stop taking and see your doctor if you begin
to experience: Headaches; Problems with your eyes; Yellowing of the skin or the whites of your eyes (jaundice); Painful swelling in your leg, sudden chest pain or difculty breathing. See a doctor if you notice: Blood clots in the veins of your legs or pelvis; Changes in your breast such as dimpling of the skin, changes in the nipples, any lumps. Other side effects: Feeling tired or dizzy; Difculty sleeping; High temperature; Depression; Feeling sick or having an upset or bloated stomach; Changes to your menstrual ow or bleeding at times other than the withdrawal bleed; Pre-menstrual symptoms such as irritability, backache or lower stomach pain; Changes to your breasts. They may become tender; Changes in secretions from your genitals; Changes in your libido; Changes to your weight or swollen ankles; Loss of hair or an increase in hair growth; Rash or other changes in your skin such as acne. Further information: For further information please contact your doctor or health professional or access the full consumer medicine information at www.medsafe.govt.nz. Pharmaco (NZ) Ltd, PO Box 4079, Auckland. This medicine is not subsidised so a charge to cover the full medicine cost and a usual doctorís visit fee will apply. January 2011
20 | Autumn 2012 www.awarenesstoday.co.nz
TAPS NA 5269
Cold sores | Sleep
Coping with COLD SORES Cold sores are small, painful, fluid-filled blisters or sores that appear on the lips, mouth, or nose that are caused by a virus. These viral sores can be painful and usually last a few days. Unlike most viral infections, the cold sore is not completely eliminated by the body's defenses. For this reason, cold sores often recur. They can be very embarrassing for some people and this fear of embarrassment can lead some to avoid social situations. Many people are not aware fever blisters and cold sores both refer to the same thing, an infection on the lips caused by the human herpes simplex virus, usually type 1 (HSV-1). In lay-men's terms ‘oral herpes’. A cold sore typically begins as an itch, tingle, or tenderness to the touch, before it grows into a full skin eruption. As the disease progresses, small fluid filled vesicles form and join together. These eventually break due to the disease progression and form ulcers. The ulcers then scab over and heal on their own in seven to 14 days. Cold sores/fever blisters usually occur on the lips, with some people getting multiple sores at a time. Some people may get them under the nose and in surrounding areas. Less frequently other parts of the body (arm, finger, leg, and eye) can also become infected.
Symptoms and signs Some patients have a "prodrome," which is when certain symptoms occur before the actual sores appear. The prodrome to herpes infections typically involves a burning or tingling sensation that precedes the appearance of blisters by a few hours or a day or two. As mentioned, the area may become reddened and develop small fluid-filled blisters. Several of these small blisters may even come together and form one large blister. Cold sores are mildly painful. When cold sores recur, the blister stage is usually short. Blisters dry up rapidly and leave scabs that last anywhere from a day to several days, depending on the severity of the infection
The causes The virus that causes cold sores is known as the herpes simplex virus (HSV). There are two types of HSV, type one and type two. Cold sores are usually caused by type one. Another term for cold sores is the dreaded word – herpes virus. The virus is spread from person to person by kissing or other close contact with sores, or even from contact with apparently "normal" skin that is shedding the virus. Infected saliva is also a means of spreading the virus.
The most contagious period is when a person has active blisters or sores. However, a person infected with the virus can pass it on to another person even when a cold sore is not present. This is because the virus is sometimes shed in saliva even when sores are not present.
If the attack is severe, a doctor should be contacted. The doctor may prescribe medications that can shorten the attack. These medications are most effective if taken early in the attack. Difficulty in eating and drinking may lead to dehydration, which may also require medical attention.
After the first infection, the virus enters the nerve cells and travels up the nerve until it comes to a place called a ganglion, which is a collection of nerve cells. There, it resides quietly in a stage that is called a "dormant" or "latent" period. In more active stages, the virus starts multiplying again and travels down the nerve to the skin, causing blisters on the lips known as cold sores.
A few people may have cold sores that come so frequently a doctor will prescribe a daily medication to reduce the number of attacks. It is not possible to predict for how long the treatment should continue because the virus continues to live in the ganglion. Thus, stopping suppressive treatment is largely a trial and error procedure.
It is not always possible to prevent an outbreak of cold sores. In people who have attacks triggered by sunburn, using sunscreen or avoiding heavy sun exposure may reduce the number of attacks.
The very first time someone gets a cold sore the symptoms can be severe. In some people, the first attack of herpes is associated with fever, swollen glands, bleeding gums, and many painful sore(s) around the mouth and nose. These signs and symptoms may last several days. The sores heal completely in two to six weeks, usually without scarring. The virus can be recovered from the saliva for days after the lesions heal. Because many people acquire the virus early in life, primary herpes usually happens during childhood.
