Managing respiratory problems in the aftermath of the fires

In the wake of Australia’s catastrophic fires, a number of people are suffering from health problems in affected areas.

For the past couple of weeks, Dr Vicky Kritikos from the Woolcock Institute of Medical Research, University of Sydney, who is also a specialist pharmacist in asthma and respiratory diseases, has volunteered her services at Vincentia’s Choice Pharmacy on the NSW South Coast to offer her professional advice and education about appropriate medication use to patients with respiratory problems as a result of the local fires.

What may have begun as an annual summer holiday with her husband, Stavros, dramatically changed as the unprecedented South Coast bushfires approached and surrounded the Jervis Bat area, as thick black smoke covered the sky New Year’s Eve.

“It happened awfully quick. We were enjoying ourselves on the beach when, all of a sudden, the sky went black – it looked as though the day became night,” Dr Kritikos said.

With the Royal Fire Service and New South Wales Police encouraging people to evacuate the area, Dr Kritikos explains how her husband and packed their car and did a practise run – to see how quick and accessible an evacuation site would be. However, they decided to remain in Vincentia as there was an immediate need to support patients with respiratory problems in the aftermath of the fires.

READ MORE: Greek research breakthrough: Mediterranean diet impact on childhood asthma

“In the past, I have conducted research at Choice Pharmacy Vincentia; two years ago and one month ago respectively, I have recruited patients into a research study looking at patterns of medication use and the use of oral corticosteroids for worsening asthma symptoms. So, the pharmacy has always been willing to participate in research that improves the management of chronic respiratory disease and staff members including pharmacists have made me feel like one of their own. So I decided to volunteer and provide my expertise, knowledge and skills to patients with unmet needs. I was very happy to do this, it was professionally satisfying for me to be able to address their needs, improve medication use which will help optimise the management of their disease,” Dr Kritikos said.

With the air quality varying from day to day, between ‘clear’ and ‘hazy’ days, people with respiratory problems are advised to stay indoors to minimise exposure to potential environmental triggers which can cause acute symptoms and increases their risk of a having an asthma exacerbation; These triggers can linger on long after the actual bushfire threat has subsided.

“What I wanted patients to realise is that by using high doses or frequent doses of reliever medication such as Ventolin only provides quick relief of symptoms to the reliever; relievers only relax the smooth muscle around the airways and do NOT treat the underlying inflammation that is characteristic of asthma. People need to take anti-inflammatory preventer medications, but because asthma is an episodic disease they stop using them when they feel better.To prevent symptoms, patients need to continue to treat their respiratory problems by using anti- inflammatory preventors which reduce the risks worsening symptoms and flare ups,” Dr Kritikos said.

READ MORE: A living nightmare: Greek Australians affected by bushfires tell their stories

“Patients also need to have a written asthma action plan and this can be formulated with their General Practitioner; with an action plan, they know exactly what to do when their respiratory problems and asthma worsen, and can help prevent potential Emergency Department visits and hospitalisation.”

Asked what inspires her to keep going in this volunteer role, Dr Kritikos said, “I love what I do and it is important to help people and patients with their needs. What I love most is when patients have that ‘light-bulb moment’ and realise they are not using medicines and/or techniques properly.”

“Asthma may not be curable but what is important for people to realise is that it can be managed effectively and they can enjoy good quality of life.”