From WXXI news.

This is connections.

I'm Evan Dawson.

Our connection this hour was made on Tuesday afternoon when our region was generally under cloudless skies.

A beautiful day, first week of June.

Lower humidity should have been a blue sky day, but it wasn't.

Instead, there was a now familiar haze in the air.

The product of Canadian wildfire smoke.

For us this week, the smoke hasn't been bad enough to cancel many activities for other parts of the country.

It's been significantly worse.

PBS reports that Canadian wildfire smoke triggered air quality alerts in the Midwest, where conditions in parts of Minnesota, Wisconsin and Michigan were rated very unhealthy.

On Tuesday.

The fires have forced more than 20,000 27,000 Canadians in three provinces to flee their homes, and the smoke has now reached Europe for the last couple of summers, we've dealt with wildfire smoke.

On occasion, 2023 was really bad.

There was that one day when Manhattan looked positively Martian.

Some days you could taste the smoke in the air.

That smell and taste of smoke was back in Minneapolis yesterday.

But not necessarily here.

Not yet.

So what do we need to understand about the wildfire smoke this year?

Is this now an annual event after all this rain we've had?

Are we really going to cancel outdoor events because of smoke?

And what about the health risks?

Hospitals from Iowa to Minnesota saw more patients this week, PBS reports because of respiratory symptoms aggravated by dirty air.

Let me welcome our guest this hour.

Someone brought visual aids.

If you're watching on YouTube, Tom Royalty is a resident media scholar at Saint John Fisher University, and he's a local resident who has dealt with asthma for decades now.

Yes, I'm 79 and my first asthma incident probably was at four years of age.

We were driving to Buffalo, New York to visit my uncle, who was in medical school, and my mother started peeling an orange.

And right around Batavia, I realized I was having a lot of trouble breathing, and my father put the car into high gear and we knew we were going to visit a resident.

He was a physician and really popular locally.

He delivered about 4500 babies locally.

His name was Doctor Charles Marino, one of my heroes, one of the smartest humans I ever met.

And I'll never forget being in this scenario of not being able to breathe or feeling like you're not being able to breathe.

And and then all of a sudden, somebody gave me a shot of adrenaline.

You know, this I learned much later in life and, you know, it's better.

It's sped up my entire system and it allowed me to start breathing again, including your heart rate, everything.

And I probably was like John Glenn getting ready to take off was probably at 180 beats per minute.

Yeah.

So I mean, treatment is changed.

We're going to be talking about that.

We're going to talk to Tom how he's been.

By the way, I'm even though we've been dealing with the smoke.

You played 18 holes this morning.

Did it I did yeah.

Okay.

Well you know very early on out because my uncle was a doctor and because there were doctors in our family and in our circle of friends, I was put in to early studies about desensitizing people.

So I used to get for 27 years, I used to get three shots in each arm of things that I was allergic to.

So pollen, cat dander, whatever.

Thinking the theory was, it would that it would, it would desensitize me.

we're not quite sure that ever really worked, because at 20 during that period of time and and after 27 years of receiving the shots, my condition didn't seem to change all that much.

What changed a lot was medication.

Things like singulair the I, which I brought along.

There you go.

There's a that's now it's called Mount Lucas as the generic version.

And this is a real ultimate game changer that, you know, was developed in my lifetime.

The albuterol, inhaler.

And then for me, this is just me personally, Vicks VapoRub put a little bit inside my nostrils and and I'm much more gold and camphor inside your nostrils.

Yeah.

Camphor.

Camphor works wonders for some people.

Okay.

And also, counterintuitively, I had a primary care physician, doctor Michael Pacino.

And again, people, locals might recognize this name.

but the allergist at the University of Rochester told me I had to take it easy, and I should do this, and I should lay down on a sofa more often and not go outdoors, especially at this time of year.

And doctor Placebo, I went to tell him and he, my mom and dad were there and I'll never forget looking at him.

He goes, do whatever you want to do.

And I said, well, I want to play football, basketball and baseball.

He goes, do it.

It was all counterintuitive, and I asked my uncle.

I said, you know, doctor Mike said I should do it.

And the allergist said I should kind of be.

It was the time when a lot of kids were getting polio.

So asthma, polio, they were both debilitating kinds of scenarios in asthma, not nearly as much.

So and I went ahead and did it, and it didn't seem to make much difference.

In fact, if anything, I think it probably helped me.

And again, counterintuitive.

Sure, sure.

You know, one that one doctor said this, another doctor said that.

Yeah.

The other doctor, the allergist kept me on the pills for 20 years, not on the pills on the, on the injections for 27 years.

And, you know, I'm still alive at 79, I play golf, I, you know, I'm really active.

10,000 steps a day.

Wildfire smoke is not going to stop this man.

Well, you know, but I do feel I do feel it in this year.

You know, I can't wait to hear what Eric has to say because I have.

I don't think I've ever sensed pollen like I've since this year.

Not just pollen.

I'm also allergic to mold.