Cold sore prevention
Taking daily prescription antiviral medications can significantly reduce the frequency of cold sores. However, the vast majority of people do not have enough attacks to justify taking a daily medicine.
healthy night’s sleep for a better sleep solution, the top of the line “Gold Label” and original “Woolrest” Biomag products feature natural wool as the sleep surface. Wool is scientifically proven to improve quality of REM sleep (Monash University), its breathable fibres, acts as a natural thermostat, pulling moisture away from your body to keep you warm in winter and cool in summer. Naturally renewable and sustainable, wool is also naturally hypoallergenic and resistant to dust mites… wool might just be the perfect sleep surface! Knowing how crucial sleep is to getting the most out of our modern lifestyles, the Woolrest Biomag brings the best global advances in technology to New Zealand. In mid 2011 Biomag launched the SAT bed in New Zealand. SAT bed with self adjusting technology addresses the three scientifically proven necessities of a great night’s sleep:
There are so many reasons why sleep is important. Sleep might just be the best thing you can do for yourself. Sleep allows your body to restore and repair itself by promoting a reduction in inflammation. Better sleep leads to improved mental dexterity and memory, as well as improving heart health, restoring the immune system and reducing
stress. A great night’s sleep can even aid weight loss. The Woolrest brand has been around for more than 35 years and is a market leader in woollen underlays. Fifteen years ago the first Biomag was produced and Woolrest Biomag was born. Developed in the search
sleep surface (just like the Woolrest Biomag) and you have a revolutionary bed design guaranteed to give a better night’s sleep. Unlike spring mattresses, the SAT bed doesn’t push up against your body, it conforms to your shape and provides near perfect support. Woolrest Biomag pride themselves on the New Zealand made quality of its products, and the assurance of no risk 60 day money back guarantee. If you’re not satisfied with a Woolrest Biomag within 60 days, send it back! Whether it’s a Woolrest Biomag, the top of the line luxurious Gold Label Biomag or the next generation SAT bed, you can be assured of a great night’s sleep. With our busy modern lifestyles demanding more and more of our time, it’s increasingly important that we get such a sleep. To make the most of your life, Biomag and SAT Bed are the answer!
1. Pressure point elimination
For more information visit:
2. Spinal alignment
3. Temperature control Utilising a unique patented foam chamber system, the SAT bed evenly distributes body pressure. The secret of the SAT bed is its core of foam cells which uses displacement to provide you with the most comfortable sleep surface possible. Top that off with a pure wool www.awarenesstoday.co.nz Autumn 2012 | 21
Attention pet lovers did you know?
What you feed your cat or dog directly affects how long they live and the quality of their life. Not all foods are created equal. There is only one way to establish what you’re really feeding your pet...read the ingredients! If you would like to discuss anything we’ve mentioned or would like to get sent some info and testimonials please give us a call, or go to our website to see the dozens of raving testimonials available. In fact a large number of clients are breeders, which is testament in itself, as these people take feeding their pets (their business), very seriously. These people normally spend a lot of time researching all options available and we’re pleased to say, they’re massive fans of our product.
In today’s competitive pet food industry, it’s hard to believe what may go into your pet food. Many companies (owned by multi-national corporations) have extensive marketing budgets, that portray a healthy pet jumping around, all thanks to their fantastic pet food. However, they seldom talk about ingredients. And to be frank, that is the most important element, followed closely by taste. Because let’s face it, if your pet doesn’t like the taste, they simply won’t eat it. (Unless it’s a Labrador....) Here’s the most important bit. The ingredients I’m not going to tell you how happy your pet will be or how high they will jump by using our pet food. I’m simply going to give you a quick lesson about ingredients and what to look for and what to avoid. The way ingredients are listed on packaging is the order that they are according to the percentage of food, so the first ingredient listed is the primary ingredient and so on down the list. Some list “by-products” as the first ingredient, usually chicken or beef. Now this doesn’t have to be a bad thing. One of the many problems with byproducts is what can go into the mix. So for cows this can mean bones, hooves, hides, hair, intestines, or with poultry by-products it can mean feet, beaks, feathers, bones, intestines, as well as the small trimmings that are left behind after they have been boned out for human consumption.
is that your animal’s stools will smell a lot better when they are fed a high quality, natural, highly digestible food that doesn’t have rancid meats and fats in it. Canidae lists chicken and turkey meal as their first ingredients. Chicken, turkey and lamb meals are dry and are less than 10% moisture and contain 50-65% meat proteins.
By law, by-products don’t have to include any meat at all in order to be called chicken or beef by-products.
