living with pain 2

eczema relief + migraine management + arthritis exercises

WINTER 2015

PAINLivingwith

magazine

FREE WITH COMPLIMENTS FROM YOUR PHARMACIST OR HEALTH PROFESSIONAL

BACK PAIN myths busted

Secrets of a Good Night’s Sleep

The Lowdown on IBS

ARTHRITISTips for managing pain

www.sigvaris.com

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ContentsLIVING WITH PAIN WINTER 2015

IN BRIEF2 News and Views

NATURAL HEALTH4 The wonders of birch

SLEEP5 Top tips for a good

night’s sleep

ARTHRITIS7 Managing your pain

IRRITABLE BOWEL SYNDROME12 Advice from an expert

ECZEMA16 Beat the winter woes

16

LIVING WITH PAINPUBLISHERPublished by Hawkhurst Media Services LtdPO Box 25679, St Heliers, Auckland 1740Director: Kerry McKenzie09 589 1054 or 0275 969 979

ADVERTISING Advertising sales: Maree Selak021 503 [email protected]

PRODUCTIONEditor: Sara [email protected]: Rose Miller at Kraftwork [email protected]: Stella Clark

PRINTERMcCollams Print

ISSN: 2324-2213

Disclaimer: Every effort is made to ensure accuracy but Living with Pain accepts no liability for errors of fact or opinion. Information in this publication is not intended to replace advice by your health professional. If in doubt check with your pain specialist, GP, nurse, dietitian or other health care professional. Editorial and advertising material does not necessarily reflect the views of the Editor or publisher. Advertising in Living with Pain does not constitute endorsement of any product.Living with Pain is an independent publication and is in no way affiliated with or endorsed by any organisation. © All rights reserved. No article in whole or part should be reprinted without permission of the Editor.

MIGRAINE20 Managing an attack

GOUT24 Getting uric acid levels down

BACK PAIN25 Five common myths

ARTHRITIS28 Exercises to keep you moving

ENDPOINT32 Useful snippets20

www.sigvaris.com

NEW TO NZ: CLINICALLY TESTED TRAVEL SUPPORT SOCKS

Do your legs cause you particular discomfort while travelling? If so, TRAVENO socks are just what you need. These socks boost circulation by applying gentle pressure to the legs. Thanks to their innovative knitted fabric, TRAVENO socks prevent odours and ensure optimum comfort and fresh-feeling legs while on the move.

Medically tested travel support socksTRAVENO will come in handy wherever you go. Scientific studies have proven that TRAVENO reduces swelling of the legs on long-haul flights and lowers the risk of thrombosis 1.

The benefits of TRAVENO for you. Intensive graduated support

(15-18mmHg around the ankle region). Reduced swelling of the legs. Breathable and easy to clean. Ideal for travelling. Medically tested

Available from pharmacies nationwide or contact [email protected] Services Freephone 0800 658 814

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in brief

NEWS AND VIEWS

A New Zealand patented lipid oil, rich in over 90 different Omega-3s, has got the scientific world talking. Numerous studies from around the world have found Lyprinol® PCSO-524® to be effective in treating osteoarthritis, asthma, allergic inflammation and DOMS (Delayed Onset of Muscle Soreness), as well as improving lung function. Scientists believe the potent anti-inflammatory action of PCSO-524® may be due to the fact the extract contains up to 91 fatty acid components and contains furan acids, which have been shown to possess more potent anti-inflammatory activity than the omega-3 fatty acid EPA.Research at a Polish hospital has found that treating sufferers of osteoarthritis with Lyprinol® PCSO-524® significantly improved both their pain symptoms and their quality of life.

Just one of 23 research papers demonstrating the effectiveness of the product, the double-blind study compared the effectiveness of PCSO-524® with fish oil on patients suffering

from osteoarthritis of knee and/or hip joints.

The researchers at Poland’s Academic Clinical Hospital concluded, “Reduction of pain was statistically evident at four weeks among the subjects who took capsules that contained PCSO-52®. Practitoners can expect quicker long-term results with less risk of side effects for their osteoarthritis patients when they recommend products that contain PCSO-524®.”They added: “Fish oil was not effective. And no side effects were observed with the patients who took PCSO-52®.”Professor Mickleborough from Atlanta University, a former UK Olympic triathlete, is another scientist who has shown great interest in PCSO-524®. Over the last three years, he has published four research papers clearly demonstrating that Lyprinol® PCSO-524® can play an important role in improving the physical performance, mobility and lung function of athletes, weekend warriors and couch potatoes.

The Good Oil Pain Free is No FunDid you know there are people who can’t feel any pain at all? This may sound blissful – no headaches, no back pain, no aching muscles – but it’s not as great as it sounds. Honest! Pain plays an important function – it tells us to STOP … running on a sprained ankle, chewing on our lip, resting our foot near the fire … which means you’re more likely to be severely injured if you can’t feel pain. Out of the 158 people with congenital insensitivity to pain (CIP) researchers looked at for a recent study, many suffered from mutilated lips and tongues, wounded or partially-missing fingers and toes, and blistered or scarred skin. Results from the study published in May are exciting, putting science one step closer to understanding the root of pain. Scientists conducting the study identified a single gene shared by people with CIP. Called PRDM12, this newly-discovered gene is being called a “super-duper pain target” which could help scientists create a more efficient, longer-lasting class of pain medications with potentially minimal side effects.

2 LIVING WITH PAIN Winter 2015

Taking the Waters in Rotorua“Living with pain is challenging and difficult,” says Dr Aaron Randell from QE Health in Rotorua. Everything is interconnected (body, mind and spirit) which is why QE Health takes an integrated approach to ‘wellness’ for ACC-funded programmes and private patients, he says.

With a team of experienced health professionals including physiotherapists, occupational therapists, psychologists and counsellors, along with specialists in rheumatology and orthotics, it’s not surprising that visitors from around New Zealand and overseas come to undergo a regime of thermal treatments, therapies and exercise at QE Health. In short, they come to Rotorua to “take the waters” just as people have been doing for over a century. (QE Health is the direct successor to the original health spa, the Rotorua Bathhouse.) QE Health also offers a well-equipped gym with skilled instructors, who can take patients through a carefully monitored programme. And – of course – to ease away aches and pains, QE Health has a spa which features mud and hot paraffin wax treatments, massage and the soothing alkaline, thermal waters of the Rachel Pool.

To find out more, visit www.qehealth.co.nz.

Back StatsLower back pain is the leading cause of disability worldwide, according to a study published in the Annals of the Rheumatic Diseases. Researchers in the UK, Australia and the US studied data from the Global Burden of Disease study, which assessed the health of people in 187 countries. They found that almost one in 10 people (9.4%) suffers from lower back pain. It’s most common in Western Europe, where 15% of the population are affected; followed by North Africa and the Middle East. Lower back pain is least common in the Caribbean and Latin America. Men (10.1%) are more likely to suffer from lower back pain than women (8.7%).

