Podcasts about Auckland City Hospital

Kiwi start-up Kitea Health has experienced a successful start to 2025. In the last three months, Kitea has secured a place in the FDA fast track programme and they've completed a world first - implanting one of their sensors into the brain of a child. The company has also revealed it's just shy of $7 million into a $10 million funding round. Kitea Health co-founder Simon Malpas says their product went through 10 years of research before getting started. "We're so pleased for Kitea to be in our clinical trials - and in Auckland City Hospital, treating Kiwis. It's just a fantastic position to be in." LISTEN ABOVESee omnystudio.com/listener for privacy information.

Kiwi start-up Kitea Health has experienced a successful start to 2025. In the last three months, Kitea has secured a place in the FDA fast track programme and they've completed a world first - implanting one of their sensors into the brain of a child. The company has also revealed it's $7 million and counting into a $10 million funding round. Kitea Health co-founder Simon Malpas says their product went through 10 years of research before getting started. "We're so pleased for Kitea to be in our clinical trials - and in Auckland City Hospital, treating Kiwis. It's just a fantastic position to be in." LISTEN ABOVESee omnystudio.com/listener for privacy information.

A seriously ill cancer patient at Auckland City Hospital had to boil water in a kettle and use a disposable vomit bowl to wash because the ward had no running hot water. Reporter Lucy Xia has more.

Test results that reveal the presence of tuberculosis are missed, and the itinerant patient has been mixing in the community for months. What would you do? In this episode, host Dr David Rankin discusses such a scenario just like this with Dr Margaret Wilsher, a respiratory physician who spent 13 years as the Chief Medical Officer at Te Toka Tumai, or Auckland City Hospital. Together they traverse the complex issue of missed test results in a hospital setting, explore the challenges healthcare professionals face when crucial test results are overlooked, the implications for patient safety, and the system breakdowns that contribute to such incidents. Dr Wilsher offers insights into the importance of a just culture, clinician welfare, and creating resilient systems. Disclaimer: The views, thoughts, and opinions expressed in the following Podcast are the speaker’s own and do not represent the views, thoughts, and opinions of the Royal Australasian College of Medical Administrators (RACMA). The material and information presented here is for general information purposes only, and should not be considered health, legal or financial advice. The cases discussed in the Podcast may be specific to the speaker’s organisation or location, and may not be applicable to other organisations, states, territories or countries. RACMA does not endorse, approve, recommend, or certify any information, product, process, service, or organisation presented or mentioned in this Podcast, and information from this Podcast should not be referenced in any way to imply such approval or endorsement. RACMA will not be held responsible for any losses, damages, or liabilities that may arise from the use of this Podcast. The Podcast may contain descriptions of health incidents that may be graphic and triggering for some people, so listener discretion is advised.See omnystudio.com/listener for privacy information.

Patients in Auckland City Hospital's main building are without hot water. An issue with pipes emerged yesterday afternoon - and will take up to three days to fix. Te Whatu Ora says it has contingency plans ensuring clinical care continues. Patient Voice Aotearoa Chair Malcolm Mulholland says the maternity ward's in that building. "They're going to have to be transported away from the maternity ward to another part of Auckland Hospital in order to have a shower - that's certainly not ideal for mothers who have just given birth." LISTEN ABOVESee omnystudio.com/listener for privacy information.

An Auckland City Hospital doctor completed a self-supported ultramarathon on all seven continents in just one year. In 2024, Dr Inia Raumati completed eight races in eight countries across all seven continents. Each ultramarathon was around 250km and took 5-6 days to complete. He joins Jason Pine to discuss the incredible feat of physical resilience and what sparked the initial idea behind the massive achievement. LISTEN ABOVE. See omnystudio.com/listener for privacy information.

A Coromandel business owner and former army medic desperately tried to save the life of a man who was shot near his remote property. Police have confirmed that one person is dead and another seriously injured after the incident, which occurred this afternoon about eight-and a-half kilometres south of the Coromandel Township, towards the top of the Peninsula. The injured man has been airlifted to Auckland City Hospital. One person was arrested and police are considering laying charges. They are not seeking anyone else in relation to the incident. A Coromandel business owner, who did not want his name used, spoke with Checkpoint producer Matthew Theunissen. 

In this episode, Peter Brindley and Leon Byker sit down with Dr. Rob Bevan, immediate past president of the College of Intensive Care Medicine (CICM) and Critical Care Director at Auckland City Hospital, Auckland, New Zealand. Dr. Bevan shares his journey through leadership in intensive care, the role of intensive care colleges, and the evolution of critical care training. He also explores the political, social, and ethical dimensions of critical care, from workforce sustainability to the unique role of intensivists as brokers of care. Episode Highlights: The Evolution of CICM: History of the CICM and the differences between the CICM and similar organizations globally. Training for Critical Care: The training pipeline in Australasia. Advocacy and Political Engagement: The role of the CICM in advocating for intensive care resources. The Value of College Convocations: Celebrating new fellows and their families and the role of meaningful ceremonies. The Intensivist as a Broker of Care: Defining the role of the ICU specialist in complex patient care. The Future of Critical Care Workforce: Addressing workforce challenges and it's sustainability. The Upcoming CICM Annual Meeting: Highlights of the upcoming 2025 meeting in Tasmania. Reflections on Leadership and Administration: Dr Bevan's Journey into administration and why it matters.

In this conversation, we will explore the critical topic of selecting prehospital clinicians for high-stakes environments. We explore the traditional methods used in clinician selection and why they may fall short in the unpredictable world of pre-hospital care. We'll discuss the need to re-define performance criteria to better suit high-pressure situations and identify which mental and physical attributes are key indicators of reliable performance in challenging settings. We will touch on the role of personality inventories and whether it's more advantageous to choose clinicians with diverse personalities or specific traits. We will also look at effective teamwork as an essential pre-requisite in prehospital care, how to assess a clinician's potential for collaboration and whether prioritising leadership or followership—or a balance of both, yields the best results. To do this I have Dr Chris Denny with me. Chris is an Emergency Medicine Specialist at the Auckland City Hospital. Additionally, he holds key roles as Medical Director of Northern Rescue (Auckland Rescue Helicopter Trust) and he is a member of the New Zealand Medical Assistance Team (WHO Emergency Medical Team). Chris has expertise spanning acute care, leadership, and education, and has been helping to advance both emergency medicine and prehospital and retrieval medicine (PHRM) in New Zealand. To see more of Chris's work please see here: https://codachange.org/on-the-selection-of-prehospital-clinicians This podcast is sponsored by PAX. Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here: ⁠⁠https://www.pax-bags.com/en/⁠⁠ This podcast is sponsored by Wel Medical. Wel Medical, is a leading provider of life-saving medical equipment. Known for their cutting-edge defibrillators, including the widely trusted iPAD SP1, Wel Medical is dedicated to making emergency tools accessible in public spaces, schools, and businesses. Their defibrillators are designed for ease of use, with clear voice prompts and visual aids, empowering anyone to help in a cardiac emergency. Wel Medical also offers a comprehensive range of first aid supplies and provides expert training, ensuring that organisations are well-prepared for any emergency. For more information, visit ⁠welmedical.com⁠ and discover how to make your environment and workplace safer today.

Dr Inia Raumati is an emergency doctor at Auckland City Hospital, he's also on a mission to be the first person in the world to run a self-supported, multi-stage ultra marathon on every continent, in a single year. He's used Tikanga (Māori values) to navigate the challenges that come with ultra-marathons around the world. He sat down with Mihi to share how the mindset needed to push through extreme situations has helped him in all aspects of life, including critical situations at the hospital, being deployed to Iraq with the NZ army, and volunteering on rescue helicopters.

Dr Inia Raumati is one of our Low Key Legends – a man who lives life in the extremes.  He works as an emergency doctor at Auckland City Hospital, was deployed to Iraq with the NZ army, holds a blue-belt in Jui Jitsu and has volunteered on rescue helicopters.  He is one of only a small group of people who have run the 4 Deserts Grand Slams, completing multi-day “raids” across the Sahara, Gobi, Atacama, and the Antarctic.  This year, Inia plans on being the first person in the world to run a self-supported, multi-stage ultra marathon (that's over 250 km per race) on every continent, in a single year.  In this episode we talk about how running helped him deal with his anger in his youth, surfing without knowing how to swim, the obstacles he's overcome, his path into medicine and the challenges of being a maori doctor in New Zealand, the most incredible stories from his ultra-marathon missions around the world and the logistics of working towards this year's goal.  Inia is a candid, Kiwi bloke, whose honest sensibility, humour, and grounded nature was refreshing - and his mental hardness and mindset will blow you away. This is an ep not to be missed. Listen on iheart or wherever you get your podcasts from, or watch the video on Youtube.   If you'd like to hire one of our guests to speak at your function or event, flick us a message by going to B2Bspeakers.co.nz.  This episode was brought to you from the Export Beer garden studio. Enjoy.     See omnystudio.com/listener for privacy information.

After a series of online threats today, police have been searching a school, hospitals and other insitutions across the country. At 9:00am this morning, Auckland's St Kentigern's College received a threating email and were advised by police to shut down immediately. Students sitting NCEA exams had to be moved and will be able to apply for a 'derived' grade. Police also attended Auckland City Hospital, Wellington Regional Hospital and Bowen Hospital in the Capital, and Burwood Hospital in Christchurch. Paul Spain from Gorilla Technology joins us.

This talk “Advancing POM in New Zealand and Australia” was originally the EBPOM Visiting Professor Plenary Lecture given at the Evidence Based Perioperative Medicine (EBPOM) 2023 World Congress. Our visiting Professor is Vanessa Beavis, the Immediate Past President of The Australian and New Zealand College of Anaesthetists (ANZCA), having just completed her 2 year term, she is a specialist anaesthetist at Auckland City Hospital, New Zealand and also an Honorary Senior Lecturer at the Department of Anaesthesiology, Auckland University. She is introduced by Monty Mythen, Senior Vice President Medical Affairs, Edwards Lifesciences, Critical Care and Emeritus Professor of Anaesthesia and Critical Care, University College London. Find out more about the ANZCA Diploma of Perioperative Medicine here: https://www.anzca.edu.au/education-training/perioperative-medicine-qualification/dip-pom

Simon's correct title reads... Professor Simon Mitchell MB ChB, PhD, DipOccMed, DipAdvDHM (ANZCA), FUHM, FANZCA, Department of Anaesthesiology, University of Auckland.  This clearly does not fit in the title of this episode however, it goes a LONG way to explaining why Simon is one of the top dogs when it comes to being able to pour a healthy amount of clarity over the common confusions between decompression sickness, decompression illness, and arterial gas embolism. Simon is a physician and scientist with specialist training in diving medicine and anesthesiology. He is widely published with over 150 papers or book chapters. He co-authored the 5th edition of 'Diving and Subaquatic Medicine' and has two chapters on decompression illness in the most recent edition of Bennett and Elliott. He has twice been Vice President of the Undersea and Hyperbaric Medicine Society (USA) and in 2010 received the society's Behnke Award for contributions to the science of diving and hyperbaric medicine. In the past, Simon was a naval diving medical officer and medical director of the Wesley Centre for Hyperbaric Medicine in Brisbane. He now works as a consultant anaesthetist at Auckland City Hospital, and Professor in Anaesthesiology at the University of Auckland. He provides on-call cover for diving and hyperbaric emergencies at the North Shore Hospital Hyperbaric Unit in Auckland. Simon assumed the role of Editor of Diving and Hyperbaric Medicine in January 2019. Simon's diving career has included more than 6,000 dives spanning sport, scientific, commercial, and military diving. He has been a lead member of teams that were the first to dive and identify three deep wrecks of high historical significance in Australia and New Zealand. At the time of one of these dives (2002) the 180 m depth represented the deepest wreck dive ever undertaken. He was elected to Fellowship of the Explorers' Club of New York in 2006, and was the DAN Rolex Diver of the Year in 2015. Ref: www.dhmjournal.com. (n.d.). DHM, Simon Mitchell. [online] Shearwater Shearwater dive computersDisclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the show

This piece focuses upon the “REMAP-CAP” trial; A Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia. It's a wide ranging discussion which looks behind the headlines of this fascinating piece of research. Their website is here: https://www.remapcap.org/ In the podcast you will hear Monty Mythen speaking with Steve Webb, Professor of Critical Care Research at Monash University, Director of Research for St John of God Healthcare, and a ICU consultant at St John of God Subiaco and the Mount Hospital and Doug Campbell, Anaesthetic specialist at Auckland City Hospital.

RACS's Trauma Committee has been pivotal in helping prevent acute trauma in the community. That includes encouraging surgeons to pursue a trauma specialty. Instrumental to its success is Dr Li Hsee, who stepped down as Chair of the Aotearoa New Zealand Trauma Committee in late 2022, after eight years in the role. Among other leadership roles in trauma both at home and internationally, Dr Hsee's responsible for the development and implementation of the first Acute Surgical Unit in Aotearoa New Zealand. He's also the Clinical Director in General Surgery at Auckland City Hospital. RACS Post Op Podcast is proudly brought to you by leading financial services organisation the Bongiorno National Network: https://bongiorno.com.au/about-us/our-bongiorno-national-network/ See omnystudio.com/listener for privacy information.

Patients in New Zealand's emergency departments are labelling wait times 'agonising'. Data comparing 2017 to 2022 shows the severity of the situation; during that period patients to Palmerston North Hospital saw a 126 percent jump in wait times. Auckland City Hospital has seen a 98 percent rise. Meanwhile, Te Whatu Ora is working to correct a more recent set of "real time" emergency wait time data, which it admits was inaccurate. Chief Executive Margie Apa told Mike Hosking more accurate data will be uploaded to the agency's website today. LISTEN ABOVE  See omnystudio.com/listener for privacy information.

Peter Knight, from Auckland, took his wife to Auckland City Hospital on Monday because she had severe abdominal pains. Staff were coping admirably, he said, but the department was clearly understaffed and overworked. One nurse said the ED was at 195 per cent capacity. St John workers were looking after patients in the corridors, he said. “It was like a war zone and it was Monday afternoon in the off-season,” he said. Te Whatu Ora interim lead for Te Toka Tumai Auckland, Dr Mike Shepherd, said that the ED had been particularly busy on Sunday and this had a flow-on effect on Monday in terms of capacity. Numbers had since settled, he said. Peter Knight joined Kerre Woodham Mornings. LISTEN ABOVESee omnystudio.com/listener for privacy information.

