Nic came to New Zealand from Ireland 27 years ago to embrace the fresh air and outdoor lifestyle. With her husband and two young children, Conor and Mackenzie, she lived on the remote island of Motutapu.  

Heading for his third birthday, Conor was a couple of years older than Mackenzie, but as his little sister grew, it was soon clear she ruled the roost. They’d spend their days playing on beaches and dashing into the sea. Mackenzie was a tough little cookie, so it was completely out of character when she began to fall over and cry out in pain. Pain that wouldn’t stop.  

It wasn’t easy seeing healthcare professionals as the mainland could only be reached by infrequent ferries. At first, Mackenzie’s outbursts were put down to toileting problems, but as they happened more often, her parents managed to get her an appointment at Starship Children’s Hospital. It turned out she had a tumour at the top of her spine. She needed surgery, chemotherapy and radiotherapy. Nic stayed with her day and night.  

Then one morning as Nic was in the hospital shower, with Mackenzie playing with her dolls on the shower floor, Nic felt a lump in her breast. Reluctantly, she had a mammogram. Reluctantly, because she wanted all her energy to go into looking after Mackenzie. But that was no longer to be. Nic had breast cancer and needed a double mastectomy. “I couldn’t believe it, mother and daughter in the same hospital having treatment at the same time, it was like the world’s idea of a sick joke”.

And then the unthinkable happened. After rallying and being able to have a party for her third birthday, Mackenzie developed an infection that developed into sepsis. “She died in my arms. It was the hardest thing ever, and grief never leaves you”.

Turning to the sea

There were days Nic didn’t want to be around any longer. She says it’s hard to convey the pain to those who haven’t experienced it. She was still having chemotherapy and her marriage had broken down. She’d always been active, and that became her saving grace. Running, cycling and swimming. Losing herself by pushing as hard as she could, but when she switched from swimming in pools to the ocean, it gave her another form of relief.

Years later, Sarah Luxon’s life was turned upside down. It was 2017. She’d always had difficulties getting pregnant, so was overjoyed when she found another baby was on the way. She and her husband Greg already had Hazel together, and she was mum to her much older, stepdaughter Tayla. Then one August morning, along came Mackenzie, born as a perfect little girl with downy hair and a little cherub nose. She had what Sarah thought were the usual grizzles, but just 13 days into her life she stopped feeding altogether. Knowing something was wrong, Sarah took her to the after-hours medical centre. They did all they could to save her, but within minutes, her heart had stopped. It was a heart defect, a "hole in the heart" and nothing could be done.  

Grief. Just as with Nic, it turned Sarah’s life upside down. “You’re never the same person again, you pull yourself out of bed, you keep coping because that’s what you have to do”. Sarah says the loss of Mackenzie hit her harder than she could ever have imagined and she felt there was little support, and any she could find was expensive.

The days could be very dark, but Sarah pushed through. Each year, she’d go with the whānau to Mackenzie Country to honour the daughter they’d lost, and it was there that she first heard about Nic.  

“The lovely lady who was booking us in to our accommodation asked why we were visiting, and when I let her know it was for the anniversary of my daughter Mackenzie she got the chills.” The lady had just been talking to Nic who was also planning to come to Tekapo to do a winter swim. The lady told Sarah about Nic’s charity, Kenzie’s Gift.  

“It was quite surreal to hear about another person who had a daughter with the same name, who’d been through the same pain”. Sarah was blown away by how Nic had used her suffering for good, creating something that could support other young people and their whānau. 

She wanted to support Nic in her work and thought plunging into the icy waters of Lake Tekapo could be a good way to fundraise. Thirteen swims for the thirteen days of Mackenzie’s life. She says the goal was to raise lots of money, but the payoff proved to be much bigger.

More than coincidences

Nic and Sarah had more in common than losing much-loved daughters named Mackenzie. They also shared a devastating diagnosis. As Sarah continued her swims, she too felt a lump which turned out to be cancer. “I’m stage 4 ovarian cancer, it’s terminal. My hope is that if my children (Sarah has since had another daughter, Willa) have to go through the unthinkable with losing me then Kenzie's Gift can at least be there to give them the support they need."    

She made contact with Nic, talked about the relief of cold immersion and they made a plan to swim together in Lake Tekapo in 2020 to mark how far they’d come. “I was excited to meet Nic. She’s shown me how to live life joyously and fully and shown me that sharing your journey doesn't make you weak it can help others,” says Sarah.