You know, when you have as much rain as we've had, I think that exacerbates mold in and around houses.

And also, you know, mold exists everywhere in our in our lives, just kind of like mushrooms, you know, they're they're everywhere.

And for me, I'm sensitive to those things.

So I probably had a few more asthma attacks this year.

And I don't like the word attacks either.

I call them asthma incidents.

Incidents?

Yeah, well, let's bring in the experts.

doctor, Daniel Croft is on the line with us.

A pulmonologist and researcher at USMC.

And Doctor Croft, thank you for making time for the program.

I'm doing well.

Happy to join everyone here.

Well, well, we'll have a lot to talk about with Doctor Croft coming up about understanding air quality, understanding risks and safety based on different conditions.

And then I do want to talk about some of what Tom's been talking about, the way treatment has changed over the years.

but first I want to turn to the chief meteorologist for Kctv TV.

That's Eric Snyder, who is back with us.

Eric, welcome.

Thank you for making time.

Hi, Evan.

How are you doing?

Great.

and, you know, it has rained every day for the last thousand days.

he's building an ark.

You know, I say, Mike, I know I'm actually thinking about building a dome over here.

but obviously this hour we're talking about, air quality and wildfire haze and smoke.

So I just want to spend a few minutes with you.

Eric, just understanding what we are seeing this week and understanding a couple of things.

the difference between higher loft smoke and why it ends up that way, and how we know if it's going to be more of a risk.

So in general, let me start with this.

What have you seen this week out of Canada?

and how does that compare to the worst of what we saw in 2023?

Oh, I suppose right off the top is just acknowledging the reality that we've got a lot of active, out-of-control fires across Canada, Manitoba, Saskatchewan, Alberta.

These have been kind of the hotspots out of this.

you know, Tom brought this up to the last few years as we've kind of entered getting close to our summer season here.

This has become a lot more of the norm.

So, you know, Evan, you bring up a good point here where we've had smoke around here over these last few days, but this has been dramatically different than what we had two years ago in 2023, roughly round about this time when a lot of that smoke was more ground based, it was more surface based.

And fortunately, we do have computer models that can kind of help with this.

You know, they're not perfect with it, but, you know, a lot of us are obviously familiar with wind blows north, south, west, east.

But the atmosphere works in three dimensions here.

So you've got a vertical component to things to as we try to assess, you know this plume coming in from Canada here.

Is this going to stay 5000 10,000ft aloft.

Or is there going to be some component of sinking to the air to bring it more down to the ground?

And fortunately, with this particular round, most of it has stayed aloft.

But it's it's kind of a roll of the dice, you know, each one of these days, weeks and incidents where we get, some of this kind of wafting on southward, what the dynamics are, what the overall pattern is.

And, you know, you get lucky with it sometimes where it stays up there, other times not so much.

And so when we hear about the Midwest, Minnesota, Wisconsin, Michigan, Iowa getting more reports of people with respiratory distress this week because of wildfire smoke, my assumption is then, well, there's must be closer to the surface.

Is that generally is that possible that ours is more aloft and theirs is not?

Yeah.

And it makes a lot of logical sense here too.

You know, two years ago when we had the issues where it was surface based here in western New York, the location of those wildfires was just on the north side of Lake Ontario.

So your proximity to the source was much closer, farther distance you get between you and the wildfires.

You tend to get it where it's got more time to to get blown aloft.

It kind of disperses a little bit more.

So it's not quite as thick.

The issue in the Northern Plains and Minnesota.

In Wisconsin, they are closer to some of the active wildfires.

So, you know, the closer you are to a fire, the more you're going to end up feeling the effects here.

what are we looking at for the rest of the week and in the next week?

this stuff here, Eric, next two days or better.

You know, I'm looking out a window right now, and we've obviously got some cloud cover here, too, but you could still tell it's there's a little bit of a haze there.

It has thinned out.

It's going to be thinner again tomorrow.

But, you know, there's another plume of this that kind of wants to do a little bit of a glancing blow here into parts of the Great Lakes in New England this weekend, and then the pattern into next week.

You know, it's got that look of maybe a couple of opportunities here for the upper level flow.

Could try to waft some of this back southward.

And you know, frankly, this is this is our new summertime reality here.

I think we're going to be dealing with this for the next few months or just periodically the pattern lines up and you get a shot.

It blows on out.

You might quiet down for a few days or a few weeks, but you go back and forth with it.

I mean, I suppose when you were in in school or when you were in training in meteorology, what?

Canadian wildfire smoke was probably not on the menu.

And now you almost have to become an expert and understand not only what's happening, but to your point where the sources and there's multiple active burns.

I mean, it seems like every year there's going to be active, burn somewhere.

It certainly seems that way.

And the last few years have followed in line with that.

And I'll tell you, there's meteorologists all over the country that over the last few years have really had to become more versed in how this works, the dynamics of all of this.

