On top of all the other disasters hitting that jewel of a city, New Orleans, and surrounding areas, many of those in the area now have to deal the illness informally known as the "Katrina Cough". Thanks to the efforts of the city and state health departments, epidemics of the well-known post-disaster illnesses such as cholera or dysentery have been avoided. However, people in the region are now exposed daily to mold, fungi, dirt, dust, pollen and awful smells. Worse, the dust that might lie on the ground and normally not be a problem is being stirred up by all the construction going on, getting into the air where it can be breathed in. You can see the dust rise when the trucks rumble by. All these factors can lead to a host of respiratory and related problems.
It is
important to remember that odor or smell is a physical thing.
When you enter a room with an open bottle of perfume, those odor particles
are physical - they can be weighed, photographed, etc.
That's fine for perfume, but
the awful odors in the Katrina disaster areas indicate that the air is filled
with nasty stuff -- spore, dust,
mold, fungus, and decay particles, which are the kind that impair cilia function.
This is very serious, because sinus and lung cilia function are the
key to all respiratory health.
We
have a wonderful mechanism called the mucociliary flow. There are thousands
of tiny hairs covering membranes in your sinuses and lungs that act like oars
to move bacteria and dust out of the chest, nose, and sinuses. When the cilia
of the chest fail, however, the body tries to get rid of the foreign matter
by coughing. For example, a person
exposed to dust all the time may not cough, because their cilia can get rid
of the dust on their own. However, when the person breathes in an
unusually large dust particle, or an unusually heavy cloud of dust, the cilia
can't get rid of it, and they cough.
Certain infections of the chest also impair cilia movement and so there
is coughing all the time to get rid of any inhaled particles. Here the doctor
tries to thin the mucus (so the particles do not get stuck in a thick mucous which the cilia cannot move) as
well as get rid of the infection.
In
the Katrina disaster areas, people are inhaling all kinds of particles and
odors and some of these are inhibiting the cilia by irritation, allergy, etc.
The particles may also be so numerous that just by their very number
they impair the cilia. It's a
double whammy though: just as the chest cilia are impaired, so are the nasal/sinus
cilia as well, and both the chest and the sinuses are susceptible to disease,
will have thick mucous, etc. This happened to 9/11 rescuers, some of whom
haven't recovered yet.
Katrina
Cough symptoms include a dry cough, runny eyes, runny nose, nasal / sinus
headache, sore throat, chest tightness, and fatigue.
One
approach for Katrina cough is to use cough suppressors to stop the patient
from coughing. This may not be a good idea, because you do want to get the
particles of nasty stuff out of your lungs.
A better recommendation is a two-step approach, reduce the number of particles
inhaled by using a mask or nasal filter, and in addition, wash out the particles
from the nose and sinuses with pulsatile irrigation
(or at least a saline wash until you can get proper
pulsatile irrigation).
For filtering, an N95 filter mask in essential. Some N95 nasal filters are also avilable which allow you to
speak and breathe normally. A painter's mask is worse than no mask, as particles
may be trapped in the mask, and you just collect and re-breathe them.
Why pulsatile sinus irrigation? You can't
do anything for the chest if the nasal and sinus cilia are unable to filter
out new material being breathed in.
Also, pus from the nose can eventually irritate the lungs. If you can
get the cilia of the nose and sinus back to proper function, then the body
can start filtering out some of the nasty stuff, giving the lungs a break. Blowing your nose, decongestants etc.
may get rid of some symptoms, but they aren't effective at getting the cilia
moving. Anything you can do to
increase cilia movement is also helpful.
Drinking warm tea with lemon and honey, though not high-tech, is an
effective means of speeding ciliary motion.
For
persistent cough, steam inhalation with your tongue out gets warm moist air
into your lungs and may be helpful. On the other hand, using a steamer in
your home in these areas may add moisture and encourage the mold. If you are trying to fight mold in the
house, you might try to get one of the steamers that fits over your nose and
mouth and prevents much steam from entering the room.
What Can I Do About My House?
Mold
is a major problem after a hurricane. A good exhaust fan is the best mold reducer.
Heating the basement helps too. Do not attempt to salvage and keep
rugs. Most experts feel these can't be saved.
A light bulb in the closet is a mold reducer. Use Clorox and bleach for removal
of mold from surfaces, but be sure to wear gloves and an N95 mask when you
do this work. Be sure to run
the fan during and after shower or bath to avoid feeding moisture to the existing
mold. The fan should be an exhaust
type to remove the condensation (don't just blow the moisture around your
house, get rid of it). Make sure
there are no leaks into the house from sprinklers or rain. An exhaust fan in the attic is a must.
More You Can Do for Your Cough
If
you have the Katrina cough, smoking and being around construction will make
you worse. If you must do construction,
you must wear gloves, use an N95 mask, and you absolutely must do nasal irrigation.
I recommend every four hours. Irrigation will remove the dust and other particles from
the nose and encourage cilia function. If you do not have access to a pulsatile irrigator at
the construction site, use any kind of saline nasal irrigation at the very
least, but get to a pulsatile machine as often as possible. Remember, some molds can affect the skin,
with itch and rash, hence the need for gloves.
Persons
who already have allergies and asthma are much more liable to get symptoms
by returning to New Orleans. Health authorities advise these people to stay
away.
Treatment
If
you exhibit a tight chest, you MUST get medication. Usually a bronchial dilator
does the trick. For chronic nasal symptoms, pulsatile
irrigation with a proper, purpose-built machine is the best treatment
for stimulating your sinus cilia. If
this is not available, at least irrigate with saline until you can get this
treatment. The primary disorder of the Katrina cough is most likely to be
impaired cilia and the longer they remain impaired, the more possibility of
long term nasal/sinus disease. Many persons after 9/11 did not use pulsatile
irrigation or other means to restore cilia function and are still symptomatic
today.
Don't
forget that warm liquids such as hot tea and chicken soup stimulate cilia
function, but that smoking inhibits this function which is essential to your
health, and essential to getting rid of your Katrina Cough.
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Last Update 2005 Nov. 28
Murray Grossan M.D.
ENTconsult@aol.com