Get checked

06/04/2021

Cabinet Minister Kirk Allan writes of her cervical cancer diagnosis:

Last week I was diagnosed with stage 3 cervical cancer – so now the fight of my life begins.

My last smear test I had was when Talei Morrison, just prior to her passing from cervical cancer, rallied her whānau, her friends, the kapa haka community and ultimately NZ to campaign for women, and particularly Māori women to get their smear tests done regularly.

To be honest, I’m one of those gals that hates anything to do with ‘down there’. And have taken a ‘see no evil, hear no evil’ type approach to that part of my body. Talei’s call to wāhine and whānau to get tested was the push I needed to get it done.

Time passes. Work piles on. Going to the doctor for anything other then an emergency goes way down the priority list.

Last year, during the campaign I noticed I was getting a lot of pain in my back, stomach and legs. I put it down to lots of driving, working long hours and the general stress of campaigns etc – so, I got my partner to give me a few mirimiri and forgot about it.

Earlier this year, I realised I was finding it hard to sit for a lengthy period of time. Always in a bit of pain. I started running to try and move the lower back area a little bit. Nothing seemed to take the pain away.

In late January I started menstruating and it didn’t stop. In hindsight, there were lots of opportunities to go touch base with a doctor. But I didn’t. I put it down to work, and was on the go, and “that stuff usually sorts itself out”.

After I had been menstruating for about 4 weeks, I went for a quick check up at the GP. She had a good look at me and tried me on some medication.

At about 6 weeks of menstruating with no change since the GP visit, I raised it with my colleague and friend, Ayesha Verrall who is a doctor, asking if the bleeding was a little odd. She asked a few more questions and I told her about the pain. She urged me, pleaded with me, “Kiri, please, please, please prioritise this and go to the doctor tomorrow.”

She made some recommendations and the next day I found myself having an ultra sound. The ultra sound found a 3 cm growth, probably benign. But the doctor made arrangements for me to go to the hospital the following day at the Women’s Clinic.

That day also happened to be the day of the tsunamis and earthquakes. I found myself managing the earthquakes early morning, then headed the hospital for another ultra sound at about 8am (just before the large evacuation notice – poor timing!).

This was a longer ultra scan then the previous day and they took a number of smears and biopsies as well. They found the growth was approx 6 cm but likely benign. We had a chat about options for removal. By and large, things seemed ok and I could get back to work that day. So I arrived back just in time for the 11.30 am stand up at the beehive.

The following week I got a call saying the smears had shown an abnormal result and I needed to come in again for a colposcopy. It sounded ok, my cousin had had one and it was just a precautionary thing I thought. I told my family and they called the Dr to ask a few questions. She was amazing and took my family’s call to explain the process (THANK YOU SO MUCH!).

Some days later, I went in for the procedure. When we arrived, I was received from reception by Robyn, a bubbly nurse who knew the East Coast well. She kept reassuring me before the appointment that she could be contacted anytime for any questions and gave me a cell phone number to call. She took us to the room where a kind Dr was waiting – and wanted to talk through the procedure. She seemed very kind and patient, but the vibe of the consultation felt more serious then the rest.

Fortunately, by this stage of testing I had formed a solid crew of folks to help me navigate the meetings and to make sure I didn’t miss anything. Mani, my partner, who came to appointments with me and asked all the follow up questions my mind couldn’t turn to. Natalie, my best mate and baby’s mum would be our first call before and after the appointments to make sure we hadn’t missed anything. Mum and Dad, being staunch advocates for well-being, they provided spiritual support. And my cuz Chelsea and other best mate Sacha on our little thread we called ‘the Angels’ bouncing questions and offering loads of moral and spiritual support as well. We had a sweet little team.

When the doctor was doing the colposcopy, she noted that there were abnormal cells showing and took another biopsy to test. She said the results would take a while, so I wasn’t expecting any further news until a few weeks later.

A handful of days later, I was jumping off a flight from Christchurch where I had been doing an RMA meeting and launching a community waterways partnership project, into Auckland where I was off to launch a Kiwis for Kiwi project with Sir John Key and Helen Clarke the co-ambassadors for the project.

