/news/health/rss 九一星空无限 Keep up with the latest in local health news with 九一星空无限talk ZB. Tue, 06 May 2025 04:41:25 Z en /news/health/postcode-variation-surveillance-colonoscopies-delays-affecting-midcentral-patients-but-not-whanganui/ /news/health/postcode-variation-surveillance-colonoscopies-delays-affecting-midcentral-patients-but-not-whanganui/ Whanganui Hospital is unaffected by the delays in surveillance colonoscopies despite a halt at neighbouring Palmerston North Hospital concerning advocates. Surveillance colonoscopies are performed on patients who have a higher risk of developing bowel cancer due to their personal medical history or family medical history, but do not currently have symptoms. Health New Zealand (HNZ) told MidCentral patients last month surveillance colonoscopies would be on hold due to capacity issues. MidCental currently has 852 patients on the surveillance waiting list, who will be booked in priority order once there is room in the service. In a statement, HNZ said they needed to prioritise acute referrals. “We understand that this could be distressing for our patients and recognise they will have concerns about what this might mean for them in terms of early prevention.” In response to questions from the Chronicle, HNZ clarified that there were no changes to the surveillance colonoscopy service in Whanganui. Bowel Cancer NZ medical advisor Professor Frank Frizelle said it appeared short-staffing at Palmerston North Hospital had led to the pause on surveillance colonoscopies. He said it was “not a sensible solution” and nearby regional hospitals could likely provide the locum staff cover for Palmerston North Hospital to continue the service. “You can never catch up [on the waitlist] because the demand is so high,” Frizelle said. “We’re supposed to be removing this variation between places, and postcode variation for patients ... but this is just another example.” HNZ group director operations MidCentral Sarah Fenwick said locum resource was in place, however, cover was still being sought for further unexpected leave and resignations. “We are committed to working towards a solution for the management of the increased demand for the service. “Any person with any symptoms is encouraged to attend their GP to ensure timely access to service provision.” Cancer Society Central Districts chief executive Debra Elgar said the Cancer Society was hugely concerned about the action taken by HNZ, and that it was “literally putting people’s lives at risk”. “This is about people who are already known to be at higher risk of developing bowel cancers and to cease a regular testing programme means they will potentially fall through the cracks. “Some of these people may elect private colonoscopy, but that is not an affordable option for everyone so there will be some who will be just waiting for symptoms to develop.” HNZ said they were actively recruiting to fill workforce vacancies and had taken several actions including the provision of additional weekly and weekend clinic sessions, some private outsourcing and locum gastroenterologist support. Meanwhile, Frizelle said it was a significant decision that would impact a group of vulnerable people. “If you’ve been told you’ve got an increased risk of bowel cancer ... it really plays with you mentally, and now the only access they can get is through the private sector which many people are not in the position to do.” Elgar said that it was well-known that screening and early detection of cancers would have a much better outcome. “We also know that it is less costly to treat at an early stage than any late stage cancer treatment so this does not seem to make good robust financial sense. “A shortfall in staffing resources must not become the reason that our people cannot access adequate oversight of their known bowel cancer risk.” Warning symptoms of bowel cancer Frizelle said patients should be proactive in visiting their healthcare provider if they observed any of the warning signs or symptoms of bowel cancer. In most people, and particularly younger people, the most common symptom of bowel cancer is rectal bleeding. Change in bowel habit: a loosening of the faeces and urgency to go to the toilet. Cluster bowel motions: abnormal stool habits such as needing to go two or three times to empty out. Weight loss Fatigue Anemia or iron deficiency Abdominal pain Eva de Jong is a reporter for the Whanganui Chronicle covering health stories and general news. She began as a reporter in 2023. Tue, 14 Jan 2025 03:55:01 Z /news/health/climate-change-how-worsening-heatwaves-could-hurt-your-heart-in-nz/ /news/health/climate-change-how-worsening-heatwaves-could-hurt-your-heart-in-nz/ Around 180,000 Kiwis already live with heart disease, and more frequent heatwaves under climate change are likely to worsen the picture. A newly-funded study is exploring how the powerhouses of our heart cells are likely to fare in extra hot weather, with the hope of finding new drugs. A separate review has found New Zealand lags behind other countries in preparing our most vulnerable for future temperature extremes. Climate change is already hurting us in ways ranging from extreme weather to air pollution and new disease outbreaks. Now, Kiwi researchers are investigating how worsening heatwaves are putting vulnerable peoples’ hearts under pressure – with the hope of finding new drugs to help cope. Mounting studies are showing that a warming planet is bad news for heart health: in the US, researchers have warned the number of heat-related cardiovascular deaths could double or even triple by mid-century. In New Zealand, where scientists project cities are likely to see a jump in heatwave days within decades, 180,000 people are already living with heart disease. In a new project, supported with a Marsden Fund grant, University of Auckland research fellow Dr Amelia Power and colleagues are examining how the powerhouses of our heart cells are likely to fare in extra hot weather. Mitochondria are responsible for converting the food we eat into usable energy, in the form of a molecule called adenosine triphosphate, or ATP. Power said the heart happened to be a particularly energy-hungry organ, and its muscle cells relied heavily on mitochondria for ATP production. “Mitochondria make up about 30% of the volume of heart muscle cells and are absolutely crucial for maintaining the heart’s constant contraction and relaxation.” Earlier work by Power and others has suggested that, at temperatures between 40-43C, mitochondria in healthy hearts can start to “uncouple” - continuing to consume oxygen but no longer producing ATP at the same rate. That could lead to the heart losing its main energy source, with potentially dire consequences. University of Auckland research fellow Dr Amelia Power. “If the heart can’t maintain its ATP supply, it’s going to struggle to pump blood effectively,” she said. “This could lead to impaired contractility, irregular heartbeats, and ultimately, heart failure.” She hypothesised that mitochondria in diseased hearts may have disrupted membranes that become “leakier” at lower temperatures compared to healthy hearts. This could further impair the heart’s ability to maintain contractility and keep beating efficiently. To test this, she and colleagues will use specialised techniques to measure heart mitochondria functions in real-time from heart tissue biopsies, at both normal and increasing temperatures. They also plan to test a drug called elamipretide, which can stabilise a key mitochondrial membrane lipid called cardiolipin. She said that might ultimately improve the temperature tolerance of mitochondria in diseased hearts, helping them maintain ATP output even as the mercury rises. “It might be something that could be given to people who are experiencing heat stress, or are just having a high fever, so they can keep up with their ATP supply,” Power said. “Going forward, understanding how temperature affects people’s health is going to be increasingly important – particularly among people with heart disease that might be more susceptible.” NZ lags behind in heatwave planning - study Power’s project comes as separate new review has set out how rising temperatures pose a growing health risk to New Zealand’s most vulnerable populations – underscoring an urgent need for stronger adaptation measures. The just published review, by a team of researchers from Malaysia and New Zealand, noted the northern half of the North Island already experienced temperatures over 25C and higher humidity for an average 45 to 55 days each year. As climate change continued to increase ambient temperatures, much of northern New Zealand would see extreme heat-related risks more rapidly. Yet the researchers found our preparedness for this warmer future lagged behind other temperate regions like southern Australia, Ireland and parts of the US, where more comprehensive measures were in place. Measures here could include encouraging people to adjust daily routines to avoid peak heat exposure, using cooling technologies, or enhancing social support networks, they said. While the researchers singled out those likely to be hit hardest – including the elderly, children, pregnant women, and those with health conditions or living in deprivation – they said there was pressing need to understand more. “Identifying these at-risk groups further stresses the urgency of targeted strategies to protect those most vulnerable and mitigate the effects of rising temperatures.” MetService has recently begun issuing heat alerts for nearly 50centres, with specific conditions set for each location. When triggered, an alert banner will appear on MetService’s website and app. Jamie Morton is a specialist in science and environmental reporting. He joined the Herald in 2011 and writes about everything from conservation and climate change to natural hazards and new technology. Sun, 12 Jan 2025 02:26:56 Z /news/health/mosquitoes-with-toxic-semen-could-stem-disease-spread-research/ /news/health/mosquitoes-with-toxic-semen-could-stem-disease-spread-research/ Genetically engineered mosquitoes with toxic semen could be a new weapon against tropical disease, Australian scientists said after trialling the novel pest control method. The “toxic male technique” aims to breed mosquitoes that express venomous proteins in their semen, killing off females after mating. Female mosquitoes are targeted because only they bite and drink blood, thereby spreading diseases such as malaria and dengue fever. Scientist Sam Beach from Australia’s Macquarie University said the method “could work as quickly as pesticides without also harming beneficial species”. “This innovative solution could transform how we manage pests, offering hope for healthier communities and a more sustainable future.” The first proof-of-concept trials used fruit flies, a common laboratory species favoured for its short two-week life cycle. Female flies that bred with “toxic” males had a significantly reduced lifespan, the scientists found. Researcher Maciej Maselko said the team would now trial the method in mosquitoes. “We still need to implement it in mosquitoes and conduct rigorous safety testing to ensure there are no risks to humans or other non-target species,” he said. Genetic engineering has been used for years to control populations of disease-spreading mosquitoes. Typically, these approaches slow reproduction by releasing hordes of male insects that are genetically modified to be sterile. Computer models showed techniques actively killing biting females could be far more effective, the research team said. The research was described in a paper published by peer-reviewed journal Nature Communications on Tuesday. - Agence France-Presse Wed, 08 Jan 2025 01:40:03 Z /news/health/first-us-bird-flu-death-is-announced-in-louisiana/ /news/health/first-us-bird-flu-death-is-announced-in-louisiana/ The first U.S. bird flu death has been reported — a person in Louisiana who had been hospitalized with severe respiratory symptoms. State health officials announced the death on Monday, and the Centers for Disease Control and Prevention confirmed it was the nation’s first due to bird flu. Health officials have said the person was older than 65, had underlying medical problems and had been in contact with sick and dead birds in a backyard flock. They also said a genetic analysis had suggested the bird flu virus had mutated inside the patient, which could have led to the more severe illness. Few other details about the person have been disclosed. Since March, 66 confirmed bird flu infections have been reported in the U.S., but previous illnesses have been mild and most have been detected among farmworkers exposed to sick poultry or dairy cows. A bird flu death was not unexpected, virus experts said. There have been more than 950 confirmed bird flu infections globally since 2003, and more than 460 of those people died, according to the World Health Organization. The bird flu virus “is a serious threat and it has historically been a deadly virus,” said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health. “This is just a tragic reminder of that.” Nuzzo noted a Canadian teen became severely ill after being infected recently. Researchers are still trying to gauge the dangers of the current version of the virus and determine what causes it to hit some people harder than others, she said. “Just because we have seen mild cases does not mean future cases will continue to be mild,” she added. In a statement, CDC officials described the Louisiana death as tragic but also said “there are no concerning virologic changes actively spreading in wild birds, poultry or cows that would raise the risk to human health.” In two of the recent U.S. cases — an adult in Missouri and a child in California — health officials have not determined how they caught the virus. The origin of the Louisiana person’s infection was not considered a mystery. But it was the first human case in the U.S. linked to exposure to backyard birds, according to the CDC. Louisiana officials say they are not aware of any other cases in their state, and U.S. officials have said they do not have any evidence that the virus is spreading from person to person. The H5N1 bird flu has been spreading widely among wild birds, poultry, cows and other animals. Its growing presence in the environment increases the chances that people will be exposed, and potentially catch it, officials have said. Officials continue to urge people who have contact with sick or dead birds to take precautions, including wearing respiratory and eye protection and gloves when handling poultry. - AP Mon, 06 Jan 2025 23:49:47 Z /news/health/covid-19-lack-of-sick-leave-a-problem-for-health-professionals-nurse-says/ /news/health/covid-19-lack-of-sick-leave-a-problem-for-health-professionals-nurse-says/ By Lucy Xia of RNZ Nurses have been reluctant to test for Covid and take time off work due to fears of running out of sick leave amid the latest influx of cases in early to mid-December, an Auckland nurse says. The Covid-19 Leave Support Scheme, which helped employers pay employees who had to self-isolate due to the virus, ended in August 2023. Communications sighted by RNZ indicated at least one of the health districts in Auckland provided a Covid-related paid special leave for staff after the scheme ended. However, that special coverage ended about six months ago. Nurse Liandra Conradie said there was an influx of Covidin early to mid-December which had a big impact on staffing. Health New Zealand – Te Whatu Ora figures showed daily cases in Auckland peaked at 109 in mid-December, but had been decreasing overall from then until the end of December – with 39 cases reported in Auckland as of December 29. Conradie said since her hospital stopped providing paid Covid special leave, staff had been hesitant to use their sick leave or annual leave when they got symptoms. “It has greater impact because some of the staff I work with have got children, and when our children get sick, we take sick leave, so our sick leave gets depleted quite quickly, “So when we then end up with Covid, that’s five days of sick leave – that’s half of our sick leave gone – and that kind of stops us from wanting to take Covid sick leave. “And then we just come to work either feeling very crappy and unwell, and getting our patients in compromising positions, but also other staff members get that, and then there’s more staff off, and having more staff off creates more other pressures,” she said. Many health staff were put in a tricky position, and had the mentality of: “If I don’t test, I don’t have Covid, so I can still work”, Conradie said. She said while the Covid cases had plateaued, she remained concerned that if the leave policy did not change, future outbreaks could spread faster and more patients would be compromised by getting Covid while in hospital. “We need to be able to provide care to our patients ... but we also need to be safe in our own practice, and if we need time off, we need to be able to actually leave that desk,” she said. Conradie wanted to see the Government revisit support options for health staff afflicted by Covid. Health NZ said it was limited in the information it could provide in response due to staff being on leave during the holiday period. Sat, 04 Jan 2025 21:36:54 Z /news/health/far-north-deputy-mayor-kelly-stratford-shares-her-journey-to-sobriety/ /news/health/far-north-deputy-mayor-kelly-stratford-shares-her-journey-to-sobriety/ Blackouts, bruising, and a sprained ankle from alcohol-fuelled nights were once a normal part of Far North Deputy