Dr. Kathryn Hagen is a specialist anaesthetist in Auckland City Hospital looking after the adult population. She is the immediate past president of the New Zealand Society of Anaesthetists and took on the deputy service clinical director role in 2020. She is passionate about encouraging people to consider how they can be part of finding solutions and solving problems. In this episode, we discuss her journey into anaesthetics, receiving critical feedback and how to respond to it, delivering feedback to others and unpack private practice - how it works, why it works, the pay difference, motivations, and its associated work-life balance. Support the showAs always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me. Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9Y

Dr. Marta Seretny is currently a research fellow in anaesthesia and perioperative medicine working at Auckland City Hospital and an honorary lecturer at the University of Auckland department of Anaesthesiology. She completed much of her postgraduate clinical training in Edinburgh, Scotland and her final years of training in Auckland New Zealand. Her PhD, awarded by the university of Edinburgh, investigated chemotherapy induced peripheral neuropathy (CIPN) using fMRI of the brain. She is interested in optimising the perioperative pathways of cancer patients in order to improve patient centred outcomes.In this episode, we discuss her journey as a Polish child refugee, seeking asylum in Italy and eventually resettling through sponsorship in Australia. We talk about the challenges in raising multilingual children, and the difficulties with third culturalism in moving between different countries. Marta shares how she found her way into anaesthetics, and breaking the stereotypes of academia.You can find her on these links:https://unidirectory.auckland.ac.nz/profile/mser366https://www.youtube.com/watch?app=desktop&v=PGKVfBlINKwNB: This episode was recorded in 2021.Support the showAs always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me. Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9Y

Dr Simon Rowley is a senior Consultant Neonatologist at Auckland City Hospital (originally National Womens' Hospital). His basic  training was in Dunedin and Christchurch and his postgraduate studies –FRACP paediatrics - were completed in Oxford, U.K. . He is currently a senior Neonatal Paediatrician in the Newborn Intensive Care Unit at National Womens' Health, Auckland City Hospital.He also practiced General Paediatrics in private for 30 years, looking after children of all ages.   He is the former chair of the Paediatric Vocational Training Committee for the Auckland and Northern Region and a Director of Physician Education a position held for 12 years. One of his main interests is the effect of early childhood experience on infant  brain development- the neurobiology of human brain development- and this interest extends to him being a trustee and presenter for the Brainwave Trust. Other interests include early childhood behavioural and developmental outcomes, and medical ethics. In particular he is interested in how we make decisions about end-of-life care in the vulnerable sick or new born infant. He is an honorary lecturer at the Auckland School of Medicine and a recipient of the Denis Pickup Teaching Award 2014 and a Distinguished Clinical Teacher Award 2015.  He is married with 4 adult children. In 2021 he received a Companion of the NZ Order of Merit at the Queen's Birthday Honours.In this episode, we discuss his journey into neonatology, his work in private and public paediatrics and how it contrasts, the differences between neonatology and paediatrics, his love for volunteering and passion for brain development, his mahi with the Brainwave Trust, and how he spent his sabbatical.Brainwave Trust:https://brainwave.org.nz/about-us/https://brainwave.org.nz/article/wiring-the-brain/ Mind That Child: https://www.goodreads.com/book/show/40196256-mind-that-childhttps://www.penguin.co.nz/books/mind-that-child-9780143771982Support the showAs always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me. Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9Y

Kia ora e te whānau. This week Eugene and Matt have the pleasure of speaking with Dr Inia Raumati (Taranaki) . Inia works in emergency medicine at Auckland City Hospital and is the only person from Aotearoa/New Zealand to complete the 4 Deserts Grand Slam, completing multi-day “raids” across the Sahara, Gobi, Atacama, and the Antarctic. Inia came to medicine after graduating as a physiotherapist, and has spent time working in anesthetics, on rescue helicopters, and deployed as part of the New Zealand Defence Force to Iraq. We kōrero with Inia about his life, his medical whakapapa, and his love of running for the deeper connection that it fostered between him and his father. Enjoy. Episode Links Inia Raumati Instagram Opus Fresh Apparel Co.Manuka PerformanceOld Mates Doug and Jasper Tina Buch Trail Nutrition SurveyCurraNZSCOTT Running Coros NZJulbo Eyewear UltrAspireirunfarGivealitle for Kerry's Rehab Dirt Church Radio on InstagramDirt Church Radio on Twitter Dirt Church Radio on Facebook Dirt Church Radio on PatreonCieleFurther Faster New Zealand

A new study has found stroke survivors want more information about sex and intimacy as part of their recovery - but rarely receive it. Over 9,500 strokes are experienced by New Zealanders each year. Stroke is the country's second single biggest killer, and the leading cause of serious adult disability. Auckland City Hospital occupational therapist Sian McGee conducted the first-of-its-kind research, asking 41 patients between the ages of 36 and 90 about their preference for receiving information about sex and intimacy. She says most of the patients surveyed expected and wanted their doctors to speak to them about the subject of sex, but few did. Clinicians, in turn, said they didn't feel confident in giving the right information. Sian McGee is presenting her study at the Stroke Society of Australasia conference which begins in Christchurch today.

A revolutionary cancer drug developed in Auckland is set to begin clinical trials. Tarloxotinib is designed to help patients with head and neck cancers for which New Zealand ranks as one of the highest in the world for cases. Auckland City Hospital radiation oncologist Dr. Andrew Macann joined Mike Hosking. LISTEN ABOVESee omnystudio.com/listener for privacy information.

Today New Zealand launches a new health system replacing 20 district health boards with a national body - Health NZ - in a bid to end postcode lottery. Health reporter Emma Russell talks to a bowel cancer patient, a hospital anaesthetist and a GP about the changes.Roz Tuitama's bowel cancer should've been picked up at least two years earlier.Our country's health system let her down.In 2015, the 57-year-old was rushed to Auckland City Hospital's ED with severe bleeding.Doctors said it was a digestive problem and sent her home, said Tuitama, a Māngere primary school assistant principal."You don't question the system ... I trusted them."By 2016 her symptoms hadn't gone away. Tuitama said she'd had several GP appointments before she was referred to a specialist for a colonoscopy, which involves a camera inserted through the anus to inspect the bowel.She waited another year for the colonoscopy. By then it was too late, the cancer had spread to her liver."Getting told you have cancer was like a movie. It went into slow motion, I was with my husband and I just said to the doctor, 'Can you say that again?'"From there, she was on "a treadmill of the cancer beast machine". She had surgery to remove a third of her colon and endured 12 rounds of chemotherapy over six months.However, her cancer continued to spread through her lungs and liver. She had more treatment, then the disease came back for the third time. Now, she's "in the clear" but it's likely the cancer will return."It's been five years of cancer ... the impact is devastating to say the least. I had to stop work ... so all of that kicks in, on top of your children being told, 'Your mother's got stage four cancer'."The eldest-of-nine was urged to get her family checked. Her little sister, who was in her 40s, also discovered she had cancer."She was caught earlier ... she wouldn't have been picked up if I wasn't already in the system," Tuitama said.There were many ways Tuitama's cancer could've been detected earlier, she said."The thing about me being a Samoan woman, there's an assumption that it's my fault that I've got this, that stigma of Pasifika, Māori, 'Why don't they look after themselves', that's not the case. You need to look at the inequities that exist because of where our people are placed."If you are going to provide access, make the language understandable, I'm not just talking about just in terms of ethnic languages, I'm talking about everyday language like 'stage four'."The system didn't speak to Tuitama so she started a support group called Alofawholeness for people facing cancer."I'm an educated woman and I couldn't navigate the system."GP not sold on 'new system'Auckland GP Marcia Walker said major change was needed to address the country's "healthcare crisis" and she wasn't convinced this "new system" would fix it."They're funding a bandaid on a haemorrhage that's been going for the last decade, and then asking us to try to keep the patient alive with just more band aids. No, no, if you're talking about system reform, do it properly ... primary care is now at that point where we are falling over," Walker said."That's translating to increased pressure at EDs and even worse wait times and patient harm and we knew this was going to happen."She said government funding needed to be taken from hospitals and given to GPs and community care."It's a bold move but right now we are just tinkering with more of the same sh** ... If you invest in community care, you'll save money spent on hospitals.""All the average New Zealander cares about is can they get into their doctor in a timely fashion? Can they get their referrals done quickly if they need them? Can they get their X-rays and ultrasounds done quickly, if they need them? Those are things that are important, and I'm not sure that any of that is going to be addressed...See omnystudio.com/listener for privacy information.

Professor Harvey White is a Cardiologist and Director of the Cardiovascular Research Unit, Auckland City Hospital. He is an Honorary Professor of Medicine University of Auckland and Fellow of the Royal Society of New Zealand.  Harvey trained at Green Lane Hospital, Auckland and Harvard and Brigham and Women's Hospital, Boston. He is the John Neutze Scholar. In recognition of his work on end-systolic volumes as the most important modifiable prognostic factor following myocardial infarction, he was awarded DSc by Otago University. He was awarded the Prince Mahidol Award by the King of Thailand for introducing fibrinolytic therapy in developing countries, including China. He is a Matai (La'uli) in Samoa for services to Samoa, and has a “pou” in the Te Awamutu Walk of Fame recognising his contribution to decreasing heart disease. He is Co-chairman of the Redefinition of Myocardial Infarction Consensus group and defined the 5 types of MIs. He is senior author on the Bleeding Academic Consortium (BARC) to define bleeding.  He has been a member of numerous guideline groups. He is a member of the Cholesterol Treatment Trialists' (CTT) Collaboration and is on 16 editorial Boards. He has over 1000 publications and 77 editorials with an H Score 121.He gave the most prestigious International Society and Federation of Cardiology lecture at the European Society of Cardiology in 1993, and Paul Dudley White lectures at the American Heart Association in 2004 and at American College of Cardiology in 2011. Harvey is recognised in the top 1% of scientists worldwide and No 5 for publication of RCT-related articles in all high-impact-factor medical journals over the past five decades. He was also awarded the highest collaboration index.  He has been NZ Chairman and President of the combined Cardiac Society of Australia and New Zealand. He was awarded the Inaugural Gold Medal at the Cardiac Society of Australia and New Zealand Annual Scientific Meeting 2019 for outstanding contribution to Cardiology.He introduced the 10 year earlier screening for Mᾱori in the absolute risk assessment and has presented this to the Health Committee on doing that for colonic screening; published on  worse outcomes for Mᾱori  after bypass surgery; has a Pou in the Te Awamutu rose gardens; introduced the Mᾱori byline for the New Zealand Medical Association and as chairman of the New Zealand Medical Services Board is responsible for the New Zealand Medical Journal.  He has also had multiple visits to Samoa doing clinics, including a WHO report, attending the 50th annual meeting of the Samoan Medical association, and a matai title La'auli, the highest mountain,  for services to Samoa.In this episode, we discuss his extensive and prolific journey in research, his work in Samoa and Māori health, and his love for cardiology. As always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me.Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9YSupport the show

Dr Kieran Davis is the new dean for the Australasian Faculty of Pain Medicine. He is a pain medicine physician and anaesthetist at Auckland City Hospital and he wants to see a more equitable service for the one in five Kiwis who suffer from chronic pain.

10 thousand steps a day has become a fitness mantra for many, A man who knows a fair bit about how many steps are good for the heart is cardiologist Professor Rob Doughty the Heart Foundation Chair at Heart Health at the University of Auckland and Auckland City Hospital.

Dr Amy Ross Russell, Neurology, University Hospital Southampton NHS Foundation Trust, interviews Dr William Diprose, Dept. of Neurology, Auckland City Hospital and Dept. of Medicine, Faculty of Medicine and Health Science, University of Auckland, New Zealand; Dr Anthony Jordan, Dept. of Clinical Immunology and Allergy, Auckland City Hospital, NZ; and Dr Neil Anderson, Dept. of Neurology, Auckland City Hospital, NZ about their recent paper reviewing the neurological features of specific autoinflammatory syndromes. Read this latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/22/2/145) and the April print issue of the journal. The paper is also discussed by Practical Neurology editors, Dr Phil Smith and Dr Geraint Fuller, in their latest podcast: https://soundcloud.com/bmjpodcasts/pn-april-2022-highlights?in=bmjpodcasts/sets/pn-podcast Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). Thank you for listening.

Dr. Nadya York is a consultant surgeon in Auckland. She immigrated from Russia aged fifteen, and completed her medical school and surgical training in New Zealand. After a two year urology fellowship in Indiana, United States of America she returned to Auckland City Hospital as a consultant urologist in 2017. Her subspecialty interest is kidney stones and laser prostate surgery. She is a wife and a mother of three young children. In her spare time she runs after her kids and/or engages in various skirmishes with the patriarchy.In this episode, we discuss her journey into urology, her love for kidney stones, her passion in breastfeeding advocacy, navigating a male-dominated field, sexism and sexual harassment, and fighting a good fight against the patriarchy. As always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me.Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9YSupport the show (https://www.patreon.com/doctornos)

Dr. Inia Raumati is an emergency medicine specialist at Auckland City Hospital. Inia also volunteered at Westpac Rescue as a Helicopter Emergency Medical Services doctor, about 4 shifts a month. He was also an Army Reservists Doctor for the NZDF, and took multiple years leave from ED to work full time for the army. Inia first graduated from Otago University with a Bachelor of Physiotherapy in 1997, he then worked for a couple of years and started Medical School in Auckland in 2000. He also has a Post Graduate Diploma in Sports Medicine. Since starting in medicine he has worked in Auckland, Whangarei, Taranaki, Sydney and Port Macquarie.In this episode, we discuss his journey from physiotherapy to medicine, his medical whakapapa, moving from anaesthetics to ED, his extensive experience in ultramarathons, racism against Māori in medicine, and desert ultras, and his work in army medicine.As always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me.Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9YSupport the show (https://www.patreon.com/doctornos)

Six people have been shot in the Auckland suburb of Glen Innes in the early hours of this morning. Five are in Auckland City Hospital, two in a serious condition. Katie Todd spoke to Morning Report from Heatherbank Street in Glen Innes.

