Over 50 people attended a public lecture at Victoria University jointly

organised by AMANZ and Sports Medicine NZ. Elizabeth Andrews, a specialist chiropractor for musicians from the UK spoke on "Healthy Practice for Musicians", which is also the title of her recently published book (see below).

Elizabeth Andrews' long career as a professional musician ensured her presentation was well grounded in the practicalities of a musician's work. Her main focus was on self-help, with demonstrations of "Touch for Health" (applied kinesiology), adapting chairs for better comfort, postural adjustments and other techniques musicians can use to look after themselves.

The audience included music teachers & students, and a range of health practitioners as well as musicians, and Elizabeth touched on issues like the relationship between a musician and her GP and the relevance of sports medicine to musicians. Elizabeth was probably given too much ground to cover in two hours, but there were plenty of questions asked during the lecture and over a glass of wine afterwards.

Workshops and individual lessons were also given by Elizabeth Andrews to students at Victoria University, Wellington Polytechnic and Otago University, and to the musicians of the New Zealand Symphony Orchestra.

AMANZ is grateful to Sports Medicine NZ for their help with the lecture and to the NZSO for their help with the arrangements for Elizabeth Andrews' visit.

For further information on "Healthy Practice for Musicians" (Rhinegold Publishing, UK, 1998, 432 pp, ISBN 0 946890 73 0) contact Elizabeth Andrews by e-mail on playwell@dircon.co.uk , or look up her website at http://www.impulse-music.co.uk /healthypractice/

AMANZ also has some brochures - see contact details elsewhere in this newsletter. If you're interested in the possibility of being part of a bulk order of the book, contact Robert Ibell on 04-385 2557, or e-mail: dawbell@actrix.gen.nz

Robert Ibell
AMANZ

Back to Contents

International Year of Older Persons 1999 (IYOP) is a focus this year for Arts Access Aotearoa. Aidan McLean, IYOP Co-ordinator, is encouraging the development of many arts projects for older adults. His work currently includes promoting the designing and making of wind banners by rest homes, in conjunction with local schools. These projects highlight the intergenerational theme of IYOP.

John Dodds and Hannah Dowsett, two professional musicians, received a funding grant from the Wellington City Council Creative Communities Scheme. They are performing a series of concerts at rest homes. Their performances are a mix of playing to a group and spending time with individuals who are unable to attend the group concerts.

The Age of Opportunity festival will be held in the Wellington Town Hall, 1^st October 1999. This major celebration of IYOP is being co-ordinated by Aidan McLean, Neil Palmer, Arts Advisor WCC and an energetic team involved with older adults and the arts. Events will include; a visual arts exhibition, musical performances, old time cinema, an intergenerational choir, a vintage car display, static displays and much more! Everyone is welcome to attend this free day.

Another Arts Access Aotearoa IYOP project is the development of a publication highlighting older adults and the arts. Currently being written by Aidan, it will feature art projects from around New Zealand and encourage rest homes and organisations to develop arts initiatives and celebrate the arts of older adults. More information on this will be included in future columns.

For further information on Arts Access Aotearoa: PO Box 9828, Wellington, telephone 04-384-1113, fax 04-384-1119, e-mail artsaccess@xtra.co.nz or visit our website: http://www.artsaccess.org.nz

Back to Contents

If you are employed, your employer now has had to nominate a private insurance company to cover treatment, rehabilitation and off work expenses. ACC no longer covers work-related injuries. Your employer is obliged to inform you of your work insurance company and the procedures to follow should you sustain a work-related injury. For many dancers and musicians where many injuries are 'gradual process' or OOS-type injuries, the criteria defining these conditions are still the same.

If you are self-employed, the legislation has given you the option to choose your own work insurer or remain with ACC.

If you are not employed, ACC will still cover you for your injuries. ACC cover is still available for all non-work related injuries, for example:

A PATIENT who suffers an injury as a result of medical misadventure, except if the treatment was for a work-related injury

A PATIENT with a claim for mental injury resulting from sexual abuse

The other major change is that you no longer need to see a doctor initially for a referral to another treatment provider, such as a physiotherapist. Therefore ACC and the Work Insurers have a list of Registered Treatment Providers who can now see you, treat and claim directly if the treatment provided is within their 'normal scope of practice'. These include acupuncturists, chiropractors, counsellor/psychologists, osteopaths, physios, podiatrists, lab technicians, etc. Not homeopaths, herbalists or other alternative practitioners, nor body conditioning therapists.