Mayor Kelly Stratford’s life. Throughout many of her teenage and adult years, she partook in binge drinking sessions, had bottles of wine stashed in her handbag, and drank homemade gin “like it was water”. But a health scare in 2017 prompted the 47-year-old of Ngāpuhi, Ngātiwai, Ngāi Te Rangi, Welsh and Irish descent to turn her life around. Stratford, who recently celebrated her seventh year of sobriety, wants to share her story about the damaging effects of alcohol abuse, particularly as people celebrate the New Year. “Sometimes I’d go out and I wouldn’t remember part of the night. “I had injuries; a sprained ankle, and bruises down my side. “I didn’t know how they happened, mostly likely during a fall.” Stratford said she drank to cope with stress such as a difficult life event or person, or hosting a kid’s party. “Every time there was a stressful situation I felt I needed something to get me through. “It was that hankering for a drink when I got stressed. “I even carried a bottle around in my bag. “I drank to excess; when I drank it was hard for me to stop.” Stratford’s wake-up call came when she visited her doctor for a check-up in 2017. She was having problems with digestion and tightness in her chest, sparking fears she was having a heart attack. “I went to the emergency department and had ECG monitoring, which was okay, but the doctor sat me down and said, ‘you’re obese’.” Kelly Stratford sticks to coffee and iced tea these days, and makes an effort to look after her health. Photo / Jenny Ling Stratford was nearly 100kg at the time. She was also going through a particularly stressful time which included moving house and selling the Trainspotter Cafe in Kawakawa which she ran with her husband Daniel. She was on the Whangaroa-Bay of Islands Community Board and was standing for a spot on council to replace Willow-Jean Prime who had won a seat in Parliament in 2017. Stratford was elected a first-time councillor in 2018. After the doctor’s appointment, she was scrolling on social media when Kelly Rennie from Busy Mum Fitness popped up on her Facebook feed. Stratford embarked on Rennie’s fitness programme with a focus on exercise, nutrition, water, stress management, and the biggie - no alcohol. “The biggest adjustment was no alcohol, but I didn’t think anything of it because I had stopped drinking in the past, like when I was pregnant. “One week in I started having severe joint pain and shaking. “It made me think, holy crap I think my body has got addicted to alcohol. I really felt the need to have a drink; it was so strong, I’d never noticed it before.” As the withdrawal symptoms subsided, and with more mental clarity, Stratford was compelled to delve deeper into why she drank. Stratford - who was named the new deputy mayor of the Far North in 2022 by then newly-minted Mayor Moko Tepania - attended counselling sessions, and admitted to friends and whānau she had an unhealthy relationship with alcohol. Hiking is one of the ways Kelly Stratford keeps healthy and manages stress. Her three children were supportive, though they told it to her straight. “They would tell me stories about when I was drunk ... that I’d get really loud and aggressive. “Having clarity helped me have conversations with loved ones who told me I wasn’t a nice person when I drank. “Buying a couple of bottles of wine a day wasn’t healthy, blacking out on a drinking evening wasn’t normal. “It wasn’t until I stopped drinking that I realised that.” These days Stratford opts for non-alcoholic drinks like soda water and iced tea, and manages stress with gardening, hiking, and gym sessions at OutFit North in Paihia. She meditates, reads books, and listens to podcasts about living sober. “I still have fun. I don’t miss the buzz that alcohol gave me, because I find that buzz just being around people.” Stratford’s message to others this festive season is: “Be safe. “Think about the negative impact of alcohol. It’s a drug. “Drink to enjoy but not to medicate or suppress. “It’s okay to sit in your feelings, you don’t have to suppress them with alcohol.” Stratford is grateful for that wake-up call seven years ago. “Everyone has some form of trauma. “For me stopping drinking, I had to deal with things that had happened in the past that were triggering or things I had not resolved. “It led me to confront not just the weight, but the deeper stuff ... everything I’d been drowning out.” Jenny Ling is a senior journalist at the Northern Advocate. She has a special interest in covering human interest stories, along with roading, lifestyle, business, and animal welfare issues. Tue, 31 Dec 2024 03:23:30 Z /news/health/locum-midwife-fails-labouring-mother-baby-dies-during-birth-after-shoulder-gets-trapped/ /news/health/locum-midwife-fails-labouring-mother-baby-dies-during-birth-after-shoulder-gets-trapped/ Medical staff worked for nearly an hour to try and revive a baby boy who was partially trapped in his mother’s cervix by his shoulder during a prolonged labour and delivery. But, despite staff administering eight doses of adrenaline to restart his heart, resuscitation attempts were unsuccessful and the boy was declared dead 54 minutes later. A coronial inquiry later found the baby died from intrapartum death - which is after the onset of labour but before they are born - as a result of prolonged first and second stages of labour complicated by shoulder dystocia. Now a report has been released by Health and Disability Commissioner Rose Wall listing a series of failures by a locum midwife who was caring for the mother, who is only identified as Ms A. Wall said the locum’s practice on that day “did not comply with midwifery competency”. “During the labour, (the midwife) did not undertake regular maternal observations, she did not always follow recommended practice regarding fetal heart auscultation and monitoring and she did not assess the progress of Ms A’s labour in an appropriate and timely manner.” She said that although the locum called for assistance when preparing to deliver the baby, once help arrived no one was made aware of any problems. Wall said the failure by the locum in not recognising that shoulder dystocia had occurred ultimately led to the baby being born “showing no signs of life”, while the mother went on to develop sepsis which she later recovered from. She said the mother felt her baby “deserved much better care than was provided” adding that midwife made her believe the hospital she was in was safe to birth. “This is a decision I regret every day,” the mother told the HDC during the investigation. Ms A’s mother told HDC that her daughter “and my moko did not get the care they deserved”. “Because of this we lost our moko and almost lost our daughter too. In this day and age, a healthy mum with a healthy baby should have the best care and our moko should not have died.” ‘All is well’ Wall said Ms A, a Jehovah’s Witness, experienced an “uncomplicated pregnancy” under the care of her lead midwife. However, that midwife went on leave and handed care over to a locum midwife who was on when the mother went into labour and called to say she was having contractions about three minutes apart at about 1am She was told to wait a little longer before the locum received a second call at 3.30am requesting to go to the birthing centre in the small rural town. After arriving at 4.15am, the mother was around 5cm dilated with her contractions increasing in regularity, mobilising well, and “showing no reason for concern”. Her next, and last noted, dilation record was at 10.55am at 8cm but by mid-afternoon a doctor asked the locum how the labour was progressing, because of concerns raised by “multiple independent staff about the labour”. He was told it was slow but “the baby was perfect”. At 2.26pm, the locum began messaging other midwives to discuss a care plan, and her original midwife noticed a missed call from her so went to the hospital at 4.30pm to take over while the locum rested for a few hours. At 6pm a senior nurse suggested that the woman be transferred to a bigger hospital for tertiary-level care but it never happened. The next vaginal exam happened at 9.01pm which showed the top of the cervix had swollen causing the anterior portion to come in front of the baby’s head. The locum noted she did not have any concerns at this point and by 10.12pm the mother began pushing. However, she said she took full ownership of her lapse in clinical judgment in not doing four-hourly maternal observations during labour and birth. A nurse who started the late shift questioned the locum at 11pm about why the labouring mother was still at the hospital but was reassured that “all was well”. There’s a discrepancy around exactly what time the baby was born, either 12.30am or 12.38am, but the mother’s partner was asked by the locum to press the emergency bell. The original midwife arrived at 12.43am and asked what help was needed and was told, “to help deliver the baby” but the locum did not say why she needed help. When she examined the mother she discovered the baby was suffering “severe shoulder dystocia and was trapped by Ms A’s pubic bone”. The baby was eventually delivered at 12.53am “showing no signs of life”. In her findings, Wall said overall she found the locum’s labour documentation “inadequate”, her maternal observations were not taken and findings from vaginal examinations were incomplete and documentation of the fetal heart did not consistently align with recommended practice. There was also an absence of documented discussions and “plans” made with the mother A about progress, and options for ongoing management. “Consequently, it is not apparent what (her)s interpretation of the labour was, or Ms A’s involvement in any decision-making.” Wall said she initially assumed the locum recognised the baby’s shoulder was stuck at 12.30am, however given there were no notes to say why she requested the original midwife to come “and nor was this crucial piece of information passed on to another nurse who said she was not asked to stay and help or made aware of any problem.” “It is difficult to ascertain with any certainty if (she) did or did not recognise the shoulder dystocia. “If she did not, this is very worrying, and represents a significant deficit in knowledge. But if she did, this is arguably more concerning as she failed to undertake the most basic measures such as calling for help and this represents a significant departure from expected practice and I disagree with her comment that there ‘was no delay in … requesting multidisciplinary assistance'." ‘I am deeply and sincerely remorseful’ In the coronial inquiry the locum offered her “deepest apologies and sincere remorse” for the couple’s loss of their baby, and the “deep grief and trauma of the loss of family memories”. “I have acknowledged fault for my role in your labour and birth. I am deeply and sincerely remorseful.” She added she had “never experienced anything like this outcome in her long professional career”. Wall asked the locum to provide a written apology to the woman for multiple breaches of the midwifery code, undertake further training, and recommended that the Midwifery Council of New Zealand “consider whether a further review of (her) competence is warranted, in light of the findings of this report”. The locum was referred to the director of proceedings, to consider disciplinary action, but no further action was taken. Belinda Feek is an Open Justice reporter based in Waikato. She has worked at 九一星空无限 for nine years and has been a journalist for 20. Mon, 02 Dec 2024 01:45:26 Z /news/health/new-zealands-biggest-hotspots-for-whooping-cough-revealed/ /news/health/new-zealands-biggest-hotspots-for-whooping-cough-revealed/ Health officials declared a whooping cough epidemic, with 263 cases reported in four weeks. Wairarapa has the highest infection rate at 25.4 cases per 100,000 people. Te Whatu Ora urges vaccination, highlighting the risk to infants, with 50% needing hospitalisation. The lower North and South Islands are the biggest hotspots for whooping cough as an epidemic sweeps the country, official data shows. Health officials on Friday declared a whooping cough epidemic and put a nationally coordinated response in place. There have been 263 cases of whooping cough in the four weeks to November 15 – the highest number of cases over a month to date for all of 2024, Health NZ Te Whatu Ora said. Te Whatu Ora urges vaccination, highlighting the risk to infants, with 50% needing hospitalisation. Photo / NZ Human Rights Commission. The latest data collated by ESR showed the highest rates of infection were in Wairarapa, Southern, Whanganui and Capital and Coast health districts. It broke down rates of infection in the four weeks to November 8. Wairarapa had 13 cases, which was by far the highest rate at 25.4 cases per 100,000 people. That was followed by Southern at 11.6 (42 cases), Whanganui at 11.4 (8 cases) and Capital and Coast at 10.4 (34 cases). Te Whatu Ora was urging people to get vaccinated, and said babies are particularly vulnerable to the life-threatening infection. “Around 50% of pēpi who catch whooping cough before the age of 12 months need hospitalisation and 1 or 2 in 100 of those hospitalised pēpi die from the infection,” said public health medicine specialist Dr Matt Reid. “While there have been no deaths so far during 2024, sadly, three infants died last year from whooping cough, and we want to stop that from happening again.” Whooping cough: What you need to know Childhood vaccinations to protect against whooping cough are needed at ages six weeks, three months and five months, and again at four years A further booster is given at age 11 years (school year 7). Vaccination is free for pregnant women. Adults are eligible for one free booster from age 45 (if they have not had four previous tetanus doses) and can get one free from age 65. Whooping cough causes breathing difficulties and severe coughing fits. The cough can go on for weeks or months which is why it is sometimes called the “100-day cough”. People are most infectious in the early stages - with the first signs of whooping cough usually appearing around 1 week after infection Symptoms (after about one week): A blocked or runny nose Sneezing A mild fever Uncontrollable coughing fits that last for a few minutes Coughing that leads to vomiting A thick mucus that can make you vomit or choke During coughing spells, young babies may gasp for air and may briefly stop breathing and turn blue Mon, 25 Nov 2024 23:25:53 Z /news/health/health-workforce-boosted-with-funding-for-50-new-senior-doctors-75-nurses/ /news/health/health-workforce-boosted-with-funding-for-50-new-senior-doctors-75-nurses/ New Zealand’s health workforce is to be boosted with 50 new senior doctors and about 75 senior specialist nurses. Health Minister Dr Shane Reti and Health NZ Commissioner Professor Lester Levy said about $30 million in extra funding will boost Health NZ’s clinical workforce. A further $12m fund will help with minor hospital improvements, the pair said in the announcement at Whangārei Hospital on Tuesday. Reti said the approximately $20m for 50 senior doctors will help fill critical workforce gaps and address health targets, particularly in regional or provincial hospitals. “This will reduce wait times, enhance patient safety and support vulnerable specialties like dermatology,” he said. The $10m for senior specialist nurses and allied health professionals will focus on areas where there are critical shortages, such as rural areas and in particular specialties like mental health, maternity and critical care. The comments come as Health NZ is under increasing pressure to meet its health targets while shaving $1.4 billion off costs. Its board was sacked in July and Levy put in as commissioner to help control overspendingto the tune of $130 million a month. Since then, Health NZ has accepted just over 400 voluntary redundancies from staff not on the clinical frontline. More redundanciesare expected. At the same time, clinical staff said they are under pressure due to a lack of suitable staff, with the likes of Dargaville Hospital operating without doctorson site for most overnight shifts. Nurses have complained roles are not being filledwhen staff are on leave or the position is vacant. Levy said the Health NZ back office, such as administrators and managers, had swollen to a size it should never have got to and some of those jobs could be cut without having an impact on patients. He said clinical recruitment into rural and provincial areas was key, to help address inequities in those areas/ Levy said recruitment would need to be done differently to help fill these rural gaps. Mon, 25 Nov 2024 23:07:39 Z /news/health/obesity-challenge-crack-down-on-junk-food-ads-takeaway-shops-says-helen-clark-foundation/ /news/health/obesity-challenge-crack-down-on-junk-food-ads-takeaway-shops-says-helen-clark-foundation/ A third of NZ adults are obese and policies focused on individual responsibility are failing, a new report says. Tackling obesity will require cracking down on junk food advertising, the proliferation of takeaways, and bringing in new levies on unhealthy products. The Government has not committed to any changes, but says it is ‘actively seeking advice’ on nutrition changes. When Dr David Galler first began working in Middlemore Hospital’s intensive care unit, his shifts were taken up by mostly young people with injuries from alcohol and violence. During his 30 years at the hospital, the make-up of patients gradually shifted. By the late 1990s, he and his colleagues were increasingly tied up by people with