Asthma is a common condition affecting the airways. It can affect anyone of any age although commonly starts during childhood normally after 1 year of age.

Symptoms are a wheeze, cough, chest tightness and feeling short of breath. It is usually easily treated with inhalers but can sometimes become serious and develop into a medical emergency.

Inhalers fall into three groups.

The first type relieves the symptoms (hence the name relievers). These are typically blue in colour (ventolin, bricanyl, respigen, salbutamol). They should only be used when you have asthma symptoms as listed above.

The second group stop you getting asthma (commonly called preventers). These need to be used every day to work. It usually takes two - four weeks after starting them to notice any benefit.

A third group of inhalers combine both these types together. These are recommended for older children & adults.

Commonly we get people to use spacers with their inhalers. This generally makes the inhalers work better. Many things make your asthma worse (e.g. smoking, infections, airborne allergens, exercise, pets and dust etc).

Cardiovascular disease comprises mainly heart disease and strokes.

Our team have a very important role of carrying out “risk assessments” on your own risk of developing one of these conditions. This usually involves taking your blood pressure, weight, height, girth measurement and then blood tests for cholesterol and diabetes.

The most common risk factors for you will be:

High blood pressure

High cholesterol

Smoking

Diabetes

Sedentary lifestyle

Poor diet and obesity

A strong family history of CVD.

We will have in place a plan to put all of our patients (over certain ages) through a risk assessment and will then be able to identify if you have a high risk, and put in place a plan to reduce it.

There are very good reasons for assessing your Cardiovascular risk as the following statistics indicate.

. About 40% of all deaths in New Zealand are due to cardiovascular disease - the highest group

. In New Zealand about 5,000 people a year die early from smoking

. One in five New Zealanders smoke

. Nearly 50% of New Zealanders are overweight

. Women are not exempt. Over 5,000 women a year die from CVD; that’s about seven times more than die of breast cancer.

So how can we help you to reduce your risk?

Our team are trained to advise you on any medications that might be necessary to reduce your blood pressure, cholesterol or any diabetes if discovered. They can support you to make dietary and exercise changes and refer to Green Prescription and can put in place smoking cessation programmes for you.

One of the problems is that people with a high cardiovascular risk usually feel very well and are unaware of the chance of an early heart attack or stroke, so this type of “preventative” care will be an important feature of patient care at Family Health Matters. We want to work with you to encourage you to have a long, productive healthy life.

www.heartfoundation.org.nz

Diabetes is a common condition that affects how the body controls the blood sugar. It comes in two forms;

The first is commonly referred to as Type 1 diabetes. This usually starts in the first 20 - 30 years of life with a strong family history component. Most Type 1 (or Insulin dependent diabetics) are under the care of specialist doctors in conjunction with general practice.

The other type of diabetes is Type 2 or non-insulin dependent diabetes. This commonly occurs in those older than 40 years but can occur in younger people. It is usually due to your body not making enough insulin to meet its needs, or your body no longer uses the insulin properly (insulin resistance). You may have both going on at once.

Risk factors for Type 2 diabetes are:

. Obesity (BMI > 30) or waist circumference > 100 cm

. Certain ethnicities (Polynesians and Maoris, South East Asians - particularly Indians)

. A parent or sibling with Type 2 diabetes

. Having diabetes whilst you are pregnant

. Having pre-diabetes (often picked up on routine blood testing).

People with diabetes are at risk of eye disease, they are higher risk for strokes and heart attacks, are more likely to need dialysis for kidney disease and there is a higher chance of having a limb amputated due to poor circulation and nervous system disruption.

Family Health Matters staff are trained to diagnose and treat your diabetes. If you are a Maori, Polynesian, or South East Asian you should be screened for diabetes at age 35 years and then every 5 years thereafter. If you are a European male or have a positive family history of diabetes you need to be tested at age 45 yrs then 5 years thereafter. All others need testing from age 55 years. Please ask our clinical staff for a blood test form.

Our clinical team work together to support you to manage your diabetes. We can help you with your diet, exercise, weight and the impact of the diabetes on you and your family and the use of medication

We recommend that all those with diabetes have regular checks.

Diabetes can be a challenging disease for you. The lifestyle changes you need to make can be difficult to do. You are commonly on four to five medications daily that need to be taken for life. We usually will need to see you every three months.

Please make contact to discuss any problems.

If you smoke, we strongly recommend you stop, and we can give you expert advice on how to achieve this.