I saw I had a missed call from the doctor with a text follow up to give her a call. I called back, going down the escalator stairs and the sound was rubbish. I skirted off to a corner to take the call properly, expecting good news.

However, my kind doctor, who had been so incredible and taken calls from my family in the evenings, called to say the colposcopy had revealed I had cervical cancer.

The ‘C’ word hits you like a jolt I had never experienced. I gripped the wall in the airport. Calmed myself down before being met by Huia, one of my DOC staff and my driver who were taking me to the event.

In the car, I called my dad first. Mum was listening in on speaker phone. And I lost it. In the car. On the way to the event. Huia’s intuition kicked in, cancelling the event while I fell apart in the car. I was dropped at my parents place. Natty and my cousin Chelsea came over. Mani flew up that night and we cried and watched stupid stuff on netflix.

Since then, it’s been a whirlwind of MRIs, CT PET scans, and preparing for chemo and radiotherapy, and any other therapy I’ll need.

The Boss, Jacinda has been a mate, a colleague and my boss through this process. I cried telling her the night I found out. And her words were profound. I’ll always have so much respect for the way she’s dealt with me over this past couple of weeks or so. A text away – always. So today, she’ll make an announcement that I’ll be taking medical leave from work to focus on the fight I have ahead of me. She’ll also be appointing acting ministers to my portfolios.

I want to thank my colleagues for their support, and especially Meka and Tamati who will be helping to take over my local electorate duties in the East Coast. Everyone along the journey this far has been simply incredible. I’ve never really had much engagement and always been a little scared of hospitals. They have communicated incredibly well, been clear, shown compassion, and made themselves available. I can’t thank the Wellington Hospital Women’s Clinic, the gynecological team and the oncology teams enough.

I’ve told a few folks by now, and often the question is, “is there anything I can do?”. My answer now is yes. Please, please, please – encourage your sisters, your mothers, your daughters, your friends – please #SmearYourMea – it may save your life – and we need you right here.

For now, my whānau and I are requesting a bit of privacy while we come to terms with the challenge ahead.

Finally, I know there may be questions about why it’s taken this long to say something publicly and to step back from work. I guess I wanted to know as much info, and have a full diagnosis before taking any major decisions. We got the full diagnosis, stage 3 cervical cancer, last Thursday so it felt appropriate to say something now. I also want to acknowledge the internal support the Boss, my colleagues and the staff in my team have given over the past couple of weeks in letting me take the time I needed to digest before making this news public – aku mihi ki a koutou.

Heoi ano, arohanui from me to all of you (for now),

Kiri Allan – the proudest ever MP for the Mighty East Coast.

This is devastating news for her whanau, friends, and collegues. She is highly regarded across the political spectrum and the people taking over her portfolios have big shoes to fill.

When people here news like this they usually ask, is there anything I can do?

Kiri has given all of us the answer:

Please, please, please – encourage your sisters, your mothers, your daughters, your friends – please #SmearYourMea – it may save your life – and we need you right here.

This is very good advice, every woman should heed.

Smears can detect cervical cancer, and the earlier the detection the greater the chance of a positive outcome.

But smears don’t detect other gynaecological cancers.

Every woman should know the symptoms of the other four: ovarian, uterine, vaginal, and vulvar.

Every man should know the symptoms of cancers peculiar to them.

We all must take responsibility for our own health.

That’s not an invitation to hypochondria, but we should all know the symptoms of other cancers and other diseases.

If symptoms persist, we should go to our GP, and keep going until we get an answer to what’s causing them.

Getting checked when you have symptoms can make a huge difference to the severity of an illness, and the outcome.


Too much politics not enough science

03/03/2021

Auckland Professor of Medicine Des Gorman is less than impressed with the ‘deja vu’ lockdown:

The situation the country has found itself in was “déjà vu” after the second lockdown in less than a month, one medical professor says. 

The latest cases of Covid-19 have plunged Auckland back into Level 3 lockdown, with the rest of the country at Level 2 – coming barely two weeks after the last three day lockdown. 

Auckland University professor of medicine Des Gorman told Mike Hosking it seemed plans were being made up on the spot. 