Products with by-products will of course look like any other pet food biscuit. The organic chemicals that make up the mush that remains will still register as amino acids and proteins etc, yet the fact is that a large percentage of it will be completely indigestible to your pet’s digestive system. This means your pet will be unable to harvest goodness for its body out of much of its food. This results in two things. First, you will have to feed more of the product to your pet to satisfy its nutritional requirements. Second, there will be more “unharvested remains” left to be picked up off your lawns. One of the huge benefits of feeding your pet a food that uses high quality ingredients is that there is less stool volume, because the animal is able to digest more of it. Another notable benefit
Here are results from three independent studies: 1) The Confidential Dog Food Report analysed over 2,000 pet foods and came up with the best nine. Canidae was one of them. The following dog foods available in New Zealand weren’t on the list; Beneful, Eukanuba, Iams, Pedigree, Purina One, Purina Pro Plan, Purina Dog Chow and Science Diet. 2) Each year The Whole Dog Journal (arguably the best dog journal in the world), rates dog foods from around the world and creates an “approved list” which includes approximately 25 foods. For more than 5 years Canidae has featured. The following
Canidae and Felidae contain 10 skin and coat conditioners with balanced Omega 6 and Omega 3 fatty Acids: chicken fat, fish meal, flax seed, sunflower oil, lecithin, linoleic acid, rosemary, sage, vitamin E and biotin. Please go to our website or give us a call for the full Declaration of Ingredients. Without a declaration of ingredients, how do you really know what’s going into your pet’s food? Why haven’t you heard of us? Simply because we’re relatively new into New Zealand. We have hundreds of satisfied clients and this year we’ve doubled the number of clients from last year and this is literally growing daily. However, Canidae for dogs and Felidae for cats have been selling in America for many years and are consistently ranked in the top few by leading pet journals and publications including The Whole Dog Journal. We also don’t have the marketing budget of the huge corporations. In fact we have relied heavily on word of mouth, which works well, but we are now starting to do print and radio.
dog foods available in New Zealand aren’t on the list; Beneful, Eukanuba, Iams, Pedigree, Purina One, Purina Pro Plan, Purina Dog Chow and Science Diet. 3) Petsumer Report also does an independent study and ranks pet food out of five, with five being the absolute best. Here’s some of the results: Beneful 0 CANIDAE 4.2 Eukanuba 2.7 Iams 2.7 Pedigree 1 Purina One 1.9 Purina Pro Plan 2.1 Purina Dog Chow 1 Science Diet 1.5
Here is a quote that I recently read in The Whole Dog Journal, arguably the best independent dog journal in the world. “I’d like to quickly dismiss the idea that any of the giants – Iams and Eukanuba, Purina, Science Diet - could possibly make dry dog foods that are as good as the foods that have a regular presence on WDJ’s “approved foods” list, (such as Canidae). The fact is, though, of course they could; they have all the resources needed to do so. They could bury most of the competition in the “natural and holistic” niche...if they followed through and used only the same high-quality ingredients typically used by the smaller, boutique brands. But they generally stop short – perhaps because they are unaccustomed to paying a lot for their raw materials, or marketing the products at a correspondingly high sales price.” - Nancy Kerns Save you time and money As mentioned this is a premium product, and if we sold in pet stores or vets, it would command a huge price tag. However, as we don’t have a “middle man” we can sell it at a price comparable to other “premium” products. In addition to this, your pet will actually require less, as he/she will actually be able to digest and utilise more of the food, which also creates less stools. In addition to this we will take the hassle out of driving to your pet store, lugging the food into and out of your boot, as we will deliver to your door free of charge. Your satisfaction is assured every time you deal with us through our Make You Happy Guarantee If we ever let you down, we’ll ask “what can we do to make you happy?” So far we’ve never refused a customer’s request. And of course there’s a full money back guarantee on the product if your pet doesn’t like it.
Gary Collins, Owner
Call for a FREE sample and more information or call now to place an order. If you place an order this month WE’LL TAKE 33% OFF YOUR FIRST ORDER when you mention this advert. You’re probably wondering what’s the catch? Well we know that almost everyone who buys from us once, buys again, and again, and again!
Ph: 0800 101 729 www.canidae.co.nz
Health | Migraines
Managing migraines Chopin, Charles Darwin, Freud, Tolstoy, Van Gogh, Elvis – some of the greatest achievers of all time had one thing in common - they were ‘migraineurs’. Migraine as a medical condition has existed for a long time. In fact its history can be traced back to 3000BC in Mesopotamia when it was described by a Turkish physician in the first century AD. Throughout medieval times, various descriptions seemed to fit the symptoms we now know as migraine. Yet despite its long history the condition of migraine is still misunderstood. Often considered as “just a headache,” and migrainuers still labelled neurotic. Migraines affect almost 20 percent of women and eight percent of men. It has a major impact on many people's lives, both at work and at home. Migraines with ‘aura’ is when a sufferer experiences one or a combination of the following: Flashing lights, jagged outlines, blind spots, numbness or tingling in the arm or the side of the face and difficulty focusing. It may also include loss of speech, feelings of weakness or confusion. Sufferers usually experience a combination of these symptoms. The pain is usually on one side of the head, pulsating and severe, with attacks lasting 4-72 hours. It can be made worse by normal physical activity and often the sufferer experiences nausea and vomiting. Many cannot tolerate strong light, noise, or movement. Migraines without ‘Aura’ do not have the same warning signs before an attack. However, it will usually include the symptoms of headache severity over a length of time, nausea and vomiting. Migraines without aura account for about 80 percent of migraine attacks. Many types of migraine have been identified, although these two are the most common. After the migraine has gone most people feel washed out for a day or so, with tired aching muscles. Others may feel relaxed and happy.