However, a doctor is the only health professional who can assess work incapacity and give you time off work, but cannot back-date this.

As you can imagine, the changes have been huge for employers and health professionals. With this has come very detailed and cumbersome forms to fill out, with ACC/Insurance claims filed everywhere! The Medical Doctors have voiced grave concerns about a number of these changes, particularly the increased paper work, bureaucracy and time-wasting form filling, budget blow-outs and general confusion. You will find many doctors have increased their ACC/accident consultation fees to recoup for the extra time and work which has been enforced upon them.

1. Determine clearly whether yours is a work-related or non-work-related injury.
1. Know who is your work's Insurance Company.
1. If you have an injury at work, record it in the 'incident book'.
1. While waiting for your consultation with a treatment provider, please ask for the accident form, either ACC's ACC45 form or the Work AITC form. Good luck with the form filling!
1. Hold on to your copy of these forms and take them everywhere you seek treatment.
1. If you need time off work, see your doctor; he/she cannot fill it retrospectively!
1. Always reassess your progress with a treatment provider; you should be making significant progress after 3-5 treatments. If not, you may need another independent opinion!

Dr Roz Wilson Sports and General Practitioner
Rotorua

An article specially written for AMANZ by Dr Keith Humphries, MBCHB, FRCNZCGP

This common disorder is mainly that of the adolescent and young adults. It is rarely diagnosed under the age of five years or over 45. The young under five probably have mild sub-clinical attacks that are not severe and usually not diagnosed.

Probably mainly due to the Herpes Simplex Virus (cold sore type virus) or Epstein -Barr (usually known as E-B) Virus. Glandular fever type syndromes of a similar clinical presentation can also be attributed to Cyto-Megalic Inclusion Virus (CMV) or from the protozoan Toxoplasma gondii (Toxoplasmosis). CMV usually appears in the older age group and is sometimes associated with other health problems in the immune-compromised, e.g, AIDS or Transplant Organ Patients, or those with cancer or receiving cancer Chemotherapy Treatments. Glandualar fever is usually used as a label in the British type countries; Infectious Mononucleosis is the name used in the USA.

Various times given by various authors, eg 5 - 10 days to 4 - 8 weeks

Usually described as mild; usually from spread of saliva, hence the nick-name the Kissing Disease. Aerosol affect (sneezing and coughing) with Fomites (faeces and urine) spread not thought to be a big factor, so that isolation is not usually recommended. Some of the early work in the 1970's was done on Yale Medical Students. In an epidemic about 70% carried detectable virus antibodies but less than 10% of them had signs or symptoms.

Disorder of protean manifestation - tiredness, malaise and generalised aches and pains in muscles and headache. Fever; swollen neck glands (cervical lymphaderopathy) and a sore throat (pharyngitis) are usually the triad of symptoms to raise the suspicion for diagnosis. Mild nausea, anorexed and upper abdominal pain with liver and spleen tenderness are common. Mild jaundice (glandular fever hepatitis) is not uncommon. A mild rash on the palate at the junction of the hard and soft palate often precedes the pharyngitis or tonsillitis. Quite often an exudative white, necrotic marked tonsillitis is seen - but beware that this can in Leukaemia, so that further blood test investigations should be mandatory. Liver and spleen tenderness and enlargement is sometimes found, sometimes quite marked. The glands in the neck (deep cervical chain) are usually small and multiple and unlike the more discrete glands of Hodgkin's Disease, Lymphomas and Tuberculosis. Glands are sometimes felt in other regional areas: ascillae (arm-pits) and groin. A measles-like rash can be found in 5% of cases. Ampicillin (Penbritin), a penicillin-type antibiotic, if administered can cause a rash in 90%-100% of cases.

