breathe

While I have previously dealt with the side effects of smoke inhalation from wildfires in my practice, never in the volume, length or intensity of this year with the smoke from Wallow fire (as well as that from the Horseshoe and other surrounding fires this year). The issues experienced as a result of or triggered by the smoke were exacerbated by both the incredible dryness (1-5% humidity many days this Spring) as well as a hard, cold winter during which there was a higher incidence of bronchitis, pneumonia and related respiratory dysfunction than I’ve seen in my seven year practice here.

This post applies generally to any situation in which there is exposure to smoke, especially from a wildfire. You’ll notice an emphasis hot, dry respiratory diagnostic patterns which is due to my climate and the conditions I see in clients most regularly here.

Overview & Etiology

Smoke is considered a noxious stimulant to the human respiratory system and can potentially trigger allergic type reactions especially in those with a existing respiratory or immune system vulnerabilities. Wildfire smoke is a combination of particles and gases, both of which can cause irritation and damage to sensitive mucosa.

One of the primary concerns when dealing with prolonged exposure to smoke is pulmonary irritation. This irritation can result in injury to the tissues and bronchial spasms as well as triggering inflammation as an immune response that can lead to a wide range of other symptoms. Joint pain, skin disorders and any autoimmune conditions (among myriad other issues) can flare up during exposure to smoke because of the immune response. Yes, that immune response can be an appropriate measure when the body is faced with such an irritant but those with chronic disease, weakened health and the very young or old may have difficulty adapting and thus fare better with herbal support and nourishment as well as appropriate nudges in the direction of health.

Those with preexisting conditions such as asthma, pulmonary obstructive disease, emphysema, heart disease, chronic sinusitis or even seasonal allergies will be extra susceptible to respiratory distress, as will the very old and very young.

Coughing, bronchial spasms, overall inflammation of the respiratory tract and fatigue are some of the most common symptoms seen in situations of either short term or long term exposure to smoke.

Irritation and injury from smoke inhalation can easily become chronic if not addressed immediately or better yet, prevented wherever possible. Here are a few of the common symptoms seen in this situation:

• Coughing or wheezing

• A scratchy throat

• Irritated sinuses

• Shortness of breath

• Rapid heartbeat

• Chest pain

• Headaches

• Stinging, burning, watering eyes

• A runny nose

• Nosebleeds

• Headaches

Preventative Measures

• Remain indoors. Yeah, you won’t hear me say that very often but especially if there is a pre existing vulnerability, it can be very important to avoid unnecessary exposure to more smoke. I’ve also noticed that the air quality by the river among the trees seems significantly higher than in other areas. There is likely still some amount of particulate matter in the air, but it certainly seems lessened.

• Don’t increase particulate matter in the air – This includes not lighting candles, woodstoves, fireplaces, cooking food at high temperatures on the stovetop and not vacuuming. All of these activities either increase or create particulate density and circulation in the air.

• HEPA filters or even air conditioners with filters and recirculating air can help cut down on particulate matter in the air indoors. Do NOT use an air conditioner or swamp cooler if it doesn’t have air filters or it will only suck in smoke and make breathing conditions worse.

• Dust masks – these help with larger particulate matter in the air but not with the gases and finer particulate matter. Firefighters give dust masks mixed reviews but in general I don’t think they provide enough protection to justify exposing yourself to more smoke.

• Stay hydrated. Instead of sports drinks or energy drinks, try a nourishing infusion or a cooling infused vinegar (berry and/or mint vinegars are great this way) diluted in cool water with or without a bit of honey. Lemon kvass is also a great choice.

• Avoid unnecessarily exerting yourself. Heavy breathing means you’re going to suck in more smoke. Avoid it if possible.

• Take extra precautions to avoid cigarette smoke. This seems obvious but when I mention it to clients they often tell me “but it’s a different kind of smoke” which is somewhat true but the cigarette smoke still serves to exacerbate the symptoms of wildfire smoke inhalation.

• Be especially conscious of breathing conditions for children and pregnant women.

• Leave the area. No one wants to leave their home, especially if it’s in danger from the fire but some health conditions may require you take a temporary leave of absence in order to prevent greater risk to your respiratory/immune/cardiovascular systems.

Nutritional Considerations

Eat Well – I can’t stress how important it is to be eating high quality whole foods such as bone broth whenever the body is under stress, especially any long term type of stress. The body will be in extra need of nutrients and minerals and as helpful as some supplements can be, they’re no replacement for real food. I also think that daily nourishing infusions of herbs such as Oatstraw or Linden are exceedingly helpful here as well.