There's 930 people in hospital with Covid today; 23 of them in ICU or a high dependency unit. And the death curve is steepening, 10 reported today, bringing the total number of Covid related deaths to 151. So how are people in hospital being treated for the virus? What's working, what's not and right now do we have access to the best medicines? Intensive care specialist Dr Colin MCArthur from Auckland City Hospital talks to Lisa Owen.

An Auckland emergency doctor says her exhausted colleagues are expecting a busy couple of weeks even as hospital cases appear close to peaking. Latest DHB figures show up to 40 percent of people at Middlemore's ED have the virus, with a quarter in Auckland City Hospital and a fifth at North Shore. Elspeth Frascatore works in one of the city's EDs and represents the Association of Salaried Medical Specialists. She told RNZ's health correspondent Rowan Quinn emergency teams are used to working hard but the past few weeks have been another level some days.

Dr. Vanessa Beavis, ANZCA president, is a leading anaesthetist who presides over an international specialty medical college, a tough gig during a world-wide health pandemic. She was previously the Director of Perioperative Services at Auckland City Hospital and her clinical interests include perioperative medicine and liver transplant anaesthesia. Her colleagues and staff would say she is the ideal person to be tasked with leading the Australian and New Zealand College of Anaesthetists through a pandemic due to her calm and respectful leadership and drive to support trainees, fellows and staff through some extraordinary moments.In this episode, we discuss her journey into medicine, working in South Africa during apartheid, the highlights and lowlights of anaesthetics, subspecialising in liver transplant anaesthetics and what makes an outstanding anaesthetics applicant.As always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me.Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9YSupport the show (https://www.patreon.com/doctornos)

There's doubt looser self-isolation rules for healthcare workers would solve staff shortages. Non-urgent surgeries have been canned for at least four weeks at Auckland City Hospital and Greenlane Hospital.  Association of Salaried Medical Specialists executive director Sarah Dalton told Mike Hosking the care of people who don't have Covid is already being delayed. She says hospital staff having to isolate because of Omicron is making that difficult. “I think we all agree we don't want to turn hospitals into super-spreader sites.” LISTEN ABOVESee omnystudio.com/listener for privacy information.

Dr. Alana Harper is an emergency medicine specialist at Auckland City Hospital adult emergency department and a Pre-Hospital Retrieval Medicine Doctor with the Auckland Rescue Helicopter Trust (ARHT) for the past 10 years. She is also the ARHT clinical lead for patient safety and quality.  Her Helicopter Emergency Medical Services (HEMS) clinical work involves mostly helicopter and road primary missions and some inter-hospital retrieval. Her clinical interests include pre-hospital and retrieval medicine (being my sub-specialty interest), clinical governance, patient safety and quality improvement (including research and audit), trauma care, simulation (and education delivery using simulation). She has recently been focusing my ongoing professional development on clinical leadership. Dr. Harper is responsible for setting up the Women in Pre-Hospital Emergency Medicine Network NZ, which is forging strong networking and mentorship links for women in emergency medical services (both aeromedical and ground) in the North Island of New Zealand.  She feels strongly about being a visible role-model and positive champion for young women wishing to pursue STEM careers, and for women clinicians (both medical and paramedical) wishing to pursue aeromedical careers and clinical leadership positions.In this episode, we discuss her journey into emergency and pre-hospital retrieval medicine, the balance between the two, the stories that have stuck with her, the support and resilience of those working fields swimming in trauma and adrenaline, gender data gaps and Invisible Women, and her love for reading. Twitter: @mini_dr & @InPHRMWomen PHRM Network: https://www.womenphrmnetworknz.orgSelection of PHRM clinicians: https://codachange.org/on-the-selection-of-prehospital-clinicians/More information on DipPHRM: https://acem.org.au/Content-Sources/Certificate-and-Diploma-Programs/Pre-Hospital-and-Retrieval-MedicineODT article mentioned: https://www.odt.co.nz/star-news/star-national/how-decade-doctors-helicopters-has-saved-thousands-livesAs always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me.Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9YSupport the show (https://www.patreon.com/doctornos)

Dr. Michelle Wise was born and raised in Canada and moved to New Zealand on completion of her O&G training. She took up her first SMO job in Whangārei Hospital, returned to Canada for a period and is now working at Auckland City Hospital. She is a clinical academic working half time in general O&G and half time at the medical school teaching and doing research. Her research interests are in reducing unnecessary intervention in childbirth, developing clinical practice guidelines to support evidence-based practice, and getting early medical abortion funded in the community. She is a huge fan of yoga and mindfulness, and learning how to use traditional and social media to advocate for women's health issues. In this episode, we discuss her journey into obstetrics & gynaecology, her passion for increasing accessibility to abortion care, COVID vaccinations in wāhine hapū, navigating media, yoga and mindfulness and work-life balance in a two-doctor household. As always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me.Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9YSupport the show (https://www.patreon.com/doctornos)

The boys cross the Tasman like they do every Wednesday, Fletch has found some news about the coming and goings at the Auckland City Hospital. Beaver clears up some comments he made last week about Nelson Asofa-Solomona's Rugby Union position and Joel is spruiking another reality TV show.

Junior doctors are demanding that the Auckland District Health Board go back to the drawing board again over its hotly debated visitor policy. Following criticism by nurses, staff and patients, on Thursday the DHB tightened its rules governing visitors to Auckland City Hospital. It was allowing two visitors per patient but changed that to one per patient - and for no more than two hours. It's still too risky says Dr Deborah Powell of the junior doctors' union. She spoke to Guyon Espiner.

Auckland's hospitals are under pressure and preparing for more with the highest rate of Covid-19 hospitalisation of any of the country's outbreaks. There are 34 patients in hospital - just under 7 percent of all people with Covid-19. Most of them are in Middlemore -17 infact - and Auckland City Hospital has 13. Staff are getting anxious - especially when they look across at New South Wales. Health Correspondent Rowan Quinn reports.

Nurses are anxious about their workplace safety if the Covid-19 outbreak escalates, believing they're wearing PPE unfit for purpose and that a stretched staff will be placed under excessive pressure. Their biggest union believes every person who worked in the same ward as an infected nurse at Auckland City Hospital needs to isolate and be tested. Instead, that advice has only been offered to those who worked the same shifts as the 21-year-old in Ward 65. New Zealand Nurses Organisation kaiwhakahaere Kerri Nuku spoke to Corin Dann.

There are now five cases of the highly infectious delta strain of Covid 19 confirmed. One of them is a nurse at Auckland City Hospital, where internal lockdown measures are now under way. The first case detected in Auckland yesterday is a 58 year old Devonport man, who also travelled to the Coromandel. It's still unclear whether the cases are linked to people coming over the border, and genomic sequencing is underway. The entire country is at alert level four. But is this hard, fast lockdown going to be enough to get on top of the virus? Susie speaks with WHO advisor and Professor of Epidemiology at the University of New South Wales, Mary-Louise McLaws.

Extracorporeal membrane oxygenation (ECMO) is an increasingly available therapy, though it remains restricted to tertiary centres.  So what does this mean for smaller peripheral units? Dr Sara Allen is an intensivist and anaesthetist from the Auckland City Hospital in New Zealand, and she joins Todd to discuss referrals for ECMO. See omnystudio.com/listener for privacy information.

MMA fighter Israel Adesanya has called for the introduction of "coward punch laws" after a fellow training partner was attacked in the early hours of Sunday morning.The UFC middleweight Champion has called for legal changes after one of his main training partners Fau Vake was bashed in Auckland's CBD. The 25-year-old is now fighting for his life in hospital.It is alleged the City Kickboxing student fell after being hit from behind."I am distraught," Adesanya said. "My gym brother may die because of the actions of these men."Back in 2012, Adesanya suffered a broken jaw after he was hit from behind. He now wants to bring attention to what he says is a lack of legal recognition of the seriousness of what are termed coward punches."In the past decade there have been numerous deaths from punches thrown when people are not looking."Vake, a promising MMA fighter and young father, is in critical condition in Auckland City Hospital.Listen above as Jack Tame and Mattew Tukaki discuss the day's news with Heather du Plessis-Allan on The Huddle

Satualafa’alagilagi Dr Leinani Aiono-Le Tagaloa is an Anaesthesiologist (Anas-the-seaologist) and Specialised Pain Medicine Physician at the Auckland Regional Pain Service at Auckland City Hospital.   Dr Ai’ono-Le Tagaloa graduated from Otago Medical School thirty years ago, trained to become a surgeon and practised as a GP before switching to anaesthesiology.  She has studied, worked and taught in New Zealand and the United States of America in a variety of institutions and fields before she returned to New Zealand about ten years ago to commence her study in pain medicine.  To talk to us more about her life, career and why she chose to focus on and specialise in pain medicine we have on the line with us now Dr Leinani Aiono-Le Tagaloa. See omnystudio.com/listener for privacy information.

Welcome to another episode of The Words Matter Podcast.In this episode of the CauseHealth Series I'm speaking with Dr Brian Broom about his Chapter 14 that he wrote for the CauseHealth Book titled “The Practice of Whole Person-Centred Healthcare” (read chapter here).Until early 2019 Brian was a Clinical Immunologist at Auckland City Hospital and is Adjunct Professor in Psychotherapy at Auckland University of Technology. He is trained in internal medicine and psychotherapy and now works to train clinicians to practice whole person-medicine and healthcare (see here).Brian has written three books addressing this issue: Somatic Illness and the Patient's Other Story, Meaning-Full Disease: How Personal Experience and Meanings Cause and Maintain Physical Illness and Transforming Clinical Practice Using a MindBody Approach: A Radical Integration.In this episode we talk about: His interesting professional journey from immunology, psychiatry and to psychotherapy. How immunology and psychotherapy seem to be rooted in different paradigms- and how he has managed to bridge the two and addressed any tensions and challenges. The role and value of the story in his whole-person perspective. Relationship-based care; which resonates with my conversation with Dr Maxi Miciak in episode 9, and it will be worth re-visiting that podcast off the back of this one (listen here). What he calls ‘Hearing stories' and making diagnoses and how these two pursuits relate. Medicine as body only practice and traditional psychotherapy as mind/story only practices and how his whole-person approach avoids this dualism. This was an absolutely captivating conversation with Brian. The sincerity and compassion in the way in which he tells his own story of his whole person-centred approach really illustrates the way that practice needs to change to be truly person-centred.If you liked the podcast, you'll love The Words Matter online course and mentoring to develop your clinical expertise  - ideal for all MSK therapists.Follow Words Matter on:Instagram @Wordsmatter_education @TheWordsMatterPodcastTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication★ Support this podcast on Patreon ★

There are calls to bring in new rules around e-scooters - after it was found users were more likely to be hospitalised than cyclists. Research published in the New Zealand Medical Journal compares the injuries of e-scooter riders and cyclists treated and Auckland City Hospital. They found e-scooter users had significantly higher levels of alcohol in their system and were less likely to wear protective gear. Reporter Karoline Tuckey has more.

People jumping on a scooter drunk, and late at night, are ending up in hospital after hours. That's a trend noted by a New Zealand Medical Journal paper comparing the injuries from e-scooter users and cyclists between 2018 and 2019 at Auckland City Hospital. One of the authors of the report, Dr Savitha Bhagvan says there should be a zero tolerance policy for alcohol and escooters, mandatory protective gear and stronger road rules. Dr Bhagvan is a trauma and general surgeon at Auckland City Hospital. She spoke to Corin Dann.

Up to one in four couples planning a baby may have difficulty conceiving. Several interventions are available that might help and Cochrane has reviewed many of these. In August 2020, our review of antioxidants for female subfertility was updated and we asked one of the authors, Dr Rebecca Mackenzie-Proctor from the Auckland City Hospital in New Zealand to tell us about the rationale for the review and the latest evidence.

Up to one in four couples planning a baby may have difficulty conceiving. Several interventions are available that might help and Cochrane has reviewed many of these. In August 2020, our review of antioxidants for female subfertility was updated and we asked one of the authors, Dr Rebecca Mackenzie-Proctor from the Auckland City Hospital in New Zealand to tell us about the rationale for the review and the latest evidence.