People who suffer from migraines spend time trying to find the underlying cause. They want to understand what is triggering the migraine and go to great lengths trying various dietary changes and pursuing multiple complementary and alternative approaches, often before discussing it in any great detail with their general practitioner. Dietary changes are rarely helpful, with only an occasional patient having their migraines triggered by a single factor. It can still be worthwhile to trial a period of a few weeks Stopping ovulation using a combined oral without coffee in patients with a regular contraceptive pill, depo provera or cerazette, high intake. can be an effective means of controlling the Interestingly, a strong cup of coffee or a glass migraines in the some cases, depending on of cola beverage can abort a headache in the suitability of the form of contraception its early stages. It is more likely that patients for the individual patient. A combined oral crave chocolate or other foods in the 24 to contraceptive is not considered safe in 48 hours prior to the period known as the women with migraines with aura, due to a prodrome, rather than the headache being small increase in the risk of stroke. triggered by food. Acute treatment alone is preferable if the The current medical explanation is people treatment is reasonably effective. If not, have inherited a tendency to migraine and preventive treatment may be required. this involves a super sensitivity to many In making this decision it is often very normal stimuli; both internal, like hormonal useful for the patient to keep a detailed changes and external, like noise, light and smell. But this does not often fully satisfy the diary for some weeks to obtain accurate information about the frequency and desire to understand the cause. severity of the migraines. Normal brain imaging may be very reassuring though is not clinically necessary in a patient Simple analgesics should not be used on more than 15 days of the month on an with a straightforward migraine. ongoing basis and triptans or ergots on Menstrual related migraines occur from two no more than 8-10 days a month to avoid days prior to three days after the onset of medication overuse headache. menstruation and are a common occurrence in women with migraines. Interestingly, these All migraine sufferers should seek advice are usually without aura, even in women who from their GP or pharmacist in the first have a history of migraines with aura, and are instance. Patients can have variable responses to different non-steroid anti-inflammatory often the most severe and the most difficult drugs (NSAIDs) and should therefore try to treat. They are generally considered to be due to a drop in oestrogen, but the details of different preparations. how this occurs is unclear.
Preventive treatments rarely stop the migraines completely. Patients need to understand that approximately 50 percent of the time they reduce the migraines by half. The choice of drug is often dictated by the side effect profile and the patient's other conditions. Patients with sleep difficulty, mood issues or other pain problems, may benefit from tricyclic antidepressants. Those with weight issues may wish to avoid sodium valproate and prefer topiramate. Detailed migraine diagnosis and treatment is important. With ongoing co-operation between the GP and the patient, migraine can often be effectively treated.
For more information and support contact Migraine Support (09) 446 6229. This article has been prepared from material from Migraine Support 2008 NZ and Dr Rosamund Hill of Auckland Medical Specialists.
? S E N A R IG M T U O B A D IE WORR 4
TOPAMAX® is a fully funded* medication which helps to prevent migraines before they start, rather than treat them as they begin. Ask your doctor about TOPAMAX and whether it could help to prevent your migraines. TOPAMAX. Ask for it by name. * Standard prescription fees apply. For more information visit www.topamax.co.nz
For more migraine-free days 1-3
TOPAMAX® (topiramate) is a PRESCRIPTION MEDICINE. Fully Funded. No Special Authority. Normal doctors and prescription fees apply. REFERENcES: 1. Silberstein SD et al. Arch Neurol 2004;61:490-495. 2. Brandes JL et al. JAMA 2004;291:965-971. 3. Diener HC et al. J Neurol 2004;251:943-950. 4. The New Zealand Pharmaceutical Schedule. February 2012. TOPAMAX® (topiramate) is a prescription medicine used for the prevention of migraines in adults. It is available as 25mg, 50 mg, 100mg and 200mg tablets, and 15mg and 25mg sprinkle capsules. WHEN NOT TO TAKE TOPAMAX: Do not take TOPAMAX if you have an allergy to it or to any of the ingredients in it. Please refer to the Consumer Medicine Information for a list of ingredients. SIDE EFFEcTS: Side effects associated with the use of TOPAMAX include drowsiness, dizziness, unusual tiredness, irritability, slowing of thought processes, tingling and numbness of hands and feet, weight loss, depression, unusual mood changes and emergence of suicidal thoughts. Serious side effects include kidney stones, pain when passing urine and sudden changes in eyesight such as blurring or loss of vision. PREcAUTIONS: Do not suddenly stop taking TOPAMAX without checking with your doctor. Before you start to take TOPAMAX, you must tell your doctor if you have or have ever had any medical conditions. In particular, tell your doctor if you are pregnant or planning to become pregnant, are breastfeeding or wish to breastfeed, have or have ever had a personality disorder or mental illness, have or have ever had kidney stones, kidney disease or a family history of kidney stones, have or have ever had liver disease or have eye problems. You should also tell your doctor if you are taking any other medicines, including medicines you can buy without a prescription from a pharmacy, supermarket or health food store. Depression and rare thoughts of self harm may be associated with taking TOPAMAX. Drink plenty of water. Do not drive or operate machinery while taking TOPAMAX. Always follow your doctor’s instructions carefully. If symptoms continue or you experience side effects, see your doctor, pharmacist or healthcare professional. For further information, please refer to the Consumer Medicine Information, which can be found on the Ministry of Health website: http://www.medsafe.govt.nz. Alternatively contact your pharmacist or Janssen-Cilag on 0800 800 806. TOPAMAX is a fully funded medicine; normal doctor’s visit fees apply. Use strictly as directed. Consult your doctor if TOPAMAX is right for you. TOPAMAX is the registered trademark of ORTHO-MCNEIL JANSSEN PHARMACEUTICAL for topiramate preparations. Date of preparation: 21 April 2009. Janssen New Zealand, Janssen-Cilag Pty Ltd, 105 Carlton Gore Rd, Newmarket, Auckland 1023. PMA TOP12NOV24-1TR TAPS PP1970 essence JC5785
24 | Autumn 2012 www.awarenesstoday.co.nz
Relax, knowing your bones are taken care of Choose the freedom of a once-yearly osteoporosis treatment One annual Aclasta infusion treats your osteoporosis for an entire year.* And best of all, Aclasta is funded† so ask your doctor if once-yearly Aclasta is right for you, and get on with doing the things you love doing.