Anti-oxidants – Smoke causes inflammation via oxidative damage so anti-oxidants seem like an excellent choice here. In addition to your standard supplements, many herbs and plants foods contain copious amounts of Vit C and other anti-oxidants. Rose (leaf, petal, fruit), Elderberries and Stinging Nettles  are all great choices that can be used as food, beverage and medicine.

Vit D3 – Supporting the immune system is especially important when dealing with smoke inhalation. 10,000 iu/day is a good daily dose for most adults, especially those who have been diagnosed with a deficiency.

There are many other options here, and you can figure anything that supports cardiovascular, immune and respiratory health will be helpful here.

Herbal Therapeutics

There are of course many more plants than those listed here that can be helpful in similar situations, my choices are made based on availability, sustainability and clinical experience. I’m also attempting to keep the list short and straight forward, primarily referencing common weedy plants or those that are widely available.

As per usual, I choose to share what I have personal experience with, and there are certainly more resources available with many great ideas. I love hearing new suggestions and ideas but I don’t actually use them in my writings/teachings until I have firsthand experience with them.

Respiratory Demulcents

Elm – Ulmus rubra, Ulmus pumila and allied species – The mucilaginous bark of this amazing genera of trees is one of the most useful overall constitutional moistening tonics I’ve ever worked with. I harvest my own and find it fairly impossible to grind to a powder so primarily work with it as a cold infusion to extract the most mucilage possible. It’s slimy and gooey but also mild and sweet tasting and wonderful as a daily nourishing infusion during fire season (and beyond). I especially like it mixed with Mulberry leaves for this purpose.

Mallows – Althaea/Malva and allied genera – Similar in many regards in this context to Elm but more cooling overall and easier to grind up. I use the dried leaves and flowers in infusions and the powdered root in honey pastes and as a gruel to help moisten the lungs and relax tense, dry tissues.

Respiratory Relaxants

Purple Sticky Aster/New England Aster – Dieteria bigelovii, Symphyotrichum (formerly Aster) novae-angliae – I’m not sure what other genera and species this action might apply to as my experience is limited to these two specific plants. In both cases, the plants are resinous, aromatic and sticky and it is at least partly this resin that seems to be responsible for their medicinal actions.

I first learned about Aster from jim mcdonald and he has a great writeup on Aster novae-angliae here http://herbcraft.org/aster.html.

He specifically says:

“The tincture seemed clearly indicated as a respiratory remedy, being uniquely clearing, relaxing & decongesting to the head & lungs.  This effect is clearly apparent when taking a bit of the tincture.  It seems to act very effectively to break up stuffy lung and sinus congestion, though as it’s not especially astringent, it doesn’t stop a drippy nose as well as, say, Goldenrod. It is, however, uniquely antispasmodic for the lung tissue; it relaxes and dilates the respiratory passages.”

This seems equally true of our local Purple Sticky Aster, which smells like a cross between Lavender and some sort of sticky baby shampoo. This has been primary remedy in many respiratory cases with symptoms of respiratory tension and congestion both in this past cold season’s bronchitis and related resp. distress as well as this year’s fire season.

Clinically, I have seen a simple of Aster flower tincture both reduce and eliminate the need for inhalers during allergy and fire season. I’ve also seen it dramatically reduce chest tension, wheezing and shortness of breath in those with mild to moderate asthma during exposure to wildfire smoke. This often works well both symptomatically and long term. More on this plant soon, as I’m in the process of writing an entire monograph about it.

Lobelia inflata – Lobelia inflata isn’t local to me but it’s such an incredible respiratory relaxant/anti-spasmodic that I always keep it on hand. I use the seeding aerial tops in a great many respiratory tincture formulae but also as a straightforward simple for treating symptoms of respiratory tension, spasming and the inability to take a deep breath. Just a few drops can work its magic. Despite its lingering bad rep in some circles, Lobelia in a normal dose (2-7 drops) can be safe and effective in children. This fire season I’ve carried a bottle with me at all times which I often end up dispensing while in the village.

Mulberry – Morus alba – I first learned about the incredible usefulness of Mulberry leaves for smoke induced respiratory distress from herbalist Cory Trusty and have been grateful to her for it ever since. The dried leaves as a tea or the fresh leaves as an elixir or tincture are cooling and relaxing, helping to drain heat and relax tension from the whole respiratory tract. This is an herb used in TCM for the treatment of asthma with lung heat and I can’t emphasize enough how useful it is during (or as a preventative measure before) exposure to wildfire smoke. Additionally, I find this to be a great (but gentle) diuretic for those who suffer from heat related edema in their extremities, especially that exacerbated by respiratory issues as well as systemic inflammation with heat signs. Other parts of the plant also make amazing medicine but I’ll save that for another time, as this common plant certainly deserves a post all its own.