Hormonal changes can bring sleep deprivation, low energy, anxiety, weight gain, heated hot flushes, dry skin, dry vaginal tissues, sagging body parts, aching joints and tendons, low mood, excess emotions and generally not a pleasant time!

Our experienced team provide menopause advice, education, and support as well as symptomatic relief & treatment to help you through menopause. We offer specialised Menopause support and 45 minute consultations are $140.00 and follow up consultations are $75.00.

Vaccines stimulate the body’s system to protect you against subsequent infection or disease.

Our practice offers preventative immunisation/vaccination across all age groups;

• Childhood - ie all immunisations on national immunisation schedule

• Young adults - ie HPV, influenza

• Older adults - ie shingles, influenza, tetanus

Childhood Immunisations:

All childhood vaccines on the National Immunisation Schedule are free to all children in New Zealand before they turn 18 years. All immigrant and visiting children can also have free immunisations.

What is Immunisation?

Immunisation is one of the best ways to protect your child against many serious diseases. It works by using a vaccine to stimulate your baby’s immune system. Babies are born with some natural immunity to certain infections because antibodies are passed on to them from their mother before birth. Breast-fed babies get additional antibodies from their mother’s milk. However, this immunity does not last long. Babies and children need immunisation to provide ongoing protection from many life-threatening diseases.

When should your child be immunised?

Immunisations starts at 6 weeks old. This allows your baby to start developing protection as soon as possible when the natural immunity from their mother begins to wear off.

The 6-week injections also incorporate the 6-week check.

Generally, women are seen for initial investigations, preferably when you are planning to get pregnant. It is important for women to take the vitamin folic acid when trying to get pregnant.

When you are pregnant we advise continuing the folic acid for the first three months and also taking a small amount of iodine (neurokare) for baby’s brain development.

We also advise screening for Down’s syndrome at about 12 weeks with a scan and special bloods tests. Then we refer you on to a midwife, who will guide you through the rest of the pregnancy and delivery.

Unfortunately, things can go wrong, including miscarriages, infections and abnormalities so we like to keep a pretty close eye on things.

Most men are particularly well-known for not having regular medical checks. These are very important and men need to stay well for their families and we encourage all men to have a regular medical check-up at least every three years.

During your appointment you will have your blood pressure, height, weight, and heart checked. We will check for any pointers in your past history, and any family history that might need further investigation.

We will do blood tests checking for a range of conditions including diabetes, high cholesterol and anaemia, prostate and bowel cancer, and anything that particularly concerns you.

The density, quality and strength of our bones diminish as we age. This leads to weakness in the bone and they are liable to fracture, often after minimal trauma or even just spontaneously.

Osteoporosis itself is not painful, but pain can result from the fractures that it causes. Osteoporosis can be debilitating and lead to hospital admissions and surgery, for instance, if a hip that breaks. Osteoporosis is a very common condition in the community. It is likely to get more common as the population ages. It affects women more than men, and for women the loss of bone density accelerates after the menopause.

There are several specific medical conditions that can cause osteoporosis, as well as some medications. You can be screened for these and we will advise you accordingly.

The best strategies for maximising bone density is to exercise regularly, maintain a healthy body weight, especially avoiding being underweight, ensure a good intake of calcium in your diet (see chart below) throughout life, and a good vitamin D intake or safe sun exposure. For women particularly, a good calcium intake from early adulthood is the best insurance for satisfactory bone density in later years.

Prescribed calcium supplements are no longer recommended due to increased heart side-effects associated with their use. Twenty minutes of sun exposure a day will maintain good vitamin D levels.

Osteoporosis is diagnosed by a special x-ray called a DEXA scan. If the scan shows your bone density to be low, and therefore at increased risk of fracture, then treatment can be given to improve the strength of the bones. One such treatment is an intra-venous injection of Aclasta, which may only need to be given once every 12 to 18 months.

One of our healthcare team will manage your intravenous Aclasta annual injection to improve your bone health.

View the New Zealand Osteoporosis website here; www.osteoporosis.org.nz

If you are having trouble kicking the habit and want to save thousands of dollars a year, come and see our team who will guide and support you though a stop smoking programme.

Quitting smoking is one of the best things you can do for your health and that of your family.

Smoking is addictive and can be very difficult to stop despite knowing they ought to stop. A discussion maybe the first step in quitting.