Nic's challenges continue

Nic’s cancer was now under control, but her body threw another curve ball into the mix. She noticed a tremor in her legs, then her hands stopped functioning as they should. She was diagnosed with Parkinson’s disease. The double whammy of dealing with her condition and the Covid lockdowns meant the trip had to be postponed.  

After settling into her treatment, she could again start to plan her trip. But way back during her cancer treatment, a scan had indicated a precursor to a condition called hypertrophic cardiomyopathy, a stiffening of the heart wall. An initial drop in heart function was bad enough, as it meant Nic had to reduce the activities she felt were keeping her sane. Less running, less cycling though mercifully she could still swim which gave her peace and kept her going.

But in 2021, a follow up MRI scan showed her heart function had plummeted to 27%. Her doctor uttered words she never thought she’d hear. “He said, Nic you need a heart transplant”. She was 48.  

“I was driving up north the next day and I just cried. My son was 21 at the time and I remember when I had cancer I thought ‘I want to get Conor to 18’, so getting him to 21 was a bonus, but I wasn’t prepared to leave him yet.” 

Again, her life started falling apart. A heart transplant is a huge undertaking, but without it she was given one-to-three years to live.  

Exhaustion took hold of her, she had to dramatically cut down her working hours, and some days she couldn’t even get to the beach to swim.

Nic was getting to the point where she felt she didn’t want to be alive. “Grief isn't just about losing someone who is precious to you, it can be about losing who you are.” She felt the blows just kept coming and on top of that she was being robbed of the way she kept her mental health in check. 

Then she got the call. A young person had tragically died and their whānau were giving Nic the most precious gift she could ever ask for. A chance of a new life. A heart. She remembers sharing a supper of sushi with Conor in hospital, as raw fish would be off the menu once she’d had the transplant. She was wheeled into the operating theatre in the early hours of the morning.

Next thing she knew, it was three days later, and her first thoughts were to honour this gift by making the most of her life .“My daughter only lived till she was three, I've been given a second lease of life at 48, so I'm going to grab it with both hands because it's the best thing I can do for the person that's gifted it to me”. 

She couldn’t think of a better way to do this than to finally get down to the South Island to swim.

Swimming with a new heart

So at last, years on, the trip to Tekapo to meet Sarah was back on the cards. Nic worked hard on recovery, taking her first dip back in the sea in Auckland ten weeks post-transplant. “I was excited and a bit nervous, but it felt so good.”  

Then one bright, sunny day in August this year, they met on the shoreline of Lake Tekapo, embracing like old friends. The majestic mountains stood guard on the horizon, the vast waters of the lake sparkled before them. There were tears, a gift for Sarah’s Mackenzie who’d have been celebrating her seventh birthday in a few days’ time, and of course, there was the release and sheer joy of walking into the lake’s icy waters. Together.

Nic could hardly believe they’d made it work. “My life still may be short as my transplant might not last and I’ve got Parkinson’s but I'm still here.”   

They emerged from the cold feeling energised and alive. “It was amazing and beautiful.” Both Nic and Sarah fully believe these cold swims have played a significant part in their recovery.

In the last few years, there’s been an explosion of interest in cold water swimming and icy dips as a boost to health. TikTok users and celebrities post videos of gasping for breath as they take the plunge. Passionate advocates like motivational speaker Wim Hof make bold claims that cold water therapy and specific breathing techniques can reduce stress, improve sleep, bolster the immune system and increase energy. But how much of this is true? 

I paid a visit to Otago University’s School of Physical Education to talk to Professor Jim Cotter and researcher Tina van Duijn. They were blunt. “A lot of the research is flimsy. The practice of cold swimming is way ahead of where the science is at.” 

But they’re interested in filling the void. I volunteered to help and so, in one of my more unusual interview settings, I was wired up to measure my heart rate, breathing and blood pressure and lowered into water that was just 8 degrees Celsius. That’s about as cold as the sea ever gets in winter in Dunedin. It would be cold if you were in a wetsuit and moving. In a swimsuit, sitting still, it was freezing.

And yes, when my body was immersed, the expected took place. My breathing and heart rates quickened; my blood pressure went up. But here’s the interesting bit. Professor Cotter was surprised to see that none of it went up by much. “You actually showed very little response.”

The cold shock response, whether big or small, is thought to be part of the benefit of cold immersion. Tina van Duijn has a theory as to why. “We know when you have a strong, cold stimulus, you become really, really focused on the present. That’s similar to what people want to achieve when they meditate. It stops you from overthinking, so at least for a little while it can give you a break.” 