Whether you are a beginner or experienced ultramarathon runner, you need to be well-prepared for every run you do. Ultra running has its bright side — the uplifting community, the sense of accomplishment, and the goals of becoming stronger. However, there are certain risks involved in the sport, and as an athlete, you need to keep yourself informed. In this episode, Eugene Bingham joins me to explain the dangers of extreme sports and marathons. We share personal stories about the damage it could do to the body — experiences that should serve as a warning to runners. Eugene also discusses things to be aware of before and during races that can endanger us, giving us five specific tips for preparation and self-management. Don’t miss this episode and learn more about the risks of and preparations for ultra running and other extreme sports!   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition, and mental performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join our free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   One-on-One Health Optimization Coaching  If you would like to work with me one to one on anything from your mindset, to head injuries,  to biohacking your health, to optimal performance or executive coaching, please book a consultation here.    Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research, and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: Learn about the risks and dangers of extreme sports and ultra running. Gain valuable insight into the things you need to be aware of before and during marathons. Understand the importance of listening to your body.   Resources Death of a runner: The rare condition that tragically claimed a life by Eugene Bingham Desert Runners on TVNZ   Episode Highlights [04:01] The Dangers of Extreme Sports and Ultramarathons Eugene participated in the 2020 Tarawera 100-mile race where an experienced runner died. The runner’s death certificate showed that he had a multi-organ failure, acute respiratory distress syndrome, and rhabdomyolysis. However, it was difficult to pinpoint the true cause of death since it can be a result of accumulated health conditions. [09:50] What Is Rhabdomyolysis? Rhabdomyolysis, or muscle breakdown, is quite common for runners. As the muscle breaks down, myoglobin from the muscle is released into the bloodstream, clogging the kidneys. It can be difficult to tell when this happens since symptoms can be easily mistaken for simple muscle soreness. This can happen to everyone, not just those who do extreme sports and ultra running. [16:27] Importance of Self-Management At some point, we have to ask ourselves if the damage we’re doing to our body is worth it. There are risks, and you have to be prepared for them.  There is a culture of not quitting unless you’re taken by the ambulance. However, we have to listen to our body before it gets to that point. [20:19] Mental Toughness and Listening to Your Body As we grow, our physical abilities and mental maturity changes. Accept that the body may not be able to take what it could years ago. The goal of pushing your limits is good but keep in mind that you also need to train and prepare yourself. Being mentally tough also means knowing when to stop and rest. [22:53] Ultra Running: 5 Tips to Remember Do not take drugs like ibuprofen and Voltaire.  Drink when you’re thirsty and do not over drink.  Be prepared for a range of weather conditions. The race does not end at the finish line. Replenish yourself after every race. Look out for each other. [28:08] Always Have Support Eugene shares his experience of having hallucinations but was kept safe by his companions. Form connections and friendships with the people you meet in races. They are bonds that last forever. Listen to the full episode to hear Eugene and Lisa share more stories about how people have helped them during races! [38:33] Conditions to Be Aware of We need to be careful about dehydration. Symptoms of hyponatremia (having low sodium levels in your blood) are swelling, nausea, and lightheadedness. Low levels of potassium and electrolyte imbalance can result in tetany seizures. Electrolyte tablets are beneficial — make sure they have all the nutrients you need. Having no appetite after a race is dangerous. We need to replenish our bodies straight away.  [47:10] Risks Are Exponential When you exponentially increase the distance you run, you exponentially increase our risks as well. All races are relative to pace. Never underestimate a race by distance. Take every race like a big deal and don’t become complacent. Recovery after a race is also crucial. Don’t succumb to peer pressure and sign up for a race immediately after. [51:53] Quick Checklist Do not expect that you can do it just because you’ve done it once before. Be aware of conditions such as rhabdomyolysis, heat stroke, hyponatremia, dehydration, seizures, electrolyte imbalances, and breaking ankles. Plan well — note altitudes and paths. Running is just like driving. Driving is considered dangerous but we don’t avoid it; we just take extra measures and precautions to make sure that we are safe.   7 Powerful Quotes from This Episode ‘People need to be really conscious of the risks — they need to be prepared to put the time in. You've got to prepare your body and you've got to know your body’. ‘Having lined up at the start line with someone who didn't make it home — that really reinforces that these are real risks and you have to be prepared for them’. ‘The race doesn't end at the finish. Some of the most dangerous time is after that: when people get to the finish line and drive home, they're tired — you can crash easily’. ‘Sometimes there's a bit of competition, isn't there. But, number one, you've got to look out for each other. You are comrades — you've got to have each other's backs’. ‘It is incredible, those connections you make. Even if you don't see each other again, but yes, you've got that bond. That's forever’. ‘Take those precautions. Just be a bit careful. We want to push ourselves. Yes, we want to be out there. Yes, we want to find new limits, but we also want to get back home’. ‘Respect the distance. You cannot run something like this without respecting it’.   About Eugene Bingham Eugene Bingham is a senior journalist at Stuff, co-host of the Dirt Church Radio trail running podcast with his mate Matt Rayment and an ultramarathon runner. In a career of almost 30 years, he’s reported and produced news and current affairs, winning multiple awards as an investigative journalist. His work has taken him to three Olympic Games, and a number of countries including Afghanistan, the Philippines and the Pacific. No matter where he goes, he always packs his running shoes. He has a marathon PB of 2h 43m and his longest event is the Tarawera Ultra 100-mile race which he ran in February 2020. Eugene is married to journalist Suzanne McFadden and they have two grown-up boys. You can listen to their podcast on Dirt Church Radio. You can also follow and support them on Patreon, Instagram, and Twitter.  Have questions you’d like to ask? You can reach Eugene at his email.   Enjoyed This Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so they can be aware of the dangers of extreme sports and ultra running. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram, and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript For The Podcast! Welcome to Pushing the Limits, the show that helps you reach your full potential, with your host, Lisa Tamati. Brought to you by lisatamati.com.  Lisa Tamati: Well, hi, everyone, and welcome back to this week's episode of Pushing the Limits. Today, I have journalist and ultramarathon running legend, Eugene Bingham, to guest. And Eugene is the host of the podcast, Dirt Church Radio, which I hope you guys are listening to. It's a really fascinating insight into the world of running and trail running. And he has a really unique style, him and his friend, Matt Raymond, run their podcast. So I hope you enjoy this interview.  Today we're talking about the dangers of extreme sports, not just ultramarathon running, but doing—pushing your body to the limits. While, you know I'm definitely a proponent of going hard and mental toughness and pushing the body and all that sort of good stuff. We also need to know about the downside. We also need to know about the risks. And recently there was a death, unfortunately, at the Tarawera Ultramarathon of a very experienced ultramarathon runner. And so we're going to dive into some of the dangers and some of the things that need to be aware of when it comes to pushing the body to the limits. And so you have an informed consent and an understanding of what you're getting into when you're doing these sorts of things.  Before we head over to the show, though, please give them a rating, review to the show if you enjoy the content. Really, really appreciate the comments and the reviews and if you can do that on iTunes, or wherever you're listening, that would be really, really appreciated. And if you haven't sold your Christmas stocking yet, please head over to my shop and check out my books, Running Hot, which is chronicling all my running adventures in my early days, Running to Extremes. Both of those books bestsellers, and my new book, Relentless - How A Mother And Daughter Defied The Odds, which is really a book about overcoming incredible obstacles, the mindset that's required, the stuff that I learned while I was running and how it helped in this very real world situation, facing a very dire situation within the family. I hope you enjoy those books and if you have read them, please reach out to me, give me a review. Again, if you can, I'd really appreciate that you can reach me at lisa@lisatamati.com.  And just a reminder too, we are still taking on a few people, on one on one health optimization coaching, if you're wanting to optimise your health, whether it be with a difficult health challenge, that you're not getting answers to mainstream health and you're wanting some help navigating the difficult waters that can sometimes be, please reach out to us. And we deal with some very intricate cases. And I have a huge network of people that I work with that we can also refer you out to. I am not a doctor, but I am a health optimisation coach and an epigenetics coach. And we use all of the things that we've spent years studying to help people navigate and advocate for them, and connect them to the right places. And this is a very different type of health service if you like and it's quite high touch and it's quite getting into the nitty gritty and being a detective basically. And I'm really enjoying this type of work and helping people whether it be with head injuries, with strokes, with cancer journeys, thyroid problems, or all these types of issues. Not that we have it or every answer there is under the sun. But we're very good at being detectives working out what's going on and referring you to the right places where required. So if you're interested in that, please reach out to us lisa@lisatamati.com. Right, now over to the show with Eugene Bingham.  Well, hi, everyone, and welcome back to the show. I have Eugene Bingham. I know he's so famous, he actually sit down with me to record this session. So fantastic to have you here. Right? How are you doing?  Eugene Bingham: I'm very well, thank you. And thank you for having me on. Such an honour.  Lisa: Fantastic. Yes. Well, I was lucky to be on your show. And you've been on mine, and we just really connected. So I wanted to get you back on because you've just written an article, which was very, I thought was an important one to discuss. And it was about the tragic death of an ultrarunner last year or this year in the Tarawera Ultramarathon. And while we don't want to go too deep into the specifics of that particular case or we'd like to know what you know about it... Eugene: Sure.  Lisa: ...but wanted to have a discussion around the dangers of extreme sport or ultramarathon running and some of the things we just need to be aware of. So, obviously Eugene and I—neither of us are doctors or any of this should be construed as medical advice, but just as—have to give them out there...  Eugene: Absolutely.  Lisa: But as runners and people who have experienced quite a lot in the running scene, and I've certainly experienced enough drama, that it is something that we need to talk about. So Eugene, tell us a little bit about what happened? And what are you happy to share  Eugene: Sure.  Lisa: ...and what you wrote about in your article, which we will link to in the show notes, by the way. Eugene: Yes. Thank you. Sure. Yes, so I was a competitor in the Tarawera hundred mile race in February, which as you said—when you said last year, it does feel like last year, doesn't it? Oh gosh, it feels like it was five years ago. But it was February 2020, all those years ago. And in that race was sort of about 260 of us lined up. And then that race was a runner an older—oh, he’s 52. So from Japan, a very experienced runner, had run Tarawera previously, had run lots of other miles, and ultraraces. And unfortunately, about a kilometre or so from the finish, he collapsed, and about 34 hours into the race. And although people rushed to help them, and he was taken to retro hospital, and eventually to Auckland City Hospital, he died. And I remember, I remember the afternoon we heard about it, and Tarawera put it up on its Facebook page to let us all know that one of our fellow runners had died and I stopped. It was a shock.  Lisa: Yes. Eugene: You know we do this thing, because we love it.  Lisa: Yes. Eugene: And because we get enjoyment from it. And he was someone who paid the ultimate price.  Lisa: Yes.  Eugene: So I—we're a couple of hats, and one of them is a journalist, and so I—but really, what first kicked in was, I really want to know what happened. I really wanted to know what happened. I've had health issues myself, had a few scares and so on. A few wobbles and races, and I thought—just from my point of view, I was really curious to find out. But I also thought it was important to find out for other runners... Lisa: Yes, absolutely. Eugene: ...or say, I listen for others. And so I started to see if I could find out. COVID got the way a little bit and distracted me. But eventually I did manage to track down what happened there. Yes. Lisa: And what was the result of the findings in this particular case? I mean, we're gonna want to discuss a few.  Eugene: Sure. Lisa: I think, in this case, it was a couple of things, wasn't it? But this is without picking—and we're certainly not picking on anybody or any, not race, or anything or saying this is bad or anything. But what was it that you discovered in it?  Eugene: Yes. Lisa: So with that, research.  Eugene: Sure. So initially, I remember the talk was that he might have had a stroke, or there might have been some sort of underlying condition.  Lisa: Yes.  Eugene: But I got a hold of his death certificate and it shows that he had multiorgan failure, and acute respiratory distress syndrome, which are both conditions that they can be in multiple causes of those sorts of things. But the one that jumped out to me was Rhabdo. You're gonna make me say that? The proper name for it. Lisa: Rhabdomyolysis Eugene: Thank you. Lisa: I'm an expert in rhabdo. Eugene: So yes, that was the third one on the list. And that was the one that really jumped out at me.  Lisa: Yes.  Eugene: Months earlier, I'd spoken to Dr Marty Hoffman, who's in a University of California Davis in the States, and he's sort of recognised around the world. Basically, if there's an ultra—there's a paper about medicine involving ultrarunning, you'll find Marty Hoffman's name on it, he knows this stuff.  So I'd run to him months ago, at the suggestion of a friend, Dr John Onate, and I had a good chat with him. And he sort of ran through the list of what we could be looking at here, but he was really—it was a stab in the dark at that point. But he told me then that they’re hipping no deaths from rhabdo, knowing deaths from rhabdo from ultrarunners.  Lisa: Yes. Eugene: Yes. And no knowing deaths from ultrarunners of the AH, exhausted and just talking it, ‘How can I train you’?  Lisa: Yes.  Eugene: So we were kind of that, like, ‘What could it be’? Yes. So when rhabdo appeared on the desk fit, I rang him back and said—I actually emailed him and said, ‘Hey, this is what it says’. And he was very surprised because he keeps track of deaths of ultrarunners around the world. And as he said, there hadn't been one recorded before, doesn't mean there hasn't been one, of course.  Lisa: Yes, it doesn't mean. Eugene: It's just no one, yes, no one knows what causes.  Lisa: And I think a lot of these things will have contributing factors in—completely unrelated but going through the journey with my dad recently it was at the end, he had multiple organ failure.  Eugene: Yes.  Lisa: He had sepsis however, and before that he had an abdominal aneurysm.  Eugene: Yes. Lisa: So it shows the progression like it. What did he actually die off?  Eugene: Yes. Yes.  Lisa: He was born with the failure probably, or zips as chicken or eek scenario. Eugene: Yes. Lisa: So these things, one leads to an acute respiratory syndrome  Eugene: Yes. Lisa: And they all lead on from one to the other when the body starts to shut down, basically.  Eugene: It's a cascade isn’t it?  Lisa: It’s a cascade. That is a very good way of putting it. So rhabdo—and while there is perhaps no documented case of a death from rhabdomyolysis, I don't know if they—I know in my life, I've had rhabdo. I can't even remember the number of times I've had rhabdo.  Eugene: Yes. Lisa: I took away kidney damage from it and the last few years, I've been trying to unravel that damage and undo that.  Eugene: Yes.  Lisa: I'm getting there slowly.  Eugene: Yes, yes.  Lisa: So it is a very as if quite a common thing. Eugene: Yes. Lisa: So we don't know whether in this case that was actual final, what actually did it? It certainly would have been a major contributing factor.  Eugene: Yes.  Lisa: Well, what is rhabdo? I suppose we better explain what rhabdos are. Eugene: Yes. So I mean, well, from your experience, you will know better than me. But I spoke to Dr Hoffman and to Dr Tom Reynolds, who's the race doctor for—one of the race doctors for Tarawera.  Lisa: Yes. Eugene: And they explained it as the muscle started to break down and the myoglobin from the muscle being released into the bloodstream. And then it basically just starts clogging up the kidneys and just causing real damage in your kidneys. The problem with it is the symptoms for sort of sound like a lot of other things and also can just sound like what you might expect running an ultramarathon. Lisa: Yes, the kind of that also. Eugene: Yes, tenderness of muscles, a bit of confusion, and so on. And then even some of the blood tests that you can do to pick it up. So they look for CK—you're much more proficient in the medical world than me. Lisa: Not more. Eugene: But the thing that they test for—it basically there was an experiment at Western States a number of years ago, where they tested bloods of people in Western states and they tested something like 160 runners, all of them had elevated CK levels.  