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Health Hints for those in the Fire Areas

Smoke is very dangerous. Most people die in fires from smoke, not burns. As the
fires sweep through Southern California, consuming hundreds of thousands of
acres, a huge amount of smoke in being inhaled and will have unfortunate
effects on the health of  many persons in these locations. The weather forecast
is for warm Santa Ana winds, aggravating the spread of the fires, with no
relief in sight (as of this writing, 2003 29 October). For the many asthmatics
and allergy patients, these fires are especially serious.

The ill effects of smoke exposure have been carefully studied since the
terrible fires in Kuwait and Indonesia. The incidence of asthma in 10 — 14
year olds was much higher than normal as well as a higher incidence of sinus
conditions.

The by-products of forest fires include chemicals such as carbon monoxide and
various aldehydes that act to impair cilia function. In the respiratory tract
— the nose, sinuses, trachea (windpipe) and the smaller airways of the lungs,
there are millions of tiny "oars" called cilia. These beat to remove foreign
material out of the sinuses. In the nose they beat backwards and move the
foreign materials, such as smoke particles, out of the nose to the stomach. In
the chest they beat upwards to move the unwanted material out of the lungs to
the throat, where the end up harmless in the stomach. If you can keep the cilia
active, you can avoid the problems that come from smoke inhalation.

One bad sign: when the cilia of the chest can’t do their job, coughing takes
over. Either there is too much material in the lungs for the cilia to handle or
the cilia aren’t moving enough to do their job. Or there could be a chemical
irritation of the lungs.

Besides avoiding the smoke, what can you do?

a.    Breathe through a wet mask when you go outside. Drive with car windows
closed and the air recycled
b.    Drink large amounts of warm/ hot tea. Tea stimulates the cilia.
Decaffeinated tea is fine.
c.    Chicken soup also speeds cilia.
d. Drink enough of any liquids so that the urine turns light.

e. Use a nasal moisturizer spray. Be sure there is no benzalkonium or  mercury
preservative that might impair the nasal function. If possible, find an
enhanced nasal moisturizing formula free of additives and preservatives. By
cleaning the nose this way you can help preserve the normal nasal function.

f. Just as you wash your hands and face to remove soot and ash, washing your
nose and sinuses can be very helpful. You can make a saline solution – 1/2
teaspoon of salt to 8 ounces of warm water with a 1/4 teaspoon of baking soda
and gently sniff this in and out the nose until the return is clear. ( It is OK
if it comes out the mouth.) Or you can  use Pulsatile Nasal Irrigation — this
is a machine that pulses at the “prime rate” to cleanse the nose/ sinuses
and help restore normal function. If you continue to inhale smoke, it is OK to
repeat the irrigation as needed. You can use salt solution or the prepared
mixtures designed for these devices.
g.    Most of the over the counter cough preparations such as Robitussin are
fine for loosening thick phlegm in the chest. Try to avoid codeine preparations
as these may slow cilia.
h.    After exposure to smoke, use pulsatile irrigation, or gentle sniffing
of nasal solution to help get the nose working well again. If the return from
the nasal irrigation is clear, then just a nasal moisturizer is needed.
i. Caution: although antihistamines work well for seasonal allergy, they may
cause additional drying of the mucus secondary to smoke exposure. Fine to use
Sudafed and similar products for congestion after smoke inhalation, but caution
in using the regular antihistamines. The congestion following smoke exposure is
not necessarily an allergic response as it is an inflammatory one.

You must not neglect your chest symptoms.  If coughing or shortness of breath
persists, the earlier you contact your doctor about an inhaler for the chest,
the better your chances are that you will not have any long term effects form
the smoke. Your doctor will prescribe an anti-inlammatory product or
combination and then you can breathe better with less cough.
.
After the fires stop, many persons continue to have thick phlegm and mucus as a
result of the smoke products affecting the cilia. Do daily pulsatile
irrigation. If thick phlegm continues, fruit enzyme lozenges  such as those
from pineapple and papaya are helpful. Look for proteolytic enzyme tablets with
both papain and bromelain in them, calibrated in enzyme activity units. These
enzymes thin the mucus and can improve the moisture levels.. Fortunately they
taste good.
Are you suffering from smoke from the Southern California Fire? Let us know
(ENTconsult@aol.com). We'd like to help, and we'd really like to hear from any
rescue centers including medical facilities.

Murray Grossan, M.D.
http://www.ent-consult.com
http://www.hydromedonline.com