Snapshot of Chronic Pain A report entitled Patterns of Chronic Pain in the New Zealand Population, led by Dr Clare Dominick, outlines that in New Zealand approximately one in six adults is living with chronic pain. Overall, 16.9% of the New Zealand adult population reported chronic pain, and 22.6% had experienced moderate to severe recent pain. Chronic pain prevalence increased with age from a low of 8.6% for 15 to 24 year olds to a high of 28.1% for those aged 75 years and over.The most frequently nominated pain sites were joints (29.9%), back (24.1%), neck (12%), pelvic region (8%), head (6.9%), stomach (5.8%) and chest (3.9%). Two-thirds (67%) of those reporting chronic pain had lived with chronic pain for five or more years.

Reproduced with permission from Headlines Autumn 2015, published by the Neurological Foundation of New Zealand.

Interesting fact Did you know that the process of healing from mineralised water is known as balneotherapy?

LIVING WITH PAIN Winter 2015 3

natural health

THE WONDERS OF BIRCH

* Markus Sommer, Healing Plants** MCC (Monograph Commission C): Anthroposophical Medicine, Commission C Monographs, German Association of Anthroposophical Doctors, 1999

Birch is the go-to natural remedy for gout and a number of other ailments.

Have you ever noticed how birch trees look younger than their years? This phenomenon is

mainly due to them being masters of elimination, says Weleda Pharmacy’s Pharmacist, Nicola Parkes. “Beneath the outer sleek surface of these serene trees, there is a constant and lively circulation of birch tree sap. This constant movement is vital for the elimination of unwanted substances.”

No wonder then that birch (Betula alba) is renowned for its purifying and detoxifying effects and has a long history of healing benefits. Those with a tendency towards gout and a build-up of inorganic material in the tissues may benefit from what birch has to offer*, says Nicola. “A cup of birch leaf tea, twice daily, is enough to support your own processes

of elimination. It is thought that regular consumption may help to reduce joint swelling and inflammation, and increase joint mobility or a general alleviation of rheumatic symptoms.**” If tea isn’t your thing, Nicola suggests trying Weleda Birch Juice, made with 94% aqueous extract of birch leaves and 6% lemon juice.

Weleda Massage Balm with Arnica, which contains a mixture of pain-relieving arnica with supporting birch, calendula and warming essential oils of lavender and rosemary; Rheuma ointment, which has a host of pain relieving ingredients; and Mandragora comp oral drops (a Pharmacy Medicine) are a few of the medicines used for arthritis, gout and rheumatism which contain birch.

You can find out more about the Weleda Pharmacy at www.weledapharmacy.co.nz.


sleep

WE ALL KNOW THAT SLEEP is a vital component of a healthy lifestyle but when you’re in pain getting to sleep and staying asleep are easier said than done. Here are our top 6 tips for a restful night’s sleep.

1Structure your Day – What you do during the day significantly impacts on how well you sleep at night. It’s important

to put some structure into your day. Aim to get up at the same time and have things planned at specific times. Go to bed when you feel sleepy, at roughly the same time every night.

2Head Outdoors – As soon as possible after you wake, get outside. Spend time outdoors every day, even if it’s

just reading. Sunlight suppresses melatonin, the hormone which helps regulate our sleep/wake cycle, and stimulates the production of serotonin, the ‘feel-good’ neurotransmitter which wakes us up and helps to lift our mood.

3Get Moving – Move as much as your pain allows; this will help you sleep better. However, avoid

any vigorous exercise in the evening.

4Establish Good Habits – Follow the commonsense advice you hear to give yourself the best chance of

a good night’s sleep. Avoid caffeine in the afternoon and evening, eat earlier rather than later and don’t eat too much, avoid alcohol, give up smoking, turn off all screens at least 30 minutes before going to bed and take the time to wind down so you go to bed relaxed.

5Manage your Pain – Talk to your GP or pain specialist about pain medication and try to take it at a time that allows

you to get the best night’s sleep possible.

SLEEP EASYSleep is that golden chain that ties health and our bodies together.Thomas Dekker, English dramatist.

6Accept – Accept that you will wake at night; everyone does, we just don’t remember waking if we fall back to

sleep within 1–2 minutes. Remember: it’s not the waking that’s the problem, it’s the going back to sleep, so try not to get wound up when you wake. Putting your clock out of sight and out of reach will help.

With thanks to Dr. Alex Bartle from The Sleep Well Clinic www.sleepwellclinic.co.nz

l Outstanding NZ export story with markets in over 40 countriesl International renown for purity, quality and effectivenessl Contains up to 91 different Omega-3s and other active marine components1

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l Internationally recommended by doctors – Lyprinol® delivers its health promise and helps users stay activel Suitable for the whole family including children 2 and older1. Mickleborough and Lindley 2013 Respiratory Medicine 2. Studies available on request 3. COA’s available on request

Always read the label and use as directed. If symptoms persist consult your healthcare professional.www.pharmahealth.co.nzFreephone0800567800Emailinfo@phealth.co.nz TAPS NA 7597

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Pharmalink International guarantees that every batch of Lyprinol® PCSO-524® passes all tests and satisfies all NZ and international standards for the purity, strength and effectiveness of its range of complex omega-3s and other ingredients.

Lyprinol® has been an essential part of my family’s daily diet for over 3 years; our two children (Katie and Alex) love the capsules, they are small, easy to take and they see them as treats. We see them as support for their developing brains and bodies.

I believe Lyprinol® is the best Omega 3 for my family as it supports heart and brain health as well as mood balance. For me it helps with flexibility, joints, mobility and healthy breathing.

As I age I find Lyprinol® supports my busy physical work and helps my body achieve my high expectations.

Surfing, windsurfing, kite boarding, mountain biking, yoga, etc all require joint suppleness, good coordination, fitness and strength. I feel Lyprinol® helps me with the demands I make on my body and I am confident that taking it regularly will help me and Stephanie stay active and keep up with our children.

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arthritis

GETTING TO GRIPS WITH THE PAIN

ARTHRITIS is the most common cause of chronic pain in New

Zealand, affecting one in six New Zealanders. “The most common reason for people to come to Arthritis New Zealand is for help in managing pain,” says Sandra Kirby, CEO of Arthritis New Zealand.

Arthritis pain can be caused by a number of things – inflammation, the process that causes heat and swelling in your joints; damage to the joints; muscle tension, from trying to protect joints from painful movements; physical or emotional stress on the body; or changes in the nervous system called ‘sensitisation’. For some conditions, such as fibromyalgia, the cause of the pain is not fully understood.

The first step in managing your pain is to find out which type of arthritis you have,

as this will determine your treatment. Every person responds differently, so be prepared to try different self-management techniques until you find what works best for you. Remember to employ these techniques every day – not just when you are in pain.

Research shows two key strategies that are likely to underpin any pain management plan:1. Exercise Regular stretching and strengthening exercises can help reduce pain. They also keep your joints moving, strengthen muscles to support your joints, reduce stress and improve sleep. 2. Medication can be helpful in managing pain when used in combination with other strategies. Do not wait for the pain to build before taking your medications and take as prescribed to receive

the most benefit. Analgesics (pain relievers) such as Paracetamol are often the first medicine your doctor will recommend to help with pain.

