When I was in third grade our teacher led an exercise to help non-asthmatics understand what an asthma attack feels like. She handed out tiny, red coffee stirrer straws and asked us to breathe through two of them. At the time, asthma was the only topic I considered myself an expert in and I remember raising my hand and saying, "No, this isn't what it's like at all -- it's like these straws, only in your lungs, and after a while it hurts."
With the smoky air and high temperatures we've experienced in Southcentral Alaska recently, I'm thinking daily about how to endure poor air quality as an outdoorsy person and asthmatic.
I experienced my first wildfire several years ago. I stood looking wide-eyed out my office window at the orange blaze sending billowing curls of smoke to the sky. I was in Reno, Nevada. The fire had started sometime that morning in the Carson Range, but still within city limits, prompting people living nearby to evacuate. I turned the radio on. I watched. I didn't get any work done. When I stepped outside, I smelled a rancid version of campfire. The air was thick with smoke. The light was orange. My eyes stung. My lungs felt pinched.
The next morning, smoke in the city, which is comparable in size and even shape to Anchorage, was worse. The radio advised "sensitive populations" to stay indoors. I sulked, and my husband teased me for being a "sensitive population." I have asthma, and my lungs are probably the weakest part of my body. When I get a cold, I get a chest cold. When I breathe smoke, it hurts.
Still, I am happy to say this is nothing compared to what my asthma was like as a kid. Between the ages of 7 and 13, I was admitted to the hospital for asthma attacks 18 times, taking doses of prednisone in the interim and utilizing three nebulizer machines, including a battery-operated one, for both parents' homes plus travel. One year I missed 130 out of 180 days of school. We treated my asthma attacks as they came up, but clearly my family struggled to understand the cause.
Asthma triggers
Asthmatic symptoms are caused by triggers, which a doctor once described to me using a cup metaphor. Up to a certain point, the cup can hold water (i.e. triggers). But once there are too many, the cup overflows, causing an asthma attack. It took my family and me a long time to identify my underlying triggers, eventually leading us to the biggest culprit: My school building. However, up to that point, like many other families with asthmatics we had to learn everything we could about managing my environment to minimize likely triggers. There were HEPA filters. I was allergic to dogs and cats (still am), so I avoided them. I lay my little pre-teen head down on hypo-allergenic pillows with plastic covering crunching under the pillowcase. There was no carpet or other surfaces in my room that could collect dust.
As an adult I still avoid dogs and cats, and I have a hard time in homes that are filled with knick knacks and all the dust that comes with them. I use a rescue inhaler before I exercise, but these are the only faraway remnants of my childhood asthma. Every time I complete a run, swim, hike, or bike I am sincerely amazed I have completed it, because my little former self is somewhere inside me, suspended in disbelief. The older I get, the stronger I feel -- lungs included.
That all comes crashing down when the air quality takes a turn for the worse and again, like my kid self, I feel helpless, wheezy, and trapped indoors. I have built a (mostly) sturdy alter-ego to my former self; an identity based in the outdoors, the opposite of where I spent so many years as a kid. I play outside. I need to be outside. When I can't be there, or when it hurts to spend time there, I feel lost. That's frustrating -- not just a little, either, but profoundly, glowering, I-am-having-a-terrible-day boxed in.
Living in Anchorage again and experiencing another summer of smoky air, I grow resigned to this new normal. Wildfires aren't just for interior Alaska or the desert southwest anymore. Caused by humans or nature, fires burn across Southcentral Alaska because it is drier and warmer than ever. I must figure out how to adapt.
Adapting to smoke
Luckily adaptation is my forte. When air quality advisories tell people like me ("sensitive populations") to stay indoors, I fall to the floor and yell, glare hard and long out the window into the weird light, and then make a Facebook post grumpily asking anyone if they have a spare gym pass. I experience the feeling of doomsday settling in around me in the form of slightly putrid looking and smelling air. I wonder how many refills I have left for my rescue inhaler, and how far away I'd have to go to breathe clean outdoor air. I become restless. I get twitchy. I become that person you hate sitting next to because they don't sit still.
After a day of smoke, I swim indoors.
After two days, I take a leisurely bike ride, trying not to work too hard and get out of breath.
And finally, telling myself a convincing story that the worst is certainly over, I go for a run. Again, I don't run too hard. I try to take kind of shallow breaths. I bring my inhaler. I ignore the burn in my throat and lungs.
This is desperation. What I'm supposed to do is stay indoors. In fact, some advice tells me to seek shelter in a fully enclosed, unventilated room at the center of my home -- and if I don't have that room, I should create it.
Masks don't work. They don't block the super-fine particulates in the air, the particularly noxious ones that do the worst damage to my lungs. Many ventilation systems won't work either because they don't have filters designed to keep out those very fine particulates.
Short of renovating my home, it seems that the best advice for "sensitive populations" is to limit outdoor exposure and exercise when it's smoky. This will take some doing. Alaska summers -- the good ones, anyway -- were not designed for being indoors, even if they're increasingly susceptible to widespread fire.
Alli Harvey lives, works and plays in Anchorage.