And I'll tell you just from us, the TV station three years ago, you know, we've got thousands of graphics that we've got in the tank here that we show on TV.

I think we had maybe three that had to do with smoke.

And after 2023, I mean, we had to just start cranking stuff out.

So even anecdotally with that, we didn't have a ton of reasons years back.

To be showing much of this doesn't mean it didn't happen.

And obviously did.

But, we've seen a pretty substantial uptick, at least locally here, and how often we've seen this affecting us the last few years.

So before we let you go a couple of the things here talking to Eric Snyder is the chief meteorologist for WBtv there.

Is it I don't want to use the word benefit, but if there's something that's not harmful and kind of cool, it's the sunset.

What is going on with sunsets in relation to the smoke.

So you got all these smoke particles that are in the air and light obviously has to pass through all that atmosphere to be able to get to us.

So when we get to sunrise and sunset, the sun is lower on the horizon.

So right off the top, smoke or not, that light is having to pass through more atmosphere.

This is why we notice the sun even on a smokeless day it looks different.

It tends to be a little more orange, a little more red the lower it gets on the horizon.

So all these smoke particles that are floating around serves to scatter and reflect light.

What's kind of cool with this is the property of light.

You've got, you know, Roy G. Before we go back to elementary school with the different colors within that light beam, they're different wavelengths.

So the shorter wavelengths, which are going to be your blues, your indigos and your violets, those tend to be bounced around more.

They tend to be scattered.

So they have a really hard time making it to our eye.

Opposite end of that, the longer wavelengths you're getting in on your oranges and your reds, those have an easier time passing through, making it through that smoke.

So two things we get from that.

And last night sunset was a great example.

It looks a lot more red.

And then it becomes this very kind of ghostly dim sun to the point where you almost have a hard time finding it as you get close to sunset, because so much of that light has been scattered and blocked.

so if you're a photographer, you know you don't hate it because it really does make for some vibrant some shots out of that.

But yeah, you hate what you have to deal with to be able to pull it off, I guess.

And you've been really keen on kind of following the Northern Lights in recent years, and people appreciate the heads up.

But when, when you give us a little warning like get down to Charlotte, get down to the beach.

Yeah, there you go.

And so I'm wondering if wildfire smoke affects the northern Lights.

Eric.

Oh, yeah, 100%.

So we had, we hit G4.

We got a scale out of this one through five.

Bigger the number, the bigger the, Aurora display G4 is a big deal.

We had that over the weekend.

I was out there trying my best, and, I got a couple of shots, but it it's just like a veil of cloud cover, you know?

It it doesn't allow you to see a whole lot.

So, you know, we had a display, but it it just makes life tough for everything.

Northern lights and seeing anything.

Well, thank you for taking the time for us.

I know this does complicate the work that you're doing, and everyone wants to know exactly what it's going to be tomorrow.

Or probably the worst is when a meteorologist gets asked, do I have to cancel our little League game?

Do I have to cancel this picnic?

And the meteorologist going, do not.

That's that's the doctor's job or that's your job to assess your own risk.

I know you're doing your best.

You're doing a great work with it.

And we appreciate you taking the time.

Eric.

Yeah, happy to do it.

Thanks, Ivan.

Eric Snyder, chief meteorologist for Rock TV.

You can follow me on the many different social channels.

He's really great.

I mean, and we've got a lot of great meteorologists in this town where meteorologist Rich town and Eric is one of the many great ones.

So, we appreciate that, listeners, if you've got questions, comments, as we shift to talking about health, we talk about, respiratory health.

we talk about pulmonary health, health and the effects, of wildfires, of effective smoke, trying to make decisions on what you do or don't do based on certain conditions.

if you have general questions on on treatment, you can call the program at 2844295 talk.

It's toll free 84429582552636.

If you call from Rochester 2639994, you can email the program connections at Zorg.

If you're watching on our YouTube channel, you can join the chat section there.

And doctor Daniel Croft is a pulmonologist and researcher at IRM.

So, you know, you heard Eric there, doctor Kraft, talking about how the last couple of years we all have recency bias, but it doesn't just feel worse.

It has been worse.

We have seen more smoke.

We've seen more incidence of smoke.

What is this week been like for you in your profession compared to the worst of 2023, when you could literally taste the smoke in the air?

Doctor?

Well, this has been a little bit different because as you mentioned, the the particulate concentrations.

So the pollution in the air has been lower.

Thankfully then in 2023 when it was absolutely horrendous, there were, periods where we had some of the worst air quality in the world back in 2023.

Thankfully, we are farther away from the fires this time.

And the particulate matter that PM 2.5, the particles that are 2.5 microns or less are lower in concentrations.

Those are, important particles for health effects.

So, thankfully, everyone in the area has had some experience with wildfires from, 2023.

So I think people are a little bit more on the alert.

I was just in clinic, the pulmonary clinic at Mary Park's asthma center yesterday, talking with patients, making sure, that everyone had a plan to stay safe.

if the air quality changed, you know, if it got even worse.