But it’s Zen-like effect doesn’t stop there. If these cold shocks are repeated, the theory is they can get the body used to responding to stress, and so reduce its reaction to everyday stresses, possibly also helping with mental health. Professor Cotter believes that could be why my response was subdued, as I bravely switch the end of my showers to cold now and then and even head into lakes and seas for a refreshing wake-up when I can. I wouldn’t describe either of these things as pleasant, but I do feel energised afterwards. It’s also become easier since the menopause but that’s another story.  

The positive effect of cold water is an area both Cotter and van Duijn are keen to explore. They say it’s likely several factors are at play. It could be the pleasure of setting and meeting a big challenge. It could also be that the repeated shocks increase feel-good hormones such as serotonin.     

It’s the physiological effects on the brain that particularly interest Van Duijn. She says one study has shown that this extreme experience can actually change neural connections. She wants to study how this occurs and has a theory to explore. “It could be that having a very strong sensation is almost like a defibrillator on the brain so that it’s synchronised and for a short time that increases connectivity.”

The researchers have big plans if the study shows a positive response. Massey says they’ll apply to have outdoor swimming instruction included as an option for England’s social prescribing practice. Social prescribing is a relatively new approach to healthcare in England. Patients can choose to go to these practitioners rather than to their GPs if they prefer not to take drugs for their condition, or for help in addition to drugs. The social prescribers are trained to assess what type of activity may help the patient’s situation, and to prescribe a course in a funded activity which could be creative, active or social. The idea is to relieve pressure on overworked GPs and give patients alternatives to pharmaceuticals.  

There are already charities running outdoor swimming courses all over England, but Massey believes NHS funding would make the practice more widely available and help with training the instructors too. “We hear about people having serious side effects [from] some antidepressant drugs and about some who simply don't like taking medications and would rather have natural activities to support themselves.”

Funding outdoor swimming in New Zealand

“It would be great if we had a social prescribing model here.” That’s the opinion of Helen Jeffery, an occupational therapist and lecturer at Otago Polytechnic who has previously worked with people who have mental health problems. In her practice, she would always integrate the use of the natural environment.

She sees value in getting people away from the urban environment and our constant interaction with technology. “Our nervous systems weren’t developed for the way we live now.” Many stresses we come across today unnecessarily evoke a fight or flight response. That means raised heart rate, blood pressure and uncomfortable feelings for no good reason.  

Exposure to nature, literally our “natural” environment, can return us to calm, allowing us to think more clearly and positively.  

In New Zealand, GPs can give so-called green prescriptions to patients to help with exercise and nutrition, but ironically, the exercise component usually involves going to the gym. “It would be much better if it was nature-based,” says Jeffery. Individual practitioners do offer outdoor therapy, she says, but it’s generally not funded.

Learning from the past

Rongoā practitioner or Māori healer, Matt Kiore (Ngāti Maniopoto) would be happy to share his knowledge. “It’s nice to have the opportunity to kōrero, don’t often get asked, usually just do the mahi,” he says. His mahi is vital to his community, he works to prevent suicide in youth and to empower anyone who is struggling with their mental health.  

We meet beside the ocean in Aramoana on another stunning South Island day.  The air is fresh and salty, the rise and fall of the waves provide a rhythmic soundtrack for our chat.

Kiore has a deep connection with the sea. Like his tīpuna or ancestors, he sees its potential. “We use it to heal the spirit, to heal the mind, to heal the body and often to heal the whānau.” The healing process can be as simple as inviting those with problems to stand at the water’s edge. “Just coming out to the sea can help release the energy that’s hurting them, we ask the sea to take it away, we ask our guardians to protect us.”  

He also takes young people into the sea to collect pāua. He says it helps to establish tikanga, or guiding principles, as they hold their breath, follow instructions, and are tasked with making sensible decisions. Kiore believes Māori healing can work hand in hand with conventional medicine, as the system can be “really good at identifying a [mental health] issue but can struggle sometimes with how to release the pain”.

Professor Cotter agrees. He thinks the natural environment could be much better utilised in wellness. He’s also amused by the current obsession with cold-water therapy. “It’s called blue therapy, but indigenous peoples call it life.” 

Still, he remains curious about the effect of outdoor swimming and will continue to study how it makes us feel so good. But he’s aware science can only take us so far. “We do want to try and understand things but sometimes we can't measure everything that matters.”