For more information about Aclasta talk to your doctor or visit www.aclasta.co.nz *It is important to have an Aclasta infusion each year to ensure you get the maximum treatment benefit. †Aclasta is fully funded for patients who meet specified criteria, although patients who choose once-yearly Aclasta will have to pay for the cost of the infusion. Aclasta® (zoledronic acid 5mg) is a prescription medicine for the treatment and prevention of osteoporosis and the treatment of Paget’s disease of the bone. Aclasta is an infusion and contains 5mg of zoledronic acid. Check with your doctor to see if Aclasta is right for you. Aclasta is fully funded for patients who meet specified criteria. Funding does not include the cost of infusion and normal doctors and prescription charges will apply. Do not use if you are pregnant or breast feeding. Not recommended in patients with kidney impairment or in children and adolescents. Caution while under dental treatment or if dental treatment is planned. Calcium, hydration status and kidney function may be assessed by your doctor before and after you are given Aclasta. Adverse effects are usually mild and transient. Common side effects are flu-like symptoms consisting of fever, fatigue, chills, and bone, joint, and/or muscle pain; anaemia; headache; dizziness, transient low blood calcium; gastrointestinal symptoms, renal impairment, breathing difficulty and lethargy. Very rarely osteonecrosis of the jaw has been reported. If symptoms persist or you have side effects see your doctor. Aclasta is the registered trademark of Novartis AG. Novartis New Zealand Limited, Auckland. For further information check the Consumer Medicine Information [CMI] at www.medsafe.govt.nz. ACL 0711-166-0713 and TAPS PP1183. INSIGHT 4468AW
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12/12/11 4:02 PM
Health | Obesity
Contemplating surgery for morbid obesity? By Robert J Fris
You have probably already searched the internet and there are several questions that you have. You find yourself wondering where to go, which operation, is it worth it, what are the risks? Firstly, obesity surgery (Bariatric surgery) is not a cosmetic procedure. It is reserved for patients who have developed an abnormality in their weight control system, for as yet unknown reasons. The abnormality will allow temporary weight loss, but the system will only allow so much and then forces the body to build the fat stores up to abnormally high levels. Calories are needed to do this, so the brain forces the patient to consume calories, even if they are on a diet. There is no will power in the world that can overcome this, just like we can only hold our breath for a limited time, no matter how strong the will power.
The surgery for weight loss is only done because of poor health, or if someone is at high risk for deteriorating health. It can abolish or dramatically improve many associated illnesses, for instance, a Type 2 diabetic has an excellent chance of stopping all medications and having normal blood sugar levels. With the improvement in health comes an important and underrated improvement in the quality of life. So the golden rule is the benefits must outweigh the risks of surgery, because none of the operations offered are perfect… they all have potential problems.
So without the abnormal drive to eat excessively, patients are able to make good choices.
A surgeon experienced in these procedures will be able to explain any contradictory statements read or heard.
It is important to realise that the operations do not make the patient change their diets… they allow them to do so, but the result is up to them.
However, although there is an emphasis on possible problems, we should not lose sight of the fact that the overwhelming number of patients do well, and wish they had it done years ago.
The three most common procedures undertaken in New Zealand are gastric banding, gastric sleeve resection and gastric bypass. Each have their pros and cons. They all have repeat surgery rates because of possible complications.