He said it showed our “inconsistent risk-management approach”, and the Government needs to improve 

“If we needed to be in level three two weeks ago, then coming down to level two in one was clearly precipitous and early.” 

Why is it like this?

Gorman said the Government’s Covid-19 response was too much politics and not enough science. . .

The way Prime Minister Jacinda Arden chose to put herself front and centre of the daily sermons from the podium of truth made the response overtly political.

There might have been grounds for her presence and delivery at first in reassuring the country as we faced the first lockdown and growing numbers of Covid-19 cases.

But she chose to stay in the limelight long after one of her ministers and more appropriately Director General of Health Ashley Bloomfield should have been the ones delivering updates.

That paid off with the election result giving Labour an outright majority but it came with risks that MIchael Bassett points out are now becoming apparent.

Watching TV last night, I couldn’t help thinking that the Prime Minister’s extraordinary luck is starting to run out. Every aspect of her lockdowns was questioned. Endless bungling over the South Auckland community outbreaks of Covid 19 were revealed, and she didn’t seem very happy about any of it. She has only herself to blame. After twelve months of wrestling day in, day out with the virus it was inevitable that eventually she would lose control of issues, given that so many other things have to be dealt with by any Prime Minister.

This is why successful leaders of governments have learned over the years to delegate. Jacinda Ardern has a bloated ministry of 26 members with two under-secretaries as well, but she insists on doing too much herself. She’s been told by her advisers that she is the surest pair of hands in the Ministry and that her popularity is vital to Labour’s standing with the public. For three years now that has been true, and even although she has sometimes seemed to be engaged in a running totter around the lip of chaos, she has remained upright. The overwhelming impression I gained from last night’s news was that if she insists on handling every detail and fronting every day on Covid 19 she will fall in. After twelve months of testing, getting the results takes far too long, contributing to the recent South Auckland problems; contact tracing has been haphazard of late; assurances the Prime Minister kept giving about lockdown rules and their enforcement proved to be wrong; her line on whether to pursue people who break the rules has been wobbly to say the least; and the silly decision to stop short of vaccinating front-line GPs in South Auckland, which wasn’t her call, reflected back on Ardern because her control of everything Covid is so omnipresent. . . .

That worked for her when she had our trust but that is being eroded by repeated lockdowns and the apparent failure to accept mistakes are being made and to learn from them.

Perhaps the international praise has gone to her head.

There is no doubt New Zealand looks good when compared with many other countries, but as Heather du Plessis-Allan points out, we don’t compare well with others:

We will always tell ourselves another lockdown is fine if we keep comparing ourselves to the worst Covid-hit countries, especially the UK and the US. Because seven days looks paltry compared to the months and months they’re pulling in the UK.

But what about all the places fighting Covid without yo-yoing in and out of lockdowns What about all the places that haven’t even had a single lockdown?

We’ve talked about Taiwan ad nauseum. Not a single lockdown there, and only nine deaths. By comparison we’ve had 26 deaths and several lockdowns.

What about New South Wales, which is increasingly looking like an example of how to combat Covid. They haven’t had a single state-wide or Sydney-wide lockdown this entire pandemic. Meanwhile, Auckland has had four lockdowns, which will be a total of 11 weeks – or nearly three months – at the end of this week.

NSW’s biggest city, Sydney, hasn’t had a single week with the whole place in lockdown. NSW has had 54 deaths, which isn’t bad for a population of about 8 million.

Premier Gladys Berejiklian’s response is nuanced. They lock down suburbs and hotspot areas, so if there’s a flare-up in the Northern Beaches, the restrictions are limited to the area, not the entire state, or even the entire city. Compare that to NZ, where Invercargill is in level 2 right now.

NSW is actively trying to avoid lockdowns. They have an excellent contact tracing system so they can put sick people into isolation, rather than all people into lockdown.
And last I checked they just went 40 days or so without a community case.

You are welcome to keep comparing us with northern hemisphere countries who are in the depths of winter to see how well we’re doing, because we’re always going to be better than the absolute worst in the world.

Or you can compare us to NSW, just across the ditch, to see how much better we could be doing.