preventable, long-term conditions, in particular complications from diabetes. Former Middlemore intensive care specialist Dr David Galler says obesity-related illnesses consumed more and more of his workload during his career, at huge expense and frustration. Photo / Jason Oxenham The rates of people with obesity-related problems rose exponentially through the 2000s. It was grim, dispiriting work, Galler said. “It was a bit like repairing broken panes of glass in a demolished building. You repair that pane of glass at considerable cost to them, their families and the state. Three months later the same person comes in with three broken panes. And then you never see them again because they’re dead.” Though obesity rates have gradually risen during the past 30 years, the political approach to the problem in New Zealand has barely changed. A report released today aims to jolt politicians into changing tack. Galler is among those endorsing its message. The Helen Clark Foundation report, Junk Food and Poor Policy, says successive governments over several decades have primarily approached obesity as a matter of individual responsibility. This approach would continue to fail unless the country’s broader food environment was addressed, the report concludes. Its authors say meaningful change would require tackling overexposure to cheap, convenient, unhealthy food that was promoted by sophisticated marketing, often targeted at children. “For Kiwis to be healthy, they need to be living in a healthy food environment,” foundation executive director Murray Bruges said. “But our streets, supermarket shelves and school canteens are packed with food that is convenient, highly processed and high in fat, salt and sugar, while our airwaves amplify and target these unhealthy products.” Helen Clark Foundation executive director Murray Bruges. Obesity is now the leading risk factor for death and disability in this country, ahead of smoking. Ministry of Health data released last week shows more than a third of New Zealand adults were obese – the third-highest rate in the OECD. Related illnesses cost the health system $2 billion a year and the economy an estimated $9 billion in lost productivity. Despite the growing social and economic toll, few New Zealand governments had introduced evidence-based, long-term steps to reduce obesity, the foundation says. Instead, they had opted for voluntary or industry-led schemes like the Health Star Rating, minor policy tweaks or brief campaigns focused on personal responsibility. Relatively small-scale reforms have stalled or rapidly dropped, often falling victim to claims of “nanny state”. One example: the Helen Clark-led Labour Government changed the rules in 2008 to allow only healthy options in school canteens, before this was quickly reversed by National when it came into power. Massey University research published last week found that, 15 years later, a fraction of school canteens met nutrition guidelines. The report says the food system is “stacked against individuals” and people could not change if they lived in an environment that made change impossible. Community leader Dave Letele says his neighbourhood is swamped by cheap, unhealthy food outlets: "We are surrounded by everything that's bad for us." Photo / RNZ “Choice implies an equal starting point,” said community leader Dave Letele, who runs health programmes for low-income households in South and West Auckland. “And that’s just not the case.” He is exasperated about the number of fast-food outlets in his community. Previous analysis by the foundation found the concentration of takeaways was highest in the most deprived suburbs in New Zealand. “How has this been allowed to happen?” he said. “Where we are just surrounded by everything that’s bad for us, right at our fingertips?” The Helen Clark Foundation made three overarching recommendations: creating a healthier food environment; embedding healthier food across hospitals, schools, daycares and other publicly owned entities; and adopting and expanding new treatments like modern weight-loss drugs. The first recommendation includes measures that have been occasionally floated in New Zealand, but never gained traction: stricter rules for advertising junk food, giving local government power to control new unhealthy food outlets (similar to alcohol laws), and making the Health Star Rating on food packaging mandatory. It also includes a levy to incentivise reformulation of products that are high in salt or sugar. Professor of Population Nutrition and Global Health Boyd Swinburn says levies on sugar are now mainstream policy worldwide. Photo / NZPA Professor Boyd Swinburn, of the University of Auckland’s School of Population Health, said with 100 countries now using a sugar tax, it was not a radical policy. “Even in the UK over the chaotic period of the Tory government with Brexit and Covid and Boris Johnson, they still managed to get through some world-leading legislation around taxing sugary drinks and banning junk food marketing to kids. So, I think it’s time that we caught up in this country with the rest of the world.” A Soft Drinks Levy introduced in the UK in 2016 led to a 35% reduction in the total sugar sold over four years and lowered hospital admissions for dental treatment, the report says. Sales of these products remained the same throughout this period because companies altered their products rather than pay the levy. Associate Health Minister Matt Doocey says he is seeking advice on what actions the Government could take to improve nutrition in New Zealand. Photo / RNZ Associate Health Minister Matt Doocey, who is responsible for nutrition, did not directly address the recommendations, but said he was actively seeking advice on what actions the Government could take to improve nutrition in New Zealand. “The Government funds the Heart Foundation in New Zealand to work with food companies to reduce sugar and salt in their products, Health NZ also funds Green Prescriptions for people wanting to be more active, with the most common reason being to support weight management.” NZ Food and Grocery Council chief executive Raewyn Bleakley said a tax on sugary drinks was a “crude tool” and that innovation, reformulation, and education were better options. Council members had worked with the Heart Foundation to reformulate their products and remove around 760 tonnes of sugar in the last decade, she said. Bleakley said the food industry followed a code for advertising products to children, and took its responsibilities in this area very seriously. Isaac Davison is an Auckland-based reporter who covers health issues. He joined the Herald in 2008 and has previously covered the environment, politics and social issues. Sun, 24 Nov 2024 19:41:08 Z /news/health/cancer-the-high-profile-kiwis-who-have-publicly-shared-their-diagnoses/ /news/health/cancer-the-high-profile-kiwis-who-have-publicly-shared-their-diagnoses/ Over the past few years, several well-known Kiwis have been diagnosed with cancer - from actor Sir Sam Neill to Green Party co-leader Marama Davidson. Some, including Neill and comedian Dai Henwood, have chosen to share their diagnoses months or even years after the fact, balancing the need for privacy in their own lives with calls to their fellow Kiwis to take their health seriously. Neill, Henwood and entertainment legends the Topp Twins have all drawn on their experiences with different forms of the disease to write and publish memoirs; Dames Jools and Lynda’s book was recognised at the 2024 Aotearoa New Zealand Book Industry Awards this year. Here are 10 high-profile Kiwis who have used their platform to raise awareness of cancer and share what they’ve learned from their experiences so far. The Topp Twins Dames Jools and Lynda Topp revealed in 2022 that they'd both been diagnosed with cancer. Photo / Alyse Wright They became Kiwi television staples with their show The Topp Twins, playing characters Camp Mother, Camp Leader, Ken and Ken, which led to a feature film and TV spinoffs; they were made Dame Companions of the New Zealand Order of Merit for services to entertainment. Then in March 2022, Dames Jools and Lynda Topp revealed they were both battling breast cancer. In an exclusive interview with TVNZ’s Sunday, the sisters shared that Jools was first to be diagnosed with breast cancer in 2006 at the age of 48 - and that her cancer had returned in 2021, when beloved sister Lynda was also diagnosed with the disease. In August this year, they were awarded the Nielsen BookData NZ Award for the best-selling New Zealand title at the 2024 Aotearoa New Zealand Book Industry Awards for their 2023 memoir Untouchable Girls: The Topp Twins’ Story. Speaking to the Herald ahead of accepting their award, the sisters shared their gratitude for the countless New Zealanders who bought and read their story. “It just really gives us a sense that we’re still loved and remembered,” Jools said. “We haven’t sung for such a long time - we’ve been out of action and I still have treatment every four weeks to stop my cancer from spreading, and so our lives have changed quite considerably. “We still have cancer, but we just take each day as it comes. We’re both pretty good at the moment.” The pair are planning to return to the stage in 2025. Sam Neill Sir Sam Neill is now in remission two years after being diagnosed with a form of blood cancer. Photo / Ross Coffey Last year, Jurassic Park star Sir Sam Neill revealed he’d been diagnosed with angioimmunoblastic T-cell lymphoma, a form of blood cancer, in 2022. He wrote in the first chapter of his memoir Did I Ever Tell You This?, published in March 2023, “The thing is, I’m crook. Possibly dying.” He underwent chemotherapy treatment after his cancer diagnosis, but it stopped working after three months and he switched his treatment to a rare anti-cancer drug which led him into remission. Neill has now been in remission for 2 years, telling the podcast Kate Thornton’s White Wine Question Time last month, “If this had happened to me 20 years ago, I wouldn’t be around to talk to you. I go in [for treatment] once a month now. But it used to be three times a month and it’s down to once a month now.” In August this year, he told the Herald, “I’m very pleased to be alive. Things weren’t looking too good there for a bit. “I’m in remission and working as you see. And I couldn’t be more glad about that,” he said from Vancouver, where he was shooting new Netflix series Untamed. He’s also recently starred in Australian drama series The Twelve. When he isn’t busy with acting projects, he’s tending his Central Otago winery Two Paddocks. The actor’s family has been in the wines and spirits industry ever since they arrived in Aotearoa in 1861, though he’s the first to actually grow wine since establishing his vineyard in 1993. “It’s been a very rewarding thing for me to be part of such a young industry, and I think we’ve done wonderful things in Central Otago,” he said. Dai Henwood Dai Henwood - comedian, dad, husband and TV host - shared his stage 4 bowel cancer diagnosis in January 2023. Photo / Michael Craig Comedian of 7 Days fame and Lego Masters host Dai Henwood was diagnosed with cancer in his bowel and liver in April 2020. But it wasn’t until January 2023 that he made his diagnosis public, adding that it had spread to his lungs. “Almost three years ago I was diagnosed with stage 4 bowel cancer,” he wrote on social media at the time. Since then, he’s undergone multiple rounds of chemotherapy, radiation and operations. Henwood has continued to share updates on his treatment and has drawn on his comedy chops to help other Kiwis living with cancer, working as an ambassador for the Cancer Society, hosting live show The Comedy Treatment and his own show Dai Hard to raise funds. Henwood told the Herald last year, “I’m blessed that I’ve been able to help out quite a few people who are in a similar situation to me ... I just feel so blessed that so many beautiful New Zealanders have seen my comedy and supported me through what is a very hard journey.” He’s since written a book, Life of Dai, with close friend Jaquie Brown, and recently released a three-part documentary Live and Let Dai on ThreeNow. The doco shows viewers the harrowing reality of coming to terms with a stage 4 cancer diagnosis, interspersed with footage from his live comedy gigs. Henwood writes himself a goodbye letter, undergoes a departure ceremony in Japan, and concludes by telling viewers that “the joy of living is all that remains”. “I don’t know how this is gonna work out, but it’s gonna work out.” Marama Davidson Greens co-leader Marama Davidson shared her cancer diagnosis with the public in June 2024. Photo / Mark Mitchell In June 2024, Green Party co-leader Marama Davidson revealed she had been diagnosed with breast cancer and would start four months of treatment. Her cancer was found early during a regular mammogram, she said, telling journalists at the time, “I have held off telling people about my diagnosis while I continue to focus on parliamentary work. “I do want to be clear, we are fortunate to have picked this up early enough to give us the best odds of getting rid of it, thanks to the breast screening programme. I reiterate how important it is that our breast screening programmes … can make sure more people are screened in time to save lives. “Wāhine mā, please book in your mammograms.” In September, Davidson thanked supporters for the “overwhelming and beautiful aroha that you all keep sending through to my whānau and I”. In early October, Green Party co-leader Chlöe Swarbrick shared a photo with Davidson days after her latest round of treatment. “Sitting around [Marama Davidson’s] kitchen table today planning the world our communities and mokopuna deserve - and how critical her wellbeing and genuine recovery is to everything we believe and must practice,” she wrote. “Basically, it was really bloody lovely to give this boss a hug today - three days after her most recent chemo infusion - and remind her how excited we are to get her back when she’s through her recovery.” Davidson plans to return to her role as co-leader of the party after her treatment has finished. Nigel Latta Nigel Latta revealed his diagnosis with incurable cancer in September 2024. In September 2024, psychologist, TV presenter and author Nigel Latta revealed he had incurable cancer. “[My surgeon], he said it was inoperable because the tumour has spread out too far through the stomach lining, and it was also incurable just because of where it’s at,” Latta, 57, said. “People talk about trauma. I’ve been through some pretty traumatic things. That was probably the most traumatic thing I’ve ever been through.” At the time, his surgeon told him that he probably had just 6 months to a year to live. However, chemotherapy has caused his lymph node activity to clear and the tumour in his stomach to shrink. Latta believes he has longer than a year, sharing on social media, “I’m pretty sure I’m going to be around for quite some time.” His advice to others going through cancer or other health issues was, “First thing, we don’t choose the things that happen to us, but we can choose how we respond. Second thing, focus on the things you can control.” Latta is undergoing chemotherapy for another two months “and then we’ll see where we’re up to”, he said. “One of the good things about cancer, is you don’t need to worry about cancer, because you’ve already got it. I don’t have to worry about getting cancer, I just have to worry about dying from cancer.” Lorna Subritzky Lorna Subritzky was diagnosed with breast cancer for the second time in 2022. Photo / Supplied In 2022, Coast broadcaster Lorna Subritzky revealed that she had been diagnosed with breast cancer for the second time in her life, after her routine mammogram was delayed due to Covid-19′s impact on the health system. At the time, she told listeners, “Unfortunately for me, they found something this time a bit more serious than last time in the other breast: a grade three tumour and also in the lymph node as well. Luckily a scan has shown it hasn’t travelled anywhere else in my body. So for that I’m very, very grateful indeed ... very pleased this has been caught early enough to be treated.” She underwent chemotherapy, radiotherapy and surgery, amid a difficult year following an endometriosis diagnosis, the death of her brother, and separating from her first husband. She underwent genetic testing after her second diagnosis, which showed she had the BRCA2 gene, increasing her risk of getting ovarian cancer. Subritzky had her ovaries and fallopian tubes surgically removed in April 2023. She told NZ Woman’s Weekly in March 2024 that she began experiencing anxiety and depression following her treatment. “Out of the blue, I suddenly started worrying about things that aren’t in my control. I try not to dwell on problems if I can, but there’s no doubt that I’ve changed hugely as a person as a result of my experiences,” she shared. On her doctor’s recommendation, she started taking mood stabilisers alongside looking after her physical health. “I’m in my mid-fifties and next birthday I’ll probably have to start saying I’m in my ‘late fifties.’ It got me thinking about how I want to spend the rest of my life. And I don’t want to spend it worrying,” she told the magazine. “The way I see it, the treatment has dealt with the cancer, but I must do my part when it comes to keeping myself healthy.” Rebekah Stott Rebekah Stott was diagnosed with cancer in 2021. Photo / Photosport Football Ferns defender Rebekah Stott revealed her diagnosis with stage three Hodgkin’s lymphoma, a form of blood cancer, in 2021. She underwent five months of chemotherapy, announcing in July 2021 that she was in complete remission following her treatment. Stott told the Herald in 2022 amid her return to the field that during her treatment “I’d go for a walk around the block and my heart rate would be at 160 and I’d be pretty tired. Going from being an athlete to hardly being able to walk around the block was pretty hard. After I finished treatment the next three months were hard mentally but I just had to be patient.” Through it all, she was constantly looking ahead to the 2023 Fifa Women’s World Cup. “It was huge. What more motivation do you need than a home World Cup in 2023?” Stott was named in the Football Ferns squad for the tournament. “I never thought it would be out of reach. There were challenges, and a lot of hard times along the journey. But I never thought I wouldn’t be able to get here,” she told the Herald at the time. “It’s been a big couple of years for me. It’s been quite tough, but I’ve definitely worked hard to get back to where I am. I am so happy to be here today.” Kiri Allan Kiri Allan revealed her cancer diagnosis in 2021. Photo / Alan Gibson Labour MP Kiri Allan revealed in April 2021 that she had been diagnosed with stage 3 cervical cancer, writing in a Facebook post, “So now the fight of my life begins.” She recalled experiencing pain in her legs, back and stomach, which she put down to the stress of working long hours in her role as a member of Parliament. It was colleague Ayesha Verrall who urged her to see a doctor. While waiting for results, she led the Civil Defence emergency response to the earthquakes that hit the North Island in March 2021, sparking a tsunami warning. When the diagnosis came, she took medical leave for treatment. “I’ve told a few folks by now, and often the question is, ‘is there anything I can do?’. My answer now is yes. Please, please, please - encourage your sisters, your mothers, your daughters, your friends - please #SmearYourMea - it may save your life - and we need you right here.” In December 2021, Allan announced that she was cancer-free, and would need to be monitored for the next five years. She told Woman’s Day in June 2022, “It’s been a tough year - I can’t lie about that. But the journey I’ve been forced to go on has also been an incredible gift ... I feel like I’ve been through a bit of a rebirth and a reset.” Aaron Cruden Aaron Cruden was diagnosed with cancer at the age of 19. Photo / Photosport Former All Black Aaron Cruden was diagnosed with testicular cancer at the age of 19 - which proved to be life-threatening as it had spread to his lungs. Shortly after making his debut for Manawatū, he was forced to cut the season short, undergoing surgery and nine weeks of chemotherapy. In December 2008, shortly after announcing he was in remission, he reflected, “You never expect to hear you have cancer at the age of 19. “That was a big shock ... my life was just beginning. My rugby was just starting to go well.” In 2015, he ruptured his ACL, which ruled him out of the Rugby World Cup that year. At the time, Cruden said he drew on his experience with cancer treatment to cope with the injury and recovery. “I guess my experience a few years when I was pretty crook came to the forefront at a time like this with an injury,” he said at the time. Cameron Suafoa Cameron Suafoa was diagnosed with sarcoma last year. Photo / Photosport Blues lock Cameron Suafoa was diagnosed with sarcoma in 2023 after a tumour was found in his back. He had the tumour surgically removed before going through radiation therapy in March this year, finishing his treatment in April. Suafoa continued to train and play during that time, though he was eventually forced to slow down and take time off as his treatment took a toll. In May, he made his triumphant return to the field with the Blues after being declared cancer-free. Suafoa told Woman’s Day in August this year that his cancer diagnosis changed “everything”. “Before the cancer, rugby used to kind of rule my life - everything revolved around it. When I wouldn’t make a team or played a bad game, it would eat me up. Now everything is different. I’m just so happy to be here.” He’s now an ambassador for the Sarcoma Foundation, aiming to help raise awareness of the rare cancer. DIETS/HEALTH CHANGES • Consult a GP or other qualified healthcare provider before starting any diet or making any health changes suggested in this article. Individual needs for nutrition and exercise may vary. Always seek the advice of your GP or other qualified health provider with any questions you may have.• Healthline provides a 24 hours a day, 7 days a week over-the-phone health service at 0800 611 116 you can call for free health advice, information and treatment from professional healthcare providers. Where to get help: • Lifeline: Call 0800 543 354 or text 4357 (HELP) (available 24/7)• Suicide Crisis Helpline: Call 0508 828 865 (0508 TAUTOKO) (available 24/7)• Youth services: (06) 3555 906• Youthline: Call 0800 376 633 or text 234• What's Up: Call 0800 942 8787 (11am to 11pm) or webchat (11am to 10.30pm)• 0800 Anxiety Helpline: 0800 269 4389 (0800 ANXIETY). This service is confidential and free of charge. Open 24/7.• Depression helpline: Call 0800 111 757 or text 4202 (available 24/7)• Helpline: Need to talk? Call or text 1737• Aoake te Rā (Bereaved by Suicide Service): Call 0800 000 053If it is an emergency and you feel like you or someone else is at risk, call 111. Thu, 10 Oct 2024 00:44:14 Z /news/health/gp-practice-says-health-nz-committee-told-it-to-start-cafe-to-bring-in-cash/ /news/health/gp-practice-says-health-nz-committee-told-it-to-start-cafe-to-bring-in-cash/ A struggling GP practice was allegedly told by a Health New Zealand-Te Whatu Ora committee to set up a cafe inside the clinic to bring in extra cash. In September, General Practice New Zealand surveyed primary health organisations (PHOs) that deliver GP services, with about 76% of them responding. The results made for stark reading. More than 60% of PHOs had clinics in their network facing closures, 61% were reducing services, and 100% were restricting patient access in some way. Among the reasons given were financial pressures and issues of burnout and retention with GPs. In the survey, one practice revealed Te Whatu Ora’s fees review committee, which made independent recommendations about increases to GP fees, suggested one medical centre set up a cafe to ease financial pressures. Andrew Swanson-Dobbs, chief executive of Dunedin-based WellSouth – the PHO for the clinic that got the cafe advice, told Checkpoint it was “silly advice”. “We shouldn’t be advising practices to do things such as open a cafe.” He said it was a “real struggle” at the moment though, with practices having sausage sizzles and asking patients to “pay one forward”. Te Whatu Ora said the fees committee was independent, so essentially the suggestion was not from the health organisation. - RNZ Tue, 08 Oct 2024 06:21:00 Z /news/health/dargaville-hospital-health-minister-dr-shane-reti-quashes-rumours-hospital-could-be-closed-down/ /news/health/dargaville-hospital-health-minister-dr-shane-reti-quashes-rumours-hospital-could-be-closed-down/ Health Minister Dr Shane Reti’s office has quashed rumours that Dargaville Hospital could be closed down, saying any such speculation is “utterly wrong”. RNZ asked Reti if there were any plans for the beleaguered hospital – either extra investment, expansion, downsizing or closure – and was told that closing Dargaville Hospital was not under consideration. A spokeswoman for Reti said that Health New Zealand Te Whatu Ora would respond with a progress update on staff recruitment at Dargaville and services for the people of Northland. “People starting these sorts of rumours [about the hospital closing] are actively undermining confidence and trust in the public health system,” the spokeswoman said. The hospital – which serves a population of more than 27,000 people across Northland’s Kaipara District – has been struggling to fill its medical roster for some time. The Health Minister is rejecting speculation that Dargaville Hospital will be closed as "“utterly wrong”. Photo / Michael Cunningham Its emergency department and 12-bed inpatient ward are often without a doctor after hours, forcing stressed nurses to rely on a commercial telehealth service for support. Top Northland health officials were to have met Dargaville nursing staff last Friday. It is not clear if that meeting went ahead because staff have been barred from speaking to media. If the hospital were to close its overnight beds, that would mean transporting patients to Whangārei Hospital, which has its own problems – in particular, high demand on its emergency department. Many emergency cases are already taken directly to Whangārei due to Dargaville Hospital’s doctor shortage. Hato Hone St John has confirmed to RNZ that Dargaville has just one ambulance. That means any time a patient has to be transferred to Whangārei, there may be no ambulance available in Dargaville and surrounding areas for two hours. Back-up is from St John stations in Whangārei or Maungaturoto, also about 50 minutes away. Dargaville Hospital currently has 12 beds in a general ward and eight in a detox unit. Northland’s other rural hospitals – Kaitāia and Kawakawa – have 26 and 20 beds, respectively. The lack of doctors at Dargaville Hospital prompted a rare nurses’ strike on August 29, with nurses saying they were stressed and fearful of the consequences of looking after patients when no doctors were available. - RNZ Tue, 08 Oct 2024 00:22:01 Z /news/health/hdc-breached-paramedic-and-emt-after-adrenaline-incorrectly-given-to-patient-causing-cardiac-arrest/ /news/health/hdc-breached-paramedic-and-emt-after-adrenaline-incorrectly-given-to-patient-causing-cardiac-arrest/ A woman thought she was going to die when she was incorrectly given a third dose of adrenaline by a medical professional, causing her to suffer a cardiac arrest. The incident occurred in January last year when the woman went into anaphylactic shock and required emergency medical assistance. According to a report released today by Deputy Health and Disability Commissioner Rose Wall, an ambulance arrived at her home with a paramedic and an Emergency Medical Technician (EMT). The paramedic gave the woman 5mg of adrenaline through a nebuliser, then 0.5mg was administered intramuscularly (IM) by the woman’s neighbour who was an off-duty nurse, under the supervision of the paramedic. A third dose was drawn into a syringe by the paramedic and handed to the EMT, without instruction on the intended administration method. As the dose was intended for the nebuliser it was 4mg, which was significantly higher than the recommended dose for IM or intravenously. The third dose was then administered intravenously by the EMT in error without the awareness of the paramedic, who was on the phone to the ambulance service’s air desk at the time. Within one minute, the woman suffered a cardiac arrest and required resuscitation and defibrillation. Her heart rhythm returned shortly after. She went on to tell the HDC that after the third dose of adrenaline was given she heard someone say something along the lines of ‘”too much adrenaline”. The woman recalled feeling “incredible pain in her brain and chest” and telling her husband: “I think I am going to die”. Following an investigation into whether the ambulance service provided the woman with the appropriate standard of care, Wall found the paramedic and EMT had breached the Code of Health and Disability Services Consumers’ Rights. According to her report, the EMT was not qualified to administer medication intravenously and had acted outside of her scope of practice. It then took three hours for medical staff to understand why the patient had gone into cardiac arrest because no one, except the EMT who had administered it, knew it had been given intravenously. The paramedic told the HDC she remembered handing the syringe to the EMT and telling her it was for the nebuliser, while the EMT said she was only told to administer it. The paramedic also said that she assumed the EMT would know to use the nebuliser because she wasn’t qualified to administer it intravenously. . However, the EMT said she felt she was unable to seek clarification from her superior who was busy with other tasks at the time. “[The paramedic handed me an unlabelled syringe and] did not state the drug, the route, the dose or any other information at that moment as required by [ambulance service] procedures,” she told the HDC. “I have identified that at that moment I was frozen … I felt powerless, I did what I was told and I could not interrupt the authority figure on the phone.” The paramedic told the HDC that after the woman was transferred to hospital she began researching adrenaline overdoses as she could not understand why she had gone into cardiac arrest. It was not until later that the cause was identified. Deputy Health and Disability Commissioner Rose Wall investigated the patient's care. Photo / Supplied The EMT said she was deeply ashamed by what had happened and she wished she had had the strength to seek clarity on the paramedic’s instruction. “I am sorry that I did not pause before acting.” Wall was critical of the way the EMT handled the incident. “No information has been provided to indicate that when faced with uncertainty, the EMT sought clarification or advice,” she said in her report. “I am especially critical of the EMT in this regard and consider this an egregious breach of the standards.” But Wall said that regardless of the EMT’s actions, the paramedic was responsible for all aspects of medicine administration. She concluded the paramedic did not provide clear instructions to the EMT nor did she adequately supervise the EMT. “Having reviewed the available information, it is clear that [the EMT] was not supervised after being delegated the task of administering adrenaline,” she said. Wall recommended the paramedic and the EMT engage in further training on anaphylaxis and adrenaline and work on their communication and teamwork. She also recommended they write a letter of apology to their patient within three weeks of the ruling. Jeremy Wilkinson is an Open Justice reporter based in Manawatū covering courts and justice issues with an interest in tribunals. He has been a journalist for nearly a decade and has worked for 九一星空无限 since 2022.   Mon, 02 Sept 2024 02:24:57 Z /news/health/healthcare-crisis-desperate-patients-queue-from-6am-at-%C5%8Dtara-clinic-for-doctor-visits/ /news/health/healthcare-crisis-desperate-patients-queue-from-6am-at-%C5%8Dtara-clinic-for-doctor-visits/ Patients queue from 6am at Ōtara clinic due to long waits and problems getting bookings at other GPs. Tamaki Health CEO: Waiting in a queue in the cold is “absolutely heartbreaking,” urges more investment in GPs. High patient volumes and staff shortages at Ōtara clinic lead to doctors working on days off. Patients in one of New Zealand’s most impoverished communities are so desperate to see a doctor they’re lining up outside in the cold hours before the clinic opens its doors. The queue outside Ōtara Local Doctors and Urgent Care starts building from 6am, with those waiting telling the Herald that trying to secure an appointment with other GP clinics often means waiting weeks to be seen. Even at the Ōtara clinic, which offers a walk-in service, patients said they can face lengthy delays if they’re not there early. The clinic is owned by Tāmaki Health and its chief executive, Lloyd McCann, described the situation as “absolutely heartbreaking” and “gutting” Patients start queuing from 6am to be seen by a GP at Local Doctors Ōtara. Photo / Ben Dickens The clinic’s community liaison manager, Lorenzo Kaisara, said the queue had progressively got worse in the five years he’d worked there. “The line just gets greater and greater even in the cold which breaks my heart. To see my people sitting out here and you’ve seen the majority who are in the cold before seven o’clock are Māori and Pacific,” he said. “They are already sick. They get more unwell sitting out here in the cold”. Dressed in a thick winter dress, puffer jacket and scarf, Toa Salaina, 44, arrived when it was still dark with her own chair to make the wait on the pavement more comfortable. “I really want to see the doctor about my pain in my back,” she said. The Ōtara clinic’s walk-in option means no appointment is necessary. “If we book the appointment and we are enrolled with another GP, they tell us it is full. That’s why we like to come here.” Toa Salaina was first in the queue at Local Doctors Ōtara. Photo / Ben Dickens However, Salaina said staff are so overrun that unless you arrive early, the wait to see the doctor can be up to five hours once inside. “That’s why we need the Government to help, to add some more nurses and doctors to help the people.” Greg McIndoe, 66, arrived at the clinic with a walking frame and hobbled towards the queue. He’d recently had knee surgery and was in pain. He said it was “outrageous” people had to line up in the cold to get care. Greg McIndoe, 66, got up early to be seen by a GP for his knee pain. Photo / Ben Dickens Around 20 people, including mothers, children and the elderly, were waiting outside when the Herald was filming, but McIndoe said the line is normally much bigger. “Usually, the line goes to the road. [It’s] just crazy,” he said. Sonya Inifi took her place in the queue at 6.15am on behalf of her dad, who had the flu. She said the wait times were “ridiculous” but even worse if you arrived late in the morning. “If we come after say nine or 10am, then you’re looking at like a five-hour wait and my dad’s sick.” Papatoetoe resident Sonya Inifi said doctors were being undervalued by the Government. Photo / Ben Dickens She said it was obvious doctors and nurses at the clinic were under a lot of pressure. “I see how stressed they are. Their staff (the clinic’s GPs and nurses) aren’t appreciated, and they haven’t been valued (by the Government) for the work that they do. The doctors are for our kids, for our people, for our families.” She wanted more action from the Government. “It’s one of the major things that need to be reconsidered, especially the wait times.” Primary care is ‘on its knees’ Dr Lloyd McCann is the CEO of Tamaki Health, which owns Local Doctors Ōtara. McCann told the Herald the queue outside the Ōtara clinic was a symptom of the “significant challenge” general practice is facing. “It’s absolutely heartbreaking. We don’t want our patients, our communities, experiencing this. People are desperate to access healthcare,” he said. The Ōtara clinic is categorised as a “very low-cost practice” – one that gets additional funding to reduce fees so its clients, mostly Māori and Pasifika, can access care. But myriad issues, including staff shortages, burnout, and an ageing population with more complex and chronic health needs, were causing serious issues. Ambulance “ramping” – where patients are delayed getting to a hospital bed – is seen as partly due to poor access to primary care, which plays a key role in early detection of problems and preventing serious illness. GPs are also managing patients who need surgical intervention longer. McCann said the way GPs were subsidised by the Government was outdated – a concern backed up by several government reports, including the Sapere Report, commissioned by the last Labour Government. “Primary care is absolutely on its knees. We’re seeing a number of clinics close throughout the country. We’re seeing a number of general practitioners just call it quits because it has got really hard,” he said. “People are doing work in their own time after hours.” McCann said general practice wasn’t given the recognition it deserved when considering the overall health of New Zealanders and the functionality of the health system as a whole. He said when general practice operates well it reduces pressure on hospitals, but said GPs had faced “years” of underinvestment. “If we have more upfront investment in primary and community care and earlier detection, we stand a better chance of actually keeping people healthy; keeping people in their homes as opposed to in hospitals.” Last month, the Government offered a 4% increase on the amount a general practice gets paid per patient, which McCann said was “not enough”, arguing a “substantive increase” was required. He said Health Minister Dr Shane Reti had long “signalled” he wanted to invest more in primary care but those on the frontline were yet to see any significant action. McCann felt the seriousness of the situation “went beyond the minister” and urged New Zealanders to demand more investment in primary care. He said it was “great” the Government had put millions into funding cancer drugs but emphasised that it would not make a difference if the “front door” of the health system was broken. “All of the investment in the best cancer drugs in the world [isn’t] actually going to make a difference to patients’ outcomes [if the cancer isn’t picked up early by GPs].” The National Party’s big health card before the last election was that it would build a new medical school in Waikato to boost GP numbers. “I think we’re at the stage where no matter how many new medical student places there are at medical school, no matter how many nurses we train, we’re always going to be playing catch-up,” McCann told the Herald. Doctor: ‘It’s very stressful when you see the queue’ Dr Niroshika Kotte Arachchige is one of 12 GPs at Local Doctors Ōtara GP. Photo / Ben Dickens When the Herald visited the Ōtara clinic, one of its 12 doctors, Dr Niroshika Kotte Arachchige, had been called in to help on her day off because staff were overwhelmed. She and her colleagues see up to 350 patients a day and despite having a dozen doctors it was “still not enough”. “For example, today is my day off. But my roster manager called me and asked if I can help the queue because there’s not enough doctors. Two of our doctors are down with Covid,” Niroshika told the Herald. The week before, she was also called in on a day off and ended up working a 13-hour shift. She said her nursing colleagues were also “exhausted” and believed fixing primary care should be a priority if the Government was serious about trying to reduce the burden on hospitals. She also regularly did extra work outside of her normal hours. “I normally come one hour early to do my inbox and my paperwork. On top of that paperwork, we get a lot of [patients] discharged from the hospital to follow up.” Her greatest concern was her patients, some of whom had to be turned away even if they queued up early. “So sometimes those who wait for four or five hours have to go home at the end of the day without seeing a doctor.” Minister: ‘Queues at any practice are concerning’ Health Minister Dr Shane Reti started his career as a GP in Whangārei. Ben Dickens Health Minister Dr Shane Reti told the Herald early-morning queues outside the Ōtara clinic were not acceptable. “I understand this particular practice may have faced challenges for some time, but of course that doesn’t make current queuing any more acceptable,” Reti said. He acknowledged “long-standing” pressure on primary care and said solutions for GPs and patients relied on recruiting and retaining more doctors and improving remuneration. Reti said the proposed new medical school would help keep more medical students in New Zealand, and in the meantime suggested greater use of healthcare assistants and technology to ease the patient and paperwork burden for GPs. The 4% pay increase for GPs included a provision which allowed practices to increase their fees to achieve a total boost in revenue of 5.88%, he said. The General Practice New Zealand chairman, Dr Bryan Betty, said the offer “does absolutely nothing to address the history of chronic underfunding”. Reti, who practised family medicine for 16 years in Whangārei, “sincerely valued” the contribution of his former colleagues but said no Budget could deliver everything all groups hoped for. Michael Morrah is a senior investigative reporter/team leader at the Herald. He won the best coverage of a major news event at the 2024 Voyager NZ Media Awards and has twice been named reporter of the year. He has been a broadcast journalist for 20 years and joined the Herald’s video team in July 2024. Mon, 02 Sept 2024 00:16:00 Z /news/health/pharmac-asked-to-consider-stopping-long-term-subsidy-of-antibiotics-after-man-s-death/ /news/health/pharmac-asked-to-consider-stopping-long-term-subsidy-of-antibiotics-after-man-s-death/ A man who died of complications linked to long-term use of antibiotics was not properly warned of the risks. The man, a paraplegic as a result of an accident years earlier, managed his lack of bladder control with occasional self-catheterisation and was prescribed nitrofurantoin to manage the associated urinary tract infections. He used it for more than two years before dying from a lung disease, pulmonary fibrosis, caused by long-term use of the medication. It was a risk no one involved in prescribing or administering the medication told him or his wife about. In a report published today, Deputy Health and Disability Commissioner Carolyn Cooper found several health professionals missed opportunities to ensure the man understood the serious risk of taking the antibiotic nitrofurantoin for more than six months. This is despite the risk having been highlighted in at least two prescriber updates published by MedSafe over the past decade. A recommendation will now be made for Pharmac to consider stopping subsidy of the drug beyond six months’ use to “special authority” approvals only, as a way to restrict its availability. Following his death in 2019, the man’s wife complained to the HDC, primarily to help prevent “another avoidable death as a result of a lack of professional knowledge about the adverse effects of the medication”. He was initially prescribed the medication by a specialist at a spinal unit of a district health board. It was successful in treating his symptoms, so his GP and a urology registrar at another public hospital continued to prescribe it, without ensuring the man understood the risks of long-term use. The pharmacy also dispensed the medication without advising the man of the risks, Cooper found. Deputy Health and Disability Commissioner Carolyn Cooper says the man was denied an opportunity to make an informed choice about continued use of the medication. He had been taking the drug for about 28 months between 2017 and 2019 and was never made aware of the known risk of pulmonary disease from its long-term use. About six to eight months after starting the medication the man developed a mild and dry cough, but as neither he nor his wife were aware that this could be related to the nitrofurantoin, they did not raise any concerns about this at the time. The opinion of specialists in the inquiry was that when the use of nitrofurantoin exceeded six months, he should have been told about the potential risks so that he could make an informed decision about whether the benefits of continuing with it outweighed the risks. Cooper said it was “very critical” that none of the health service providers who cared for the man, named in the decision as Mr A, ensured he understood the risks, so she considered that no single individual or service was significantly more responsible. “Clearly, several providers failed Mr A.” Cooper said the complaint has highlighted that some practitioners who prescribe and dispense nitrofurantoin, including those who treated this man, were not aware of the potential for serious lung damage from long-term use beyond six months. “It has shone a light on a very important issue and prompted necessary improvements and education to reduce the chances of a similar situation in future,” she said. The providers involved have made significant changes and improvements. The pharmacy that dispensed the medication has asked the Pharmacy Defence Association to distribute the appropriate information to all community pharmacists. The owner said that before the incident they were not aware of the particular risk. “When we initially discussed this as a team, I found that some of our pharmacists are aware of the rare adverse effect associated with long-term use of nitrofurantoin … Other pharmacists did not know this … All our pharmacists are now acutely aware of this risk.” The spinal unit at Health NZ is creating an information document to be shared via the College of General Practitioners and the medical centre has conducted an audit of all patients prescribed this medication for monitoring and to ensure the side effects are reiterated to them. The man’s GP has since made “radical changes” to prescribing practices including providing written information from the New Zealand Formulary for all long-term medications for patients and discussing the pertinent side effects with them. In addition to the changes already made, Cooper listed follow-up recommendations including that the RCollege of General Practitioners and Te Tāhū Hauora|Health Quality & Safety Commission consider how best to further highlight awareness of the medication risks. In a recommendation to Medsafe and the Medical Protection Society, Cooper believed a more direct approach to the urology community was worthwhile through the publication of regular updates on the risks of long-term use of nitrofurantoin. Cooper said in concluding the investigation that she acknowledged and supported the wishes of the man’s wife in making the complaint. Mon, 26 Aug 2024 02:30:55 Z /news/health/young-mother-with-endometriosis-challenges-decision-to-deny-hysterectomy-due-to-age/ /news/health/young-mother-with-endometriosis-challenges-decision-to-deny-hysterectomy-due-to-age/ A mother in her 20s who hoped that having her uterus removed would help relieve her painful endometriosis symptoms was denied the surgery because of her age and an assumption that she might want more children in the future. The woman and her husband, who have two children, were determined that a hysterectomy would solve her problems. However, the specialist doctor she was seeing at the time spent considerable time trying to convince the couple to re-think the irreversible option. The woman has since had the surgery after leaving the doctor’s care and consulting another. “I can now be the active, healthy, present mother I had always hoped to be for my two children. “My pain has significantly reduced and I am no longer bound by my dysfunctioning body. It is so disappointing that this level of freedom was not afforded to me sooner,” the woman told the Health and Disability Commissioner after laying a complaint about the care she received from the first doctor. In a decision released today Deputy Health and Disability Commissioner, Deborah James found the doctor breached the woman’s health consumer rights on one aspect of her complaint, and recommended that the doctor apologise to the woman, and re-familiarise himself with the Medical Council’s statements on communication and consent. The woman also raised concerns about the doctor’s communication with her generally. The doctor accepted that there were aspects of his communication that might have been handled better. James said the care provided by the gynaecologist, who worked both publicly and privately, appeared to have been unduly influenced by his own views about what he perceived to be the best course of action for the woman. An independent specialist she sought to assist her with the case felt that most gynaecologists would not rush to offer a hysterectomy to a woman of her age - but equally, the option should not be withheld purely on the basis of age, and that ongoing discussion about it, particularly after counselling and perhaps a second opinion, would make this a reasonable option to discuss openly. The woman also advised the HDC that she suffered permanent nerve damage in her thigh secondary to being placed in a particular position during a second laparoscopic excision of endometriosis performed by the doctor in November 2020. Complaint timeline The woman was referred to the specialist in 2019 with pelvic pain, who confirmed and removed a moderate amount of endometriosis. The following May she returned to the same doctor complaining of pelvic pain again and was recommended to try a different oral contraceptive pill, and the possibility of introducing pain modulators was discussed. The doctor explained that “there [would] be a role for a second laparoscopic procedure”, but he wanted to avoid this procedure for as long as possible and first try to “exhaust all other medical options”. A follow-up appointment in July 2020 recorded that the different contraceptive was working well but the pain modulator was making the woman “very sleepy” and an alternative was suggested. The doctor again documented that the plan was to try to exhaust all the medical options before considering further laparoscopic surgery. The woman was experiencing bleeding and pain and booked an early follow-up appointment. She had tried switching back to a contraceptive she was on previously but this did not stop the bleeding or pain. The doctor noted that although the surgery would “definitely sort out the bleeding” a small chance remained that the pain could persist. He explained that offering a hysterectomy at her age was a case that would need to be discussed in the endometriosis multi-disciplinary meeting and would need to have some consensus from different consultants. The doctor also suggested that not having tried the small T-shaped hormonal contraceptive device, a Mirena, as suggested would make it more challenging to present the woman’s case. The woman told the HDC that she had declined a Mirena on multiple occasions previously and she felt that the doctor had “verbally coerced” her into agreeing to the Mirena insertion. Her understanding was that the doctor would present her case to the multi-disciplinary team if she tried the Mirena and that she was “essentially being blackmailed” into agreeing to a form of medication she did not want but begrudgingly accepted. The doctor was under the impression that the woman wanted to proceed with the insertion, which was attempted, but not tolerated so the woman was booked to have the Mirena insertion under general anaesthetic the next day at a private hospital. The woman said the attempted insertion was “the single most painful thing I have experienced”. The doctor documented that he would refer the woman’s request for a hysterectomy to the endometriosis multi-disciplinary meeting at the public hospital. Recommendations from multi-disciplinary team He told her it had been recommended that the next option would be treatment to suppress ovulation and induce temporary menopause plus hormone replacement therapy and that a clinical psychology review was done and a second opinion from another gynaecologist before proceeding with a hysterectomy. The woman was sceptical that the doctor had taken her case to the meeting because she received nothing in writing and no further information. Deborah James said there was no documentation outlining what specific recommendations were discussed and whether those recommendations were progressed, however, independent assessment was there was no reason to doubt that the case was presented. In November 2020 the woman underwent a second laparoscopic excision that was said to be without complication but within a few hours of waking from the surgery, the woman noticed that her right thigh was “completely numb”. At a follow-up appointment, the doctor said he believed it was likely due to compression of the nerve, secondary to lithotomy position the woman was placed in. After an appointment in December 2020, the woman told the doctor that she did not want any further follow-up with him as she was seeing another gynaecologist. The doctor later apologised to the woman for the distress that she had experienced. James said that based on the advice from the obstetrician and gynaecologist from whom she had sought guidance on the case, no departure from the standard of care was identified but she was concerned that the doctor had not provided the woman with information that a reasonable person in her circumstances would expect to receive regarding the options to treat her bleeding and pain. Neither had he given the woman honest and accurate answers about the multi-disciplinary meeting. James said it was her view that the woman had a right to receive an explanation of the available option of a hysterectomy.   