Robert J Fris MB ChB FRCS FACS FACP Bariatric Surgeon
All of the operations work and as long as the patient follows the lifestyle changes; the end result will be much the same. There is no best operation. If there was, the whole world would be doing it. The difference lies in how the weight is lost, the risks of each procedure, the side effects they have and the amount of follow-up. An experienced surgeon would discuss all the options fully. The operations all restrict the volume that can be eaten at each meal. But the operations differ from restrictive diets in that they all affect the abnormal body chemistry that morbidly obese patients have. They instantly switch off the obsessive thinking these patents have about food and hunger.
Its not just the surgery... Its the support that counts
Robert J Fris MB ChB FRCS FACS FACP
• Over 2000 weight loss procedures (Gastric Banding, Gastric Sleeve Resection, and Gastric Balloon) since 1998 • The first to use a full multidisciplinary team approach (Surgeon, Bariatrician, Psychologist, Dietician)
• Internationally recognized research • Everyone has a thorough explanation of their problem, why diets haven’t worked, why surgery, which operation, and realistic goals. (Not unrealistic “ideal weights”) GASTRIC SLEEVE RESECTION
For more information, go to www.northridgesurgery.co.nz or www.nzobesitysurgery.co.nz For appointments phone 09 444 3660, or 0800lapsurg if you are out of the Auckland region. GASTRIC BYPASS
26 | Autumn 2012 www.awarenesstoday.co.nz
Health | Dermatology
" Any changes in hormones, be it stopping or changing birth control pills, pregnancy or menopause, can trigger outbreaks.
Keeping it clean
By Ramona Bates MD It is Monday morning and you’re meeting an important new business client for lunch. Now what’s this pimple on your jaw line? One in every five women over age 25 has adult acne. More women than men have adult acne. It may be either acne which never stopped from childhood into adulthood (persistent acne) or first time acne (late-onset acne). Adult acne is caused by pores becoming clogged by sebum, an oily substance produced by the skin’s sebaceous glands. The clogged pores then attract bacteria and become inflamed. There are many triggers for adult acne outbreaks. One is hormonal. Any changes in hormones, be it stopping or changing birth control pills, pregnancy or menopause, can trigger outbreaks. Most of these hormonal shifts are simply normal fluctuations in hormones, not hormonal imbalance. It is important to have a good skin care regimen. What works for teenage skin does not always work with adult skin which is drier in spite of the oil clogged pores.
Treatment Start with a gentle cleanser, like Cetaphil or Aquanil. If you have sensitive skin, avoid products that contain beads or granules whose abrasive nature can irritate sensitive skin. It is important to keep your face clean during the day. Wash your face twice daily with the cleanser using cold or warm water. Hot water is drying. Cold water can help tighten the pores. Use your hands to wash your face or a really soft washcloth. Rough washcloths can irritate the skin. Add a mild chemical exfoliator such as salicylic acid or glycolic acid which are found in many women’s cosmetics and in acne treatments. The salicylic and glycolic acid can also help prevent skin discoloration. Harsh scrubs or repeated microdermabrasion will irritate the skin and make acne worse. Products that contain benzoyl peroxide can be used to spot-treat a breakout. They can help kill bacteria and treat the adult acne. Using an over-the-counter retinol product
can help clean pores and reduce fine wrinkles. Sunscreens are important for skincare for prevention of aging and skin cancer. It is also important for adult acne patients to use a sunscreen meant for the face as some sunscreens can clog pores and cause acne. If a good skin care regimen is not enough, then see your dermatologist. You may be someone who needs a topical antibiotic cream or oral antibiotic. You may also benefit from blue light therapy or laser treatments
This article from Ramona Bates MD was provided courtesy of eMaxHealth and New Zealand Dermatological Society Incorporated. For more information visit www.dermnet.org.nz.
Putting the focus on healthy skin Having healthy skin is not just about appearances. Every human adult has more than 1.5 metres of skin containing nerve endings, hair follicles, sweat glands and blood vessels. It is the largest organ in the human body.
can help patients with skin problems - from acne and insect bites to psoriasis.
Healthy, undamaged skin is a key factor in maintaining good health - it’s not simply about looking good. At all stages of our lives, it is important to protect and value the The Pharmacy Guild of New Zealand (the skin we have. The Focus on Skin handbook Guild) has produced new member pharmacy is a training resource for pharmacy staff. It resources highlighting the importance of includes information about the management healthy skin. The Focus on Skin handbook of common skin conditions that pharmacy and posters are a way community pharmacists staff can provide advice on.
Not your Face
The Focus on Skin campaign is the latest in the Guild’s “Focus” series. It promotes the role of community pharmacy as the health professional people see most often. The Focus on Skin resources include handbooks for pharmacy staff and four posters of different sizes. Earlier promotional material on joints, eyes and feet can still be ordered on the Guild’s website www.pgnz.org.nz.
Coverplast Hydrocolloid Blemish Dots ®
Discreetly covers skin imperfections whilst promoting healing.