So I think, thankfully, we haven't seen those high levels, but, it's it's definitely a good reminder to know what the AQI is, the air quality index, so that you can follow along on your phone.

Is there a handy way to know what that number means for you, and how to interpret it in terms of what you should be doing, what you should not be doing?

Yes.

The the AQI, that air quality index by the EPA, they have a nice color coded guide where they have different the different levels of AQI, and then they have a corresponding, guidance on what to do or what not to do during each level.

So, where we are right now, we're hovering around 5050 and less is considered green as in, okay, you know, that's okay for normal activity.

Now we've drifted in the past couple days up into the yellow, the moderate air quality range.

And in that range we think about, folks that have certain conditions.

So individuals with asthma or COPD or cardiac conditions, could be at more risk for an exacerbation, of those conditions.

And so folks, with those diseases and the very young and very old, or the older, over 65, also should pay attention to this.

And one, final very important population is individuals who are pregnant, also need to be careful when air quality worsens.

So those are those are the main groups.

When we start drifting into that moderate range.

that need to be careful.

Tom, how did you feel?

how have you felt this week?

You've been outside a bunch this week.

Played 18 holes this morning.

No issues with the air quality for you.

As someone who's been, an asthmatic for years now, actually, I, I did have an issue.

I played golf yesterday morning as well, and out of nowhere on the way home, I first off, I, I noticed so much more pollen there.

And this is the typical time of year.

And I, you know, my allergies.

I'm specific specific to cat dander.

all the pollens and and mold.

and I after yesterday's round, out of nowhere, I came into my house and started feeling the tightening and knew that, you know, something.

And in an incident was probable.

And I waited to see how it develops.

And once, once you start, I also have anxiety.

So when you a lot of people don't look at me and say, you can't possibly have anxiety.

I didn't know this about you until just now.

And I've known you and we've known each other for a long time.

Yeah.

So I yeah, I've been taking Zoloft since they first developed it, and and it helps immensely.

but yeah, yesterday, out of nowhere within 15 minutes after coming from out of doors but coming to my house and my house backs into Durand Eastman Park.

So it's probably a, you know, it's it's a pollen center of the universe.

And I started having some issues.

I only need one shot with the, the inhaler and, to rest for a few minutes and stay out of the out of doors for a while.

The doctor's giving great advice.

I'm not the best at following advice because I, at 79 years old, I think I'm, Yeah, I'm.

I already passed a life expectancy, I think, and I'm still in pretty good shape, so.

And I think golf helps me more than golfing.

Not just golf, but being outdoors and walking and whatnot helps me more than being indoors and being sedate.

You're also a male, and that doesn't help you with following doctor directions.

So there's a lot of things working against, you know, don't say that.

Don't generalize about Doctor Croft.

Tom's experience there.

You know, he feels a little tightness.

He's been outside.

You know, there's again, it wasn't like 2023, but we've had some smoke issues.

How how would you rate his handling of it?

how would you rate this patient?

Well, I think Mr.

Priority is really listening to his body.

So, yeah, he has plenty of experience.

And working with his asthma and and that's the key for everyone with any type of lung or heart condition is to know how they respond to certain, insults and irritants.

And I found it, very interesting.

The, the air quality, when it worsens, it can actually worsen the pollen in the air.

So the air, not no air pollution or not.

Yeah.

Air pollution, little particles are not just little cannonballs bouncing around in the atmosphere.

They are very react.

They have they can, cause oxidative stress or oxidative change.

It's kind of like a hydrogen peroxide that you put on, to clean with that bubbling.

They have some of that potential.

And so they change the allergy, the allergens in the air and the pollen, they can split the pollen apart.

They can denature it so that it can even become more allergenic, as in it could cause you more trouble.

So you have pollution, allergens.

Those both working together to make things difficult.

Then throw in a 90 degree day, right?

And heat itself makes asthma very difficult.

And that was yesterday.

you know that was a triple, threat to folks with, lung disease.

So the chemistry, the atmospheric chemistry of the particles is fascinating.

but unfortunately is working against us here in terms of, you know, keeping everyone breathing well.

Right.

And so let me just ask a couple of questions about Canadian wildfire smoke.

And then I want to talk more about some of the treatment that Tom talked about.

And Tom brought these visual aids.

so we're going to talk about how people do get treated.

But in general, doctor, if we get if we get one rough day from wildfire smoke, you know, you may see as we did in 2023, certain outdoor events cancel or scaled back.

Schools were pretty aggressive about that.

If you get multiple I understand why it's hard for people to want to cancel events, but is there a cumulative effect?

I mean, can you get a I hate to use this phrase, but, can you get away with one day of of rough air quality?

and what's the difference between hey, I was outside for half an hour versus this is a four hour event.

It's pretty strenuous.

And we're going to go do something tomorrow in the same conditions.

I mean, talk to me a little bit about when when we see the smoke come back as Eric says we will.