Quitline — ph 0800 778 778 will help and support you with your plan, and nicotine replacement products are readily via Quitline or via one of our healthcare team

It is very important to have strategies in place to deal with those situations where you are tempted to light up again.

If the support programmes are not successful, one of our healthcare team can recommend oral medications to assist, or we can develop a programme for you that will include nicotine replacement therapies or in some cases oral medication.

There are special programmes for expectant mothers who smoke, or women planning on becoming pregnant. These are also available through our healthcare team . Pregnancy related complications occur more frequently in women who smoke.

Adults who smoke in a household with young babies and children increases the risk for the child having breathing problems, chest infections and asthma and an increased risk of cot death.

Some helpful links include:

www.quit.org.nz

www.health.govt.nz/your-health/healthy-living/addictions/smoking

www.aukatikakaipaipai.co.nz

Our team is highly experienced with children and their health needs.

We enjoy catching up with our young patients at the time of their 6-week, 3 month and 5-month visits, in addition to the usual Plunket visits.

Seeking health care isn’t always easy for young people. You might worry about being judged or feeling embarrassed. Sometimes it might feel a bit daunting to make an appointment and get here.

We want our practice team to make young people feel valued and welcome so here are a few tips if you have been thinking about getting some help from us.

– Privacy: From the age of 16 you are entitled to have your health information kept confidential. For most under 16-year olds we would also maintain confidentiality unless there was a serious threat to your safety or to the safety of somebody else. We do use mobile phones for communication so please check that we have your correct number.

– Appointments: You can make a booking by calling the practice. Be sure to give the receptionist your mobile number as we will send a reminder text to you the evening before your appointment. We do have an online booking service, but you will need to register for this. Our receptionists will be happy to show you how to do this. If you prefer or if you simply have a question, you can email our reception@familyhealthmatters.co.nz

– Mental Health: Young people may experience distress and unhappiness in many forms. It is a difficult time of life! If you are struggling, reach out to us for help. We can help sort out what is going on and direct you to the right help. We have an association with Alliance Health + Psych Services and can offer registered patients aged 12-19 four free visits with their psychologists. You may need to be helped by the Kari Centre specialists and we can organize this for you.

Here are some other useful links:

www.youthline.co.nz

www.thelowdown.co.nz

www.auntydee.co.nz

www.moodtools.org

www.sparx.org.nz

www.anxiety.org.nz/24hr-anxiety-helpline/

1737.org.nz

www.healthnavigator.org.nz/healthy-living/teens-young-adults/

Here is a link to a series of videos that explain the different roles of health professionals you may be referred to by the team

https://www.healthnavigator.org.nz/videos/m/mental-health-youth/camhs-services-for-youth/

-Fees: we have a funded contraception clinic if you are eligible

-Family: If you are concerned about your young person, we would like to know so we can offer support and help.

Here are some useful links for parents:

www.commonground.org.nz

www.theparentingplace.com

www.police.govt.nz/advice/personal-community/keeping-safe/teenager-safe

www.healthnavigator.org.nz/healthy-living/teens-young-adults/

We aim to provide an excellent standard of patient-focused sexual health care. For friendly, confidential assessment and treatment make an appointment by phone or online.

If you have symptoms and need an urgent appointment you can walk in and we will see you on the day.

We offer:

. diagnosis and management of sexually transmitted infections

. sexual health counselling

. treatment of genital skin conditions and genital pain

. all types of contraception including injectable depo, implants, IUCDs

. advice on sexuality and gender issues

. referrals for ACC and non-ACC sexual abuse counselling.

Helpful links include:

Auckland Sexual Health Services

New Zealand Aids Foundation

Rainbow Youth

Youthline

Before setting off on your overseas trip it is now more important than ever to get accurate advice on how to remain healthy whilst you are away. You may also be required to have proof of certain vaccinations and Covid 19 clearance before you will be allowed to enter some countries. Organising your travel health needs is complex and involves much more than just getting a few vaccinations.

You need to get it sorted out at least 6 weeks prior to departing.

Give us a call, make an appointment and lets help you get it sorted.

Our care provides full well-women checks including cervical smears, breast examination, discreet sexually transmitted disease care, all contraceptive needs and full screening checks for general health and cardiovascular risk.

Breast Cancer

We provide advice on factors that affect a women’s risk of breast cancer and how to lower your risk. We offer assessment, clinical breast examination, enrolment and referral for breast cancer screening and diagnostic tests.