Mon, 19 Aug 2024 02:17:45 Z /news/health/health-minister-shane-reti-confident-in-whangarei-hospital-s-emergency-department/ /news/health/health-minister-shane-reti-confident-in-whangarei-hospital-s-emergency-department/ Health Minister Shane Reti has defended Whangārei Hospital’s emergency department, saying it never closed to new patients and remains open 24/7. Reti’s comments come after the hospital’s ED hit “Code Black” last Friday after reaching more than 150% capacity. “It’s vitally important New Zealanders know they can get acute care from their emergency department when they need it,” he said. “Our EDs don’t turn people away, or close. “On Friday in Whangārei, I understand there was a period around the middle of the day when a number of presentations arrived close together. “The experienced team there worked through those presentations. “The Whangārei ED never closed to new patients and, as always, it remains open 24/7.” The declaration of a “code black” is made when the situation in a hospital is deemed critical, triggering an emergency escalation response by management. Concerns were raised after staff told RNZ on Friday there had been more than 80 arrivals since midnight, including 21 within one hour. A Health NZ spokesperson said it was not uncommon for the ED to go into code black, but it would continue to take patients who needed emergency care. Health Minister Shane Reti said he is confident in Whangārei Hospital’s emergency department. Reti reiterated Health NZ’s statement. “Whangārei Hospital is one of our high performing hospitals, particularly the ED,” he said. “HNZ has told me that wait times on Thursday and Friday of last week were almost exactly the same as last year, and that reflects the well performing nature of this particular team. “While EDs will always be busy, especially over winter, and I have confidence the trained professionals across New Zealand are delivering very good care. “The public can share that confidence too.” Whangārei Mayor Vince Cocurullo said the pressure on the emergency department highlighted that a new hospital was needed. Cocurullo said Northlanders have needed a new hospital for the past 20 years, and it was now at a “critical stage”. Reti said the rebuild was still “a priority”. “The planned main set of works is currently having additional design work completed but look at the Kotoku block – I opened that a few months ago. “The Whānau House, the residential house, is very close to opening as well, and the outpatient Child Health Centre is out for procurement. “So, there’s a lot of good work already delivered and soon to happen around the Whangārei campus, and that hospital upgrade is a priority.” In 2022, the Labour-led Government committed $759 million to stage one of the rebuild, due to be completed in 2031. This will include a new radiology and emergency department (ED) plus theatres, ICU, coronary care unit, support services and a new child health centre. The second stage, including a 158-bed ward tower and an acute assessment unit, is yet to be funded. Mon, 19 Aug 2024 01:12:11 Z /news/health/whang%C4%81rei-hospital-ed-hits-code-black/ /news/health/whang%C4%81rei-hospital-ed-hits-code-black/ An earlier version of this story included the incorrect information that being in Code Black meant the ED was unable to accept more patients. Health New Zealand has also clarified that the patient transfer had nothing to do with staffing at Bay of Islands Hospital. Whangārei Hospital's emergency department hit "Code Black" today after reaching more than 150 percent capacity. A Health NZ spokesperson said it was not uncommon for the ED to go into Code Black, but it would continue to take patients who needed emergency care. Health New Zealand Te Whatu Ora Group Director of Operations Alex Pimm said Whangārei Hospital continues to accept patients and new admissions and any claims otherwise are completely inaccurate. "Patients and their families can be assured that they will be seen and anyone who requires hospital level care will receive it. "The emergency department uses the Emergency Department at A Glance (EDAAG) system, which has four escalations (green-amber-red-black), factoring in patient numbers, acuity, patient waiting time, and resuscitation bed capacity. "Colour coding systems are blunt tools used in ED, which is a highly dynamic environment, and the status can change back and forth in minutes over the course of a 24-hour period. It is a real time measure. "The ED may arbitrarily trigger a particular colour status multiple times in one day as demand and pressures change." Staff have told RNZ there have been more than 80 arrivals since midnight, including 21 within one hour. "I have never seen this before," one said. This afternoon the ED was at 156 percent capacity. Whangārei's ED - which has space to treat 32 patients - had 50 patients. Staff said they were being asked to pick up workload from smaller rural hospitals, which were struggling with their own staff shortages. A medical registrar had been asked to take calls for Dargaville patients and up to nine patients had been transferred from Whangārei, they said. Bay of Islands Hospital at Kawakawa has been forced to downgrade services this weekend due to a doctor shortage. However, Health New Zealand said the patients who were transferred from Bay of Islands to Whangārei would have been transferred anyway "due to their acuity and needing to be treated in a larger hospital", and it had nothing to do with staffing at Bay of Islands. Bay of Islands Hospital at Kawakawa has been forced to downgrade services this weekend due to a doctor shortage. RNZ understands up to nine patients from Bay of Islands were transferred to Whangārei yesterday, and a medical registrar had been asked to take calls for Dargaville patients, too. The declaration of a "code black" is made when the situation in a hospital is deemed critical, triggering an emergency escalation response by management. It is not always restricted to the emergency department, but could involve "bed block" within the hospital itself, which can mean patients who need to be admitted have to stay in ED until beds become available. At some hospitals, it can mean procedures and operations have to be delayed. However, there is no suggestion that is likely to happen in this instance. Patients will never be turned away from an emergency department, regardless of the code a hospital is in. Health Minister Shane Reti has declined to comment. By Ruth Hill and Kate Green of RNZ  Fri, 16 Aug 2024 03:51:05 Z /news/health/misread-smear-tests-that-allowed-woman-s-incurable-cancer-extremely-unfortunate-hdc-finds/ /news/health/misread-smear-tests-that-allowed-woman-s-incurable-cancer-extremely-unfortunate-hdc-finds/ A woman suffered emotional and financial distress because of an almost eight-month delay in being told her smear tests were twice incorrectly assessed as normal, when in fact she had cervical cancer that is now incurable, the Health and Disability Commissioner has found.  However, in a report released today Morag McDowell found no one can be held accountable for the human error that caused Pippa van Paauwe’s smear tests to be misread in both 2017 and 2020.  Those twin mistakes allowed her cervical cancer to develop past the point of curability, but were somewhat unavoidable, McDowell said. A recent change to HPV testing as the main method of screening will significantly cut the false negative rate, she said.  “[van Paauwe] has endured an extremely unfortunate set of circumstances.”  However, the lengthy delay in telling the mother of two about those errors breached her rights under the Code of Health and Disability Services Consumers’ Rights, McDowell determined.  There was confusion among clinicians as to who had primary responsibility for disclosing the smear review findings, McDowell found, and a lack of clear processes.  “Patients are entitled to an open, truthful and timely discussion about what went wrong and why,” McDowell said.  The 40-year-old mum publicised her situation in a Herald story last September.  Pippa van Paauwe receiving treatment in October 2022.  In her complaint to the HDC, she said the thought that other women might be similarly failed by the health system keeps her awake at night.  “I would not wish my experience on my worst enemy. Before I die I need to know that I have done everything I can to make sure this does not happen to anyone else. I will have no peace unless I do.”  After heavy menstrual bleeding van Paauwe was diagnosed with stage 3 cervical cancer in March 2022. This was later upgraded to stage 4 in September that year.  In April 2022 her specialist asked the National Cervical Screening Programme (NCSP) - part of Te Whatu Ora Health New Zealand - to recheck her previous smear test results.  Cervical cancer is usually preceded by at least 10 years of pre-cancerous abnormality.  In December 2022 she was told that both her March 2017 and February 2020 smears were misread. If those tests had been correctly read, her cancer would likely have been curable.  Her slides had been pre-screened with an automated device, which finds 22 microscopic fields of view most likely to contain abnormal cells. These were then checked by the cytoscientist or cytotechnician.  Health and Disability Commissioner Morag McDowell said the move to HPV screening would reduce false negative results. Photo / HDC  In her report, McDowell agreed with Health NZ’s earlier finding that the false negative smear tests, “were the result of a misinterpretation of slides, for which no one can be held accountable”.  “In making this finding, I acknowledge how very unfortunate this situation is for [van Paauwe] — that in conjunction with the recognised false negative rate of cervical screening, [her] slides were misinterpreted consecutively, which accounts for the minority of false negative results.”  McDowell said she was pleased by the implementation of HPV testing as the primary method of cervical screening, which happened in September last year. Its testing is more effective than cervical cytology (smear testing), with 95% sensitivity as opposed to 70-75%.  “It is encouraging to read that the implementation of HPV testing will significantly reduce false negative rates, require each smear to undergo a double review, improve communication, reduce inequities for Māori, and improve access to screening.  “Although I appreciate that this does not change the outcome for [van Paauwe], I hope she takes comfort in the fact that this programme appears robust and accountable and will minimise the risk of her unfortunate situation happening to other women in New Zealand.  “I take this opportunity to encourage all women, especially wahine Māori, to get tested under the new HPV screening method.”  The results of the retrospective review of van Paauwe’s 2017 and 2020 smear tests, which found they had been misread, were first emailed to a specialist on May 6 2022.  They emailed the results to another specialist who had taken over her care on September 9, and asked them to inform van Paauwe, who had just been told of her Stage 4 diagnosis.  So as to not deliver more upsetting news, they delayed doing so until December 29 2022 - a decision they have now apologised in writing for.  Health minister Dr Shane Reti has been lobbied by women's health advocates to make cervical cancer screening free for all women. Photo / RNZ  McDowell said other failings included a lack of clear processes around a retrospective review of previous smear results in the event of cancer, and the fact an investigation into van Paauwe’s case by Health NZ happened only at her request.  The national screening unit has promised to this year introduce a formal audit of all cases of invasive cervical cancer, including a review of any slides reported as normal in the previous screening round.  Health NZ Te Toka Tumai Auckland (formerly Auckland DHB) is preparing new guidance on open communication for its staff.  van Paauwe is currently clear of detectable signs of cancer, following treatment including immunotherapy, which was self-funded to begin with and is now covered by ACC under medical misadventure.  She was glad better processes were being put in place, but told the Herald it was disappointing that no breach had been found about her smears being misread.  “The fact it happened consecutively to the same person remains too coincidental for my liking.”  Nicholas Jones is an investigative reporter at the Herald. He was a finalist for Reporter of the Year at the 2024 Voyager Media Awards, and has won numerous national media awards for his reporting and feature writing.  Mon, 22 Jul 2024 02:12:28 Z /news/health/pharmac-director-dr-anthony-jordan-quits-over-government-s-treaty-of-waitangi-directive/ /news/health/pharmac-director-dr-anthony-jordan-quits-over-government-s-treaty-of-waitangi-directive/ By RNZ  Pharmac director Dr Anthony Jordan has quit over the Government’s Treaty directive, the Pharmac Minister’s office says.  Associate Health Minister David Seymour this week told Pharmac it was inappropriate for the agency to keep considering the Treaty of Waitangi’s place in the health sector.  Seymour has released his letter to Pharmac board chair Paula Bennett setting out his expectations for the agency.  “Pharmac’s role should focus on delivering improved health outcomes underpinned by robust data and evidence, in accordance with its statutory responsibilities,” he wrote.  Jordan joined the Pharmac board in December 2021 and his term was due to end in December 2024.  Bennett said in a statement Jordan’s decision to resign was effective immediately.  “I am told Dr Jordan has made a significant contribution to Pharmac’s strategic direction and operational focus over the past few years,” she said.  “Other board members, the chief executive and the teams at Pharmac have greatly appreciated the clinical expertise and insights he has brought to his role on the board, and we wish him all the best for the future.”  Seymour would appoint a new board member in due course, she said.  In his letter to Pharmac, Seymour also said there were some illnesses and treatments where ethnicity was a factor, and that he had never argued ethnicity should not be considered in such cases.  Bennett said Seymour’s letter had set out clearly the need for Pharmac to consider the voices of all New Zealanders, and highlighted the focus on a social investment approach.  As part of National’s coalition agreement with Act, Seymour has been tasked with reforming Pharmac’s funding model, to account for positive fiscal impacts on the Crown of funding more medicines.  Pharmac will be required to update its statement of intent to reflect the Government’s priorities, and continue to outline how it is implementing the findings from the 2022 review.  - RNZ  Fri, 19 Jul 2024 03:02:26 Z /news/health/grandmother-battling-cancer-told-the-one-drug-keeping-her-alive-will-no-longer-be-funded/ /news/health/grandmother-battling-cancer-told-the-one-drug-keeping-her-alive-will-no-longer-be-funded/ After battling lung cancer and two brain tumours, Christchurch mum Kiri Carter has been told the one drug keeping her alive will no longer be funded. The 57-year-old met her husband, Kevin seven years ago. When the pandemic hit, Carter suffered from what doctors initially thought was Long Covid. “That wasn’t Long Covid though. It was lung cancer, stage four,” she said. “The doctors basically said we can’t treat you, see ya later.” Two months later, Kevin and Kiri got married. After receiving a terminal cancer diagnosis, Kiri and Kevin Carter got married. Photo / Dolce Wedding Photography “Well, I was given six to nine months by the hospital … we thought we’d better get onto it,” Carter said. Newly wed with two older children and three young grandchildren to watch over, Carter was determined to stay alive. When the hospital told her she couldn’t be treated, she approached St George’s Private Hospital. “I saw an oncologist there, a brilliant one called Raj, and he says, ‘now I can help you extend your life by giving you pemetrexed, but it’s going to cost $70,000′,” Carter said. After extensive fundraising and taking out an early family inheritance, Carter managed to get the treatment. Not long after that, she began experiencing symptoms with her head, too. “I got really sick, I was walking into door frames … so my husband took me into the emergency department,” she said. “I told them you’ve got to look at my head there’s something wrong.” The doctors found a brain tumour. A few days later, she had brain surgery. And a few days after that, she had to go under the knife again. “The surgeon said, ‘Oh, we left half that behind … we have to do it again’,” she said. After battling lung cancer, Kiri Carter was diagnosed with brain cancer. Photo / Supplied Fast forward to June this year, Kiri has been diagnosed with a second brain tumour. While awaiting a treatment plan to remove it, Pharmac told her it can no longer fund her drug - Pemetrexed. According to its website, renewal of the drug is only administered if there has been “no evidence of disease progression”. Despite the fact the drug is keeping her alive, the company has deemed Carter ineligible due to her brain tumours. Fortunately, Carter met Johanna Tawharu. Johanna Tawharu and Kiri Carter met on the neurology ward in Christchurch hospital and were friends instantly. Photo / Supplied “I remember the first moment I met Kiri, it was pretty cool, we met in the neurology ward in hospital,” Tawharu said. “I said what you in for … she laughed and said, ‘Oh I’ve actually got a tumour in my skull’,” Tawharu said. “She was just so casual about it, I didn’t quite know what to say. “Just that one conversation changed my whole life.” Tawharu wasn’t in a good place when she met Carter. She had been in and out of surgery for a spinal injury. “I really thought that I was in my lowest space, until I met Kiri.” Kiri Carter was given six-to-nine months to live, two years later, she is still fighting. Photo / Supplied Carter and Tawharu were friends instantly. Tawharu was “gutted” by Pharmac’s response. “I think Pharmac has a responsibility. I mean, they are a multi-billion-dollar corporation ... why should they get to deem who lives and who dies,” she said. Tawharu has since set up a Givealittle to “give Kiri the gift of time”. “I started it because I wanted more time with her, but I also wanted her to have more time with her family,” she said. “She gets up every day, she gardens, she cooks, she bakes, she cleans and she’s stopping to vomit because she’s sick, you know? “This woman, she doesn’t want to waste any time.” On July 3, Carter had her final round of radiation. Kiri Carter received her final round of radiation on July 3. Photo / Supplied “We are keeping our fingers and toes crossed for Kiri’s radiation treatment to work and kill off that ugly brain tumour,” Tawharu said. “Keep being you Kiri. You have so many people who care about you, who are following your journey and sending you well wishes.” Carter feels Pharmac’s decision to pull funding was premature. She said wasn’t sure the brain tumours were related to the lung cancer pemetrexed was treating in the first place. Pharmac responded to Herald questions, saying that every eight months, if a clinician determines that an individual’s cancer has progressed, they are no longer eligible to receive treatment. “We know it’s very difficult to manage a life-changing condition such as lung cancer and that access to medicines is a very important part of treatment,” a Pharmac spokesperson said. “Pharmac has to make difficult decisions about what treatments are funded and for who, and to do that we rely on the best available clinical evidence and assessment, as well as understanding the day-to-day reality of what it’s like to live with health conditions. “Pharmac sets eligibility criteria for medicines to help make sure we target funded treatments to those most likely to benefit. Our eligibility criteria are based off the clinical advice we receive and the evidence available to us.” Carter felt the agency could have used a more empathetic response. “It’s like people telling you you’re not worth saving,” she said. In spite of her terminal diagnosis, and no treatment funding, Carter remains calm and positive. “I don’t tend to stress out too much, because, you know, you deal with worse things, it doesn’t help my health if I’m going to stress out,” she said with a laugh. - NZ Herald Mon, 08 Jul 2024 00:30:22 Z /news/health/should-your-child-be-on-tiktok-kiwi-social-media-expert-says-banning-it-isn-t-the-answer/ /news/health/should-your-child-be-on-tiktok-kiwi-social-media-expert-says-banning-it-isn-t-the-answer/ The United States government is set to ban TikTok unless the company’s owner can find a buyer, while in Australia, one state is considering a social media ban for under-16-year-olds. Should New Zealand follow suit? And should Kiwi parents be worried about their kids using TikTok? A New Zealand-based expert weighs in and shares practical tips for parents and teens.  Recent research shows Kiwi kids spend about a third of their time outside of school on screens, while a nationwide cellphone ban in New Zealand schools aims to reduce distractions in the classroom. Experts around the world fear excessive time online is negatively affecting young people’s mental health, leading to growing calls to ban or restrict social media use among kids and teens.  Social media expert Katie Brown isn’t convinced banning apps like TikTok is the answer.  Brown is the founder and CEO of Te Ao Matihiko and Social Good, as well as the representative for Facebook owner Meta in Aotearoa. She advocates for Māori in technology and led the Unite Against Covid-19 campaign during the pandemic.  “If it’s about safety, it doesn’t fix the issue that’s at the heart of it, which is that some bad actors are putting bad information out there that people can have access to on any platform,” she tells the NZ Herald.  “So, we need to really get to the heart of where those people are coming from, trying to stop that from even happening, but also equipping our young people with the tools that they need to navigate safely online.”  As Brown points out, Aotearoa famously spearheaded the Christchurch Call following the mosque attacks in 2019.  “That’s all about security provisions from all of the social media platforms around keeping the people on there safe and making sure that the content doesn’t result in something as horrific as what we’ve seen,” she explains.  “In Australia, they have concerns about the safety of younger people under the age of 16 accessing TikTok and the content that they’re accessing, and so they’re trying to get an age limit.”  But as Brown notes, the proposed ban is being pushed in only New South Wales, and won’t necessarily be effective unless the rest of the country gets on board.     Social media expert Katie Brown wants parents and caregivers to equip their young people with the tools they need to stay safe online.     In her view, a ban would lead to “underground behaviour”. “They’ll secretly go on it or they’ll go on a VPN. And so, then if they encounter content that makes them uncomfortable, who are they going to talk to about it?”  While the medium may have changed in recent decades, young people have always sought their own spaces away from adults to establish their identities and connect with one another.  “They’re going to be online, they love being online to connect with different people. We don’t talk about the good part enough, which is it’s such a good connector,” Brown says, adding that those positive aspects of social media are often overlooked.  “The best thing that people can do is bring it out in the open and have conversations with young people about what they see online and what content they’re looking at. [Then] we can strengthen our young people and equip them with all the tools to build resilience.”  So, how do you have those conversations as a parent? And how can you model healthy social media use for your kids?     Does your child know what to do if they come across negative content on social media? Photo / Alex Cairns     Talk with your kids about their online identity  Those of us of a certain age cringe when we think about photos or statuses we posted on our Facebook walls in the site’s early days. Twenty years ago, no one was thinking about their “digital footprint” — but now, Gen Alpha has the chance to learn from previous generations.  Brown advises getting your kids to think about their online identity.  “Who do you want to be online, how much of your identity are you willing to share? And then what are your strategies if you feel that you’re unsafe?”  As parents, you get to put parameters around social media use that Brown encourages.  “It might be, you can go on TikTok when you’re in the lounge, or you can’t be on it until you’re 15. Those are decisions that they [parents] need to make for the wellbeing of the young person.”  Brown notes that TikTok is aware of the registration age, and its algorithm shouldn’t send unsuitable content to a young user, and this offers “a little bit of reassurance”.  “That does not mean they can’t go and look at that stuff,” she explains. “But it does mean that the machine itself has some built-in support.”    Try ‘co-scrolling’ with your child  Brown suggests “co-scrolling” with your child — looking at social media content together.  “Scrolling together, having a look at content, reflect on that content and why you like it, and why you might not engage with some other content. So it’s creating that reflective behaviour, but also teaching the algorithm, this is some good content, give us more of that,” she explains.  This helps promote positive social media use, she says.  “It means that social media isn’t a hidden activity for our young people, it’s out in the open. Parents know what they’re up to. And they feel safe to have conversations if they see something that makes them feel unsafe.  “If they see behaviour happening that’s bad, then they can take action.”     Brown suggests scrolling through social media with your child and highlighting positive content.     Responding to negative social media content  Brown suggests talking through potential scenarios with your child so they know what to do if they come across negative online content.  “How do you report something? Who’s a safe person that you can talk to? And then how can you help out a friend that might be struggling as well?  “If there’s someone who’s saying really nasty stuff, who is bullying, we’ve got processes as a family to deal with that and we’ve talked about it. I think it’s really important to have those discussions if you can.”  If your child or someone else is being bullied on a social media platform, Brown advises they avoid engaging with the user, take screenshots for reference, and tell a trusted adult about the incident.  “It’s really important to recognise bullying for what it is, and take the appropriate measures outside of the platform.”  Those measures could include reporting the incident to the social media platform in question, or to Netsafe.     What do parents need to know about TikTok?  Writing for Parenting Place, Holly Jean Brooker previously shared some advice with the Herald about how to approach TikTok as a parent.  “You’re the one who best knows your child, and you’re the one who best knows your values,” she shared.  “At Parenting Place, we strongly encourage you to make decisions that you think are best for your family. And know that you can always change those decisions. It’s vital that we stay connected with our kids and regularly check in on what they’re doing online — both at home and when they’re out with friends.  “With TikTok, even if our kids don’t have their own account, they can appear on their friends’ accounts, access TikTok through a web browser and even set up an account on their friend’s phone.”  Brooker notes the importance of having “robust conversation” with your child about the pros and cons of the app.  “We also need to bring our kids into this conversation as often and as honestly as possible, too. This supports them to make good decisions for themselves - whether we’re watching or not.”     Where to get help:  Lifeline: Call 0800 543 354 or text 4357 (HELP) (available 24/7) Suicide Crisis Helpline: Call 0508 828 865 (0508 TAUTOKO) (available 24/7) Youth services: (06) 3555 906 Youthline: Call 0800 376 633 or text 234 What's Up: Call 0800 942 8787 (11am to 11pm) or webchat (11am to 10.30pm) Depression helpline: Call 0800 111 757 or text 4202 (available 24/7) Helpline: Need to talk? Call or text 1737 Aoake te Rā (Bereaved by Suicide Service): Call 0800 000 053 If it is an emergency and you feel like you or someone else is at risk, call 111.     Bethany Reitsma is an Auckland-based journalist covering lifestyle and entertainment stories who joined the Herald in 2019. She specialises in telling Kiwis’ real-life stories, money-saving hacks and anything even remotely related to coffee.      Mon, 17 Jun 2024 08:49:11 Z /news/health/health-how-to-lower-your-risk-of-falling-as-you-get-older/ /news/health/health-how-to-lower-your-risk-of-falling-as-you-get-older/ One in four older adults in the U.S. will fall each year, putting them at risk of injury, broken bones and even death.  Falls are a growing public health concern as the country's population sees record numbers of people turn 65 — now and in the future. But common as falls may be, they are not inevitable.  "The more work we do, the more we realize that that healthy aging doesn't have to include falling," said Cara McDermott, who researches falls at Duke University School of Medicine.  Here are some recommendations on how to reduce your risk of falling.  Fall-proof your home Start with how your house is set up: Consider removing small area rugs, change out dim lighting and don't put pots and pans in hard-to-reach places.  Then, aim for providing extra stability in places where its easier to lose your balance. Install railings on both sides of the stairs, a grab bar in a bathroom and no-slip strips on wood or tile floors.  It's also important to keep your home clean: Don't leave items on the floor, and clean up spills before they dry up and become harder to deal with.  Consider using a walker or cane to keep you stable, but make sure it's right for your height and that you know how to use it properly.  The National Institute on Aging has a full guide on its website with tips on how to fall-proof your home, room by room.  Exercise to build strength and balance Go back to the basics with Newton's first law: A body in motion stays in motion. That is, staying active can help prevent future issues — even if you've fallen before and are worried that it might happen again.  Many exercises that can help prevent falls, even if you have limited mobility, like chair yoga, tai chi and walking.  "It doesn't mean that you have to go out and start running marathons or anything like that, but simply (do) functional exercises," McDermott, said.  Make exercising fun and social by doing it with others in a group setting or playing with grandchildren.  The key: Know your limits and do what your doctor says is right for you.  Medications may increase your risk Many medications can have side effects like light-headedness, sleepiness or other things that impair your balance.  McDermott said older adults should talk to their primary care doctor about all of the medications they are on — and how they may work in combination. A primary care doctor or pharmacist can see the whole picture and help find alternative medications that won't throw you off balance.  But, she added, "I would never, ever recommend that somebody discontinue a medication without talking to their prescriber first."  Stay on top of screenings Changes in hearing, vision and other senses are common as you age and can contribute to falls. Make sure to have your hearing and vision tested regularly.  Bone health matters, too.  The Mayo Clinic estimates 10 million Americans have osteoporosis, which weakens the bones and makes it more likely to break something when you fall.  Taking Vitamin D and calcium can help improve bone health, and if needed, your doctor can test your bone density and recommend treatment.  Falls aren't usually caused by one thing Knowing that falls might be a combination of causes, do some of the previous suggestions to lower your risk.  And, if you do fall, let your doctor know — even if it seems minor. A fall can have wide-reaching implications and you'll want to address the root cause to keep it from becoming a pattern.  "Maybe it is a one-time thing, but get it checked out anyway," McDermott said.  -AP Mon, 17 Jun 2024 08:22:50 Z /news/health/drinking-lots-of-water-can-be-a-healthy-habit-here-s-when-and-why-it-can-prove-toxic/ /news/health/drinking-lots-of-water-can-be-a-healthy-habit-here-s-when-and-why-it-can-prove-toxic/ In late 2023, actor Brooke Shields suffered a seizure after “flooding” her body with water. Shields became dangerously low on sodium while preparing for her show by drinking loads of water. “I flooded my system and I drowned myself,” she would later explain. “And if you don’t have enough sodium in your blood or urine or your body, you can have a seizure.”  Shields said she found herself walking around outside for “no reason at all”, wondering: “Why am I out here?”  “Then I walk into the restaurant and go to the sommelier who had just taken an hour to watch my run through. That’s when everything went black. Then my hands drop to my side and I go headfirst into the wall.”  Shields added that she was “frothing at the mouth, totally blue, trying to swallow my tongue”.  