We have to get a little bit used to checking the the air quality conditions, the, the cumulative effect and what you can sort of get away with and what you can't.

This is a great point, to think about.

And the the cumulative effect of all the exposures that we have is a concept known as the exposure zone.

It's something we think about in health research.

And that's the cumulative, you know, the sum of all the exposure that you've had in your life.

So, back when there was smoking in restaurants and other venues.

Right.

That's part of the exposure as part of my exposure.

I'm from Indiana, back when we were one of the last states to get that smoking out of restaurants.

But, you know, those were, in a, in a sense, wildfire episodes, right?

Of my youth, was the smoking in restaurants and other exposure there.

And so expose them is an important concept, for folks to know.

But to answer your specific question, what's one day versus several days?

And it does matter.

The cumulative exposure does matter.

And so our bodies are resilient, right.

We're able to take the slings and arrows of everyday life all the, the hot days, the cold days, the dust, you know, everything.

And our bodies have mechanisms to try to resolve that inflammation.

and so certainly multiple days of an exposure is worse than a single day.

And to get, you know, talking about getting away with it, everyone has to manage their own risk.

And so I think our key as clinicians and, and researchers is that everyone just knows what that risk is.

And so that's where you should feel empowered that you have, you know, the EPA, a great governmental agency, that is providing, valuable information for you, so that you can you can read, you know, the color chart and see, okay, where am I on the chart?

Should I be altering my activity?

so I think just in summary, yes, the cumulative exposure, does matter.

but it's, it's a dynamic process, right?

Even through one day, the air quality changes.

We're going in between yellow and green right now.

Right.

so that's where you have to track it on your own, where one, broadcast like this, we won't be able to forecast perfectly, what's going to happen in these coming days?

that'll be in your hands to stay safe.

Well, I'm glad you bring up cigaret smoking.

And I want the, the audience will correct me if I'm misremembering, but maybe.

Tom, you can help me.

Maybe.

Doctor, you remember I thought I when I was growing up in the 80s, maybe in the 90s, that there were these ads where they would show you a smoker's lung.

You know, I to me and it was tar.

I mean, it was kind of black and not attractive.

And they would show you a healthy lung to try to scare you and it not smoking and, and, you know, to let you know what your future what what it might portend for your future if you keep smoking.

I think I remember and that was one of the lessons I remember as a kid hearing from that.

And this is where maybe I have this wrong, is that if you have smoked for years and you stop, that, you may not get your lung to look like the healthy lung, but it doesn't have to look like that tar covered thing forever, that it actually gets better.

That yes, there's been a cumulative effect, but if you stop the bad activity, you can, it doesn't stay that way forever.

Is that wrong, doctor?

What's the reality there?

The reality is our lungs are very resilient, and there are little cilia.

Those little, beating fingers, in our lungs and in our.

The same as what you've heard of in your intestines, that absorb nutrients.

we have cilia, in our, in our lungs that are sweeping all the mucus, up, so that we can spit it out or more likely, swallow it, which is what we do all day.

I think, this gets into maybe a fast fact for the audience in that we create about a liter of mucus, a day between our nose or mouth and our lungs.

We don't need it.

Really.

There's some day that we need that that's meant to make you feel better.

Okay.

Because that's your first line of defense, that mucus.

Think of it as your your shield to all this pollution, to the, the pollen and everything that's trying to sweep that junk out of your lungs.

And so all day we just end up swallowing the mucus.

and that keeps us safe.

So as unsettling as that may be to, unfortunately, the lunch hour crowd.

you know, that is key thing, that is keeping you safe.

That's our first line of defense, but we have others, within the body, you know, for things that sneak past.

And so if I've smoked for 30 years and we could see that lung and I stopped for ten years, ten years later, how different would my lung look, right?

Yeah.

And so to answer your specific question about how does your lung look with, with the smoke exposure, the lung is able to clear where it's going with the cilia.

Yeah.

Yes.

All this, all this clearing was that it is trying to clean up the lung.

And so, folks, they have taken that great step to stop smoking.

that I've met in clinic.

and I'm, very, very proud of their efforts because it's very difficult.

Difficult thing to do, but so good for your health.

they are they can experience after quitting, that their cough actually can transiently worsen.

And that's a good thing, because that means the cilia are waking up and they're starting to get all that mucus and the tar and all those chemicals, trying to get it out of your body.

now it can't get everything.

They'll still be that long or still have a tint to it.

And I'll have some of the black, tar in there.

but your body's going to do absolutely everything it can, to sweep everything out.

And clear it out.

I mean, do you remember time when all this talk about smoking?

The doctor mentioned smoking bans on restaurants, and it was like 20 plus years ago.

I was this young reporter.

I was first, I was in West Virginia.

They were debating a smoking ban.

Come to Rochester, they're debating a smoking ban.

And you talk to people.

Be like that.

We can't do that.

I used to teach in England.

You can't imagine the pub response.

And then I went to Dublin one weekend and they were discussing a smoking ban and the, the all the pub owners were saying, well, we'll be out of business within six months, exactly like people will never go out.

