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Canadian wildfires are not going away. For many patients with alpha-1 antitrypsin deficiency (AATD) who are lung-affected, the question remains, how do the wildfires affect them? It’s going to look different for a lot of people, depending on the circumstances.

A lung-affected family member recently told me they might wear an N95 mask even though they aren’t in the worst part of the United States. They live at least 2 hours north of me. I had to think: had I taken any precautions? The answer was no because no obvious smoke seemed to be in my area. I live in the Ozarks, where it’s rare to hear of anything like that.

I certainly don’t smell anything. My sense of smell is not the greatest, but I surely would have noticed something. What I did notice is that this past week, I have had to use my inhaler over twice the amount I usually do, and I hadn’t been able to discern why. I wondered if that had anything to do with the smoke.

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Who knows, right? It’s hard to say. However, a couple of days later, as if to underline this thought, I read this article about how the smoke worsened in some parts of the country in recent weeks. I appreciate how the article notes the probability of this continuing for the rest of the summer. And those of us with AATD need to be prepared.

Read more about comorbidities in AATD

Patients with AATD all over the country have been discussing getting masks. Right now, it seems the N95 mask has the best filtration. The smoke particles are so fine, they normally come through a regular mask more easily. Plus, when I think about how much harder I breathe when I wear a mask, breathing in that much more smoke isn’t healthy. So, to me, the N95 seems like a good option.

And the kind of air quality we are seeing in the northeastern US is not good for anyone, let alone someone with lung impairment. So all the more reason to be aware of what’s going on. We need to decide if it’s really worth it to go in to work on a given day if the air is that toxic. If we don’t weigh the costs and benefits, we may panic and make the wrong decision.

Sometimes I put myself in the place of a single person living alone in New York City. Suppose the smoke is getting bad enough to affect me physically, but no one can tell from looking at me. Is staying home to protect my lungs going to be honored by my employer, or could it get me fired? Or if I go to work today, is it going to affect my performance?

I know if I expose myself to smoke for very long, I will have an asthma attack. It might be best to see what it does to me to really understand what’s going on before going in because I am very attached to my work. I imagine it would be hard to predict if my inhaler would actually work in New York City. So, I would want to do a test to check my responsiveness to the inhaler.

Read more about AATD guidelines

A forest fire was reflected in Okanagan Lake, British Columbia, Canada. Credit: Getty Images

These are the types of questions a patient with lung ailments must weigh and discuss with their employer and family, depending on where they live. This season will affect us all in the long term if we expose ourselves to this smoke daily.

I can’t imagine what it’s like to live in one of these more affected areas. I am sure the people who live there are thankful for wind changes. I know a lot of people are using air purifiers, which also come with various risks due to ozone production from some machines.

I’m glad I don’t live in New York City because I am sure my rescue inhaler would not be enough to drive to work without a problem. Right now, I am having a hard enough time with allergies, let alone adding smoke into the mix. I am taking all the allergy medicine I can possibly function on to get through the day.

My message to other alpha-1s is this: Know your risks. Please be careful about what you expose yourself to. Check your air quality app, and if you don’t have one, use for the local air quality. Come up with a plan for if/when the smoke blows your way. We’re gonna get through this, one way or another, together.