An innovative technology that acts like a second, extra-thin, flexible and discreet skin. Helping to reduce redness, absorb secretions and reduce the size of spots. Thanks to their rounded and barely visible apperarance, Coverplast Blemish Dots can also be used under make-up, allowing imperfections to heal whilst being perfectly camouflaged. Discreetly covers skin imperfections whilst promoting healing. Available at all leading Pharmacies. Always read the label and use as directed. If symptoms persist, consult your health care professional. BSN Medical, distributed by: Smith & Nephew Pty Ltd Health Division, Telephone 0800 807 663 www.smith-nephew.com/nz
www.awarenesstoday.co.nz Autumn 2012 | 27
Health | Cancer
Some lumps can be benign The doctors at the Women’s Cancer Centre of New Zealand understand that for most women, the prospect of being faced with a diagnosis of cancer brings with it a range of emotions, anxieties and social fears, both for the person, their families and people close to them. Ovarian Cancer is the second most common gynaecological cancer. Each year about 170 New Zealand women die from cervical cancer and 310 new women are diagnosed as having invasive cancer of the cervix. Maori women are over two-and-a-half times more likely to develop the disease as non-Maori women. The new cervical cancer vaccine for young women is effective against the “high risk” viruses that can cause cervical cancer and will help prevent at least 70 percent of cervical cancers. Being vaccinated does not reduce the need to be involved with the cervical screening, but it does reduce the chance of having significant precancerous change or invasive cancer of the cervix - for this reason it is strongly recommended. The National Screening Programme is conducted at family planning clinics or
general practices, according to an agreed protocol, then referred to specialist for a closer examination if need. Each year there are around 25,000 abnormal smear test results among New Zealand women. Your GP should try and ascertain if possible whether it is from the uterus, cervix, ovaries or non-gynaecological. The GP should also look for other lumps in the abdomen or if there is ascites (fluid in the abdomen). It is important to communicate with the patient that some lumps are benign, but further tests need to be done. The follow up test should be prescribed include a Ca 125 blood test and imaging, usually a transvaginal ultrasound (TVS), if there is concern that the mass is arising from the ovary. But it is important that early diagnosis is found. When cervical cancers are diagnosed
early most people are cured. When changes are detected before a cancer has formed, fertility can be, and is retained. If cancers are found, cure is mostly by surgery and sometimes by radiotherapy, but fertility can seldom be retained which make it so important to have regular check ups. In postmenopausal women Ca125 (blood test) has a 96 percent positive predictive value for cancer. In premenopausal women the specificity is low as elevated blood levels can be from benign conditions including fibroids, endometriosis and depends on the time of the cycle. Ultrasound alone is not accurate in diagnosing ovarian cancers; usually a combination of both tests are more accurate in a diagnosis. Some of the lumps found can be benign. There is a ‘Risk of Malignancy Index’ that uses a combination of the Ca125 - the women’s menopausal status and ultrasound features to score the risk. Women need to be involved in the Cervical Screening Programme. Without cervical screening about one out of 90 women will develop cervical cancer and one out of 200 will die from it. With screening about one out of 570 will develop cervical cancer and one out of 1,280 will die from it.
By Dr Ai Ling Tan
Nearly all the 300 new cervical cancers in each year are occurring in people who are NOT in the programme and that can not be fully effective until all women are involved. Encourage your women friends and colleagues to have cervical smears so we can bring down the death rate. This article was compiled from information supplied by Dr Ai Ling Tan and the doctors of the Women’s Cancer Centre; for more information www.womenscancer.co.nz.
Without cervical screening about one out of 90 women will develop cervical cancer and one out of 200 will die from it.
We don’t just build houses. We build hope in your community. Habitat for Humanity is a global not-for-profit organisation seeking to eliminate poverty housing worldwide. What makes us different is that we offer a ‘hand up, not a hand out’. Families contribute sweat equity hours and their repayments are reinvested back into the programme for more families, fostering pride, self esteem and hope for the future. Your contribution will ensure we can expand the programme and help even more New Zealand families become a better part of your community. Call us today on 0800 442 248 to find out more, or visit www.habitat.org.nz
www.habitat.org.nz 28 | Autumn 2012 www.awarenesstoday.co.nz
Health | Irritable Bowels
Inflammatory bowel disease and irritable bowel syndrome - what’s the difference? People are often confused with these two conditions as there is a lot of similarity in not only the abbreviated titles – IBS and IBD, but in the nature of symptoms experienced.
IBD is diagnosed by colonoscopy (examining the lining of the colon with a long flexible tube with a tiny video camera on the end), where the doctor can see the inflammation, or by biopsies that show the diseased cells under a microscope.