Lisa: Yes.  Eugene: So in part, it's just a function of ultrarunning, your muscles are gonna break down to some extent. So that makes it very, very tricky to find out, to discover it. And Dr Hoffman said, ‘Sometimes the first sign that you get that someone's got rhabdo, is they have a seizure’.  Lisa: Yes.  Eugene: So it can be a tricky, tricky condition to pick up. Yes, that's really—it's hard, isn't it? It's really hard. Lisa: It is hard and—but when you are going for—and some of these races are 24, 36, 50 something hours, you're going to have some breakdown of muscle and you… Eugene: You are. Lisa: I mean, keeping an eye on the colour of your urine or if you are not producing… Eugene: Yes, that’s an important one. Yes. Lisa: It is probably the easiest thing to think about. Because like you say, the nausea and headaches and confusion and fatigue are all very general parts about running anyway. So keeping an eye on it, like getting a pouch of fluid. What I would find is that in the lower abdomen, and I don't know if whether this is an actual medical symptom or not. But in the lower abdomen, I've developed this pot gap running and, it wasn't fat, obviously.  Eugene: Yes.  Lisa: ...within a couple of hours. It was fluid, and would usually coincide with my kidneys—they’re not producing or producing very little output. So I think there might be a sign that something's going on there.  Eugene: Right.  Lisa: In rhabdo, like, we're talking ultramarathons, but I have seen a case of rhabdo in a half marathon in summer.  Eugene: Yes.  Lisa: Yes. So a mild case, but enough to be taken to hospital. So it's not even just people doing the extreme extreme stuff.  Eugene: Yes.  Lisa: But it is a very—and you have to ask yourself, how much damage are we doing every time we do and I often asked, ‘Why are you not running anymore’? ‘Why are you not doing it anymore’? And apart from life's gotten a bit crazy. Am I? Indeed yes.  Eugene: Yes, yes.  Lisa: Should I have not got the time to be doing offers? I want longevity and while I love ultras, and I love the culture. And I love what I got to do. And I'm certainly not, I mean, I train lots of ultrarunners. I for myself, don't want to put myself at that risk anymore. Now that I'm also 50 and I want longevity. And therefore my health comes before my sporting ambitions now. It didn't when I was younger, but now with—unfortunately, one of the side effects of studying medical stuff for the last five years, is that I'm now a little bit more cautious.  Eugene: Yes.  Lisa: Because ignorance is bliss.  Eugene: Yes.  Lisa: What you don't know, you just go and do.  Eugene: Yes.  Lisa: You don’t actually know the implications and sometimes, you don't actually know the implications until well down the track, like, you use to check. Eugene: Yes. yes, sure. Lisa: That's where I'm sitting at the moment, as far as the sort of the dangers and the risks. I mean, how did you feel as a runner, who—you were in the same race doing the same distance? You're a little bit north of 25 now. Eugene: Jump 47. Lisa: You're 47?  Eugene: Yes. 47, yes.  Lisa: And did this make you stop and think about, ‘Do I want to keep doing this stuff? How do I feel about it’? Eugene: Yes, it sure does. It sure does make your family think of that, doesn't that? I think it reinforces that you need to have really good self management. You need to be well prepared. I spoke to—when I spoke to Dr Reynolds, and I said to him, ‘We had this big conversation about all the cold coloured urine and all that sort of stuff’. That sounds a bit odd, and a little different other conditions that can come about. Yes, and so on. And I said to him, ‘Boy listen to all of that. Do you recommend people run ultramarathons’? And he said, ‘Look. At three o'clock when the medical team is full. And I've got my hands full, I look around, and I go, What the hell have we been doing this for’? But he says, ‘But it's a small proportion that gets badly affected. And as long as you manage your risks, and you're aware of it’, he said one of the things that he's really concerned about is people jumping up the distance too quickly. Lisa: Yes.  Eugene: Or the runner suddenly, ‘Wow, I'm gonna run 100 miler’, because it has become, I think it's… Lisa: The new marathon.  Eugene: I told him, I spent more time trying to talk people out of doing milers than I do in trying to talk them into doing milers. I don't think I talk to any other or talked anyone into doing a miler. It's a very personal choice. I spend a lot of time talking to people out of it, makes me so again. But again, I don't know if that's a good idea, mate.  Lisa: Me too.  Eugene: Yes. And it sounds bad.  Lisa: Yes.  Eugene: Try running podcasts. Lisa: I know. You know, my buddy out running. Eugene: Yes. But I just think people need to be really conscious of the risks.  Lisa: Yes.  Eugene: And they need to be prepared to put the time in. And that's one of the things that you've identified. You've got to prepare your body. And you've got to know your body. I mean, I took—I've been running my whole life. And I didn't take the decision to enter the miler, lightly, certainly would now knowing what I do know now. And when I say no, I mean, I'd always heard of rhabdo. I'd heard of AIH, I'd heard of dehydrational systems.    And you sort of think about you sort of like, ‘Yes, yes, yes’. But having lined up at the start line with someone who didn't make it home that really reinforces that these are real risks, and you have to be prepared for them. You have to be ready for them. So, I'm not gonna stop ultrarunning, I don't think. But I'm certainly going to be a hell of a lot more careful. And listen to my body.  Lisa: Exactly.  Eugene: Sometimes you can get that. I find one side of ultra running that I struggle with a little bit is the whole kind of ‘You're not going to quit unless the ambulance takes you off the course’ kind of thing. I don't like that. I don’t really like that. Lisa: I totally agree. Eugene: You know, I agree. I love the whole mental toughness thing out of it. Don't get me wrong. That's one of the things that I enjoy about it. But you have to listen to your body. You have to listen to your body. I've pulled out of a 100k race, where I could have pushed on. You know. Looking back, it's like, ‘Yes, I could have pushed on, at what cost’? You know?  Lisa: Yes.  Eugene: Yes, it just wasn't worth it. Could I push through and be out there for another hours and hours and hours and hours? Putting myself...  Lisa: Yes.  Eugene: Yes, sure. I could have but what was the risk? What could have happened? And what do I get out of it? Instead I actually came away from that race having learned a hell of a lot of lessons. And they prepared me for the miler, actually. Lisa: Yes. And I think that’s some beautiful attitude and in a very wise mind. Some of the things that I did in my younger years or even—I’m talking 40s. Eugene: Yes, yes. Lisa: We're stupid. There is no other word for it. And especially in the 30s, my 30s, I thought I was bulletproof and I could push and I had that mentality, you're going to have to drag me away, framing and I have seen lots of others. And I have nearly pushed my body on a number of occasions to the point of death and I've been very, very lucky not to have died.  I've had tetany seizures, which is where your potassium level and your electrolytes are so out of whack that the whole body cramps and so I'm having a heart attack. I was luckily at that at the point that I head out, I was in Alaska, and I'd been for six weeks out in Yukon with poor nutrition and so on and pushing the body every day. I just come off a mountain when this tetany seizure hit. Luckily, I was two minutes from a hospital, and they saved my life.  Eugene: Wow. Lisa: But that would have been deadly very quickly. I've experienced extreme levels of dehydration in the Libyan desert where we only had like one and a half to two litres of water a day in 40 plus temperatures. And gone to the point where I no longer was in control of my body, and my—not only just hallucinations but the central nervous system starting to shut down. Massive kidney damage, and taking nearly two years to recover from that.  I’ve had food poisoning while running across Niger, and again bleeding at both ends pushing it to the absolute limit I did pull out of that race at 64 hours after 222Ks but that was way too late. I've gotten away by the skin of my teeth. Not to mention going through war zones or military body areas Eugene: Yes. Lisa: Or being in really dangerous situations and that's a whole podcast in itself. But it wasn't worth it. Now I think I was just so afraid of failure I was so afraid of not achieving that, which I'd set out to do that. And I have to think about it now and go I wasn't in—people who are in war scenarios or some survival situation where you have to freakin go to the limit alive. Eugene: Yes. Lisa: But I wasn't in there. This is a—well, Libyan desert ended up like that, but you know what I mean? Eugene: Midnight summer bitches.  Lisa: Oh yes, it’s some stupid shit. It really was. But at what costs? Now, I've had a lot of health issues in the last five to six years and a lot of that comes from—I haven't been able to have children you know and so on and so forth. And these are the contributing factors  Eugene: Sure enough. Lisa: That's the only reason for certain things, but now as a coach and as an older wiser woman, I don't want to see people pushing their bodies to that point where they actually close to dying or causing major damage to the body.  Eugene: Yes, yes.  Lisa: It really is not worth it. Eugene: I mean this pushing the limits isn't there. And mentally, I think there's a lot to be said for having a goal that's going to stretch you when you are going to go for it. But the key is to be prepared, isn’t it? To actually have done the training...  Lisa: The training  Eugene: ...to prepare your body. To test—so that you know when your body's screaming at you, you know it’s saying, ‘Okay, you know what, you know to pull the pen or you know to stop and rest or whatever’. I think there was some good—Tom Reynolds had some five tips which are really good.  Lisa: Yes. Let’s hear them  Eugene: To prepare yourself for an ultra especially ultras but even marathons I suppose  Lisa: Absolutely. Eugene: Number one on his list, and I think he would make this number 1, 2, 3, 4, 5 is don't take drugs like Ibuprofen and Voltaren and those sorts of things.  Lisa: Super important. Eugene: Do not take them. Yes, super important. The second one is drink to thirst. You know that you can have problems—your own problems if you have too much liquid.  Lisa: Yes, which we’re talking about in a sec. Eugene: Yes. Be prepared for the conditions. Have a plan for a range of conditions. So make sure you've got thermals. Make sure you've got your jackets and sawn and layers that you can take on and take off especially if you're going to some of these remote areas that we go to as ultrarunners.  Number four, the race doesn't end at the finish. Pack warm clothes, get some food ready that you can eat, some liquids. And another thing that he pointed out to me is actually some of the most dangerous times is after that finish line. When people get to the finish line, and drive hard, and they're tired. Lisa: It's so true. Eugene: You can crash easily for a second crash.  Lisa: Yes.  Eugene: And number five is look out for each other. and I think that's so important. Sometimes there's a bit of competition isn't there? But number one, you've got to look out for each other Lisa: Yes.  Eugene: You are comrades in this together and you've got to have each other's backs. And there's little relationships that you build up with someone you've never met before. I still remember having a good chat to a farmer from Jordan. I spent a lot of hours with him at Tarawera. Haven't spoken up since, never met him before in my life, but there we were together at Bizmates on the trail. Lisa: Awesome. Eugene: Keeping an eye on each other. Looking out for each other. You make sure they've got their bottles filled at the aid station. You make sure that they're not getting confused or anything like that—just looking out for each other. Simple isn’t it? Lisa: That’s gold. Eugene: And that was the five tips that he gave. Actually, they're pretty good tips. Lisa: They are very good tips, and a couple other ones to pick out like the training. In my early days as a coach, I remember taking an athlete who went from half marathon to running the Big Red Run 250Ks. Eugene: Wow. Lisa: Inside a month.  Eugene: Oh. Lisa: Now on a red mat, that was stupid.  Eugene: YeS.  Lisa: He came over to do 100k to be fair, and he was doing so well. He just decided to carry on and to do the whole thing. And it was an incredible achievement.  Eugene: Oh, yes.  Lisa: However, broken my butt. Like, it never was quite the same afterwards. And he wasn't ready. He wasn't, like, his body wasn't ready. So when you prepare your body, when you're training, you doing these long runs, and you're doing back to back running, and you're doing strength training, you're doing mobility work, all these things are preparing the muscles so that they don't break down so quickly and they don't need—you don't need about rhabdo.  And another big piece of the puzzle is the experience side of things. Because then you can actually start to feel when your body's doing a chick or not. As I run, I used to do like little chickens every half hour or an hour I'd go right I'm doing a control like a pilot would before he flies the airplane. ‘How is everything? How am I feeling? Have I ever drunk in the last 10 minutes? Have I eaten anything? When was the last time I weighed? When was the last time’... Just doing a mental checklist as often as you can.  Now one of the hard things with ultra though is that you start to lose your brain function, so all the blood flow is going away from your executive function up here and you become like a bit of a moron. You’re like, ‘Oh, oh’. Eugene: Absolutely. Solving maths? Impossible. Lisa: Impossible. Or maybe doing a 24 hour race, the one at the Millennium Stadium, and there was some guys they’re testing us just for a laugh, doing Noughts and Crosses as we run around the track and our brain function is a day and night wore on just we weren't even able to add up one plus one anymore. We just completely like, ‘Eh’? He’s got low blood and my brain is not functioning. So what that does mean is that your ability to make good decisions is also impaired. I remember saying to one of my friends who was a paramedic and she was with me in Death Valley, in the second time I did Death Valley. And she says, I said to her, ‘You are responsible for my health’. I was lucky I had a crew in that situation. If you pull me out, you pull me out. I know that you won't pull me prematurely because you know what, it's taken me to get here. But my life is in your hands and I respect that. I respect you. I respect your knowledge as paramedic. If you tell me it's over, it's over. And she will be able to make that decision because I knew from my personality and from my matter that cost me to get there wasn't going to be pulling out anytime soon. So sometimes if you can have in the case where you have a crew have somebody say, ‘This is now getting dangerous’. And it's a fine line. Like I pulled my husband out of a race once, Northburn, a race that I co-founded a few years ago in the South Island. And he was doing the 100k and he actually rang me on the cellphone, and it seem the case, we had a massive storm up in the mountains. It was wild. It was his first 100k, he was in the mountains. He was scared shirtless. He was hypothermic. And I was like, ‘Oh my god, darling, just come home’. You know? So that was—and he could have pushed on.  Eugene: Yes. Lisa: And mentally that cost him a lot because he pulled out, and he didn't push over that hub. So there's this fine line between it should’ve been ours... Eugene: But he lives to tell the story.  Lisa: Exactly, and he's done that, so it wasn’t... Eugene: Exactly, that doesn't matter, you know? We love those stories. I love reading your books. I love reading the things that you've been through. But, my gosh, when you think about the risks as you say and the cost, and that's a common story. You're not alone in there, That's the sport we’re in.  Lisa: Yes. Eugene: It's ridiculous to me. But you know, it's a tough one. And it's, I think that's a really good idea. Having someone who's who's got your back. Someone who you can trust, like you say, they're not going to pull you out you know just because you stub your toe. Oh gosh... Lisa: Just because you’re... Eugene: Exactly. Exactly. Who hasn't? But you can trust them so that when you've gone to that thin line, bang!  Lisa: Yes.  Eugene: Come on my area.  Lisa: Yes.  Eugene: And I was lucky to have a really good mate who phased me. I went through some hallucinations. Nothing major. But he thought it was—I had my mate. And he was looking out for me. In fact, he laughed at me. Lisa: What did you see in your hallucination? Eugene: Oh, I hit home. So we were running around on an unfamiliar course. We were coming around the back of Blue Lake. Up towards the Blue Lake aid station. So about 120km. And it was just before sunrise. So, you get that funny light.  Lisa: Yes.  Eugene: It's still dark, but the light is changing. And I swore coming up to the aid station, I swore I saw a robot sitting off to the side of the trail. And in my photo frame mind, I justified it as ‘Oh, it must be like reading, it must be scanning us telling the aid section that we're coming’. And so I saw it. And said to my mate, ‘James, there’s a robot. It's pretty cool’. And he's like, ‘The what’? ‘The robot there’. And he's like, ‘There’s nothing, man’. And I think it was a tree or something. I don't know what it was. But it's funny how I justified it to myself. So it was fine. And then after the light changed, I got a couple of situations where it's quite unlikely to cause hallucination or is vision going. But I—the ground was just like liquid glass. Lisa: Wow, that’s cool. Eugene: I was like, ‘Oh, should I put my foot down or not’? And James said, ‘What are you doing? Come on’! It was like, ‘What's going on with the ground’?  Lisa: [32:58] inaudible the glass. Well. Eugene: So that was but—people have some great hallucinations, don't know. But the point of that was, I had my mate there. It was never unsafe. And I'm grateful for that. So I think that's a really good tip, Lisa, to have a crew with you. Lisa: I think hooking up. Or if you're in a race where you don't have crew—which most of them are. And that you do hook up with somebody. If you can try and not too many people because then your pacing will be all out. But if you can just hook up with one person or maybe two at the max. I remember running the Gobi Desert in the Sahara with same gash who was in the desert runners movie together and this is great footage and desert runners is playing at the moment on TVNZ if anyone wants to check it out, it’s a cool movie. And yes we're running along holding each other's hands, bawling our eyes out, and but we got each other through both of those messiest days, both in the Sahara, and in the Gobi. And we ran together in India as well but with crews in that case. But that comradeship that we have there was just gold. It just helped.  