By Caroline Moassessi
(This is the third report from Caroline we have published in the past four years. For some reason we skipped 2015. Her previous reports can be found here and here.)
“When you can’t breathe, nothing else matters”. Timeless wisdom from the American Lung Association. Fires in the Western United States are as regular as the Fourth of July and don’t stop when the fireworks are done. In my little spot on the planet, Reno, NV, we are a smoke magnet! The Southern California Sobranes and Sand Fires are blazing, sending smoke up to Reno from the south. I wanted to run an errand across town this week to help a colleague retrieve some asthma education materials, of all things, from a storage unit. She urged me to stay home as the air was frightening and she could see the cloud of smoke rolling towards my neighborhood. I quickly closed all our windows and canceled my kid’s outdoor activities. Soon enough, the smoke arrived and the Sierra Nevada Mountains disappeared.
Last evening, a fire started just north of Reno. That makes three in the area. Hundreds have been evacuated. Pleas on social media for volunteer firefighters to report to duty went viral. That old trapped feeling is creeping up like plastic bags over our heads. The fear of dry lightning fires expected compound our dread. Our phones are pinging out Red Flag Warnings of high winds and fire danger. Nowhere to run. Smoke to the north. Smoke to the South, trapped by mountains on both sides.
My friend’s four children who all have asthma are faced with possibly skipping a very important swim tournament this weekend since the event will be held outdoors. One is nationally ranked and even though the air quality may not be bad enough to cancel the tournament, it might be too risky for an asthmatic.
During these times, I keep an eye on the Air Now website, which reports current air quality by regions. I specifically look for Moderate or Unhealthy for Sensitive Groups (USG). Including action days, when the Air Quality Index (AQI) is in the unhealthy range, local health departments will issue warnings on these days to stay indoors and avoid outdoor exercise. The purpose of AQI index is to act as a guide for those of us with lung disease and for those who have healthy lungs and are in danger due to the dangerous air quality. Often, just looking out the window or stepping outdoors is not enough to detect poor air quality. I can drive 15 minutes north with clear skies in front of me and suddenly be engulfed in smoke.
The subtle-yet-nasty impact of poor air quality from forest fires is real. Asthma is a mental health issue even without the smoke, and medicines like Singulair and inhaled steroids carry mood and behavior risks of their own. It is a little known fact that asthma can cause irritability and depression. I used to blame my mood shifts on perimenopause until I noticed my own children’s attitude changes when the air quality plummets. Everyone gets edgy and grumpy. Simple tasks become monumental. Our physician enlightened us on this phenomenon and now we know how to confront it–once you can see the dragon, it’s easier to slay.
I double-checked our medicine cabinet to ensure we have plenty of asthma medication on hand despite the problems. Our lungs are already twitchy. The last situation I want is to not have unexpired rescue medications. I advised my son to stay indoors and keep an eye on his asthma, I’ve banned my elderly father from running errands. My daughter and husband are on a trip to Los Angeles where they had to drive through smoke engulfed areas and I have read them the riot act on taking precautions.
For my own asthma, I have run through the standard pharmacopeia with mixed results. My allergist provided a nice sampling of various asthma medications and it appears that my perimenopause and these meds don’t work so well together. As if asthma and asthma meds weren’t enough. The results were sleepless night and anxiety over small things. I would wake up at 2 a.m. worrying about not having enough printer paper. You know, the really worrisome things in life. My fluctuating estrogen impacts my asthma by creating proteins that increase inflammation in my lungs.
I personally, have turned to Traditional Chinese Medicine (TCM) to manage my asthma in combination with the use of asthma rescue inhalers and my back up of inhaled steroids. {Note: this is not being done under the direction of Dr. Xiu-Min Li.} I grew up in the San Francisco Bay Area, where TCM was commonplace and I returned to taking herbs and doing acupuncture for asthma, both of which have been serving me well.
My asthma is under control right now, but my lungs are no match for that fine particulate carbon, which can create asthma in families that have no family history of allergies even. I ran errands last night at 10 p.m., when I thought the sky looked clear, I ended up coughing away and scurrying home. No sack of flour is worth an asthma attack. And yes, when you can’t breathe, nothing else matters.
Caroline Moassessi is the founder and author of the International food allergy and asthma blogsite Gratefulfoodie. She recently received a FARE vision award and is a Huffington Post Blogger. Caroline’s passion as a food allergy and asthma advocate included being the lead advocate for mandated stock epinephrine in Nevada. She presented the need for laws protecting people with life threatening anaphylaxis at the National Conference of State Legislators along side past president Senator Debbie Smith.
Caroline sits on the American Lung Association (ALA) National Social Media Work group, and is the past regional Advocacy Chair, past National Advocacy Work Group member, past Secretary/Treasurer for the ALA of the Southwest region, past president of the Board of Directors for the American Lung Association in Northern Nevada, and was a founding member of the National Allergy and Anaphylaxis Council. Caroline discusses food allergies on her local ABC affiliate network, works as a food allergy liaison with her local school district, contributes to Allergic Living Magazine, and has spoken at the Food Allergy Blogger Conference, Minnesota Food Allergy Conference, Salt Lake City Food Allergy Conference, and the American Thoracic Society’s International Conference. She is a co-group leader and co-founder of the Northern Nevada Asthma and Food Allergy Education Group