And by the way, people used to smoke on airplanes and smoke profusely on airplanes, and they actually had a nonsmoking area of the airplane in which the smoke was, can't you think, roll down the window now?

You can't can't.

And it's being circulated.

It's just what to me, it's one of those things where decades later, you look back and you go, I can't even believe we ever smoked in restaurants.

What young.

The doctor brought up something interesting, too, about quitting smoking because as an asthmatic for seven years, I smoked and my uncle would just.

My uncle, Doctor Marino, would look at me and he'd say, how can I fix you?

But while he was saying that to me, he had a cigar in his mouth and it took him time to quit.

Mister Rogers got me to quit, and my daughter Amy was three years old.

I was working on a textbook that summer.

I told this story many times, and Amy was watching Mister Rogers in the in the room right next to me, and I'm sitting there typing away, and she comes in and she's looks at me and she's got her thumb in her mouth, and she takes the them out.

And I said, how are you, babe?

And she said, daddy, would you quit smoking?

I want to keep you.

Oh, and I, you know, I two years later I and I could never had another cigaret after that.

It was done at that line and he he must have said something to them two years later.

I interviewed him here in 1977, and I told him that story, and he wept on air, and he got tears in his eyes.

And I said, you do that for the for everyone who watches you.

And I especially, you know, having my three year old daughter coming up with this brilliant moment of logic that overcame the, you know, the awful habit that I had.

but also my dad smoked in the house constantly, and there was always, you know, there was cigaret smoke everywhere.

And then I grew up in a bar and there was smoking in the bar everywhere.

It's just interesting to see the cultural change.

This idea that you can't have a smoking ban in restaurants, bars are going to go out of business.

Restaurants go out of business.

People won't go now, I smell smoke in a restaurant one time and I'm like, what is happening?

I'll never be back.

Yeah, how could anybody?

I mean, it's just a it's it's a very, very I want to ask the doctor a question.

Yeah, yeah.

Because, doctor, you probably know something about the, the years of giving shots for desensitizing, as medics and people who suffer allergies.

Is that still around?

Is it effective?

Do we experiment with it at all?

Yes, absolutely.

And so the field of allergy and immunology has grown in leaps and bounds in the past decade.

And allergy shots are more effective now than ever.

And there are other biologic medications that can help, greatly with allergies.

so, yes, that research has been very active and it's helped many, many thousands of people, manage their allergies.

So those same shots that you got are still still helping people.

And now I stopped at to after 27 years that it didn't seem to make too much difference.

But I think you're talking about the the the accumulative approach.

I, I do too.

I started taking Singulair years ago, and one of the things my doctor and my allergist said both said was they said it's really important that you keep taking this on a regular basis because it does tend to build up in the system.

And I've noticed since I started taking now it's meant to look at, that I have more control.

the incidence of asthma are fewer and far between, and they're far less dramatic.

And are we still giving adrenaline to patients?

That was on my list to hear so, so so that's why I used to get these shots of adrenaline and feel like I was going to fly to the moon.

Here's what we're going to do.

We're going to take our only break.

We're going to come back and we're going to have no it's okay.

Tom's looking at the clock.

The clock I usually break around 1245.

They want me to break around 1230.

I'm a scofflaw, but, but I'm in control of the show time.

It's my short break when we want.

Now we're going to come right back and we're going to talk about treatment.

So, I want to hit Tom's question.

I want to know if they're still doing, adrenaline shots or, epinephrine, whatever it is.

So but I also want to get some listener questions.

Jillian's got a question about, different kinds of treatment, wants to share her stories.

Tim's got an email that I'm going to read, about cancellation of activities and how to deal with safety.

So we're talking about the Canadian wildfire smoke.

But the broader context is, you know, air quality.

It's about lung quality.

It's about how we breathe and how we recognize our problems.

So I've got a question about how to recognize if kids need to get checked.

So, we got a lot we're going to get to here.

Time priority is helping steer the ship and studio.

He's a resident media scholar at Saint John Fisher University, and I didn't know until recently.

He suffers from asthma, and he was talking about his own story there.

Doctor Daniel Croft is on the line with us, a pulmonologist and researcher at the University of Rochester Medical Center.

We're right back with your questions.

Coming up in our second hour, more of the candidates for Rochester City Council in part four out of five.

In our series of interviews with the candidates, 15 total candidates have been on the ballot for five seats.

And it's Mitch Gruber and and Louis joining us in studio next hour.

Your chance to hear from the candidates before you vote on connections.

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This is connections.

I'm Evan Dawson.

we'll read your emails at connections at six.

I talk in just a moment.

or if you want to comment on YouTube in the chat section, we're talking about how you're dealing with the wildfire smoke.

And again, the point that Eric Snyder of CTV made earlier this hour is important.

This is not 2023, 2023.

The source of the Canadian wildfires was physically closer to us.

And that matters.

