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By Murray Grossan MD
 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 10/29/03). 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.
b. Drink large amounts of warm/ hot tea. Tea
stimulates the cilia. Decaffeinated tea is fine.
c. Chicken soup also activates cilia.
d. Drink enough of any liquids so that your
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 the 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-inflammatory product or combination
and then you can breathe better with less cough.
Take care of your eyes as well. Here are helpful
hints from a Los Angeles eye specialist:
1. Protective glasses or sunglasses are essential.
There can be excessive glare from the sun filtering through
the smoke, and anti-glare coatings can be very helpful.
2. In active fire areas, goggles can help prevent
ashes or debris from blowing into the eyes, burning either
the cornea or conjuntiva. If something should blow into the
eye, immediately irrigate the eyes with cool water (or any
water available) for at least ten minutes before seeking medical
attention.
3.Dryness, burning and stinging can be helped
by frequent use of over-the -counter Artificial Tears, available
at any pharmacy or supermarket. These can be used as often
as every hour, if necessary.
4.People with contact lenses are at greater
risk for drying and irritation. It would be safer to wear
glasses during the times of poor air quality. If contact lenses
must be worn, non-preserved Artificial Tears should be instilled
frequently.
5.If the eyes actually become painful, consult
an ophthalmologist, as there is a greater risk for corneal
abrasions or infections.
6. As with all risky situations, common sense
is the number one protection against serious eye injuries.
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.
Dr Grossan's Hydro-Pulse
Nasal Irrigator for sinus sufferers is available at AllergyBuyersClub.com
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