Lack of compliance with isolation requirements is the immediate cause of the latest lockdown but as the ODT editorialises, we can point our fingers at the government too:

The Government, and especially the Ministry of Health, does not escape blame. Despite many hard-won improvements over the past 12 months, parts of the ministry’s operations are still lethargic when these crises hit.

New Zealand’s lucky streak, supposedly, ended because of the community case from one of the few Papatoetoe High School families not contacted for about a week after contract tracers went to work. Apparently, various phone numbers were often tried.

The failure to door-knock within days, however, was not misfortune but lack of urgent drive. Any decent media reporter, when phone calls failed, would have been visiting the family home long before the first family positive test.

Similarly, the wait by patients for many hours for advice from Healthline is poor.

How many people, who should have been tested, simply gave up? An underlying message is that the Government, despite all the strong words, might not really care that much. Only now, late as usual, do we learn of further scaling of surge capacity on Healthline.

There remain major questions, too, about the lack of use of saliva testing. . . 

There are also questions about the MInistry’s and government’s competence when contact tracing is failing us:

After more than a year of dealing with Covid-19 the Government is still failing its own contact tracing performance measures and is failing to be open and transparent about locations of interest, National’s Health spokesperson Dr Shane Reti says.

Information supplied to National from the Health Minister show that in both the recent Northland case and the Papatoetoe outbreak, the Ministry of Health failed against two measures of contact tracing that were considered ‘critical’ by the Government.

The Government sets a target of having 80 per cent of contacts of an index case located and isolated within four days. But in some cases related to these two incidents, only 52 per cent of contacts were isolated within four days.

“Alongside reports from the current Papatoetoe outbreak that contacts were called but not visited, this shows the Government needs to do better with contact tracing,” Dr Reti says.

“Dr Ayesha Verrall’s audit into the Government’s contact tracing regime last year made it clear that our system was lacklustre, and the Government promised to turn this around.”

The Government needs to say whether its contact tracing indicators have ever been completely met in any of the many community outbreaks since the Americold community cases sent Auckland into lockdown last year, Dr Reti says.

“There is no excuse for not implementing Dr Ayesha Verrall’s recommendations in full given she’s sitting right there at the Cabinet table.”

Meanwhile, recently released documents show six locations of interest were undisclosed in the recent Northland outbreak – nearly 20 per cent of all the locations in that case.

“The Director General of Health has said non-disclosure is a rare event but nearly 20 per cent of all locations can’t possibly be considered rare,” Dr Reti says.

“It’s important that the public knows these locations because it impacts not only the people inside but potentially those outside, like kerbside rubbish collectors.

“Properly identifying locations of interest would likely lead to more people coming forward, rather than less.

Claiming that medical centres don’t need to be disclosed because they have an appointment book that shows who was there doesn’t really work as an excuse, Dr Reti says.

“As someone who has owned and managed many medical centres, I know it’s not possible to tell who is in the waiting room at any one time, who are accompanying patients, or who has entered just to use the bathroom or pass a message on.

“We need to understand the rules for non-disclosure and they need to be consistently applied and with an assurance that the risk of transmission is exceptionally low.

They might have got away with mistakes in the early days when, as they pointed out there was no rule book.

But it’s now a year since the first case of Covid-19 was diagnosed in New Zealand and that excuse has long past its use-by date.

Most of us have done as requested but patience wears thinner with each lockdown and the government’s failure to be open about its plans over where-to-from-here raises questions over whether or not it has one.

Businesses are justified in asking for the plan to be made public.

Some of the country’s most powerful business leaders are demanding the government lay out its Covid-19 plan, including how it is measuring its current strategy and its plans to get the border open. . . 

The group is calling for clarity and openness, saying the details need to be made available beyond government circles.

Mercury chair Prue Flacks said major New Zealand businesses would welcome the opportunity to assist the government in its longer-term planning.

“We’ve seen the open and transparent approach taken by Australia on its vaccine roll-out plan, the launch last week by the United Kingdom government of a clear plan to manage a path out of its current lockdown and the ongoing success in Taiwan of avoiding lockdowns through using technology to manage home isolation.