Useful links include:

New Zealand Breast Cancer Foundation

Breastscreen Aoatearoa

Breast Feeding

Our healthcare team are available to provide advice and support for breast feeding mothers.

Violence Against Women

Violence and abuse can affect women from all backgrounds resulting in physical harm and emotional distress. Our healthcare team are here to help you.

This link will take you to the Auckland Women’s Refuge website.

Menopause

Our healthcare team are able to provide menopause advice, education and support as well as symptomatic relief and treatment. You can find out about your treatment options and receive advice and treatment on sexual issues associated with menopause.

MedicineNet.com

Contraception and Sterilisation

Free contraception for eligible woman. We provide advice and ongoing support and monitoring for all types of contraception including oral contraception, injectable depo contraception, contraception implants and IUCDs.

Family Planning website

Cervical Cancer

Cervical smears are available from our clinical team at a time that is convenient to you. We would encourage you to be part of our cervical smear recall system to assist you in having your smears regularly.

Menstrual Problems and Pelvic Pain

Consult your doctor for painful periods, irregular bleeding or premenstrual syndrome.

Fertility Issues

Contact our team in the first instance and we will investigate and refer as appropriate.

Eligibility criteria for funded flu vaccine

The flu season for 2024 begins on 2 April 2024. The flu vaccine is free for those who are most vulnerable to becoming very sick if they get the flu.

For the 2024 flu season, the vaccine is funded for everyone 65 years old and over. If you are not eligible for a FREE Flu Vaccine, the cost is $38.00 for adults and children.

It is also funded for people under 65 who are most at risk of becoming very sick from flu, such as people:

• with long-term conditions (like asthma, diabetes or cardiovascular disease)

• with reduced immune function

• who are pregnant

• with specific mental health conditions or addiction issues

• under 4 years of age who have been hospitalised for respiratory illness or have a history of significant respiratory illness.

You can find further information in the following links:

• 2024 Flu season

• Media release: Flu vaccine available to 1.7 million New Zealanders in 2024

There are also two advanced flu vaccines, available from 01 April 2024;

1. The 2024 Advanced Flu Vaccine, for patients aged between 6 months and 64 years, is called FLUCELVAX Quad* - This is a non-funded vaccine, and the cost is $45.00.

2. The 2024 Advanced flu vaccine, for patients aged 65 years and over, is called FLUAD Quad** - This is a non-funded vaccine, and the cost is $50.00.

Bookings for the Advanced Flu Vaccines (FLUCELVAX QUAD and FLUAD QUAD) are available Monday – Thursday from 01 April.

If you are interested in booking an Advanced Flu Vaccine please advise, by return email, your preferred booking date and specify morning or afternoon.

* WHY SHOULD I CHOOSE FLUCELVAX QUAD?

1. Designed to be an exact match to the flu strains that are circulating this year.

2. Shown to be up to 19% more effective than standard influenza vaccines at protecting you from the flu.

3. Established safety profile with more than 200 million doses distributed worldwide.

** WHY SHOULD I CHOOSE FLUAD QUAD?

1. Lower risk of medical encounters due to influenza-related outcomes, including hospitalisations and GP Visits.

2. Longer protection – Antibody levels are higher at 12 months post vaccination.

3. Established safety profile with more than 270 million doses distributed worldwide.

For more information, please refer to: https://www.immune.org.nz/vaccine/influenza-vaccine

Over 17 Yrs $19.50

14 - 17 Yrs $13.00

Under 14 Yrs No Charge

1st Initial Appointment $39.00

Double Appointment $39.00

Non-Resident $150.00

Under 17 Yrs $ 50.00

Over 17 Yrs $ 90.00

Liquid Nitrogen $10.00+

Joint injections $30.00+

Cervical Smears $15.00+

Biopsies and Excisions $200 - $350.00

Forms / Certificates $20.00

Scripts / Faxed scripts $10.00

Non-ACC Dressings $5 - $50.00

ECG $20.00+

Driver Licence $60.00

Insurance - Medical and Legal $150.00+

B12 Injection $15.00

Travel Consultations $40.00

IV Infusions up to $400.00

Under 25 Years sexual Health (4 visits per year) No Charge

IUD / Jadelle Insertions (Excluding the cost of the IUD / Jadelle) $190.00

Specialised 45 minute Menopause Consultation

Enrolled Patient $39.00

Casual Patient $140.00

Follow up consultation enrolled $19.50

Follow up consultation Casual $75.00