When you [34:17] escaped shirtless you hit someone the and we did get lost and we did fold our paces and we did have all sorts of dramas and we kept each other going through all those hard times and I think that's one of the beautiful memories for me that I take away from that. And there were other people I've done the things with... And the depth of connection that you have with a human being when you've gone through something like that it's just next level. And that's one of the beautiful things because we’re talking about all our negatives here but it is just like—she’s a very amazing woman that one. She’s done incredible things. Eugene: It is incredible, isn’t it. Those connections you make.  Lisa: Yes.  Eugene: The friendships you forge. Even if you don't see each other again, but you've got that bond. That's forever.  Lisa: Yes.  Eugene: Those moments that you shared when you're vulnerable. Lisa: When you're up [35:11] Creek and literally. Guys who didn't even speak the same language or a woman I remember running in the Sahara at one point with a—I was crying, she was crying. She was from South America somewhere, didn't speak a word of English, or another French guy picked me up in Jordan when I was running across there and I'd passed out and he came along, picked me up, got me into the next checkpoint. The French guy and Niger, it's just like, ‘Wow’. The stuff that you help each other through. It's gold, but does this do happen, you know?  Eugene: They do. They do. Yes. Lisa: We have one in the Gobi Desert. We had a young man, Nicholas Kruse was only like 30 or 31, I think. And he was first time doing it. And he wasn't trained enough, I don't think. And he—I think he underestimated the thing. And he unfortunately probably paid the ultimate price. And then you've got also the dangers. I mean, you got cases like with Turia Pitt, the forest fires in Australia, or there are things that could go wrong. Eugene: Yes, absolutely. Lisa: Even in these organisers' races. You have falls where you've hit your head and concussions and... Just because you're in an organised event, do not think that there isn't an element of danger, or that you're going to have to be self-reliant, you cannot. And inside these countries is beyond the abilities of the organisers actually to cover every base. Eugene: Absolutely. Well, even in races in New Zealand, we go to some remote places, and races route is difficult to get. You're not just going to be able to ring up 111 and get an ambulance there.  Lisa: No. Eugene: It's not like that. I've been in a 100k race where—because there have been lots of runners going through this. It was a narrow bit of the trail. And it was really dry there. And runners have been going over this bit of land. And basically, as the day wore on, it sort of started to break down a little bit. And I was just the unlucky one stick on the trail in a way. And I slid down this bank...  Lisa: Oh my god. Eugene: ...and down, down, down, down down, thinking, ‘Uh-oh, when's this going to stop’? Luckily, I hit, I came to a stop on a tree, not badly. And then basically had to scrape my way back up. Now, I was fine. But you know, those sorts of things can happen if I stumbled in a wrong way as I came off the trail and hit my head, whatever. So you are—yes, you will, I mean, it’s not... Well, I mean, when we've been out on a run in a cotton wool, so [37:57] do we. But we don't want to go everybody. But you don't need to be conscious. Lisa: I'll be conscious of it. I think... Eugene: And even when you're training too, when you're training, when you are going out in remote areas. Make sure you tell someone where you're going. Preferably run with some other mates. Maybe think about taking a locator beacon with you if you're going somewhere really remote.  Lisa: Absolutely. Eugene: Have a phone with you, do those sorts of things. Take those precautions. Just be a bit careful. Yes, we want to push ourselves. Yes, we want to be out there. Yes, we want to find new limits. But we also want to get back home.  Lisa: Yes, we want to come home to our families and not die on the way.  Eugene: Yes. Lisa: If we can. I mean, people can take it to the level that they want to go to, but just don't want people going and thinking that everything's safe because it's an organised event or because hundreds of other people have done it, means absolutely nothing. Eugene: Absolutely.  Lisa: I’ll tell you, like how many thousands of people have climbed Mount Everest, but it's still a frickin dangerous thing to do. Eugene: Absolutely.  Lisa: Doesn't mean it's safe just because lots of people have done it. I think like—if we just went through a bit of a list now of some of your things that you'd like from a medical perspective, that you should gone this research on and find out about.  One of them, so we've talked about rhabdomyolysis. Dehydration is the opposite, is well known, dehydration is what we think about more, and that's certainly something that can then can lead to troubles. And you've got hyponatraemia or EAH, so hyponatraemia let's just talk about that one briefly because it's a biggie. Hyponatraemia is a low sodium level in the body. I've had it. Lots of people give this. And it's again, a hard one to diagnose because it is very similar to the opposite problem, which is dehydration. So hyponatraemia you've actually got too much water on board.  One of the signs of this I'm even doing was 100k, one of those Oxfam ones. And because we'd been walking for so long, it was a walking running situation thing. And I got really bad hyponatraemia in that one. I was drinking a lot. I wasn't having my electrolytes, right. And my hands were like elephant hands.  Eugene: Wow.  Lisa: So that's an indication that there's something going on. So look for signs like that, look for swelling, edema. And yes, that could like...  Eugene: Nausea, lightheadedness, those sorts of things as well. Lisa: Coordination, going haywire. And the problem with hyponatraemia is you don't want to just be thinking it's dehydration and then drinking more. So it's an—it's a low sodium. So, your potassium and your sodium are having antagonistic relationships in your body. And you have, for every three bits of sodium that gets pushed out of the cells, three bits of potassium come into the cells. And it's like, it acts like a pump. And it's actually what helps your muscles contract.  So if you get that sodium, potassium, ainger, other electrolytes out of whack, there's a whole lot of things that can happen. hyponatraemia being one of them. In another one being a tetany seizure, which is what I mentioned what I had in Alaska.  Eugene: Yes, so what's that? Lisa: So this is where—in my case, it was a potassium that was really, really low in the body at 1.4. Like it’s deadly... Eugene: Wow.  Lisa: Deadly low. And I'd had in the couple of weeks building up to this actual seizure. My hands were doing this, and I was cramping all the time. And that was so—if you ever start doing that, like this weird thing where your hands are starting to spin. Eugene: So, like dinosaur hands on. Lisa: Yes, so your fingers—for those listening can't see me do my funny thing here. It's the muscles contracting and your fingers are pulling in. So I remember, swimming at some point, and the lead up to this with this was happening to me. I was like, ‘What the hell's that’? And then it would go off again. But there was a sign that I didn't have enough potassium as I found out later. Eugene: All right. Lisa: So then I had, a couple of weeks later, this tetany seizure, and it started with the whole body. Just like every muscle in the body cramping all at the same time, the most painful thing you can ever—like really bad pain, including your face muscles, including your heart, which is the problem.  And in there, the pain was horrific. I thought I was dying, I was. Luckily I just come off a mountain, or was taking shelter in a public library because it was pouring with rain and freezing cold. And this happened in the library. And there was a paramedic in the library who just happened to be fixing a light bulb. He saw me go down.  Eugene: That’s one of the 43:10 [inaudible] moments. Lisa: Yes, that was very lucky. He put a gel straight into my mouth. He just happened to have a gel on him. And that gave a little bit of glucose and stuff too, and managed to release the seizure for a couple of minutes before it happened again. But by then he got me into the ambulance and around to the hospital pretty quick, smart. And they were able to save me. But that could have been deadly. That could have been a massive heart attack on the way out. I've seen that also happen and we were in the outback of Australia with friend Chris Ord. And he had a seizure at mile, coming in at 90 sort, and we've been running in 40 odd degrees heat and he'd been taking electrolyte tablets. So people electrolyte tablets are absolutely crucial. You've got to have them. The ones he was taking didn't have potassium. They had everything else in them but their ratios weren't right. And he ended up—we had to—again incredible pain, whole body seizing, racing him into the hospital Alice Springs.  What I did do and what you can do in a case like that is give him three cans of Redbull—not advertising for Redbull or because generally that’s a shit thing to be drinking. And this case, with what it's got in it and the sugars and stuff that helped. So yes, but that's just a potassium sodium balance.  Eugene: Yes .That's the thing, isn't it? We're missing with our chemistry. We're missing with the body's chemistry. I don't know what it was but I had one race where I just finished and as soon as I finished, I started shaking.  Lisa: Oh, yes. Eugene: Shaking and shaking. I couldn't stop for hours. And it wasn't cold. I wasn't cold. Lisa: Oh, I know what it is. Eugene: Well, what is it? Because... Lisa: I don't know the name of it. But I've had that many times. It's basically where you've just got nothing left in the body.  Eugene: Yes, somebody said to me, glycogen. Yes, just the glycogen is gone.  Lisa: You just got nothing, you got nothing to heat because you know we heating ourselves all the time with our glycogen supplies and our glucose is running out of their body. And you were just on absolute zero basically, taking your blood sugar, I bet you’re in a really, really low  Eugene: Right.  Lisa: And so like, in Death—I’m telling my bloody stories, but...  Eugene: Why not? Lisa: A member in Death Valley. We be head like 55 degrees during the day, I’ve had heat stroke and had all that. And then at nighttime, it was 40 degrees. And I got shivers. I was doing that. I was like this and it was 40 degrees.And I was like, ‘Really, what the hell is going on? It's 40 degrees’. It was a lot colder than it had been, but I just had nothing left in the tank and therefore I was shaking.  And that can be a real danger when you say in the Himalayas, which I've also done and that's where you just cannot warm up. You can't keep your heat going. And these can run into other problems where you just stuck—your blood sugar just keep dropping, and you can end up when—going into a coma just because your blood sugar is too low, and you got hypothermia. Eugene: The other problem that happens. And I've had this a couple of times after ultras is I just have zero appetite, I can't, I just can't face the thought of food. You got to get something into you, you go start replenishing your body, you got to look at soups or something to get some nutrition back into it. Because like you say, it can be dangerous. Lisa: And that's a recovery too, like, if you can get something in it will help you recover a heck of a lot faster even like just generally fully training runs, if you can get something in within an hour. But usually within an hour, you just do not feel, you just feel like vomiting if you eat too much. So you just have to take a little, little, little nibble, nibble, nibble. And something that you're really—usually savoury salty things that you will get have a taste for. So soup or things or something like that. Just trying to eat something in. My gosh, there's a lot to be worried about. Eugene: And that's the thing, that's the thing. These are all things that you need to be conscious of. But you manage your rests, don't you? You can manage them. And what one of the other things that Dr Reynold said, and I think is pertinent today, what just what we're dwelling on the bad things is that these risks are exponential. So he says, ‘Don't think that you run 100k all year, well, then 160Ks, that's only another 60k’. It's an exponential increase, and an exponential increase in those risks as well. So conscious of those things as well.  Lisa: So watch when you're jumping up in this.  Eugene: Yes.  Lisa: And also don't fall into the trap of thinking, ‘Oh, I did it once. Therefore, it's a piece of cake. I could do it either’. I've run into this where I came off the back of a Himalayan one. I just done 222Ks. I thought it was the bee's knees. And then I went and did it just a couple of weeks later and I hadn't recovered properly a 50k in Australia. And the wheels freakin came off at 25k. It wasn't the—I had to be risky for some beer drinking Ausies in the middle of the bush. I'll tell you your ego suddenly deflated.  Eugene: Yes, absolutely, Lisa and it's—I learned that lesson even just with the map just for the marathon.  Lisa: Don’t say that. Eugene: But just for the marathon. I ran my first marathon when I was 21 and I trained for it. And so I found it actually quite easy. I don't mean that—I wasn't fast but but it was I got to the end of it. I can't keep waiting for the wall. The wall never came. I got—I thought, ‘Ah’! So I made the mistake thinking marathon is easy. A piece of cake. Yes, run up on the next one. [49:13] ecruzi hardly did any training.  Lisa: Oh.  Eugene: My bad, so bad. And it was like it was just the marathon telling me, ‘Sunshine’...  Lisa: Respect. Eugene: ‘Respect the distance’. You cannot run something like this without respecting it. And it was a good listen.  Lisa: Good listen. Eugene: Good listen, I'll let my listen. But I let my listen.  Lisa: And in by that token, respect any distance. People often say to me, I'm just doing it, I'm just doing half marathons, or I'm just doing marathons and because I've done lots of ultramarathons they think, ‘Oh, that would be nothing for you’. And I'm like, ‘Hell no’. Eugene: Hell no. Absolutely. Lisa: Every distance has to respect because it’s sort of basic thing for starters. 100 metres is a long way when you're going at Usain Bolt and 5k is really fast when you're going at your maximum. And a team K is an attunity. It's all relative to pace for status. And the second thing is never think because you did it once. Next time, it's going to be sweet. And Eugene has given us an absolute good example of that. And it is. It’s like take every race is that first is a big deal. And you have to prepare your body for it.  And don't—oh, another mistake I made this was awesome. Another embarrassing thing. So you know. Done 25 years of stupid stuff and then when my mum got sick I didn't train obviously properly for 10 months and then I ran across the north on and raising money for charity a friend who’ve died, Samuel Gibson a wonderful man that we lost. And I was so moved. I decided I'm going to run anyway. And I have not been training for 10 months because I've been looking after my mum and I sort of thought out, this sweet, have done this backwards and upside down. I can do this. Oh my God, my ass got handed to me. And I got through it. But oh, hell, it was hell. It was not funny. So prepare. And even though you've done it a100 times doesn't mean you still got it. Eugene: That's right. That's right. Lisa: I assume I don't got it now. Eugene: And that point you made earlier about recovery, too. I did a 100k race and then you had this plan to recover, to take weeks off, got peer pressure. Mates we're doing a 50k. ‘Come on. Come on, man. I don't want peer pressure. Peer pressure’. ‘Okay. You’re already lined up to this 50k race’. Oh boy. And it just set me backwards. It set me back so far, you know?  Lisa: Mentaly too. Eugene: Yes. Absolutely. Absolutely. Yes. Yes. Yes. So, yes, respect things. Lisa: We've got to respect things. We've got to not expect that our bodies got it just because we've done it once before. Be aware of things like rhabdomyolysis, heatstroke, hyponatraemia, altitude if you're doing altitude, podcasts in itself, be aware of burnout...  Eugene: Hypothermia. Lisa: ...hypothermia, dehydration. All of these things are things that we can and do happen to be seizures, electrolyte imbalances, getting lost, going through dangerous places, breaking ankles, and all that sort of thing. So part, it is, can happen. So, be aware of that. And we're not saying don't go out and have adventures, because that'd be really critical. But prepare for those adventures. Get proper training. Get proper coaching. Know what you're in for. Eugene: It's like driving a car. One of the most dangerous things we do. But we make sure we wear our seatbelts, we make sure our cars have got a Warrant of Fitness and the service, and everything. We make sure there's air in the tires, we make sure there's fuel in the tank, and our bodies have got to be like that as well.  Lisa: Exactly. Eugene: That driving is so so dangerous. You know, so many people a year die on our roads.  Lisa: Yes, more than ultras.  Eugene: Yes, so we don't not drive. We just make sure that when we drive we are prepared and our cars are prepared. Well, that's the same as running. There are risks, not as much as driving. But there are risks, but we just make sure we've got air in the tires, we've got fuel in the tank, that we're serviced, and ready to go when we line up for races. Lisa: Brilliant. Eugene, you've been fantastic today. And now you've got another thing to get to. So I want to thank you for writing that article. And thank you for your honesty and openness about this because it's really important that we do talk about it in our running community and to share the good, the bad and the ugly. So I think it's important. And keep up the great work. Of course, people should go and listen to Dirt Church Radio. It's a fantastic podcast that  Eugene: We have great gear that’s wireless.  Lisa: Honoured to be on your show, mate. And I love talking to you and I love what you do. So thanks very much, mate for being on the show today.  Eugene: Anytime. Thanks, Lisa. That's it this week for Pushing the Limits. Be sure to rate, review, and share with your friends and head over and visit Lisa and her team at lisatamati.com