“It will be beneficial for all New Zealand if the Ministry of Health and other agencies take an open and transparent approach to the development of a path towards sustainable virus management.” . . .

We are all justified in not just asking for the plan, but asking that it be less about politics and more about science.


Simon said

22/04/2020

Simon Bridges posted his view on the government’s decision to extend the lockdown at level 4 that has unleashed a lot of criticism.

A union and doctors are saying similar things but they’re not getting the same media pile-on.

Could it be, as Heather du Plessis-Allan said yesterday, it’s not what he said but that Simon said it?

Here’s what he said:

The decision for New Zealand to stay locked down in Level 4 shows the Government hasn’t done the groundwork required to have us ready.

The public has done a great job of self-isolating and social distancing. The entire country has made huge sacrifices to ensure the four week lockdown was effective.

Unfortunately the Government hasn’t done enough and isn’t ready by its own standards and rhetoric.

New Zealand is being held back because the Government has not used this time to ensure best practice of testing and tracing and the availability of PPE hasn’t been at the standard it should have been.

The PSA is still saying that PPE distributions for health workers has been unreliable and uneven.

. . . “We have repeatedly been promised PPE. Our members have repeatedly been told the DHBs and the Ministry of Health will keep them safe. These promises have repeatedly been broken,” says Melissa Woolley, Assistant National Secretary of the PSA.

“At least 128 health workers have been infected with Covid-19 so far, and we know for a fact that thousands of our members are working without reliable access to PPE. These tend to be workers in predominantly female industries, undervalued and underpaid for decades, and they have once again been forgotten about when it counts.” . .

Back to what Simon said:

The rate of testing for the first half of lockdown was low, work has only just begun on surveillance testing to confirm whether community transmission is occurring. Tracing is the biggest challenge and experts have identified major shortcomings in the methods being used by the Government.

All of that is factual.

This is a real shame as businesses will suffer further damage and that will lead to poor health outcomes as a result of the huge stress this will cause for a lot of people.

Rapid and easily accessible testing for workers with symptoms will be essential to give small businesses the confidence needed to get back to work.

I’m sure many Kiwis feel frustration that we still can’t do many things Australians have done through the entire lockdown period, at great cost in terms of jobs and livelihoods, with similar health outcomes.

The decision to be guided by the arbitrary notion of essential rather than safety has meant far fewer businesses were able to operate, far more are in danger of folding and far more jobs will be lost.

It’s no less safe to buy a novel online, for someone with their own tools to do an elderly person’s garden, for a sole operator to carry out his or her trade this week than it will be next week, but the level 4 rules prevent that and level 3 will allow it.

I now worry that the harm of staying in lockdown will be greater than if we were to come out. We will no doubt see a rise in mental health problems and stress related illnesses.

I also have real concerns about the delay in healthcare for some people, like cancer treatment, screening and thousands of operations across the country.

Poorer physical and mental health as a result of rising unemployment is also a fact.

Several doctors have raised concerns about the risks, and costs, of delayed diagnosis and treatment.

New Zealanders can be proud of the sacrifices they have made during this difficult time. The Government must now move as fast as it can to sort out the issues with tracing, testing and PPE so we can get our country moving again.

Simon is not alone in saying tracing needs improvement.

Dr Ayesha Verrall, who audited the national contact tracing system said the contact tracing system was only a third as good as it needed to be.

Dr Verrall told Nine to Noon the numbers were promising, but more still needed to be done to improve the system as case numbers dropped.

That so few people have died of Covid-19 and the number of cases is low and declining needs to be acknowledged but that doesn’t mean that no questions can be asked and no criticisms made on how that’s been achieved.

As an electorate MP, Simon will have had lots of constituents coming to him with problems caused by the lockdown. His MPs will have passed on issues raised by their constituents. He owes it to them, and all the others whose lives have been, and will continue to be, blighted by the government’s actions to criticise its policies and performance.

As Leader of the Opposition, Simon has not only the right, but the duty to question the government and point out shortcomings in its actions.

People have the right to argue about what he said, but it is wrong to criticise him for saying it.

This is New Zealand, not North Korea where no criticism of their dear leader is permitted.


%d bloggers like this: