Melanie Cole MS (Host): Fire season is here, and we're here to discuss steps you should take to keep your lungs healthy when the air is smoking, and maintaining good respiratory health is so important. Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole, and joining me, we have fan favorite, Dr. Anirudh Rai. He's a Primary Care Physician at Henry Mayo Newhall Primary Care. Dr. Rai, always a pleasure to have you with us today. So the first thing is how is this fire season so far?

Anirudh Rai, MD: Yeah, it's always a pleasure to be on the podcast, honestly. And at least, from where I am in Santa Clarita, um, and we definitely noticed the fires, they weren't as bad as they were two weeks ago, where the sky was basically clouded. It was almost apocalyptic, I would say. Uh, but we do feel the ashes and, and we do feel the exposure to the fires, but thankfully I think our, our firefighters job of keeping that bay.

Host: Okay. So you are a Primary Care physician and keeping healthy lungs is really important and a little bit more difficult during fire season. If you can smell that smoke, and sometimes it seems like when we see it on TV, it seems like it's further away and you could smell it, but you necessarily can't see it. Like you said, the apocalyptic when it was really black clouds everywhere, is the air safe? Or if you can smell it, it's there?

Anirudh Rai, MD: Ideally. Yeah. Your senses are there to kind of warn you of these kinds of measures. And if you were able to smell it, then you're in a pretty good area where you're having the particles of the fire reach your respiratory tract. And that's what we're to talk about, ways to kind of help, prevent that or keep your lungs healthy. And to kind of talk about what are the patient populations that are most prone to it as well.

Host: Well then let's start with that. What are the patient populations that are most prone to having respiratory issues when there's kind of a smokier air?

Anirudh Rai, MD: That's a pretty broad question, but to simplify things, there are patients, to start off with, patients who've already had a bad lung, those who are smokers, those who have a history of asthma, that is either well controlled or somewhat difficult to control. These are the more basic patient population that tends to have a higher risk of having these particulates

enter their lungs and then cause exacerbations or basically cause them to cough and just have a hard time breathing. The other patient population actually is our pediatric population, our kids and our infants, so to speak. The reason for that is because since they are smaller, they'll be breathing a bit faster than our normal population, which is normal for their age.

So they have what we call a higher minute speed ventilation, meaning they tend to be inhaling more than our normal population would, so they're more prone to these particulates as well. And the best thing to do is to kind of monitor them, keep an eye on them. And if you're ever worried, definitely call your doctor to say, Hey, is there something I should be doing?

Host: Are we able to take safety precautions when the air is smoky? Do masks work? I mean, because that was the first thing that I thought of was masks. We wore them for so many other reasons and illness and respiratory illnesses. Do they work to help filter out some of the smoke?

Anirudh Rai, MD: There have been studies done on this thankfully enough. Masks have their role in this to a certain extent. The best way to describe it is when a fire burns, you have essentially a lot of chemicals, and a lot of particles that are essentially introduced into the air.

The particles include basically the carbon material that's been disintegrated, and you have smaller particles that are introduced. But the things that worry people a bit more would be the carbon monoxide and these noxious gas that are in the air. And unfortunately, masks aren't meant to prevent these sort of noxious gas, such as carbon monoxide and these kinds of chemicals.

They don't prevent these chemicals from entering your lungs. So unfortunately masks don't help in that regard, but the larger particles these masks can help with, but more often than not the studies have shown that unfortunately the volatile chemicals are the ones that tend to cause more havoc in the long run, rather than the small particles, which the masks do help with.

Host: Thank you for clearing that up. Now, what about our children? You mentioned them at the beginning here, and obviously our kids are playing summer sports, they're at camp, they're going to the beach, they're doing all this stuff outside is where everybody is. So do we need to be extra careful with children? And if so, tell us which children? Is it all of them? Babies specifically? Talk to us about our little kiddos.

Anirudh Rai, MD: You're right, it is summertime. Kids, families love to go outside, there's a lot of traveling going on as well. And for that, I would say, keep an eye on them, avoid areas that are of high smoke, where you could actually visually see the smoke and seek the local authorities.

Sometimes they have mapping of where the winds are blowing, where the, essentially the fallout of the ashes is coming as well. And to generally to avoid those areas until it becomes clear would be the best sort of precaution to take. If you are in those areas and you do have a kiddo, typically I would say, keep kiddos being newborns up to at least five, six years old.

They tend to have a higher minute ventilation. Not only that, they're more active. So keep an eye on them would be the best sort of care I would give them. And if it is an area where you do have high smoke, I would recommend staying indoors till things clear up or traveling to a different location as to avoid more exposure to the particles and the carbon monoxide per se.

