Smoke and smokers

[runcyclexcski]

Hi all --

Assuming your asthma is well controlled (via Xolair or your inhaler of choice), do you still get symptoms if exposed to smoke (e.g. a nearby fire), or from being near smokers? I have a respirator mask with me at all times, but it still takes a few breaths to realize there is an issue and to react. Today there was a fire next to my office. The air supply is not filtered (need to install an intake filter there). The smoke was not major (clear sky etc), but I could smell it, and after 4-5 breaths I started getting chest-tight. It's good that I was able to take the blue inhaler, go home, and retreat into my HEPA tent. But the thought of always being vulnerable like this (and that a fancy drug and my respirator/tent are the only things that keep me alive), is unnerving. I am on Xolair, so I thought I could deal with at least some minor challenge like this. In the winter, people burn wood all the time just "to stay cozy".

[floating_]

I do, but smoke is an irritant to normal lungs, so asthmatic ones are more likely to be adversely affected.

I'm typically well controlled with Xolair and Relvar/Spiriva. Plus antihistamines. My Prednisolone usage is now just a replacement dose for my AI.

[Gareth57]

strangely wood smoke rarely affects me, recently I'm burning some wood not to stay cosy but to take the chill off as the central heating is too expensive (gas was costing me a small fortune before the big hikes in price and before our income dropped)

[runcyclexcski in reply to Gareth57]

Hi Gareth -- sorry for the judgmental quotation marks about wood burning to stay cozy. I mostly experienced this when running/walking through posh neighborhoods where, it appeared, the cost of central gas was not an issue.

[Lysistrata Administrator Community Ambassador]

I'm not sure that Xolair is going to help you or anyone much with something like wood smoke. It's not really an allergen or such (well, I suppose there might be an element of that if someone was burning plants an asthmatic was allergic to!) It's more of a direct irritant, and that's going to bother many people with a tendency to twitchy airways even if their asthma in general is non-allergic like mine.

I'm not properly controlled at all but I have my ups and downs and I've found if I'm relatively ok then it takes more to set me off, and some smaller triggers will be less of a problem. So if I'm doing ok my lungs might notice, but not be majorly affected by, walking past a smoker on the street or very brief exposure to a fire. Other triggers will affect me much more however good I was to start with - that would be being close to a smoker for more than just walking past/in a confined space, or being around woodsmoke or a fire for longer. I was definitely affected recently (needing several nebs, though not an admission or anything) by being at an outdoor play where they set off pink smoke things- glad it wasn't inside (or maybe they wouldn't have done it inside?)

As an aside, I also find theatrical 'smoke' an issue - the pink things weren't that, and I know theatrical smoke isn't really smoke (dry ice I think?), but my lungs still don't like it and it seems very popular in a lot of productions! Probably a good job I'm not in showbiz, I'd never manage all that plus the hairspray and deodorant etc backstage.

[peege in reply to Lysistrata]

Absolutely the same here with the theatre smoke! There was some the other week in the new Ian Hislop play on the life of Spike Milligan. It's worrying enough sitting so close to others in a theatre..... those herbal cigarettes they sometimes use in theatres are awful too.

P

[beech in reply to peege]

Funny you saying that; I’ve just been to see that play tonight and my immediate thought on seeing that ‘smoke’ was “Oh no!” for exactly that reason. Luckily there wasn’t much, and the theatre was moving the air out and stopping smoke drift that I could tell!

[runcyclexcski in reply to Lysistrata]

Lysistrata -- do you think acetylcholine reflex disruptors might prevent this twitchiness? I still haven't tried them. Generally, I find that, as my asthma gets better, the time delay between the initial exposure and the onset of feeling bad gets longer (it used to take < 1 min, and now it takes 10 min to get sick, and the degree of sickness is less). So on Xolair I have the time to react, and to take the blue inhaler (the latter takes 15-30 min to work for me).

How do you cope -- do you have a respirator with you at all times?

Another setting in which smoke is frequent is camping. Most people think that one absolutely must burn some trees to experience "proper camping". For that reason, I never stay at campsites, and just try wild-camping. Liquid white gas fuel works fine for cooking and is smoke free (all my Ti pots look clean).

[Lysistrata Administrator Community Ambassador in reply to runcyclexcski]

Do you mean antimuscarinics like tiotropium (Spiriva)? I'm on Spiriva and it's great, probably helps me be less twitchy overall - ipratropium also helps if things get worse. However, I can't think of anything that's going to stop me reacting to major smoke triggers. I don't personally experience the time delay thing, it's more about intensity I find, but I'm not on a biologic and of course there's a lot of individuality in how people respond to triggers.

I don't have a respirator no - I just deal with it as it comes. I do have a home nebuliser and my portable one is very small and powerful if I need to deal with anything (fully sanctioned by my consultant and I don't overuse it, for anyone else reading!)

I'll take your word for it on the camping, as I have no desire to do that in any form!😅

[runcyclexcski in reply to Lysistrata]

I should ask my nurse about tiotropium. I am about to have my next cortisol bloodwork done (to authorize the move from 3 mg to 2 mg of the dope... i.e. prednisolone ), so it's a good chance to ask. Maybe will help with EIA as well.

[Itswonderful]

sorry you had this experience. If I walk past people who are smoking it effects me and there have been times I’ve just had to go home and start prednisone. I had a conversation with speech and language at the Brompton a couple of weeks ago about this. They have offered me a face to face appointment to have a test to see what happens when I’m exposed to cigarette smoke and other things so they can give me tailored techniques to use. Maybe something like this would be of use to you?

[runcyclexcski in reply to Itswonderful]

>>> I’ve just had to go home and start prednisone

How did you avoid this -- do you have to stay vigilant at all times? I avoid crowded areas in European cities for this reason.

[Itswonderful in reply to runcyclexcski]

sorry to hear this. Yes I’m vigilant and I avoid! I carry a theee layer filter mask with me when I’m out then if I do come across smokers etc I put it on. No one takes any notice of people wearing masks anymore so it’s easy. Like you I also avoid crowds!

[runcyclexcski in reply to Itswonderful]

Sounds very familiar! If there was a technology to implant an efficient filter inside of my nasal cavity, I would do the surgery. I used to use nasal filters (made of fine foam at about 80 holes per inch), but they restrict the air flow and are not as efficient as FFP3/carbon face masks.

[Itswonderful in reply to runcyclexcski]

thank the Lord for face masks then! Take care.

[AutumnHedgerow]

as far as I understand the particulates of wood smoke are dangerous for everybody not just us and will be subject to legislation under the clean air act I believe. But no idea when. Presumably not for now as would be a political hot potato under current fuel cap crisis.

[runcyclexcski in reply to AutumnHedgerow]

>>> Presumably not for now as would be a political hot potato under current fuel cap crisis.

So true.

The particles are dangerous to all, but for most it's a "slow-burning" ailment caused by smoke, not an acute one like for the asthmatics. For that matter, they would also have to ban BBQs, and that is probably even harder politically :).

[AutumnHedgerow in reply to runcyclexcski]

…. And bonfires!

[Tree20862]

I still have symptoms but I do not have as severe as reaction as I did before I started Xolair. For me Xolair does not get rid of my asthma but it does decrease the reaction of my lungs to irritants like smoke or allergens.