Usually a full blood count (FBC) and liver function tests (LFS) should be made to support the diagnosis. With the clinical picture and a WBC (white blood count) showing abnormal mononucleosis cells (lymphocytes) of 10%-80% will give the chief clue but other disorders, such as CMV, Toxoplasmosis and even Tuberculosis can give a similar picture. There is usually a slight rise in the total WBC (10,000 to 20,000 per m.m3). The more specific tests, eg, the now somewhat old-fashioned Paul-Burrell Test (two American physicians) can be done. This is a "hit and miss" test and often has to be repeated to get a positive test, ie, you can still have glandular fever and have a negative P-B test. The more specific EBV antibody tests are popular but expensive. They are sometimes misinterpreted. Acute infection requires a positive 1g M test, however a positive 1g on the EBV test may persist lifelong and merely indicates present or past exposure. The severity of the generalised illness can to some extent be supported by a more severe abnormality in the live function tests, so that hight enzyme tests usually indicate a more severe disease. Thrombocytopaenia (low platelet count) is sometimes found.

Most cases have symptoms for 3 - 4 weeks. Malaise particularly, with difficulty in concentrating, eg, study for exams, may last 3 - 4 months. Improvement is usually seen by disappearance of swollen glands, sore throat declines and resumption to normal of the FBC and LFS. Some advocates of ME (myalgic encephalopathy) or Chronic Fatigue Syndrome latch on to the diagnosis of long term glandular fever as the cause. Glandular fever is usually a benign self-limiting disorder, however rare fatal disorders have been recorded, particularly from the rupture of an enlarged, friable spleen.

Mainly symptomatic. Rest and good sensible food is the chief advice given. Active physical exercise and sport often delays recovery and of course rupture of a friable spleen is possible, particularly in contact sports. Bed rest and adequate fluids in acute cases. The usual recommendation is for little or no alcohol, particularly with abnormal liver function tests. Some doctors use steroids (Prednisone, etc) with severe symptoms, eg, very bad throat symptoms or liver function tests.

It is not usually thought to "spread through the office" or to be spread by air conditioning or to be highly infectious. Seasonal epidemics, however, do seem to occur. Many people have resistance and it is unusual to spread from husband to wife or "around the flat" Common sense and optimism should be a good recommendation for this common interesting disorder.

PS: in AIDS, glandular fever can be a presenting symptom.

Back to Contents

FROM DANZ:

As part of our on-going DANZ day series, DANZ will be hosting a Healthier Dancer Series. Following successful workshops in Christchurch and Dunedin earlier this year, we are set to continue the series in Auckland and Wellington. These days will provide a valuable resource to a wide cross-section of the dance community from dance teachers, professional dancers and dance students, to interested members of the public.

Issues covered will include:

Workshops will be led by Susan Simpson, a graduate of the New Zealand School of Dance and Otago Polytechnic. Since gaining her graduate diploma in Physiotherapy she has worked with a variety of clients including the prestigious Royal Ballet Company and Rambert Dance Company, both in London. Susan currently works at the New Zealand School of Dance and Wakefield Physiotherapy Clinic in Wellington.

Dates for the Auckland and Wellington workshops are still to be confirmed.

For details contact danz (04) 382 8463

Back to Contents

FOOTNOTE DANCE COMPANY

• pheromone
  Shona McCullagh
• From Zero to Nothing
  Chris Jannides
• Two axe handles across
  Katherine Waldner
• Over the Moon
  Deirdre Tarrant
• One more than Two
  Catherine Gardner
• Matter Over Mind
  Sally Stopforth

and a new work by company dancer Melanie Turner, called Spanner

The dancers Jane Duncan, Melanie Turner, Moss Asher-Patterson, Stu Armstrong and apprentice Nicole Gerber form a strong company with excellent teaching skills.

Company Director Deirdre Tarrant has been looking at ways of maintaining professional strength and flexibility, combining technique class with other methods. Kilda Northcott and Susie Simpson sessions have been added when the company is in its homebased Wellington studio.

Enquiries or tickets for Footnote please contact Rowena Snell, Administration Manager, on phone: (04) 384 7285 or fax: (04) 801 5010

Back to Contents

AMANZ NEWS

On a more sombre note, we send condolensces to Ann Rowse for the passing of her husband Ken Sudell on July 18th.

Monday October 18th, 7.30pm. This is an Alternative Therapies evening with presentations from practitioners including Alison Kyle (Pilates) and Elke Dunlop (Feldenkrais). Please dress in loose, comfortable clothing for this interesting, exciting evening. Venue:

Wellington Conservatorium of Music, (Massey University) Room 1D16 in block 1 through Entrance C off Wallace Street.

Back to Contents