Host: So if they have to do children's sports, if they are outside at camp and they can't go somewhere else; is there anything we as parents should do like after camp? Do we keep them inside? Can we give them a steam shower? Is there anything that can help sort of clear those particulates out of their lungs?

Anirudh Rai, MD: Your body does a pretty good job of actually clearing out these particles, like coughing and sneezing, so your body has a good mechanism for that. But the best thing to do in an area where you do have a lot of smoke would be to stay indoors, close the doors, close the windows, and have some sort of air system inside that could help actually filter those particles.

HEPA systems do exist and they tend to be very helpful in that regard, but they are pretty expensive. Sometimes having an indoor air conditioner can help also produce that sort of air that's in motion that's clearing up whatever's indoors. But the key thing is to stay indoors, avoid having open windows, because that's how these particles and chemicals do get in.

Host: So, would that be the same advice for people that work out outside? The people that run, the people that walk, the people that like to play weekend sports as adults? I mean, I'm a walker, so that would bum me out. So are you saying we need to, like, treadmill, work out indoors, work out at health clubs, that sort of thing?

Anirudh Rai, MD: I hate to say don't go outdoors. I'll be honest, because people do love going outdoors, and I'm a fan too. Hiking, all that good stuff. Particularly in seasons like this, I would say it's best to avoid the outdoors until you know it's clear. Usually your eyes do a pretty good job of determining if, you know, is their environment good.

Your sense of smell does a good too, and of course we have technology to help facilitate that. I would say if you're in an area where you have more smoke, if you have more particles, if you feel like there's something in the air, definitely get more information. Stay indoors until you get more information.

And I would say treadmill until you can, otherwise, uh, try to go to a more distant local gym or hike in an area where it's not being covered in that sort of residue.

Host: And what about if somebody is feeling that tightness, that fullness, you know, we've all felt that when you have a respiratory illness, or if you've been around, I don't know, in a city and behind a bus for a while, that kind of thing, you kind of feel that tightness, that fullness in your chest. What do we do if we feel that, or if we're wheezing or feel short of breath?

Anirudh Rai, MD: So I did fail to mention one of them would be our elderly population that's also at risk for these kind of scenarios as well. And usually in these scenarios, you would have wheezing, you would have coughing. I would say talk to your doctor, because sometimes having an inhaler in hand, just in case you, if your lungs are more prone to it, or are more reactive to these environments, can be very helpful to at least get you through it.

Inhalers do a good job of kind of expanding your lungs, so you're breathing a bit more, and sometimes it even expels a lot of these chemicals out too, just by that mechanism alone. I would say if you're in those areas or if you're more prone to it, talk to your doctor, they could actually get you connected with having an inhaler, get you connected with a pulmonologist too, to kind of see, Hey, are your lungs healthy?

Because it's important, especially in fire season, to maintain your lungs and to monitor your own health as well.

Host: Now I would like you to speak to the listeners, Dr. Rai, as we get ready to wrap up. And like I said at the beginning, you're just a great guest. I want you to speak to the listeners about the wildfires themselves. Sometimes these are spontaneous, so there's really nothing we can do. But if you were to offer as a doctor who sees people with these respiratory issues, when there are fires, your best advice about preventing wildfires, you're like Smokey the Bear, or really helping ourselves to stay healthy so that maybe we're not in that immunocompromised category where these fires are going to really affect us.

Anirudh Rai, MD: Fires in general, as we mentioned before, you're in Southern California, you're in pretty much the matchbox of during the summer, fires happen all the time here. Ideally being cognizant of where you are, where you're staying, what your limitations are, but more often than not, the best way to do that is actually to follow up with your main doctor.

Do some blood work, talk to them, they could do a full exam to kind of see, are you in those prone environments? Are you in a prone pathology? Are you immunocompromised? Do you have lungs that are strong? These are questions that your doctor could definitely answer and give you more insight about yourself as well.

The best thing to do, I would say, is be cautious, avoid essentially smoking in general, avoid any sort of particularly in the July era where fireworks are there, avoid fireworks unnecessarily if you can, because that can also cause fires. There are a lot of ways humans can prevent fires as well, but the most part you're right.

Most of these fires, I would say a lot of them, are essentially naturally made being cautious about it, being cautious about your family, but more importantly, talk to your doctor because it's important to know if your lungs are healthy or not, and the best way to do that is talk to your doctor to see if they get you connected.

Host: Great advice, Dr. Rai, as always, and you're very entertaining and informational and educational and all of those things. What a great guest. Thank you so much for joining us again. And to learn more about good lung health practices, please visit Henry Mayo Newhall Hospital's online health library and you can find that at library.Henrymayo.com. And that concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. And please always remember to subscribe, rate, and review It's Your Health Radio on Apple Podcasts, Spotify, iHeart, and Pandora. Until next time, I'm Melanie Cole.