For both conditions symptoms may include an erratic bowel habit, diarrhea, abdominal pain, fatigue, bloating, wind and constipation. Getting back to IBS on the other hand, People may present with only one or more of while is not considered an organic disease the symptoms can be severe. There is these symptoms, or all of them. evidence that this can be caused by an The big difference is that irritable bowel acute inflammatory response to an infection syndrome (IBS) does not have any organic that leaves the bowel with a low grade disease process, which means it does not lead inflammation not detectable by usual means. to another disease, and is often managed No abnormalities show in blood or stool with dietary intervention. tests, and a colonoscopy is normal, which Inflammatory bowel disease (IBD) is a term can be frustrating for someone who is quite used to cover inflammatory conditions in the debilitated. small and/or large bowel. These conditions IBS is usually triggered by an event such as are Crohn’s disease, ulcerative colitis and an infection, travel, major life crisis, or by other types of colitis. In IBD the lining of the other conditions such as endometriosis which bowel wall is inflamed and often ulcerated, irritate the bowel. causing symptoms which make the person quite unwell. Once the bowel is “irritable” it is The cause of IBD is not really known, though some scientists believe it to be an autoimmune response where the body’s defence mechanism is attacking the lining of the bowel, not unlike some forms of arthritis, which are also an auto-immune disease.
hypersensitive to distension caused by gas, which can lead to changes in bowel activity. Some foods and stress or anxiety commonly contribute. There is a particular group of foods known as FODMaPs (Fermentable Oligosaccharides, Disaccharides,
Monosaccharides and Polyols) that can cause an intolerance, where they are not well absorbed, giving bacteria that live in the gut a great free feed, creating gas, bloating and pain, diarrhea, or sometimes constipation.
multidisciplinary patient care. In addition Intus has a dedicated IBS clinic, which is the only one of its kind in Australasia. For further information ph (03) 977 5977 or email email@example.com
Removing these foods brings relief to most people, and by a gradual reintroduction process the ‘actual’ offending food such as lactose is identified. Stress management strategies and gaining trust in your own coping abilities also help. Medications to treat diarrhea or constipation can be useful and some find benefit from peppermint oil or probiotics. The best management strategy is to find the cause of symptoms and treat that in a constructive manner. It is important, when seeking help for IBS, that blood and stool tests are done to make sure something like IBD, bowel cancer or other disease processes aren’t the cause of your symptoms. Intus, Digestive and Colorectal Care has specialists who treat both conditions. Its colorectal surgeons and gastroenterologists are at the leading edge of diagnostic and treatment options and provide outstanding
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15/03/12 2:37 PM www.awarenesstoday.co.nz Autumn 2012 | 29
Health | Veins
Understanding varicose veins Varicose veins are a common problem affecting both men and women. With age, the blood vessel walls tend to weaken and lose their elasticity. Varicose veins occur when the valves within the veins become inefficient (incompetent), and allow the blood to backflow. The blood pools in the area below the affected value causing the vein to enlarge and stretch. They appear under the skin like blue streaks or bulging, twisted rope-like cords on the leg from the ankle to the groin. While the appearance of the veins may be obvious for all to see, the other symptoms associated with them may not be. Many people also suffer from pain (an aching or cramping feeling in the legs), heaviness or tiredness, burning or tingling sensations, swelling, throbbing or tender areas around the veins. Varicose veins usually develop between the age of 30 and 60 and tend to worsen with age if left untreated, they may develop into more serious complications, such as inflammation (phlebitis), blood clots (e.g.DVT), ankle sores or skin ulcers and bleeding.
Varicose veins are more common in women than men and a have a tendency to run in families. A number of factors can contribute to the development of varicose veins for example; hormonal factors, excess weight, pregnancy, circulatory problems, such as blood clots, injury or inflammation of the veins. Lifestyle factors also can play an important role and people who have jobs that involve standing for prolonged periods of time are at greater risk. As the veins are usually easily visible, it makes it easy for a simple diagnosis by your doctor, he may wish to send you for an ultrasound, called a Doppler, to check if there are no blood clots.
during daily activities and help to compress the veins, keeping them from stretching and limiting any discomfort or pain. The three main treatment options for varicose veins are surgery, sclerotherapy and endovenous laser treatment. But there are factors that can help prevent varicose veins including avoiding crossing the legs when sitting, regularly exercising, maintaining a healthy body weight, avoiding tight clothing that constricts the groin and waist, e.g. knee high pantyhose and avoiding constipation. When standing for long periods, shift your weight from one leg to the other every few minutes.
There is no cure for varicose veins however, treatment may not be required unless symptoms are problematic. If the varicose are small and not too uncomfortable, elastic compression stockings may be recommended. These are worn
You don’t have to live with varicose veins. VenaCure EVLT® is the first choice for many clinicians in New Zealand and around the world for treatment of varicose veins. It uses targeted laser energy to seal the vein shut and help you look and feel better. •
Treatment in less than one hour
May be performed in the doctor’s office under local anaesthetic
Up to 98% success rate even after five years1
Immediate relief of symptoms
An immediate return to normal activities
No general anaesthesia or hospital stay
No unsightly scars
For the name of a clinic nearest you: 0508 634 103 | www.nzms.co.nz
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Like all medical procedures there are benefits and risks. Speak to your doctor/specialist about the risks of treatment. 1Min, R.J; Khilnani, N.M.: “Endovenous Laser Ablation of Varicose Veins”. J. Cardiovasc Surg. 2005; 46:395-405
30 | Autumn 2012 www.awarenesstoday.co.nz
Published on Mar 21, 2012