I wanted to make some observations and suggestions about the smoke that has been such a big problem this summer.
We always expect to see quite a few patients with asthma or bronchitis worsened by the winter inversions that we get each year – but we don’t typically see many people with smoke-related worsening. This year has definitely been different! We have been treating patients who are short-of breath, coughing, and wheezing this summer (many more than normal) – almost certainly due to the smoke.
Smoke acts primarily as an irritant in worsening breathing and can also bother the throat, the nose, and the eyes. In general, asthma that is worse because of an irritant can be harder to treat, and may respond less well to medications, than asthma that is worse because of an allergy — i.e. being around a cat you’re allergic to. That is what we have seen this summer – people getting less than expected results from their medications. Several patients who were taking their medications faithfully noticed increased symptoms and have needed to increase the dose of their daily inhalers, while others have needed a few days of oral steroids to get things under control. It feels like we have had the awful winter inversions with us all summer.
Hopefully, the smoke from local fires will be gone soon. If not, what to do?
Smoke Avoidance Tip 1: Avoid the smoke as much as possible. Keep doors and windows closed 24/7. Exercise inside, not outdoors if you can, or wait for relatively ‘clean’ air days to work-out outside. Postpone yard work until the air is a bit better if you can.
Smoke Avoidance Tip 2: If you are taking asthma meds, make sure you are taking them regularly as directed. Many adults can stop their asthma inhalers during the summer months – maybe not this year? If you are taking your meds appropriately, but still having problems, you may need to increase the dose, or change medications entirely. Some may need oral steroids to get things under control initially. If you are struggling, but don’t use any asthma meds, it is time to see your doctor.
Smoke Avoidance Tip 3: Remember that coughing may be due to chest irritation, or due to post-nasal drainage from an irritated nose or throat (or both). In addition to asthma meds, you may benefit from regular nasal sprays, throat lozenges, and even gargling with saline.
Smoke Avoidance Tip 4: You may do better if you wear a face mask while outside. I say ‘may do better’ because it makes a big difference what type of mask you use. A cheap, poorly fitting mask may do little, while a more expensive, correctly fitted mask could help a lot. See this recent (brief) report on face masks and air pollution.
Smoke Avoidance Tip 5: This may the right time to talk to the financial advisor and see if there is money for a small cottage in the Alps? Or Hawaii? Anywhere that the air quality is better!
Smoke Avoidance Tip 6: Pray for rain!
Good luck dealing with our air quality. Keep in mind that although smoke from local fires has diminished, it still may occur this fall and will most certainly be present next year. Please let us know if we can help.
Duane J. Harris M.D.
Intermountain Allergy and Asthma of Draper
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