Soft tissue injuries are common and one of the Cochrane Reviews of their treatment was updated in August 2020 to assess the effects of different types of pain killer. Here's Peter Jones from Auckland City Hospital in New Zealand to outline the latest findings.

Soft tissue injuries are common and one of the Cochrane Reviews of their treatment was updated in August 2020 to assess the effects of different types of pain killer. Here's Peter Jones from Auckland City Hospital in New Zealand to outline the latest findings.

Colin McArthur is an Intensivist and director of research at Auckland City Hospital in New Zealand, and is the Co-lead for the Australia-New Zealand arm of the REMAP-CAP study, which today releases the results of its first domain study, corticosteroids. Colin joins Todd on the podcast to discuss the results of this important trial See omnystudio.com/policies/listener for privacy information.

Fewer patients die and less ICU support is needed when patients with Covid-19 are given corticosteroids. That's according to new research published today by the Journal of the American Medical Association. Dr Colin McArthur is an intensivist and researcher at Auckland City Hospital, who leads the trial in New Zealand and is a co-author of the World Health Organisation meta-analysis published on Thursday. He speaks to Susie Ferguson.

This piece is a question and answer session regarding the care of elderly patients undergoing surgery. Discussion topics include; The RELIEF trial, e health tools, gathering and accessing data, whether it is better to over estimate risks and which risk calculator is most appropriate to use where you are? It features; Professor Jacqueline Close, Geriatrician, Prince Of Wales Hospital, Clinical Director, Falls, Balance and Injury Research Centre, David Storey, Head of Anaesthesia, Perioperative and Pain Medicine Unit (APPMU), Melbourne Medical School, University of Melbourne; Director, Melbourne Clinical and Translational Sciences (MCATS) research platform and Dr Doug Campbell, Anaesthesia Specialist at Auckland City Hospital. -- Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine. The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups. For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

Which precautions should oncology patients during the pandemic? We asked Dr Giuseppe Sasso, Clinical Director of the Radiation Oncology Department at the Northern Regional Cancer and Blood Services, Auckland City Hospital and Auckland District Health Board (ADHB). - Quali precauzioni devono adottare i pazienti oncologici durante la pandemia? Lo abbiamo chiesto al dottor Giuseppe Sasso, che lavora in Nuova Zelanda presso i Northern Regional Cancer and Blood Services.

Critically ill COVID-19 patients in New Zealand will be given anti-malaria drug hydroxychlorquine as part of a trial to find a potential cure.The trial led by Auckland City Hospital intensive care specialist Dr Colin McArthur is one of 13 given more than 3.8 million dollars of government funding for COVID-19 research.McArthur told Chris Lynch there's no evidence at the moment for its routine use and it does have some side effects.He says they'll be looking at the balance between the side effects and the benefits it provides patients.

Health officials have contacted 18 passengers seated on a flight near the first person in New Zealand to be diagnosed with coronavirus.The one person in New Zealand to be diagnosed with coronavirus, who returned on a flight last Wednesday, remains in Auckland City Hospital.Prime Minister Jacinda Ardern said today that the patient was in a stable condition and improving. The patient's family members were in self-isolation and were showing no signs of infection.Health officials were still searching for other passengers on the patient's flight and would go doorknocking if required to contact them.Ardern said the Government was holding off on imposing wider restrictions on travellers arriving in New Zealand as the coronavirus outbreak spreads overseas.The Government was receiving advice from health officials as to whether there needed to be further border restrictions.So far, the only restrictions are in place on travellers from China and Iran.If someone arrived in New Zealand displaying possible coronavirus symptoms, Ardern said they would "of course" be tested.But she said the Government won't be just testing anyone "just because they have asked".People would first need to display symptoms of the virus, such as a high temperature.Ardern repeated her assurance to the public that there was no need to swamp supermarkets, after reports of mass purchases of items including hand sanitisers, water and toilet paper."There is no need to stockpile," she told media at Auckland Airport.Ardern stressed that said New Zealand has an "incredibly robust" pandemic plan."We already had a plan in place… to deal with any further outbreak."Officials have been planning for a pandemic – that plan is "already in place".Ardern said its response to date has been "textbook".Meanwhile major supermarkets are working hard to restock sold-out and high-demand items in the way of apparent panic buying after New Zealand's first case of coronavirus was confirmed.The Ministry of Health confirmed on Friday that a person in their 60s who flew in from Iran on Wednesday is in Auckland City Hospital with coronavirus after being taken there by family.They are in an isolation ward and public health officials are tracing other people they have been close to, including passengers on the flight.The patient is said to be "stable and continuing to improve". 

An expert says a Covid-19 outbreak in New Zealand isn't inevitable but it is likely.New Zealand's first confirmed patient, a person in their 60s, is improving in isolation at Auckland City Hospital.Health officials say the risk to the public remains low.But Otago University infectious diseases expert David Murdoch told Chris Lynch New Zealand is likely to have more cases."Just seeing how quickly it's been able to spread within China, and I think we are seeing it crop up with cases that apparently didn't have any obvious contact with China."He says that the global spread isn't surprising."It is what we anticipated. Now I think we're seeing it spreading to a quite a number of cases."I think it is tracking along the lines of what many of us anticipated." 

Listen above as Shane Te Pou and Lorna Subritzky joined Andrew Dickens to discuss the public and government's reactions to the one case of coronavirus diagnosed in New Zealand. Major supermarkets are working hard to restock sold-out and high-demand items in the way of apparent panic buying after New Zealand's first case of coronavirus was confirmed.The Ministry of Health confirmed a person in their 60s who flew in from Iran on Wednesday is in Auckland City Hospital with coronavirus after being taken there by family.They are in an isolation ward and public health officials are tracing other people they have been close to, including passengers on the flight.The patient is said to be "stable and continuing to improve".However, in the way of the announcement that the potentially deadly virus was present in New Zealand, Auckland supermarkets were hammered by customers stocking up on essentials like toilet paper and water.At some stores, queues were out the door and people even lined up before opening.Empty shelves at Pak'nSave, Lincoln Rd, Auckland. Photo / SuppliedHand sanitiser has been unavailable at supermarkets for days due to the coronavirus scare.A shopper at one Pak'nSave supermarket on Friday night said it was as if people were "stocking up for the apocalypse".This morning a Foodstuffs spokesperson assured customers that the company was working hard to make sure essential items were available.Foodstuffs own major supermarkets Pak'nSave, New World and Four Square."We have been prioritising deliveries over the weekend to stores which have seen increased customer demand," the spokesperson told the Herald."Since the coronavirus has emerged globally, demand for products including hand sanitiser has significantly increased."We're working with suppliers to secure more stock as soon as possible, but volumes are limited due to international demand."Customers can expect stores to be out of stock completely or to have quantity limitations in place."The spokesperson said if customers continued to shop "normally", stores would have no issues providing "the usual range of products"."We would ask customers to resist the urge to stock up as this simply puts unnecessary pressure on stores," they said.There had also been an increase in online shopping at Foodstuffs supermarket chains.Shelves at Pak'nSave Wairau.It is thought some people may be using that service in a bid to source items they suspect they might not get in person in store.But that is not the case."Online shopping is a valuable resource for convenience and we have seen an uptake in shoppers using the service over the weekend," said the spokesperson."Stores are following the usual online protocols, so if a product is out of stock, the customer is contacted or offered an alternative, or if an alternative is not available, they are advised accordingly."The Herald sought comment from Countdown on this issue.General manager of corporate affairs, quality, safety and sustainability Kiri Hannifin was reluctant to comment but gave a short statement."We would urge customers not to stockpile," she said."There's no need to panic and we have systems in place and are working with our suppliers to manage demand so that we can provide the essentials that Kiwis want."We're also monitoring products, our stores and online shopping throughout the day and getting stock into stores as best we can."We'd reiterate that stockpiling isn't necessary and we'd encourage customers to simply shop as they normally would."Earlier this weekend, authorities called for calm."Health authorities are closely monitoring the situation in line with World Health Organisation guidance and I encourage Aucklanders to remain calm," said Mayor Phil Goff."The ministry will advise if any public health measures become necessary."Prime Minister Jacinda Ardern also weighed in, telling the public to continue with everyday life."If you need a bottle of milk, go and get it. If you don't, do not...

Health officials have contacted 18 passengers seated on a flight near the first person in New Zealand to be diagnosed with coronavirus.The one person in New Zealand to be diagnosed with coronavirus, who returned on a flight last Wednesday, remains in Auckland City Hospital.Prime Minister Jacinda Ardern said today that the patient was in a stable condition and improving. The patient's family members were in self-isolation and were showing no signs of infection.Health officials were still searching for other passengers on the patient's flight and would go doorknocking if required to contact them.Ardern said the Government was holding off on imposing wider restrictions on travellers arriving in New Zealand as the coronavirus outbreak spreads overseas.The Government was receiving advice from health officials as to whether there needed to be further border restrictions.So far, the only restrictions are in place on travellers from China and Iran.If someone arrived in New Zealand displaying possible coronavirus symptoms, Ardern said they would "of course" be tested.But she said the Government won't be just testing anyone "just because they have asked".People would first need to display symptoms of the virus, such as a high temperature.Ardern repeated her assurance to the public that there was no need to swamp supermarkets, after reports of mass purchases of items including hand sanitisers, water and toilet paper."There is no need to stockpile," she told media at Auckland Airport.Ardern stressed that said New Zealand has an "incredibly robust" pandemic plan."We already had a plan in place… to deal with any further outbreak."Officials have been planning for a pandemic – that plan is "already in place".Ardern said its response to date has been "textbook".Meanwhile major supermarkets are working hard to restock sold-out and high-demand items in the way of apparent panic buying after New Zealand's first case of coronavirus was confirmed.The Ministry of Health confirmed on Friday that a person in their 60s who flew in from Iran on Wednesday is in Auckland City Hospital with coronavirus after being taken there by family.They are in an isolation ward and public health officials are tracing other people they have been close to, including passengers on the flight.The patient is said to be "stable and continuing to improve". 

This piece is a fascinating overview of Australia and New Zealand's Emergency Laparotomy Audit - Quality Improvement (ANZELA-QI). It works as an update on the initiative, provides all the background you need including explanations regarding, structure, organisation and additional support as well as answering key questions such as: Do we need it? How do you join and what happens when you do? A link to the slides for this talk is here: http://www.anzca.edu.au/documents/03-ben-griffiths_anzela-qi-an-update.pdf Presented by Ben Griffiths, consultant anesthetist at Auckland City Hospital, anaesthetic lead for ANZELA-QI.

This is the panel discussion which tackles emergency surgery. Discussion begins with more detail regarding the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial. Featuring, Professor Carol Peden, Executive Director of the Center for Heath System Innovation and Professor of Anesthesiology at the Keck School of Medicine of the University of Southern California, Fellow of the Institute for Healthcare Improvement (IHI), Ben Griffiths, consultant anesthetist at Auckland City Hospital, anaesthetic lead for ANZELA-QI and Michael Cox, Professor of Surgery, Nepean Hospital.