Like Shields, many people may be unaware of the dangers of drinking excessive amounts of water – especially because hydration is so often associated with health benefits. Models and celebrities often advocate drinking lots of water to help maintain clear, smooth skin. Some social media influencers have promoted drinking a gallon of water daily for weight loss.  But excessive water consumption can cause hyponatraemia – a potentially fatal condition of low sodium in the blood.  The body strictly regulates its water content to maintain the optimum level of total body water and “osmolality” – the concentration of dissolved particles in your blood. Osmolality increases when you are dehydrated and decreases when you have too much fluid in your blood.  Osmolality is monitored by osmoreceptors that regulate sodium and water balance in the hypothalamus – the part of the brain that controls numerous hormones. These osmoreceptors signal the release of antidiuretic hormone (ADH), which acts on blood vessels and the kidneys to control the amount of water and salt in the body.  In healthy people, the body releases ADH when osmolality becomes high. ADH tells the kidneys to reabsorb water, which makes urine more concentrated. The reabsorbed water dilutes the blood, bringing osmolality back to normal levels.  Low blood osmolality suppresses the release of ADH, reducing how much water the kidneys reabsorb. This dilutes your urine, which the body then passes to rid itself of the excess water.  Healthy urine should be clear and odourless. Darker, yellower urine with a noticeable odour can indicate dehydration – although medications and certain foods, including asparagus, can affect urine colour and odour, too.      How much is too much?  Adults should consume two-to-three litres per day, of which around 20 per cent comes from food. However, we can lose up to ten litres of water through perspiration – so sweating during exercise or in hot weather increases the amount of water we need to replace through drinking.  Some medical conditions can cause overhydration. Approximately one in five schizophrenia patients drink water compulsively, a dangerous condition known as psychogenic polydipsia. One long-term study found that patients with psychogenic polydipsia have a “74 per cent greater chance of dying before a non-polydipsic patient”.  In some cases, people with anorexia nervosa can also suffer from compulsive water drinking.  For those suffering from polydipsia, treatment is focused on medication to reduce the urge to drink, as well as increasing sodium levels. This should be done gradually to avoid causing myelinolysis – neurological damage caused by rapid changes in sodium levels in nerve cells.  In rare cases, some users of the illegal drug MDMA (also known as ecstasy) have died after drinking copious amounts of water to rehydrate after dancing and sweating.  Symptoms of too much water consumption include nausea, vomiting and headaches. In serious cases, the brain can swell, which can lead to confusion, seizures, coma and death. Photo / Getty  Symptoms of too much water consumption include nausea, vomiting and headaches. In serious cases, the brain can swell, which can lead to confusion, seizures, coma and death. Photo / Getty  The drug increases body temperature, so users drink water to avoid overheating. Unfortunately, MDMA also triggers the unnecessary release of ADH, causing water retention. The body becomes unable to rid itself of excess water, which affects its electrolyte levels – causing cells to swell with water.  Symptoms of water intoxication start with nausea, vomiting, blurred vision and dizziness. As the condition progresses, sufferers can often display symptoms of psychosis, such as inappropriate behaviour, confusion, delusions, disorientation and hallucinations.  These symptoms are caused by hyponatraemia, where sodium levels are diluted or depleted in blood and the subsequent imbalance of electrolytes affects the nervous system. Water begins to move into the brain causing a cerebral oedema – brain swelling because of excessive fluid buildup, which is usually fatal if not treated.  A healthy body will tell you when it needs water. If you’re thirsty and your urine is dark with a noticeable odour, then you need to drink more. If you aren’t thirsty and your urine is clear or the colour of light straw, then you’re already doing a good job of hydrating yourself.  Adam Taylor, Professor and Director of the Clinical Anatomy Learning Centre, Lancaster University  This article is republished from The Conversation under a Creative Commons license. Read the original article.  Fri, 31 May 2024 07:27:00 Z /news/health/tourette-s-in-new-zealand-kiwi-father-and-son-explain-what-living-with-the-condition-is-really-like/ /news/health/tourette-s-in-new-zealand-kiwi-father-and-son-explain-what-living-with-the-condition-is-really-like/ Think of Tourette’s and you might think of involuntary swearing, gestures or noises, often portrayed in pop culture as something to be made fun of. In reality, only 10 per cent of people with Tourette’s have the ‘swearing tic’, coprolalia. In New Zealand, one in 100 young people live with the neurological disorder and the stigma that comes with it. Here an Auckland-based father and son both living with Tourette’s explain what it’s really like, and what needs to change about the way it’s perceived in New Zealand.   When Chris Henderson was 9 years old, a GP prescribed him “harsh” antipsychotic medication and told him to stare into a mirror to see how “crazy” he looked.   It was 1987 and Henderson had just been diagnosed with Tourette’s syndrome. He’d been experiencing some of the signs since he was as young as 3 or 4 years old, such as eye rolling and motor tics.   “When you’re 9 and you’ve got a doctor telling you that, and you’ve got a mum and a dad and a sister that care and you don’t know what to do except stare in a mirror, you kind of have to figure it out yourself,” he tells the NZ Herald.   Now 46, he’s the founder and CEO of Pita Pit New Zealand and a father of three. But ever since his diagnosis, Henderson says, “it’s still always felt like I couldn’t talk about it, because of those early years.”   Growing up, his friends knew he wasn’t “weird or odd” for having Tourette’s, but during his intermediate and high school years, “the bullying became really hard”.   His tics haven’t gone away or changed over time. “I’m probably able to manage them slightly better as an adult,” Henderson says.   “The same triggers are nervousness and anxiety, pressure, tiredness. And so when I feel any of those symptoms, my tics flare up a little bit. When I’m relaxed and in a really pure place of happiness and contentment, they tend to subside.”   After his own “horrific” experience being medicated with haloperidol - which is also used to treat symptoms of schizophrenia and bipolar disorder - he says, “There’s not a direct medical fix, in my opinion, for Tourette’s.”   What does help is general wellbeing; a balanced diet, exercise, and support from family and friends.   Two of Henderson’s three children, including son Ryder, 11, also have Tourette’s. Asked whether his own experience has helped him parent his sons living with the condition, he says it’s actually the other way around.   “To tell the truth, my kids talk about it better than I do. They really do,” he shares. “But for me, I still feel uncomfortable about raising it with them, because of the traumas I had when I was Ryder’s age.   “So the beautiful thing about it is we just chat about it. We just chat. ‘Oh, Dad, this is my tic today’. My other son will come home and go, ‘Dad, I had this tic today that was so weird or funny’.   “It’s just a part of the brain that’s wired a bit differently. Ryder’s just a normal kid, I’m a normal father, business owner, husband, sportsman.”   Henderson says it’s important that there’s more research into the disorder, which isn’t widely understood, as well as better awareness from the public and Government around just how many young people live with the symptoms today.   “What needs to change for people living with Tourette’s is just the normalcy of it all, just to debunk the myth that it’s wrong or weird.   “I want people to know it’s okay. When you see someone with it, try and understand what it is and just don’t raise it with them, just talk to them as a person.”     ‘Just the way our brains are’   Like his dad, 11-year-old Ryder remembers having Tourette’s since before his preschool days. But for the intermediate school student, it’s “completely normal”.   “When I get excited, nervous or anxious about something coming up or happening like a cross-country race or going on a trip somewhere new, my tics get bigger and some of them can give me pain, like in my neck,” he explains.   Ryder takes medication for ADHD, which can make his tics worse and in turn, this can make it difficult for him to focus at school.   “Going to this new school, I’ve had some people being mean about my Tourette’s and stuff,” he says.   Dad Chris came to his school to do a presentation about Tourette’s for his classmates, and Ryder says the kids are “a lot nicer” to him now they understand it better.   “Most people just ask me why I make funny movements and once I tell them I have Tourette’s, they are cool about it.”   Having a family that understands Tourette’s makes all the difference. “It makes me feel way better not being alone. It makes me feel like I can tic in a safe space without trying to hide it.”   He wants Kiwi kids his age to know that Tourette’s is “completely normal”, and that “if they ever see anyone with Tourette’s getting bullied, they have to stop it”.   “I can’t help it. You can’t tell someone to stop because it is just the way our brains are.”      What Kiwis need to know about Tourette’s   It’s Tourette’s Awareness Month in New Zealand until June 15, and the Tourette’s Association of New Zealand (TANZ) is looking to raise awareness and funds through its Swear to Make a Difference campaign.   The association’s general manager Emma Henderson explains that the campaign is not designed to make light of people’s tics, but rather to draw attention to the fact that 90 per cent of those with Tourette’s do not have coprolalia.   She is also Chris Henderson’s sister, and knows all too well that the disorder is “misunderstood” by many.   “We just want people to accept those that have Tourette’s in their community and talk to people with Tourette’s, find out what it’s like to live with and know that it is difficult, but we’re not your punchline,” she tells the NZ Herald.   “It is a spectrum and while some tics are manageable for those living with it, it can range through to a debilitating syndrome that really has a direct impact on people’s lives.”   TANZ is the only charity in the country that supports those living with the disorder, providing resources and advocacy and running Camp Twitch for young Kiwis with Tourette’s and their families, all without government funding.   The cause of Tourette’s is uncertain, though research suggests genetics and environmental factors have a part to play, according to TANZ.   To find out more about Tourette’s and the Swear to Make a Difference campaign, you can visit the TANZ website here. You can donate to TANZ here.   If you think you or someone you know may have Tourette’s syndrome, the first step is to visit your GP, who can refer you to a specialist for diagnosis.   Bethany Reitsma is an Auckland-based journalist covering lifestyle and entertainment stories who joined the Herald in 2019. She specialises in telling Kiwis’ real-life stories, money-saving hacks and anything even remotely related to coffee.  Fri, 31 May 2024 03:24:34 Z /news/health/how-to-meditate-if-you-cant-sit-still/ /news/health/how-to-meditate-if-you-cant-sit-still/ The first time Marcelle Hutchins sat down to meditate, she put on a guided session, relaxed her shoulders and tried to close her eyes. She lasted two minutes.  "I had a deadline, and I thought, 'I don't know if I can sit still this long,'" said Hutchins, who was working as a radio journalist.  At the urging of her father, a longtime practitioner, she tried again and managed to finish a 10-minute video on her third attempt. "I remember feeling this sense of joy and relaxation," she said. "I used to be that person who said, 'I can't meditate.'"  Hutchins has since become a certified meditation teacher — and serves as an example that busy, restless people who try once should try again. Research shows a daily meditation practice can reduce anxiety, improve overall health and increase social connections, among other benefits.  The trick is to get over that initial barrier. Experts say it's more achievable when you throw common misconceptions out the window. For instance, many people try meditation only once because they feel they're doing it wrong or that they can't turn off their brain.  That's not the point, says Tara Brach, who holds a doctorate in psychology and has trained more than 7,000 people to be meditation teachers.  "It's not about stopping thoughts. The mind generates thoughts the way body creates enzymes," she said. "It's about being able to get larger than the thoughts and witness them."    Start simple  There is no right way to meditate, Brach stressed.  The key is to relax and focus on something in the present moment. Feel your breath pass through your nostrils, listen to a guided recording, mentally scan your body from head to toe, repeat a loving phrase to yourself or try countless other techniques.  You can sit on the floor, in a chair or on a cushion. If you can't get comfortable, lie down. You don't even need to close your eyes, though it's recommended to try.  There is no standard amount of time to begin with, but set an achievable goal.  "You can customize it to who you are," said Brach, author of several books, including "Radical Acceptance: Embracing Your Life With the Heart of a Buddha."  "Start with the most you can comfortably do without having to feel like you want to quit," she said.  That could mean starting with as little as a few minutes, said John Mitchell, an associate professor in psychiatry and behavioral sciences at Duke University who uses meditation to treat patients with ADHD. The goal should be working meditation into a routine and focusing on the quality of the practice, not the quantity.  "Then the question is, what do we do to create success so we can have momentum and start off without feeling like you're failing right way?" he said.    When you can't sit still  When you inevitably get distracted — everyone does — notice the thought or urge to move, acknowledge it and bring your attention back to where you are.  Instead of judging yourself, get curious for a minute about the nature of restlessness, Brach said. Ask yourself, "What does it really feel like if I want to jump out of my skin?"  Then take a long, deep breath, and sit for one more minute. If you still want to move, then move. But Brach recommended doing so mindfully. Stand up, do a light stretch, take a deep breath and sit again. You will be surprised at how that sense of restlessness will change over time, she said. "It will evolve."  If the restlessness builds to a point where you are uncomfortable, consider taking a slow, meditative walk, Mitchell said. Stay alert but calm, focusing on the sounds, sights and smells around you, or maybe on the sensation of the wind and sun on your face.  "You're not restricted," he said. "You don't have to sit there in silence and be still all the time."    Tomorrow, and the next day, try again  After sticking through the first session, you will almost certainly feel calmer, no matter the length. But to get the full benefits, as with exercise, research shows you need to practice consistently.  For people having trouble starting, that can be daunting, but Brach suggested trying a few techniques to find the right fit.  "It takes a bit of experimentation to find the style of meditation that works for your particular body, mind and personality," she said.  Luckily, there's a universe of free meditation resources online.  "Nobody reading this needs to go buy anything," she said.  -AP Mon, 20 May 2024 02:47:27 Z /news/health/health-minister-on-tackling-the-threat-of-international-doctors-leaving-over-cultural-differences/ /news/health/health-minister-on-tackling-the-threat-of-international-doctors-leaving-over-cultural-differences/ Health Minister Shane Reti says the Government has several measures in place to keep international doctors in their roles, as a study reveals many struggle to adapt to the health sector's work culture. The threat of the country losing international… Wed, 24 Apr 2024 03:58:26 Z /news/health/just-normal-theatre-why-some-claim-the-impending-doctors-strike-shouldnt-be-the-focus/ /news/health/just-normal-theatre-why-some-claim-the-impending-doctors-strike-shouldnt-be-the-focus/ The recently announced plans for a doctor's strike next month have been labelled "just the normal theatre of bargaining" by the former Health NZ chairman, claiming the strike threat shouldn't be the focus but rather the country's inability to resolve… Tue, 23 Apr 2024 03:16:37 Z /news/health/what-went-wrong-nursing-advocates-on-what-was-learned-from-hospital-machete-attack/ /news/health/what-went-wrong-nursing-advocates-on-what-was-learned-from-hospital-machete-attack/ Band-Aid security solutions, double-tasked security staff and a lack of de-escalation training have been identified as lessons learned from a horror hospital attack over Easter Weekend that involved a machete. A Wairarapa Hospital visitor suffered a skull fracture after the… Wed, 03 Apr 2024 03:03:35 Z