It doesn't mean that just because these particular wildfires are farther away in geographic distance, it doesn't mean that we're not gonna have any problems.

but it does mean that we're a little fortunate geographically this time around.

That means the smoke is likely to be higher in the atmosphere, likely to be less irritating to us.

But it certainly could change.

And probably, as Eric says, we have to go throughout the rest of the summer just kind of watching the maps and the charts in the flow.

So that's part of the deal, and we'll get to your emails about that in a moment.

Tom Petty mentioned tell the story and then let's get the doctor's point on this.

When you were a young child.

Yes.

I mean, what, five, ten years old between probably between the ages of four, maybe to eight years old.

I probably went to hospital emergency rooms 40 times, 40 times for it, for asthma, for asthma.

Because, you know, I just could not breathe.

I could not feel care going in.

And because we had doctor sensitive family as well.

And how many times did they give you a shot of adrenaline?

Every time.

Dozens of times, yes.

I mean, one shot at a time.

But so what do you remember being the experience then?

Did it work.

Immediate relief.

But also getting the jitters and you know, and having trouble sleeping for a couple of days because you know at that time you know, unlike what I weigh today, at that time I was 110.

But no kidding I was a hundred.

You were a little guy.

I mean yeah, no, no, I, I was probably 80 pounds when they started doing this and they were saving my life in the process.

But you know, a lot of life saving techniques have adverse effects as well.

I feel like I'm reading Sherlock Holmes and they're just giving everybody brandy for everything.

But I mean, that's but adrenaline, you know, apparently, was the treatment.

And from what I'm seeing, Doctor Daniel Kraft, maybe still occasionally in emergency situations take us through, this kind of a treatment.

Yeah.

So I'm, I'm glad that you made it through all those exacerbations.

Sorry that you had to suffer, so much with your asthma.

But, doctor, I have to tell you something.

My uncle used to say to me all the time.

He would remind me over and over again.

He said, if you had been born in 1926 instead of 1946, you probably wouldn't be alive today because of, you know, some simple things that are not simple thing, complex things and treatments that we came up with.

So, so, doctor, what was what he went through?

Was that common at the time?

Because this was back in the 50s.

In the 50s, if it was that common at the time?

Yeah, I think the the treatment teams there were reaching for the medications that they had that could, you know, help, you know, help asthma.

I think our understanding of asthma and asthma treatments has advanced greatly, since that time.

And to directly answer your question, is epinephrine ever given for asthma?

Yes, it is given, but in certain situations.

So if a patient comes in and we're worried that they have anaphylaxis, which is an overwhelming allergic response, to some kind of stimulus, for example, folks that are allergic to, bee stings or, you know, if there's other, specific allergy there.

But, for folks that are having anaphylaxis.

Absolutely.

That's given in the emergency department also in a specific condition called angioedema.

So when the throat and that would be if the throat is swelling and the mouth and the back of the throat is swelling, sometimes it's given in that case too.

But for the majority of asthma exacerbations we focus on beta agonists.

And so these are albuterol.

So albuterol is called a beta agonist.

And that's meant to try to relax the lungs or to open up, the lungs to help with airflow and, and to talk about the jitters, the jitters that you experience from the epinephrine.

sometimes if someone has a severe asthma attack, they don't just do two puffs on their inhaler and call it a day.

They have to go on a continuous albuterol nebulizer within the emergency department.

And they certainly also, are experiencing the jitters, from, that stimulation.

but they are breathing, which is the most important point.

But, we we take asthma treatment very seriously, even with all the advances.

Asthma is a life threatening condition when you get an exacerbation.

So it's not something, to sit on if you're having worse and worse symptoms that are not relieved by rescue inhalers or your everyday, maintenance inhalers.

it's time to call, call for help.

It's time to get into the emergency department because it, it unfortunately still is a life threatening and life ending, illness for some doctor.

Do you consider it an autoimmune disease?

I think more of it.

And there are different types of asthma.

And so there are there are multiple different phenotypes of asthma.

We call them phenotypes kind of groupings of asthma.

And so it's hard to say we wouldn't say that it is an autoimmune disease.

Kind of a blanket statement.

There is more of an inflammatory allergic disease more than a autoimmune disease, which you would think of, kind of like a rheumatoid arthritis or a lupus.

those conditions, would be more classical, for an autoimmune disease.

All right.

I've got a bunch of emails.

Let's get through as many as we can here.

Okay?

Sure.

Vincent wants to know about the health dangers of second hand cigaret or cigar smoke in outdoor settings.

So outdoor settings, second hand smoking.

I read this and I thought, well, I think you're outside.

I think you're probably good, but, doctor, do you want to weigh in on that?

This is a great question because as the restaurants have, you know, stopped it indoors, sometimes you hear and, you know, a restaurant that has the picnic tables out or you're, you're in an outdoor setting and someone walks by your table at a restaurant.

They have, a cigaret there.

and I think you're correct in thinking that the risk is less, because you're in an outdoor setting because you have to think about, what's the volume of distribution?