Peach – Prunus persica – Cool, sweet and moistening, Peach leaf is broadly applicable for all sorts of respiratory tension and heat as well as the immune hyperfunction that can occur in response to wildfire smoke. The tincture, elixir or even just the tea made with the dried leaves all serve admirably.

Respiratory Stimulants

Note: I tend to use respiratory stimulants such as Osha in formula rather than as simples during fire season since they’re often somewhat warming and drying and can exacerbate symptoms if not used carefully and specifically.

Elecampane – Inula helenium – Many people consider Elecampane a general lung cure all and in deed its range of use is broad, deep and time-honored. Although most people tend to be dry and wheezy rather than wet and wheezy during fire season there are certainly cases where folks are having a hard time expectorating mucus and there’s a sense of oppression and dampness in the lungs. This is a symptom pattern indicating Inula and here it can be used as a simple or in formula.

Ragweed – Ambrosia spp. – Ragweed is more neutral energetically and the aerial tops harvested pre-flowering can be a lifesaver for those with asthma accompanied by lax tissues and free-flowing secretions. Being an astringent as well as stimulating, it tends to be very effective in promoting expectoration while simultaneously lessening the overall volume of secretions.

Osha – Ligusticum spp. – Warming, drying, aromatic, bitter and diffusive, Osha is something of a magical plant (actually, I haven’t met any non-magical plants yet) in many ways. In this context, it’s excellent at preventing infection or chronic congestion during and after exposure to smoke. It’s a strong herb and I tend to blend it with something moistening and cooling like Mallow during fire season.

Mucus Membrane Tonics

Spanish Needles/Beggar’s Ticks – Bidens spp. – A common and often cursed weed, the cooling Bidens are called for where the mucuso has become dry, lost its pliability and elasticity and has become prone to infection and inflammation. Bidens, especially when taken consistently over time, has the ability to restore both “juiciness” (to quote Henriette Kress) and tone to the mucus membranes and thereby reduce discomfort, irritation, hyper-reactivity to allergens, excessive fluid loss and chance of infection. Mucus membrane tonics can also help reduce the occurence of nosebleeds (as can demulcents).

Goldenseal – Hydrastis canadensis – Not being local to me, I use Goldenseal very (as in extremely) rarely. When I do, it’s because I need a cooling remedy that works as a mucus membrane trophorestorative, which is truly Goldenseal’s greatest medicinal application as far as I have seen. Like Bidens, it helps to restore tone and function to the mucosa:

“The whole drug… appears to stimulate the respiratory and circulatory apparatus, imparting increased tone and power.”
– King’s American Dispensatory

Yerba Mansa – Anemopsis californica – Unlike the two previous herbs in this category, Yerba Mansa is warming and aromatic and I find it more appropriate to cases where long term mucosa infection or inflammation has caused the tissues to become boggy, drippy and achy. Where there are existing heat signs I’m apt to blend it with Bidens or some Mallow.

Immune System Tonics with Lung Affinities

American Spikenard – Aralia racemosa – This plant, especially roots or berries, seems to act as a mild adaptogen with a particular affinity for the mucosa and respiratory tract. It works best when given long term, especially where there are signs of fatigue, chronic inflammation and overall deficiency. I’ve used as a tincture, elixir, infused honey and decoction and all preparations work well, the key is consistency over time.

Reishi – Ganoderma lucidum – A strong decoction of Reishi is excellent for lessening inflammation and nervous system reactivity while increasing lung capacity, endurance and energy. Like Aralia, Reishi is an adaptogen with an affinity for the respiratory system. As such, it is best used consistently over time. Reishi has a huge arrange of application but is phenomenal in the context of wildfire smoke exposure because of the way it increases energy, decreases inflammation, calms the nervous system and serves to protect and heal the lungs.

Tissue Healing Herbs

There are a great many herbs that work as general tissue healers through various actions, any of these that suit you would be beneficial added to a nourishing infusion, here are a few to consider: Plantain, Evening Primrose (Oenothera spp.), Oatstraw, Nettle, Mullein, Elderflower, Rose petal/leaf, Alder leaf and so many more.