Concern about breathing trouble as a result of the California wildfires.

[Catholicnerd]

Hello, Doctor.  I'm a resident of a town in California, the site of a recent wildfire (in addition to the other fires burning through the state) that has deposited ash throughout the area over the past two weeks,  I am 23 years of age and in reasonably good health, aside from being slightly overweight and having GERD.  About a week ago I awoke in the  middle of the night feeling short of breath and unable to swallow mucous in my throat without the help of liquid, and this has reoccurred almost every night since. I feel like I am fighting against two hands that are pushing against me while I breathe in, but a pulse-oximetry test at my primary's office this past Wednesday reassured me that my breathing is still effective despite the discomfort.

At my appointment,  my primary noticed that I had swelling of the nasal passages and the throat.  He prescribed medication for my acid reflux and Mucinex D to relieve the nasal swelling/postnasal drip.  The Mucinex has indeed helped my nasal swelling a slight bit, and I am now able to clear a lot of the mucous in my throat.  What I've been coughing up, however, is sometimes filled with small pieces of what I think is the same ash that's been falling around the area, and the right side of my chest is very sore after I cough.  The pain has lasted for hours and the spot is sore to the touch.  In addition, I feel a slight burning sensation in my lungs for hours after coughing.  This started after I attempted some moderate exercise on Thursday morning, so I'm guessing that it's just muscle pain completely unrelated to breathing.  

My main concern is about the resistance I perceive that I am encountering when breathing and the self-presumed particulate matter in my sputum.  Should I seek the help of my primary yet this weekend, or is this something to be expected when there is moderate air pollution due to a wildfire?  Many thanks for your input.

[National Jewish Health]

From your description, you seem to be having a bad reaction to the polluted air, causing you to have non-infectious bronchitis and/or pneumonia, the normal pulse oximetry notwithstanding.  It appears also that, with the bronchitis, you are having significant bronchospasm, as a person with asthma might.  You should have a chest x-ray for if you have pneumonia, you will need more intensive therapy.  You could also have a condition called bronchiolitis and that too would require the use of more intensive medicine, including oral steroid medicine.

Regardless of what the x-ray shows you could benefit from the type of inhaled medicine used to treat people with asthma.

For the time being, you should avoid exercise, especially outdoor exercise.  You should stay indoors, be it at home or work with air-conditioning, and go outdoors only when absolutely necessary.  You should also ask your doctor to prescribe a mask to filter out particulate matter in the air.

Finally, if there is any way to reduce your exposure by going to a less polluted part of the state, for a while, you should do it.  If your condition worsens, you may have to see a lung specialist and, if you do, ask him/her about the above advice.

[Catholicnerd]

I should add elaborate a bit and say that the feeling of resistance while breathing in was initially a problem at night, then during both night and day, and now mostly at night, with some periods of relief.  In other words, it's fluctuating.