Scott Webb (Host): Winter can be hard on all of us and it's important that we take care of our lungs, especially if we have lung diseases. My guest today has some suggestions for how we can stay healthier in the winter and protect our lungs. I'm joined today by Dr. Bashar Alhariri. He's a Board Certified Pulmonary Critical Care Physician practicing at Franciscan Health. This is the Franciscan Health Doc Pod. I'm Scott Webb.

Doctor, it's so nice to have you here today. I know with winter coming, you know, the cold and flu months and maybe COVID and a whole bunch of other things, and it's just really important for us all, maybe anytime, but especially this time of year, to keep our lungs healthy in these winter months. And, you know, I know these various seasons can bring different triggers especially for those who suffer from lung complications.

So maybe you could just explain as we get rolling here, what the winter months trigger in terms of lung health.

Bashar Chihada Alhariri, MD, FCCP: Cold weather can negatively affect our lungs in several ways, actually. So the cold air usually narrows the airways, which cause what we call bronchospasm, and it means the airway gets narrow and tightened, and you get the feeling of shortness of breath, which make it difficult and harder to breathe.

Plus, dry air can cause wheezing, coughing. Especially problematic for people with chronic lung disease like asthma or COPD. Plus, it can increase the mucus production when the cold air enters the nose, it can cause the vessels in our nose to expand and stimulate more mucus production. Again, this can cause some trouble breathing, with some runny nose.

Host: Sure.

Bashar Chihada Alhariri, MD, FCCP: And the last will be, poor indoor quality during the winter months. As you know, usually it's cold, so we stay inside, indoors, and when you spend more time in the winter, poor indoor air quality can increase the number of allergens and even potential infections if there's no good ventilation system especially in the crowded area inside.

Host: Yeah, definitely. And those of us in the Illinois, Indiana states, in this region here, we spend a lot of time indoors. So as you say, air quality in the winter months is important. And I'm wondering, you mentioned those with chronic lung diseases. So whether we're talking about asthma, bronchitis, COPD, or emphysema even, how do they specifically prepare for the challenges of breathing during the winter months?

Bashar Chihada Alhariri, MD, FCCP: This is a great question. There are a few measures that we can take, obviously. For example, if it's exceptionally cold, windy, or very dry outside, as you said, during those most coldest days, we can limit our outdoor time, especially if you have respiratory issues. And we can always watch for any signs of respiratory problems.

So if you notice yourself when you are in those cold days starting to cough or wheeze or have trouble breathing, so, that will be the perfect time to seek medical attention. Obviously you can wear protective gear. The idea is to cover the mouth and the nose like a scarf or mask outside to help warm and humidify the air before it enters our lungs.

 Keep yourself warm, dress in layers, especially if you're planning on spending a long time outdoor during the cold month weathers and obviously breathe through your nose. As you know, if we breathe through the nose, it will warm and humidify the air, making it easier for our lung to process this cold air. Breathing through your mouth can lead to dry, cold air, irritating the lung, the way I explained it earlier.

Host: Yeah, like some of this seems like common sense, but when I hear it from an expert, I say, right, breathe through your nose when you're outdoors, when you're in the cold, right?

Bashar Chihada Alhariri, MD, FCCP: Right, exactly. As I explained, it will make it warm and less dry and easier to breathe, especially with someone with asthma or COPD, chronic obstructive pulmonary disease.

Host: Yeah. And I know that cold can, as you're saying, like, literally sort of take our breath away. Are there any productive winter breathing strategies that can really help folks keep their lungs healthy during those cold, brutal winter months?

Bashar Chihada Alhariri, MD, FCCP: As I mentioned earlier, we could try to wear protective gears, keep yourself warm. And, obviously the indoor air quality is very important too. So we can use humidifier to keep the air moist or make sure our ventilatory system is really appropriate by ensuring good ventilation, without losing the heat, by using the air exchangers or air purifiers.

Host: Yeah, just thinking about this, I'm thinking about how much time do I spend indoors and outdoors and specifically as you're saying about the indoor, like home air quality and trying to avoid attacks, especially for folks with, you know, these chronic lung diseases, you mentioned humidifiers, maybe inhalers, are there medicines?

I don't know if this is true or not, I'm maybe just making this up, but I feel like maybe there are certain foods or diets, Doctor, that also help.

Bashar Chihada Alhariri, MD, FCCP: Yeah, that's a good question too. Actually, the main thing we tell our patients is to stay hydrated too. Drink plenty of fluids. That will make the mucus thinner, which can otherwise build up due to cold weather leading to blockages or infections in the airways. So keep hydrated, keep warm, keep the quality of air better, as I mentioned earlier, by using the air purifiers, those are helpful.

And obviously, air humidifier. Because with the weather, it's really important if it's very cold, warm air just inside. And then lastly, taking medication as prescribed. I always tell my patients, follow your doctor's advice, and ensure you take all the inhaler or whatever prescribed medication routinely, especially before going outdoors.

And always, always for asthma patient, I always tell them that have your rescue inhaler or any other necessary medication on you when you go into the cold weather, so you can use it promptly.

Host: Yeah, it's great to go outside and have fun and build snowmen or shovel the snow on the driveway, but obviously remember that rescue inhaler.

Bashar Chihada Alhariri, MD, FCCP: That's right. If you're prepared, you should be good to go. And, uh, as I mentioned before, if any signs of trouble breathing, then go inside and then if persistent, notify your medical provider.

Host: Yeah, reach out, sure. Is it a thing, Doctor, that folks can actually sort of build up their immune system? Can we load up for winter and give ourselves better immunity as we head into the cold and flu seasons? Is that a thing? Can we do that?

Bashar Chihada Alhariri, MD, FCCP: Yes. Yes, definitely. And eating healthy, follow a good diet and then stay active, and obviously get vaccinated. This can help prevent all the infections that are common during the cold month and can worsen the lung conditions. As you know, there are many important vaccines like the influenza, like pneumonia and COVID-19 vaccine. They came with a new booster recently. And obviously for some patients with pulmonary and other medical issues, the RSV vaccine is important. It protects ourselves from viral illnesses and reduces the risk of the complications if we get infected, so.

Host: Reduce the complications, reduce the severity, all that good stuff. Always great advice when we start talking about vaccines. Good stuff today, Doctor. Just want to finish up and, you know, sort of your final thoughts, you know, period at the end of the sentence, if you will. But when we think about keeping folks healthy in these winter months, especially those with chronic lung diseases, what's your best advice?

Bashar Chihada Alhariri, MD, FCCP: One of the best advice I have for you all other than get vaccinated is to avoid smoking. And avoid even secondhand tobacco exposure and avoid vaping. As you know, smoking irritates your lungs and increases the risk of respiratory illnesses, especially during winter. So, I would say avoid smoking environments, make sure it's very good ventilation inside our houses, or places where we live and make sure you stay away from the irritants, including secondhand tobacco, which will exacerbate your pulmonary symptoms.

Host: Yeah, for sure. Well, great advice from an expert today, Doctor. I really appreciate your time. Thank you so much.

Bashar Chihada Alhariri, MD, FCCP: Yeah, we're happy to help. Thank you.

Host: And for more information, visit franciscanhealth.org and search lung health. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.