“Many of the people who come to us to learn more about pain management find the four Ps of self-management useful,” says Sandra. “Pacing yourself; Prioritising tasks; Planning to spread the ‘heavy’ tasks throughout the day; and Posture, because good posture will conserve energy.”

Other things to try:Heat and Cold: Ask your doctor or physiotherapist whether heat or cold is best for you. Heat relaxes your muscles and stimulates blood circulation. You could try a warm bath, sauna or placing a heat pack or hot water bottle over the painful area for 15 minutes. Cold numbs the painful area and

Living with pain can be the hardest part of living with arthritis but thankfully there are many things you can do to manage your pain.


reduces swelling. Applying cold treatments, such as ice packs, to the painful area for 15 minutes may be especially useful for hot, swollen joints, such as during a ‘flare-up’. You can repeat heat or cold treatments throughout the day. Make sure the temperature of your skin has returned to normal before re-applying and protect skin by placing a hand towel between skin and heat or ice pack. Relaxation and distraction: People often find that stress can make their pain worse.

Relaxation techniques such as meditation, deep breathing and visualisation can help to reduce stress and muscle tension. These techniques need to be practised and you may have to try several of them before you find one that works for you.

Focusing your attention on something other than your pain can also help you cope with pain. This might involve exercising, reading, listening to music or other methods to take your mind away from your pain.

Complementary therapies • Many people with arthritis find massage a useful way to relax and reduce muscle tension. Make sure the massage therapist has experience working with people who have arthritis. • Acupuncture is an ancient Chinese practice of putting small, thin needles into the skin at specific points on the body to alter our experience of pain. Some people with osteoarthritis may find it useful alongside other proven treatments. • Transcutaneous electrical nerve stimulation (TENS) is a non-invasive, low-risk nerve stimulation intended to reduce pain. TENS can be useful for chronic pain in osteoarthritis. Check with your physiotherapist to see if this treatment is appropriate for you. • Capsaicin is the active component of chilli peppers and is used in many creams to relieve pain. Remember not to use capsaicin if you have broken skin, skin irritation, or previous allergic reactions to capsaicin.

Key things to remember• Pain doesn’t have to rule your life.

• Create a plan for managing pain.

• Exercise every day.

• Take medications as prescribed.

• Include relaxation and distraction in your daily routine.

• Prevent pain from building by breaking up activities throughout the day.

• There are good days and bad days; make sure you have a plan for bad days.

• There are no rights or wrongs – find what works for you.

Continues on page 10


Many people with arthritis find massage a useful way to relax and reduce muscle tension

It may surprise you, but moving is one of the best pain relievers. Move, move, move is the advice often given to those suffering with arthritis. We used to think that people with arthritis should rest their joints but we now know that resting can increase the pain.

Exercise helps relieve pain and stiffness and increases joint flexibility and muscle strength. Strong muscles help support joints and improve balance and mobility. Stretching exercises like Tai Chi and yoga are excellent for strengthening muscles.

Movement – any movement – increases circulation. Improving circulation may improve numerous problems, including the condition of pain–affected limbs. Good blood supply nourishes bone and tissue.

Movement Helps Relieve Pain

Aircycles are available from pharmacies. For more information or to order visit www.aircycle.co.nz or phone 04 569 5013.

Arthritis Appeal Week is 22nd – 28th September. Arthritis New Zealand receives $5 from each direct order. Mark your order “Arthritis” and post $38.90 to Aircycle, PO Box 45 105, Waterloo, Lower Hutt. 5042

“The Aircycle is even better than the information says.”

“My knees have gone and I’ve been using a walker but now I don’t need it around the house. I can move more freely and have much less pain in both my hands and feet.” — G. Rumbles

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The AirCycle enables you to keep joints and muscles moving in feet, legs, hands, shoulders and lower back while you watch TV, work at a desk, enjoy coffee or chat on the phone. The exercise is non-weight bearing and gentle, but effective in promoting circulation, strengthening muscles and keeping your joints “oiled”.

Designed to ease the pain and stiff joints of arthritis sufferers, the AirCycle also helps people with other conditions – those with diabetic foot problems, swollen ankles, Parkinson’s, cramps and those who sit for long periods, travellers, convalescent patients and office workers.


For a copy of the Arthritis New Zealand booklet Managing Your Pain visit www.arthritis.org.nz

For more information and support visit: www.arthritis.org.nz or call 0800 663463 to talk to an Arthritis Educator or register for a seminar on Managing Pain in your area.

Other websites to look at include • www.paintoolkit.org• www.lifeline.co.nz • www.calm.auckland.ac.nz • www.healthnavigator.org.nz

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Professional AdviceLiving with pain can be very isolating. Many people find their social lives are the first casualty of chronic pain. Finding others who understand and help provide motivation makes a big difference.

Arthritis New Zealand provides a range of services that help people with pain, and their Arthritis Educators can provide individual phone consultations – call 0800 663 463. In addition they run popular pain management seminars around the country and a range of self management programmes. A visit to the Arthritis New Zealand website or a call to 0800 663 463 is a great start to a pain management plan.

Managing your pain www.arthritis.org.nz

arthritis

Living with pain is a massive challenge.Let our team of specialists in arthiritis rehabilitation and chronic pain help you.• Rheumatology • Physiotherapy and

Fitness Gym• Orthotics• Thermal Spa Therapies• Pre and post surgical

rehabilitationWe accept private and DHB and ACC funded clients.

07 348 0189 • www.qehealth.co.nz 1073 Whakaue Street, Rotorua


References: 1. Celebrex Data Sheet. 2. Ex Manufacturer price of Celebrex, Pfizer NZCELEBREX® Capsules CELEBREX (celecoxib) is a prescription medicine containing 100 mg or 200 mg celecoxib. It is used in adults to treat pain and inflammation in osteoarthritis, rheumatoid arthritis or ankylosing spondylitis; to manage acute pain including dental pain or following surgery; treatment for menstrual cramps (period pain). CELEBREX has risks and benefits. Consult your doctor to see if CELEBREX is right for you and use strictly as directed. Do not take CELEBREX if you are allergic to celecoxib, any of the other ingredients in CELEBREX capsules, other Coxibs, aspirin, NSAIDs (Non-steroidal Anti-Inflammatory Drugs) or sulphonamides; have had a heart attack or stroke; have severe liver problems, severe kidney disease, an ulcer or gastric bleeding, Irritable Bowel Disease, or heart failure; are to have an operation for your heart or circulation, or you are already taking an NSAID. Caution is needed if you are taking a drug to stop your blood clotting, have diabetes, heart disease, high blood pressure, high cholesterol levels, heart failure or a history of heart problems; have allergies; are pregnant, breastfeeding; intend to become pregnant or breastfeed; have aspirin-sensitive asthma, liver or kidney problems; have had allergic type reactions; take medicine for high blood pressure or heart failure; have fluid retention; have a peptic ulcer, are vomiting blood or material that looks like ground coffee; have bleeding from the back passage or bloody diarrhoea; drink lots of alcohol, smoke or have a current infection. Tell your doctor if you are taking any other medicines. Common side effects include: stomach pain; diarrhoea; indigestion; wind; feeling sick; back pain; swollen hands, ankles and feet; dizziness; headache; insomnia; sore throat; runny nose; sinusitis; upper respiratory tract infection; skin rash. CELEBREX is an unfunded prescription medicine. A pharmacy charge and normal doctor’s fees apply for all prescriptions. Further information on CELEBREX is available from www.medsafe.govt.nz or Pfizer New Zealand Limited, Level 1, Suite 1.4, Building B, 8 Nugent Street, Grafton, Auckland 1023, PO Box 3998, Auckland, New Zealand. www.pfizer.co.nz. Ph. 0800 736 363. V11014. P9658. TAPSNA7530. H&T CEL0019LWP. 05/15.

