Opinion
Lake County is geographically situated in a basin, and smoke does not dissipate quickly. Smoke was especially bad in our neighborhood, possibly because the surrounding hills trapped the air. Neighboring homes were visible only through a smoky veil months after the fire storm.
Inhalation of polluted air can result in a toxic injury to the airways, which may cause changes in some people similar to asthma (technically, fibrosis and T-cell activation) and can be experienced as coughing, bloody cough, shortness of breath, reduced lung capacity or related symptoms.
If reaction to airborne toxins is immediate or exposure is severe, the ensuing condition is called Reactive Airways Dysfunction Syndrome (RADS); if exposure is spread out over time or is a lower level of toxin, the reaction is called irritant induced asthma (IIA). The medical establishment does not uniformly recognize the second definition, so chronic or low-level exposure is often called “low-dose RADS.”
Both diagnoses agree, however, that symptoms appear fairly quickly upon exposure (usually within one to 10 days), so if someone has symptoms appearing weeks after exposure has ended, RADS is likely not the cause of lung distress. Both RADS and low-dose RADS are similar to “occupational asthma,” like the condition suffered by firefighters or clean-up workers in a chemical spill. And instances are on the rise.
Many people will recover completely, some may take as long as six months to two years to become free of symptoms, and some may develop a persistent asthma-like condition. Many will remain vulnerable to further toxic exposure like smoke or chemicals.
A summary prognosis of RADS is given by Environmental Health Perspectives (EHPonline.org):
Patients that seek timely medical help often have excellent recovery. Some patients do experience ongoing night-time symptoms, and may intermittently develop acute symptoms for some time. Some patients that are prescribed corticosteroids may develop steroid dependency.
Understanding of RADS could save time and money in diagnosing sufferers. Often, this irritation does not show up on x-rays, and usually all other options are ruled out by expensive medical tests before RADS is considered. This delays the treatment of symptoms so that the body can begin recovery. The accepted short-term treatment is corticosteroids, which treats symptoms only, by reducing inflammation.
There are implications for local health officials if, as I suspect, others in the county experienced similar ailments. The county’s health department could ask local doctors to report increased complaints of any unusual nature, and officials could review methods of informing the public about air warnings and health measures. Perhaps the dangers of smoke inhalation could be made part of the county’s fire prevention program.
Individuals and caregivers could benefit from a public education program that addresses masks, air filters, keeping doors and windows closed on “bad air” days, and how to keep informed about local air conditions.
For further information, see the following.
Corticosteroids for chronic obstructive pulmonary disease (COPD):
www.questdiagnostics.com/kbase/topic/detail/drug/hw165533/detail.htm
Inhaler Eased Lung Problems in 9/11 Workers/Firefighters who used drug early gained some symptom relief, study found:
Occupational Asthma: A Review:
www.ehponline.org/members/2000/suppl-4/697-704lombardo/lombardo-full.html
Reactive Airways Dysfunction Syndrome (RADS) and irritant induced asthma (IIA):
http://toxicology.leadingexperts.com/rads.html
Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures:
www.chestjournal.org/content/88/3/376.abstract
Short-term Effects of Wood Smoke Exposure on the Respiratory System Among Charcoal Production Workers:
www.chestjournal.org/content/119/4/1260.abstract
When Asthma and COPD Coexist
www.copd-international.com/Library/asthma-coexist.htm
Janis Paris lives in Spring Valley.
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- Written by: Lake County News Reports
Tuesday's fiscal report to the Board of Supervisors lists an obscene, ongoing millions of dollars spent by Lake County on an aggregate of residential treatment in other counties, hospitalizations in other counties, incarcerations (of Lake County's mentally ill) and on board and care facilities in various locations, including one local one.
Kristy Kelly, director of Mental Health Services, explained that persons exiting board and care where clients “lives are laid out for them” are simply not equipped to occupy any other housing available in Lake County. She notes the Lighthouse project as an example: It assumes an independent level of functional ability. When clients return to our community from any number of locked, residential, or board and care facilities, they face the immediate bleak fact that there exists no proper level of care for them here. It's either “all laid out for them” or it does nor exist – not at all – for our most seriously mentally ill.
This is the fast road to institutional recidivism. It also costs Lake County an incredible amount of money.
Supervisor Anthony Farmington conjectured out loud to Kelly today that “residential treatment within Lake County has probably already been discounted as a solution based on some analysis or other?” “No” is the answer to that. “Residential care has not been cost evaluated because,” according to Kelly, “we do not have enough staff.”
Hmm.
On Tuesday I shared with the board my personal story and passionate plea for sound crisis intervention including the staffing (rather than layoff) to create a local crisis center. Imagine a mission to prevent hospitalizations and wrongful incarcerations. The Lighthouse could be such a place (not included on the list of deficit spending that the board received Tuesday). Envision a clinically supervised stabilization center skilled in suicide prevention, contracting for safety, family crisis counseling, and a day program to provide that vital missing link: the intermediate development of essential skills, that practical community bridge, locally situated, staffed with eight county employees whose names and lives are slated to a chopping block instead.
I shared this: My daughter was incarcerated for two months (charges dismissed due to mental illness), two hospitalizations in another county, and just returned home this week from two months in board and care. All this ensued since last October when our pleas for crisis prevention were denied expressly for reasons of “understaffing.” Today the only thing that stands between my daughter and a return to costly institutional care rests with In-Home Supportive Services, a funding put at imminent risk today as Lake County Mental Health raids Social Service funds to pay the jail or the hospital. This means, if IHSS funding is cut, she is at immediate risk. Again. Tuesday I learned how much Lake County went into debt over my situation since last October; I wonder how much they saved by not providing crisis intervention six months ago.
If you or your family are affected by these issues, please contact me at 707-355-9209 and share. We are returning to the process of reestablishing a local National Alliance for the Mentally Ill (NAMI) in Lake County. This was initiated last summer, but I dropped my ball last October and I'm sorry for that. State Mental Health Funding (MHSA) from Sacramento requires that local agencies carefully consult consumers and their families in planning expenditures to address the right needs. Let's talk.
Sarah Shems is a social worker who lives in Hidden Valley Lake.
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- Written by: Sarah Shems
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