Help me welcome Dr. Christine Van Cott. Dr. Van Cott practices General Surgery and Hepatopancreaticobiliary (HPB) Surgery at Saint Vincent’s Medical Center in Bridgeport, CT, where she is the chief of general surgery and director of acute care trauma services. She is a mom to two boys and has been married for 16 years. She is the Surgical Clerkship Director and a Professor of Surgery at the Frank H. Netter MD School of Medicine. Dr. Van Cott earned her MD at State University of New York at Buffalo and completed General Surgery residency at Hospital of St. Raphael, New Haven, CT. She went on to complete a fellowship in HPB Surgery at Auckland City Hospital, New Zealand. Dr. Van Cott leads the Netter SOM Surgery Interest Group with great success. Having served as a faculty mentor for this group since its creation, she has helped gather volumes of medical students throughout the four years of school for panels, networking events, volunteer projects, and shadowing opportunities. She is dedicated to helping medical students achieve what they are passionate about, and assists in providing opportunities for mentorship to students beginning on day-one.

This piece is a question and answer session regarding the care of elderly patients undergoing surgery. Discussion topics include; The RELIEF trial, e health tools, gathering and accessing data, whether it is better to over estimate risks and which risk calculator is most appropriate to use where you are? It features; Professor Jacqueline Close, Geriatrician, Prince Of Wales Hospital, Clinical Director, Falls, Balance and Injury Research Centre, David Storey, Head of Anaesthesia, Perioperative and Pain Medicine Unit (APPMU), Melbourne Medical School, University of Melbourne; Director, Melbourne Clinical and Translational Sciences (MCATS) research platform and Dr Doug Campbell, Anaesthesia Specialist at Auckland City Hospital. -- Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine. The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups. For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

A transport export says any regulation around drink driving on e-scooters would be extremely complex. A study by Auckland City Hospital on e-scooter injuries has prompted another call for a zero alcohol limit for people riding them.The study, published in today's New Zealand Medical Journal, reveals 180 patients were admitted to the hospital's emergency department in the first five months of e-scooter use in Auckland.Senior Transport Engineer for Transport Consultancy firm Viastrada Glen Koorey told Simon and Phil the regulation around low powered vehicles is broad, and changes around intoxication would have widespread ramifications for other transport modes. LISTEN ABOVE

Booze is a factor in nearly one in 10 cases dealt with by Auckland City Hospital's emergency department, new research shows.A study published today in the New Zealand Medical Journal found that, in the space of just a year, more than 5000 people showed up at the ED with alcohol-related injuries.These patients were most likely to be men in their 20s and 30s, and to turn up at nights during weekends, public holidays and over the summer months.The study showed how they were often brought in by emergency services and stayed longer in hospital than other patients.Yet they also frequently walked out before a doctor could treat them – and in other cases, they had to be forcibly removed.One recent survey found 92 per cent of ED staff were encountering verbal and physical aggression from drunk patients; for two-thirds of them, that was at least a weekly occurrence."EDs have recognised for a long time that alcohol is an issue for their patients and it's always useful if we have some solid data about the size of the problem," said the study's leader, Professor Bridget Kool of the University of Auckland."It also means we can monitor trends to tell if things are getting worse or better, or if initiatives are working or not."Of more than 70,000 cases that Auckland Hospital's ED saw, about 7 per cent were alcohol-related.And of those patients, two-thirds were men, about half were in their 20s and 30, and 28 per cent came from deprivation.Māori were also over-represented, accounting for 17 per cent of those cases, despite making up just 8 per cent of Auckland District Health Board's population.The cases made up 6 per cent of all those seen in evenings, and then 18 per cent of those treated between 11pm and 7am.Half turned up via emergency services – yet just 8 per cent were classified as having life-threatening injuries.Once at ED, they stayed there an average five hours – two hours longer than the median stay time.Kool said some past interventions, such as St John setting up stations in the city, had led to fewer of these cases reaching ED.Waikato Hospital ED doctor John Bonning said drunk patients continue to be a major problem for his colleagues. Photo / Supplied"That's not solving the problem, but it's saying that maybe some of these people don't need to go to hospital, because they're a burden on emergency departments."While the solution to binge drinking largely lay in public health and community efforts, Kool said EDs had run screening trials with patients."This is where staff will ask patients about their drinking while they're sitting in an ED and thinking, 'God, that was stupid'."They just give them some brief advice and that's been shown to be effective in people's drinking, but these things need to be resourced – and currently, our EDs are already over-burdened."John Bonning, Australasian College for Emergency Medicine (ACEM) president and Waikato Hospital emergency doctor, said alcohol was likely the most preventable public health issue facing EDs."It's an ongoing problem, it's constant and it's certainly not getting better," he said."You're just trying to do your best for patients … and to get these drunk people come in with what's essentially a preventable condition, and get physically and verbally abused, it's really, really challenging."

This piece is a fascinating overview of Australia and New Zealand's Emergency Laparotomy Audit - Quality Improvement (ANZELA-QI). It works as an update on the initiative, provides all the background you need including explanations regarding, structure, organisation and additional support as well as answering key questions such as: Do we need it? How do you join and what happens when you do? A link to the slides for this talk is here: http://www.anzca.edu.au/documents/03-ben-griffiths_anzela-qi-an-update.pdf Presented by Ben Griffiths, consultant anesthetist at Auckland City Hospital, anaesthetic lead for ANZELA-QI.

How do we accurately calculate the risks to our patients? What are the best tools for the right circumstances? Where can we find data to improve these methods? Originally titled "50 shades of grey, how (in)accurate are risk prediction scores" the slides from this talk are here: http://www.anzca.edu.au/documents/02-doug-campbell_fifty-shades-of-grey.pdf The risk calculator is here: https://nzrisk.com/ Presented by Dr Doug Campbell, Anaesthesia Specialist at Auckland City Hospital. -- Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine. The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups. For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

This is the panel discussion which tackles emergency surgery. Discussion begins with more detail regarding the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial. Featuring, Professor Carol Peden, Executive Director of the Center for Heath System Innovation and Professor of Anesthesiology at the Keck School of Medicine of the University of Southern California, Fellow of the Institute for Healthcare Improvement (IHI), Ben Griffiths, consultant anesthetist at Auckland City Hospital, anaesthetic lead for ANZELA-QI and Michael Cox, Professor of Surgery, Nepean Hospital.

Dr Tony Smith has had first hand experience treating patients with meningococcal disease and meningitis in intensive care units at North Shore Hospital and Auckland City Hospital. He has been profoundly influenced by this devastating disease and describes it as one of the most difficult to diagnose and as ‘every clinician’s worst nightmare’. A truly tragic disease, it can take a healthy normal human being and kill them quickly. Dr Smith talks in detail about the treatment of patients, outcomes, and the development of guidelines for pre-hospital management.

As well as strategies that are focused mainly on the woman, interventions to help couples to become pregnant include some to directly help men who are subfertile and those targeting men where the couple has unexplained subfertility. One of the Cochrane Reviews with this focus on men looks at giving them oral supplementation with antioxidants, and new evidence was added to this in March 2019. We asked Rebecca Mackenzie‐Proctor from the Auckland City Hospital in New Zealand to bring us to up-to-date.

As well as strategies that are focused mainly on the woman, interventions to help couples to become pregnant include some to directly help men who are subfertile and those targeting men where the couple has unexplained subfertility. One of the Cochrane Reviews with this focus on men looks at giving them oral supplementation with antioxidants, and new evidence was added to this in March 2019. We asked Rebecca Mackenzie‐Proctor from the Auckland City Hospital in New Zealand to bring us to up-to-date.

As well as strategies that are focused mainly on the woman, interventions to help couples to become pregnant include some to directly help men who are subfertile and those targeting men where the couple has unexplained subfertility. One of the Cochrane Reviews with this focus on men looks at giving them oral supplementation with antioxidants, and new evidence was added to this in March 2019. We asked Rebecca Mackenzie‐Proctor from the Auckland City Hospital in New Zealand to bring us to up-to-date.

This piece is a fascinating overview of Australia and New Zealand's Emergency Laparotomy Audit - Quality Improvement (ANZELA-QI). It works as an update on the initiative, provides all the background you need including explanations regarding, structure, organisation and additional support as well as answering key questions such as: Do we need it? How do you join and what happens when you do? A link to the slides for this talk is here: http://www.anzca.edu.au/documents/03-ben-griffiths_anzela-qi-an-update.pdf Presented by Ben Griffiths, consultant anesthetist at Auckland City Hospital, anaesthetic lead for ANZELA-QI. -- Brought to you by the Perioperative Medicine Special Interest Group (SIG) in association with the Australian and New Zealand Society for Geriatric Medicine and the Internal Medicine Society of Australia and New Zealand at the 7th annual Australasian Symposium of Perioperative Medicine. The Perioperative Medicine Special Interest Group (SIG) has three aims; improve patient safety and outcomes, share knowledge and collaborate with specialty groups, develop the specialty of perioperative medicine with various craft groups. For more information follow this link here: http://www.anzca.edu.au/fellows/special-interest-groups/perioperative-medicine

Up to one in four couples planning a baby may have difficulty conceiving. Several interventions are available that might help and Cochrane keeps many of these under review. In July 2017, the Cochrane Review of antioxidants for female subfertility was updated and we asked one of the authors, Dr Rebecca Mackenzie-Proctor from the Auckland City Hospital in New Zealand to tell us about the rationale for the review and the latest evidence.

Do you give feedback to your intensive care colleagues when they do their job well? Have you become overscheduled because you have trouble saying no to new tasks? How well do you listen to the views of the intensive care nurses in your ICU?   The first international guest of the podcast series, Dr Colin McArthur, is a highly experienced intensivist, anaesthetist, researcher, administrator and leader from Auckland in New Zealand. In this episode he reflects on many aspects of his career and gives loads of useful advice about aspects such as giving both positive and negative feedback, learning to say no so we don’t exceed our work capacity, and listening to and respecting the views of the intensive care nurses in our ICUs. Colin is a senior intensive care specialist and past-Clinical Director in the Department of Critical Care Medicine at the Auckland City Hospital in Auckland. He is the immediate past Chair of the ANZICS Clinical Trials Group, with which he has been actively involved since its formation in the mid-1990’s. Colin currently leads research governance for New Zealand’s largest clinical research facility at Auckland City Hospital, and holds adjunct/honorary appointments at Auckland and Monash Universities. He is married to Juliet and has 3 sons in their early 20’s. Colin is currently in transition from being a keen runner to (in his words) a mediocre cyclist. Colin is wise, thoughtful, hugely supportive, skilled in many areas, and highly experienced, making what he says all the more useful to intensivists and trainees at all levels. Having been a leader for much of his career, he encourages trainees to find out how intensive care is delivered in many different institutions, both locally and internationally; he describes how although self-reflection is important, hearing the views of others on our performance is even better; he discusses his attitude to sleep and how the hours before midnight count most; and he tells how the benefits of running for him have included ensuring regular exercise, helping manage stress, and weight control. Also hear him speak about how: He found ICU an intimidating place when he first transferred patients from surgery as an anaesthetic trainee but began to like the people who worked there He worked for 2 years in Hong Kong and learnt from Dr Teik Oh, a pioneer and true master of intensive care in the Asian and Australasian region Senior mentors in our career can teach us about communication, interacting with others and the other highly important non-technical skills Working in an ICU that might be considered strong has good and bad aspects but does provide leadership in looking after the sickest patients Intensivists need to grow in their careers to operate at a level above simply having basic clinical skills so as to allow the main focus to be overall patient management through coordination and communication We can learn from seeing things done both well and done poorly The days in which he feels he is not at his best are usually related to what he has brought to work by not being well rested, not being well fed or not having done exercise He likes to get to work a little bit early to enable social interaction prior to the work phase of the day Tough he finds it to keep the details of more than 12 patients in his mind A really good stress management strategy is to carefully pick our battles Most intensivists would benefit from having a string to their bow other than simply clinical work Speaking to families and patients requires regular and multiple interactions, honesty, frankness, recognition of uncertainty, recognition of the limitations of medical knowledge and the need to value what the families bring to the conversation With this podcast, and the previous episodes, please help me in my quest to improve patient care, in ICUs all round the world, by inspiring all of us to more masterfully interact with our patients, their families and our fellow health professionals to deliver the most satisfactory outcomes to all. It would be much appreciated if you helped spread the word by simply emailing your colleagues or posting on social media. If you wish to send any feedback or simply want to keep the conversation from this episode going, please leave a comment on this page, go to the Mastering Intensive Care page on facebook, post on twitter using #masteringintensivecare or send an email to andrew@masteringintensivecare.com.

Audio Journal of Cardiovascular Medicine Reporting from ACC 2007 Reduced Mortality and Repeat MI with Enoxaparin for Patients with ST Elevation Myocardial Infarction HARVEY WHITE, Auckland City Hospital, New Zealand REFERENCE: European Heart Journal Advanced On-Line Publication April 24th, 2007 Enoxaparin could be the new standard anti-thrombotic therapy for patients receiving fibrinolysis for ST elevation myocardial infarction. This finding is from the double-blind EXTRACT-TIMI 25 Trial which compared the low molecular weight heparin with unfractionated heparin and saw a consistent treatment superiority from enoxaparin with a reduction in repeat myocardial infarction and mortality. Sarah Maxwell spoke with the principal investigator Harvey White at the Auckland City Hospital in New Zealand.

Audio Journal of Cardiovascular Medicine Reporting from ACC 2007 Fewer Major Bleeding Events with Bivalirudin For Patients with Acute Coronary Syndromes: The ACUITY Study REFERENCE: ACUITY Trial, ACC.07 Scientific Session and i2 Innovations Summit. Presentation Number: 2414-5 Patients with acute coronary syndromes who take bivalirudin have fewer major bleeding events and a lower incidence of late stent thrombosis’ compared with those who receive standard heparin therapy. This is the finding of one year results from the ACUITY Study announced by Gregg Stone of Columbia University, New York during the American College of Cardiology annual meeting that took place in New Orleans. Sarah Maxwell asked Harvey White at the Auckland City Hospital in New Zealand to comment about the ACUITY investigation.

Audio Journal of Cardiovascular Medicine Reporting from American College of Cardiology, New Orleans, March 24-27, 2007 "COURAGE" Trial Assessed: New Guidelines for Patients with Stable Coronary Disease? REFERENCE: ACC 2007 & N Engl J Med 356: March 2007 HARVEY WHITE, Auckland City Hospital The finding from the COURAGE trial: that angioplasty adds no benefits to optimal medical therapy alone for patients with stable coronary disease, should give pause for thought among clinicians all over the world, according to Harvey White, who discussed the new data with Peter Goodwin.