FAST AND POWERFUL PAIN RELIEF IS NOW MORE AFFORDABLE.1,2

CELEBREX is a prescription medicine that is used for the temporary or short-term relief of pain, including dental pain, following surgery or period pain. And with a recent price reduction, it’s now more affordable than ever.

CELEBREX is also used to relieve symptoms of tenderness, swelling and stiffness from osteoarthritis, rheumatoid arthritis and ankylosing spondylitis.1

So ask your doctor if CELEBREX is right for you – a FREE trial may be available from your doctor.

Q: What is IBS? Irritable bowel syndrome is a condition of heightened sensitivity of the gastro-intestinal tract in the absence of a definable organic cause.

Q: What are the symptoms of IBS? IBS is characterised by chronic abdominal pain, bloating and altered bowel habits (constipation and/or diarrhoea).

Q: How common is IBS?IBS is very common. Population studies suggest that it affects 10-15% of the population but of these only about 15% seek medical attention.

Q: What causes IBS? The cause is not known. A gastrointestinal infectious episode is a known trigger but the mechanism that the disease is caused by is not fully understood.

irritable bowel syndrome

THE LOWDOWN ON IBS Auckland Gastroenterologist Dr Alasdair Patrick sheds some light on the symptoms, triggers and best management practices for IBS, a common and often painful condition that affects 10-15% of the population.

Q: Who is most likely to be affected by IBS and what are the risk factors? IBS can affect anyone, at any age. However, younger people are more likely to be diagnosed with IBS and women outnumber men 2:1 in the statistics. There is also a higher risk of developing IBS if you have a family history of it.

Q: How is IBS best treated? The treatment of IBS is complex. Avoidance of triggers with dietary intervention is probably the most successful treatment – the low FODMAP diet has the best evidence for benefit. Assistance from a psychologist is beneficial for some patients and reducing stress and using relaxation techniques can help. In constipation-predominant IBS, fibre supplementation is helpful. There is also some evidence now for probiotics but the evidence is still conflicting.

continues on page 14

A-Z of FODMAPFODMAP is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols, short-chain carbohydrates that are incompletely absorbed in the gastrointestinal tract and can be easily fermented by gut bacteria. Many health professionals recommend IBS sufferers follow a low-FODMAP diet as developed by the research team at Melbourne’s Monash University. This involves avoiding or cutting back on high FODMAP foods such as onions, garlic, sausages, wheat, beer etc. The aim of a low-FODMAP diet is to eliminate the FODMAP carbohydrates in order to starve the bad bacteria in the gut, allowing health-giving bacteria to flourish and gradually tip the balance in their favour.

For more information on the FODMAP diet, visit the Monash University website www.med.monash.edu/cecs/gastro/fodmap/ and check out the low-FODMAP app available for iPhones and Android. Ideally, consult with a pharmacist, doctor or dietitian for assistance.


Choose your probiotic

wisely

Always read the label and use only as directed. If symptoms persist, consult your healthcare professional. HOWARU® is a trademark of Danisco A/S and used under licence.

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YOUR GUT, YOUR HEALTH It pays to choose your probiotic course wisely to ensure you are giving your digestive system the best chance to work optimally.Try Nutra-life® ProBiotic 50 Billion – the highest strength of shelf-stable probiotic available in New Zealand.

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With so many factors influencing digestive health, it’s no surprise more of us are turning to probiotics for our wellbeing. But probiotics come in different strains, all of which do different things. Are you getting the most from yours?

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The immunity connectionIf your digestive tract is workingwell and you are getting thenutrients you need, the roll-oneffect is that your immune systemis strong. Healthy numbers ofprobiotics help your gastrointestinallining act as a barrier to unwantedorganisms, thereby supporting yournatural immune defences.Additionally, scientific research hasfound that some probiotic strainsactually produce essentialB vitamins, which help immunity.

Probiotics, or beneficial bacteria, are not all the same. You’ll find them bottled up in different strengths and different strains. Storage needs vary too, with some needing refrigeration and others needing none. And then there are variations in how the probiotics are released in order to maximise benefits.Nutra-Life® ProBiotic 50 Billion contains the highest number of shelf-stable probiotics on the shelf. With 11 researched strains of beneficial bacteria including HOWARU®, it contains more strains of probiotics than many other supplements on shelf, which means a greater spread of benefits for you.The vegetable-based capsule is cleverly constructed with a DRCap technology for delayed release. This allows probiotics to survive the acidic stomach environment and to be released into your small intestine. DIGESTION – IMPORTANT & VULNERABLEProbiotic bacteria can aid digestion by modulating gut flora and supporting a healthy gastrointestinal lining. This means that nutrients from food can be absorbed and metabolised better. Supporting the number of good bacteria with regular concentrated doses of probiotics can help maintain healthy gut flora. Resources can be depleted for a number of reasons, including taking antibiotics, feeling stressed, smoking, drinking alcohol or having a poor diet.

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Q: What can IBS sufferers do specifically to alleviate abdominal pain? Avoid triggers and talk to your doctor about medical options such as Colofac, TCAs, SSRIs or Rifaxamin.

Q: Does IBS increase a person’s risk of developing colorectal cancer? No.

Q: Once you’ve had IBS is it likely to recur? Following a trigger such as an infection, the majority of people do improve and go

Probiotics 101The word probiotic is thought to come from the Latin ‘pro’ meaning for and the Greek ‘biotic’ meaning life. Probiotics are a type of live ‘good’ micro-organism that competes for space and food in the gut with ‘bad’ micro-organisms and may confer a health benefit on a host. Many health practitioners believe IBS sufferers would benefit from a daily high-quality probiotic supplement. Fermented foods such as buttermilk, sauerkraut, miso and live yoghurt also contain probiotics, but not enough to right an intestinal imbalance without supplements.

Preventing Gastroenteritis

Gastroenteritis is a known trigger for IBS and highly infectious. Here are some tips to help you avoid a bout of gastro.

• Always wash your hands thoroughly after going to the toilet and before eating or preparing food.

• If someone in your house has vomiting or diarrhoea, clean the toilet (including the seat and handle) thoroughly with disinfectant after each episode.

• Avoid sharing towels, facecloths, cutlery, cups, drink bottles etc.

