Poor air quality affects local patients with COPD

Respiratory therapists at Legacy Salmon Creek Medical Center were already worried about their patients when the temperatures started to climb earlier this week. But then the wildfire smoke blanketing much of Washington made its way to the metro area, leading therapists to brace for the worst.

“I’ve just been holding my breath and watching for names to come into our system,” Mike Morris, a respiratory therapist at Legacy Salmon Creek, said Thursday. “I don’t want to see my people today.”

Temperatures above 90 degrees and low humidity are problematic for people with chronic obstructive pulmonary disease, or COPD. Add in the smoke and smog, and the risk for flare-ups goes up even more, said Morris, COPD education coordinator at the hospital.

As of Thursday afternoon, only three COPD patients had been admitted for breathing problems. Another handful of people had arrived in the emergency department for breathing-related problems.

Morris worries that those numbers will go up.

“Hopefully, the heat’s keeping them inside by their air conditioner,” he said.

COPD is a chronic inflammatory lung disease. People with COPD have increased mucus production. When their lungs are agitated, that production goes up even more as the lungs work to wash themselves out, said Curtis Morrison, a respiratory therapist and cardiopulmonary supervisor.

In addition, the mucus is thicker during hot temperatures, making it more difficult to clear through coughing, Morris said. The mucus buildup can lead to shortness of breath and, if uncontrolled, can land the patient in the hospital emergency department.

One such example

That’s what happened to 85-year-old Joyce Hovis of Vancouver.

Hovis knew the air quality wasn’t good last weekend, when the temperatures started to climb, but she felt OK. On Monday, she watered her garden, picked vegetables, had company over for lunch and played pinochle. But once she got home after playing cards and slowed down for the day, she started having trouble breathing. By Tuesday morning, her condition has worsened.

“I knew I had to get to the hospital,” she said.

After rounds of medication, steroids and antibiotics for an infection, Hovis was feeling better by Thursday afternoon, but she wasn’t quite well enough to go home.

It had been nearly one year since Hovis was last hospitalized for complications with her COPD. Legacy Salmon Creek has worked to reduce 30-day readmission rates by educating patients who come through the emergency department about COPD triggers and creating action plans for handling breathing problems. Thirty-day readmission rates were regularly in the 20 percent range; now, they’re down to 8 percent, Morrison said.

That’s important because those flare-ups impact life expectancy.

“Anytime a COPD patient flares up, it’s doing more permanent damage,” Morris said. “Anytime they have a flare-up, their odds of making it through that year goes down.”

So as long as the temperatures are up and air quality is down, Morris and Morrison recommend people with COPD and other respiratory illnesses take precautions, such as staying indoors with an air conditioner, which acts as a filter, and making trips outside brief, perhaps even wearing a mask.

“It’s not a bad idea when conditions are like this,” Morrison said.