• Regularly wash kitchen surfaces and utensils with hot, soapy water. Wash your scrubbing brush regularly in the dishwasher.

• Never store raw and cooked foods together.

• Make sure that food is properly refrigerated.

• Never eat food that is past its use-by date.

• If you are travelling in a country with poor standards of food and water hygiene, avoid drinking tap water (including ice cubes), or eating raw or undercooked meat, ice cream, shellfish, eggs, salads, fruit and vegetables that have been peeled or have damaged skin, unpasteurised milk, cheese and other dairy products.

into remission. However if the symptoms have been there for a prolonged period (around two years or more), IBS is likely to recur periodically throughout life.

Q: When should you see a doctor? If there is any uncertainty about the diagnosis or if there are alarm symptoms such as weight loss and bleeding. If the symptoms are affecting your quality of life or are severe or if your symptoms are progressively worsening. Also if there is a family history

of cancer or other serious gastrointestinal tract diseases, it is a good idea to see a doctor.

Q: What are the possible complications of IBS? The main impacts are on lifestyle and quality of life – providing the diagnosis is correct!

Q: Is there anything non-sufferers can do in order to prevent IBS?Yes, avoid gastroenteritis (see above) and ensure you have a healthy lifestyle (watch what you eat, exercise and stress less!).

Dr Alasdair Patrick is a consultant gastroenterologist at Auckland’s Middlemore Hospital and MacMurray Gastroenterology. He is also Director of Physician Training at Counties Manukau DHB and lectures at the University of Auckland.

Note: The diagnosis of IBS should be made by a medical practitioner.


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IF YOU SUFFER from an allergic skin condition you may have noticed it

can get worse in cold weather. We tend to take hotter showers in winter, for starters, which dry out the skin. Skin tends to lose water through evaporation as well due to the difference between the inside and outside air temperatures. Dryness worsens eczema and even people without underlying skin conditions can find themselves with dry, itchy skin.

Heidi Darcy, clinical advisor at Comvita, explains:

COMBATTING WINTER DRYNESS

There’s lots to love about winter – cosying up by the fire, hearty soups, wild walks on the beach – but cold temperatures can bring misery to those with eczema and other allergic skin conditions.

“Dry, itchy skin is a hallmark of eczema. It occurs when there is a lack of moisture in the top layer of skin. Healthy skin has plentiful oils that envelop the cells, keeping the skin soft and flexible and sealing in water. When skin lacks sufficient oils, large amounts of water can escape. The surface becomes dry, inflexible, and itchy. Cooler weather aggravates dry skin as low humidity causes more water to evaporate.”

A recent survey from Allergy UK showed that cold weather was the single biggest

trigger for eczema, followed by house dust mites and pets. The research found that 91% of those with eczema say their skin dries out more in winter, while 77% say their skin itches more.

Eczema affects up to 10% of adults and 20% of school children. The condition is characterised by inflammation of the skin with intense itching, reddening, dryness, scaling and sore broken skin.

One in five of those surveyed say they stay indoors when their skin is bad but

eczema


ECZEMA SUPPORT GROUPS IN NEW ZEALANDItchy Kids is a New Zealand-based support group for parents of children with eczema. The aim is to offer much needed moral and practical support so families can look after themselves and each other. The Itchy Kids website has lots of useful information about managing eczema as well as a list of useful links for more information. The Kiwi support group was first set up in Wellington in 2004 and continues to be run by parents. There is also an Auckland-based group. See www.itchykids.org.nz.

Eczema Care NZ was set up last year as a private Facebook page for people with eczema and/or their carers. It’s a place for people to share experiences, vent about problems, ask for help, share recipes and more. Go to Facebook and search for Eczema Care NZ and ask to join.

MANAGING ECZEMAHere are the key areas to concentrate on when managing eczema:

• Combat dry skin by moisturising with emollients and bath products.

• Identify triggers through observation and testing – and then try to avoid them. Triggers may include food or environmental factors, such as dust mites.

• Reduce the itch so there is less temptation to scratch. This might mean using antihistamines or topical products.

• Tackle any inflammation through the use of steroids or alternative treatments.

• Watch out for signs of skin infection – get a diagnosis and appropriate treatment, such as oral or topical antibiotics.

• Be aware that eczema is very individual and may change over time or with the seasons. Keep in touch with your GP, nurse or specialist to ensure you get the right diagnosis and ongoing support.

Allergy UK says staying indoors isn’t the solution. Maureen Jenkins, Clinical Director of Allergy UK, says, “Cold weather is often the initial trigger of a skin condition, so the natural thing to do is retreat indoors and keep warm. But central heating and lack of ventilation will inevitably make skin conditions worse. The indoor environment creates an ideal breeding ground for house dust mites which in turn can exacerbate symptoms.”

If you are suffering from eczema, Allergy UK advises:• Drinking plenty of water to hydrate the skin and keeping the skin moisturised are essential.• Anyone suffering from eczema should use copious amounts of bland emollients twice or more a day.• Don’t use soaps and perfumed products.• Wear cotton clothing to keep skin cool and avoid synthetic fabrics.

Allergy UK advises the use of copious amounts of bland emollients twice or more a day


Heidi Darcy, Comvita’s clinical advisor, advises on the best way to dress open sores using Medihoney® Antibacterial Wound Gel™.

People with eczema experience frequent damage to the skin from scratching itchy skin, inflammation and from dry, cracked skin forming deep splits.

Why dress the wound?

It is important to cover wounds with a dressing. This keeps the surface of the wounds moist so that they heal faster and with less scarring. Dressings help to reduce pain and discomfort and they also lessen the risk of infection. People with eczema have a higher risk of skin infection. Even though eczema wounds can be very small, bacteria and viruses are much smaller and can easily get into the tissue through small scratches. If infection is present, a dressing can help to prevent it from spreading by covering and containing the fluid.

Creams or wound dressing?

Topical creams and skincare products are a key part of managing eczema and reducing the associated symptoms. However, the majority of creams are only designed to be used on skin that is not broken. Some creams may even slow down the process of wound healing. Wounds need to be dressed with sterile dressings that reduce the risk of infection and provide the right environment for the wound to heal. When the wound has healed, normal moisturisers and skin care products can then be applied.

Talk to your pharmacist about the right product for you.

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4. If there are many small skin splits on the hands, apply Wound Gel and cover with cotton gloves.

Scratching

Inflammation

Dry skin splits

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WHAT TO DO WHEN MIGRAINE STRIKES “Many people with migraine manage it without too much trouble, but for a few it is a distressing, frustrating and horrible disorder which has a major impact on their lives,” says Neurologist Dr Jon Simcock, Medical Adviser with the Neurological Foundation of New Zealand. Here he offers some suggestions for what to do when migraine strikes.

Act EarlyWhatever medication works for you, it is important you take it early on in a migraine attack, partly because medications are not well absorbed when nausea develops, and partly because a severe headache may not be relieved by analgesic medication such as paracetamol or codeine. These two medications can be used in combination, sometimes with the addition of aspirin, Dr Simcock says. An alternative is a non-steroidal anti-inflammatory agent.

Using an anti-emetic (anti-nausea medication) such as Maxolon can improve the absorption of analgesic medications and combinations of the two (for example Paramax) are commonly used.

Dose EffectivelyThe dose of medication needs to be effective, says Dr Simcock. “It is better to take a full dose at the onset rather than seeing whether a modest dose taken at the onset will be helpful and then taking another dose if it is not.” For example, paracetamol could be given as three tablets in an average adult and four tablets for a large adult.

Specific treatment for migraine is the triptans; these block the cascade of biochemical changes in the walls of the blood vessels that cause the headache and may also have an effect on the brain itself.

The triptans successfully relieve the attacks in up to half of patients with migraine, but need to be

migraine


taken as soon as you are aware a migraine is starting. “The triptans do not usually work if administration is delayed to the point where scalp hypersensitivity has developed,” Dr Simcock says.

Triptans are given by tablet (Imigran) or by a wafer which dissolves in the mouth (Maxalt). Imigran can also be given by self-administered subcutaneous injection – this is more effective than the tablet but may give rise to side effects more frequently. The triptans are relatively short-acting and when the headache has been relieved, a slow release NSAID can be taken to prevent recurrence of the headache.

Dr Simcock says it is best to avoid pethidine, Tramadol and morphine. “Although some patients say these are the only medications that relieve their headache, dependence on these medications develops quickly.”

Talk to your pharmacist, doctor or specialist about what medication will be best for you.

NauseaThe medications for nausea include metoclopramide (Maxolon) and prochlorperazine (Antinaus, Buccastem or Stemetil). When medications are not absorbed from the stomach because of nausea or vomiting, they can be given by injection, advises Dr Simcock. “However, this requires a visit to the hospital or to the doctor which is inconvenient, uncomfortable and expensive. Absorption from the rectum is better than from the stomach, but it is surprising how many people are averse to using suppositories, even for very debilitating attacks.”

Other Things to TryFor many people, particularly children, a simple analgesic and bed rest is sufficient. Other things that might help include retiring to a quiet, darkened room; the use of a hot or cold pack (or alternating hot/cold packs); firm pressure over the temples; slow diaphragmatic breathing and sleep (although, conversely, some people find caffeine helps).

Depending on the frequency and severity of your attacks, it might be helpful to take regular medication to prevent the attacks occurring. Again, seek medical advice to find out what might work for you.

With thanks to Sue Giddens and Dr Jon Simcock from the Neurological Foundation. Dr Simcock has written a handbook, Migraine: A Patient’s Guide, which is available from the Neurological Foundation’s website www.neurological.org.nz/resources

2

MigraineA PA T I E N T ’ S G U I D E

NEUROLOGICALFOUNDAT IONO F N E W Z E A L A N D

Acting early and dosing effectively are the keys to managing a migraine attack, say the experts.


Q: Sonaflam is fast-acting which means it cannot be long-lasting: TRUE OR FALSE?A: FALSE! Sonaflam is both fast-acting and long-lasting, which is what makes Sonaflam unique.

This is because the mechanisms for fast-acting and long-lasting have nothing to do with each other. Sonaflam is fast-acting due to the absorption of the Naproxen Sodium salt and long-lasting (12-15 hours) due to the long half-life of naproxen.

What is Sonaflam?Sonaflam is a non-steroidal anti-inflammatory medicine (NSAID).

How does Sonaflam work?Sonaflam, and NSAIDS in general, block the production of prostaglandins. Among other actions, prostaglandins are pain messengers and cause pain, increased sensitivity to pain, uterus contraction, swelling/inflammation and fever. Prostaglandin production is increased during an injury, periods, and during physical exercise. Blocking prostaglandin production reduces pain, the increased sensitivity to pain and swelling.

What can Sonaflam be used for?Sonaflam can be used for short-term (acute) conditions and long-term (chronic) conditions. In New Zealand, Sonaflam is indicated (i.e. Medsafe approved for use) for the treatment of the following conditions:• Acute musculoskeletal disorders (such as sprains, direct trauma, lumbro-sacral pain, cervical spondylitis, fibrositis, bursitis and tendonitis);• Period pain, and uterine pain following I.U.D. insertion;• Dental pain;• Migraine headaches, prophylaxis and acute treatment;• Rheumatoid arthritis (chronic), osteoarthritis (chronic), ankylosing spondylitis (chronic) and acute gout;• Juvenile arthritis (chronic)

Why use Sonaflam rather than another over-the-counter (OTC) NSAID or analgesic?Sonaflam has the following points of difference:• Long-lasting. The half-life of Sonaflam is 12-15 hours meaning a longer dose-interval of 6-12 hours (mild pain 8-12 hrs, moderate pain 6 hrs) and fewer tablets per day. (The half-life of Diclofenac is 1-2 hours, Ibuprofen ~2 hours and Paracetamol 3 hours.)• Fast-acting: The sodium salt of Naproxen allows rapid absorption resulting in Sonaflam tablets having an analgesic effect within 15 minutes. Peak plasma concentrations are within 60 minutes. • Efficacy/safety balance: Recent studies show that Naproxen has a much lower cardiovascular and stroke risk than Diclofenac and, to a lesser extent, Ibuprofen. • Toxicity: Comparable to placebo and Ibuprofen at OTC doses. Other studies have specifically addressed the risk of serious gastro-intestinal complications at OTC dosages of Naproxen and determined these as similar risk to Ibuprofen.

Who shouldn’t take Sonaflam?Do not take Sonaflam, unless recommended by your doctor, if:• You are sensitive to Aspirin, Ibuprofen or other anti-inflammatories;• You have history of GI ulcers e.g. stomach ulcers;• You are pregnant or could be pregnant;• You are taking anti-coagulants e.g. Warfarin;• You are under 12 years.

Sonaflam is non-drowsy and may be taken with or without food. It can be purchased over-the-counter without a prescription.

Do not exceed recommended dose. If pain persists see your doctor. Do not give to children under 12 years of age except on doctor’s advice. Check with your pharmacist or doctor before using Sonaflam if you are taking other medicines. Do not take if pregnant, if sensitive to Aspirin or anti-inflammatories, have a stomach ulcer or are taking anti-coagulants, unless recommended by your doctor. See pack insert for more information. Keep out of reach of children.References available on request.

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back pain sports injuries

migraines arthritis

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sonaflam is recommended for a number of analgesic and anti-inflammatory conditions. e.g.

Sonaflam can be taken anytime WITH OR WITHOUT FOOD! Available from all Leading Pharmacies WITHOUT a prescription!

Lasts up to 24 hours with maximum daily dosing – Sonaflam gets you through the night!

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sonaflam(Naproxen sodium)

275mg tablet

Ibuprofen 200mg tablet

Paracetamol 500mg tablet

Diclofenac 25mg tablet

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8

10

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14

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Data From Martindale 2011

For long lasting pain and inflammation relief!

24 HOUR RELIEFWITH MAXIMUM DAILY DOSING

New Zealand may be known as ‘the Gout Capital of the World’ but that’s no excuse to accept gout attacks as normal. In fact, it should be an incentive to get your uric acid levels tested by your GP or nurse. It’s a quick and easy test that could save you pain and long-term negative health effects.

‘DON’T BE TRAPPED by gout’ is the latest message from

Arthritis New Zealand. Their key advice: get your uric acid levels down below 0.36. “If there is too much uric acid in your blood, the acids can turn into crystals in your joints, especially your toes, knees, elbows, wrists and fingers,” says Professor Nicola Dalbeth, Rheumatologist. “And if left untreated, gout can damage your joints, bones, and possibly also your heart and kidneys.”

As anyone who has gout will tell you, gout attacks are extremely painful. The crystals caused by the uric acid build-up cause lumps, called tophi (pronounced toe-fy), which can make it hard for

OUT WITH GOUTgout

sufferers to wear shoes, use a knife and fork, write and walk easily, if they get too big.

What causes high uric acid levels?Eighty percent of high uric acid is caused by your body not getting rid of uric acid properly. This could be due to your genes, your weight or kidney problems. Twenty percent of high uric acid is caused by what you eat and drink.

How can you get rid of uric acid?It’s the 80:20 answer again. You can get rid of 80% of uric acid by taking uric acid medication every day. The other 20% can be controlled through lifestyle changes – by eating less seafood and meat; by drinking water instead of beer, fizzy drinks and orange juice; and by being active and losing weight if you need to.

Most people get rid of uric acid through their urine. Some though, including many Māori and Pacific people, only get rid of some of their uric acid, and the rest stays in their blood.

MedicationThere are two types of medication to get the uric acid level down – some medicines stop your body making too

much uric acid and some medicines help your body get rid of uric acid through your urine. Your doctor should start you on a low dose and slowly build up to a stronger dose.

Gout attacks are treated with anti-inflammatory medicines.

Remember: your target is to get your uric acid levels down to 0.36 (although if you have tophi you might need to get them down to 0.30) so you will need to get your uric acid level checked regularly.

For more information, go to www.goutnz.org.nz

Important things to remember

• Keep taking your uric acid medicine every day, even when you’re feeling well.• Tell your doctor or nurse if you get a gout attack. • Stop taking uric acid medicine immediately if you get a bad skin rash and tell your doctor or nurse straight away.• Have your uric acid levels checked regularly.


It’s important to get your facts right when it comes to managing back pain and a great place to start is to debunk some of the myths!

back pain

To learn more, download a copy of ‘Taking Care of Your Back’ from the Physiotherapy New Zealand website www.physiotherapy.org.nz.

DEBUNKING THE MYTHS

“Most back pain is caused by something being out of place.” In reality, most back pain is caused by strains

to the ligaments, tendons and muscles that support the joints in the back. Manipulation often provides pain relief and assists with restoring normal joint movement but it does not ‘pop’ something back into place. Consequently regular or on-going manipulation is not required.

“You often need surgery to cure back pain.” Actually very few people require surgery to

cure their back pain. In fact research has shown that with nonspecific low back pain the results of surgery are no better than a physiotherapy rehabilitation programme.

“Bed rest is often the best remedy for back pain.” In fact, the opposite is true: extended periods

of bed rest can hinder recovery from back pain! People with back pain are encouraged to remain active and, if off work, return to work as soon as possible.

“You often need an x-ray or MRI scan to identify what has caused your back pain.”International guidelines do not recommend

the routine use of x-ray or MRI for patients presenting with low back pain. This is because x-rays and MRIs may not provide useful information, and can raise patient concern by identifying changes that are harmless.

“Once you start having back pain, you often have to live with it for the rest of your life.”

There is always the possibility that back pain can recur but it’s not a given by any means. A physiotherapy programme can teach you how to prevent recurrence and how to cope if you experience any problems.

MYTH #1

MYTH #2

MYTH #3

MYTH #4

MYTH #5


Haemorrhoids…Half of us will get them at some point

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It may be a tricky subject, but haemorrhoids are so common, half of us will get them at some point. And both men and women are affected.

SO WHAT EXACTLYARE THEY?

Despite their notoriety, there’s often a lack of understanding about haemorrhoids.Also known as piles, they are inflamed veins in the region of the anus, caused by pressure.They can be internal or external, and lead to the following:• Pain and itching• Blood on toilet paper, in

stools and the toilet bowl• Painful swelling or hard

lumps.

They can be painful, stubborn, and in many cases they can keep coming back.

But if you think there’s not much more you can do other than ‘put up’ with them, then think again.

What can really make the difference is seeing your doctor: the expert who can also prescribe an expert treatment.


Tips on preventionModern lifestyles involving longperiods of sitting and inactivityhave contributed to anincreasing number of sufferers.Other factors include:• Poor eating habits / not

drinking enough water• Constipation / diarrhoea• Pregnancy• Straining on the toilet• Obesity• Heavy lifting.As you age your skin tissu e weakens and stretches more easily, so those aged 40 and older are more likely to get haemorrhoids.

Even better, it works fast and is long-lasting too.

Ultraproct is also fully funded, so you’ll only have to pay your usual doctor’s and prescription charges. In return, you’ll get targeted treatment that gives long-lasting relief.

DON’T GRIN AND BEAR ITJust putting up with haemorrhoids and not seeking help can mean you suffer unnecessarily. Don’t sit on symptoms – get along to your doctor instead.

YOUR DOCTOR – KEY TO RELIEFNot everyone wants to talk about haemorrhoids, but unless you see your doctor you might be relying on a bit of guesswork when it comes to treating them. So seeing your doctor is a really important step.

They’ll give you a proper diagnosis, so you can be sure it’s haemorrhoids and not something else.

Your doctor can also prescribe a treatment called Ultraproct®.

ULTRAPROCT® CAN HELPUltraproct is a unique formulation of active ingredients proven to treat the most troublesome symptoms, including the pain, itch and inflammation.

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ULTRAPROCT® Ointment and Suppositories

(Ointment contains 0.92 mg fluocortolone pivalate, 0.95 mgfluocortolone hexanoate and 5 mg cinchocaine hydrochlorideper gram)

(Suppositories contain 0.61 mg fluocortolone pivalate, 0.63 mgfluocortolone hexanoate and 1 mg cinchocaine hydrochlorideper suppository). ULTRAPROCT is a fully funded prescriptionmedicine. Normal doctor’s fees and pharmacy charges will apply.Do not use ULTRAPROCT in the first trimester of pregnancy. Onlyuse in second and third trimester of pregnancy and breastfeedingwhen prescribed by your doctor; do not use if you suffer fromvirus diseases, tuberculosis or syphilitic processes in the areato be treated. Prolonged use (longer than 4 weeks) should beavoided. Care must be taken to ensure ULTRAPROCT does notcome into contact with the eyes. Careful hand washing after useis recommended. Tell your doctor if you notice any unwantedeffect, or if there is a change in your health that you think mightbe caused by ULTRAPROCT. Always use ULTRAPROCT strictlyas directed by your doctor. Additional consumer medicineinformation can be obtained from the Medsafe websitewww.medsafe.govt.nz or from bioCSL (NZ) Ltd, PO Box 62 590Greenlane, Auckland 1546. Freephone 0800 502 757 orwww.biocsl.co.nz ULTRAPROCT® is a registered trademarkof Bayer Schering Pharma AG. ULTR-035-07/15. TAPS CH3932


Lower legs and feet

1 Sit towards the front of a chair, bring your feet so they are under your knees and planted firmly on the ground. Keep a straight back and stand up

without holding the sides of the chair. This is great for developing leg strength and balance. Repeat 3 to 5 times at first, gradually increasing as you feel able to.

arthritis

Stand and deliver If you have arthritis, you’ll know the importance of appropriate exercise. Here are some stretches and strengthening exercises you can do at home.With thanks to PhysiotherapyNew Zealand and Arthritis NewZealand. For a copy of Arthritis:Exercises to Keep you Moving,visit the Arthritis New Zealandwebsite www.arthritis.org.nz.

2 Practise picking things up with your toes or scrunching tissues or paper towels under your toes and big toe while

sitting. Repeat 3 to 5 times with each foot.

1a 1b

2a 2b

If you are unsure which type of exercise is best for you, consult your health professional before beginning. If you experience pain that doesn’t go away immediately after finishing any of these exercises, we recommend you get an assessment from a registered health professional, such as a physiotherapist. To find a physio visit www.physiotherapy.org.nz/findaphysio.


3d

Elbows and shoulders

3 Reach forward with your hands and straighten your elbows. Then reach your hands above your head as high as you can.

Slowly lower your arms sideways until they’re resting against your sides. Repeat 3 to 5 times.

3a 3b 3c

Lower back

5 Stand up straight. Reach one hand down the side of one thigh

and feel a stretch on the opposite side of your body. Hold for 10 to 20 seconds and repeat 3 to 5 times.

4 Standing with your arms by your sides, turn your hands so that your thumbs are facing forward. Keeping your elbows and

arms straight, stretch your arms backwards as far as you can, before returning your arms to your sides. Repeat 3 to 5 times.

4a 4b

6 Place the palms of your hands on the top of the rear

of your pelvis and arch your lower back. You'll feel a stretch in your lower back and the front of your hips. Hold for 10 to 20 seconds and repeat 3 to 5 times.

7 Put your hands on the front of your thighs and

slowly reach your hands downwards as far as you can comfortably do, flexing your lower back. Curl back up to stand straight again. Repeat 3 to 5 times.

5a

5b

6a 6b

7a

7b 7c


IN BRIEF

• Onychomycosis is a fungal infection of the toenails or fingernails. This is a common disease estimated to affect up to 350,000 New Zealanders.*1

• Fungal nail infections won’t go away without treatment.

• Treatment can take 6-12 months as the nails must grow out.

• Loceryl® is available from your local Pharmacy.

If your nails are cracked or yellowing, you could have a fungal nail infection called onychomycosis.

What is Onychomycosis? • Pronounced ON-E-CO-MY-CO-SIS, it is a term to

describe a fungal nail infection.• Onychomycosis is a common disease estimated

to affect up to 350,000 New Zealanders.• Onychomycosis occurs when the fungus

invades the nail bed.• The infected nail may be yellow to brown, thick,

brittle and/or separated from the nail bed.• The fungus can infect the nail because of injury

to the nail, tight footwear, or due to a pre-existing medical condition.

• The fungi thrive in humid environments and can spread to others or from one nail to another.

• Early treatment can prevent disease progression.

How is it treated?Loceryl® is clinically proven to penetrate the nail and kill the fungus, so you have nothing to hide.1-3

• Loceryl® is a lacquer that releases an active ingredient which penetrates the nail to get to the site of infection and kills the fungus.1,4

• Contains all you need to treat 1–2 nails for up to 12 months.4

• Easy to use because it is a once or twice weekly application.2,4

What makes Loceryl® different?• No nail removal required• No need for daily application

* Prevalence of onychomycosis in general population is between 2–8%

References: 1. Welsh O et al. Onychomycosis, Clin Dermatol 2010 28(2): 151-9 2. Zaug M. Amorolfine Nail Lacquer: Once-Weekly Application in Onychomycosis, Supplement to JAMA SEA July 1993:19-22 3. Elewski BE. Onychomycosis: Pathogenesis, Diagnosis,and Management, Clinical Microbiology Reviews, July 1998, Vol 11, No 3:415-429 4. Loceryl® Australian Product Information 2011 and New Zealand Datasheet February 5th 2012 5. Mensing H et al. ClinExp Dermatol 1992:17 (Suppl 1):29-32

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How does Loceryl® treat Onychomycosis?

Yeasts

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1 LOCERYL® penetrates the nail to get to the site of infection.1,4

2 LOCERYL® active ingredient has a broad spectrum of activity to kill the fungus which causes onychomycosis. 1,4

3 LOCERYL® maintains its effect within the nail for a minimum of 7 days to continue to kill the fungus. 1,5

4 The LOCERYL® Lacquer protects the nail from re-infection. 5

Visit the website www.loceryl.co.nz for more information.


1

Tired of daily treatments? Use

† For 1-2 nails for up to 12 months.Always read the label. Use only as directed. If symptoms persist see your healthcare professional.

References: 1. Best selling topical anti-fungal brand. Onychomycosis Midas data at MAT December 2014, in value. 2. Loceryl Nail Lacquer PI © Galderma Australia Pty Ltd, Suite 4 13B Narabang Way, Belrose NSW 2085, Australia. Ph: 1800 800 765. A.B.N. 12 003 976 930 Distributed in NZ by Healthcare Logistics, 58 Richard Pearse Drive, Airport Oaks, Auckland, NZ. Ph: 0800 174 104. TAPS NZ7607

Only 1-2 applications weekly

Only 1 purchase to cover the full treatment†

Only 1 product needed to kill a broad spectrum of nail fungus2

endpoint

USEFUL SNIPPETSHere are some of the interesting things we’ve learnt putting this issue together …

That we don’t remember waking if we fall back to sleep within 1-2 minutes PAGE 5

That slow diaphragmatic breathing can

help alleviate pain during a migraine

attack PAGE 21

That birch trees are brilliant at eliminating

substances they don’t want PAGE 4

That in cases of nonspecific low back pain, the results of surgery are no better than a physiotherapy rehabilitation programme PAGE 25

That approximately one in six adult New Zealanders are living

with chronic pain PAGE 3

That eczema affects more children than adults PAGE 16

That the active component of chilli peppers (capsaicin) is used in many creams to relieve pain PAGE 8

That some people are insensitive to pain (and that that’s not a

good thing!) PAGE 2

That the process of healing from

mineralised water is known as balneotherapy

PAGE 3

That the crystals caused by uric acid build-up in

gout sufferers can cause lumps, called

tophi PAGE 24


Always read the label. Use only as directed. If symptoms persist see your healthcare professional. People allergic to eggs should not use this product. Vitaco Health (NZ) Ltd., Auckland. *individual results may vary. NEM® is a registered trademark of ESM Technologies, LLC. 69

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living with pain 2

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