What what about the space that you're around?

So if your space is the entire Earth, in theory, it can diffuse.

well, but I think, you know, this is a good time to think about second hand smoke.

Kind of like we're thinking about these wildfires, right?

The wildfires, you know, you're not starting the wildfires, not in your backyard, but it's wafting over to you.

And so all those same characteristics that we talked about, the distance you are from the wildfire or cigaret, the intensity of it, is it a whole group of people smoking?

your individual sunset ability, whether you have a disease like asthma or COPD or heart disease that could be irritated by an inflammatory, inflammatory particles like secondhand smoke or wildfire.

so I think one thing I would like to do within the air pollution space and, within the research and medical space is to try to break down the walls between these different types of air pollution.

I think we should be thinking about air pollution, whether it's from wildfires, the tailpipe of a car, the smokestack of an industry, the, secondhand smoke from a cigaret or e-cigarette, you know, the side stream, these particles, we have to think of these all as a group, right?

It all contributes to our air quality.

And so that's why you see one of the recommendations during wildfire, events like this, one of the recommendations is don't pile on with more emissions if you're smoking.

Let's try to stop, stop smoking.

If you're, you know, try not to use the gas lawn equipment, during the day, filling the cars, with gas, driving less, that helps the Earth globally.

But it also doesn't push us up into that higher level of pollution as a community.

So it's, you know, that's you have to there's some selflessness there of, you know, helping the community as well.

But that's part of the goal is let's not let's not pile on while the air quality is questionable or moderate.

And so, Vincent, it sounds like less risk, but not no risk, especially if you're in really close proximity, even outdoors with secondhand, you know.

Okay.

And so here's Paul and I feel for Paul.

Paul emails to say after coming off my annual 8 to 10 day, bout with hay fever about two weeks ago, I didn't realize symptoms.

I was experiencing excessive coughing, extreme fatigue, some dizziness was actually pneumonia.

I was finally diagnosed last Sunday morning with a chest X-ray.

I'm just completing my regimen of medications but not feeling better.

And now you're telling me not to breathe the air, period.

What do I do?

Stay indoors with all the windows closed all day.

Wear a mask all day everywhere?

Do I leave town?

This is getting a little old.

Paul, I'm with you on.

This is getting old.

I don't think anybody said don't breathe any of the air.

Period.

And I think part of the point is that this summer, at least so far, or this spring so far, we are fortunate in Rochester Vis-A-Vis the Midwest, they are experiencing lower and heavier doses of Canadian wildfire smoke.

So no one is saying you can't breathe the air, but I hear you on days or weeks like this, you've got to be really frustrated.

And I'm going to ask Doctor Croft.

I mean, he's wondering when I go out, do I wear a mask?

Do I can I stay indoors even knowing that some of the outdoor air is filtering indoors and then, you know, where is someone really safe?

So Paul's gone through a lot.

What would you say to him, doctor?

Yeah.

Well, first, I'm so sorry that you have just gone through a pneumonia.

That's an incredibly serious infection.

I'm glad that you got treatment for it.

and I hear you, too.

It's frustrating.

It's the summer.

The kids have been cooped up.

You know, you want to get them outside.

You want to get outside?

but right now, for you, your lungs have been through quite a bit.

Your lungs are in clean up mode.

All the all the bacteria that were in there from that pneumonia, all the mute, all that mucus, all the dead cells from the battle that happened between the antibiotics, your body and the, bacteria in there.

So your body, your cilia are working overtime to clear all that junk out of there.

And so this gets into a bit of the pile on, you know, piling on idea where if there's a bad air pollution day, you know, that's adding more junk for the lungs to clear out.

So, you can manage, you know, manage your risk and what you're comfortable with.

you know, going outside, there's good, mental health benefits.

There's, you know, it's good to be outside.

It's just I would if I were you, I would, take a look at the weather app on your phone, scroll down to the AQI and try to pick your spots where we're more in the green than the the yellow.

And if you're able to tolerate wearing a mask when you're in the yellow and you want to go outside, the yellow or the orange, you know, I think I think you can go for it.

But, though you've been through, you've been through a lot, so I don't want you to feel like you're a prisoner.

I don't want anyone to feel like they're a prisoner in their own home.

but what we want you to be able to do is manage your own risk and kind of pick your spots, more strategically.

Paul.

Good luck to you.

Let's keep moving fast.

We've got a lot to get to.

Greg in San Diego.

Rochester expats have made us the public square everywhere.

Thanks for listening, Greg.

Go ahead.

Yeah, yeah, I've been treated with albuterol and, other daily kinds of, inhalers, which in the past, year and a half.

I am taking an injection.

I give it to myself once a month.

It's a drug called blue collar.

And my question is, how does that work with the inhalers to control asthma or, you know, whatever, other problems.

there may be some prescribed by my pulmonologist.

It comes to my house, and I inject myself, and I'm just not totally sure what it does.

Okay.

Go ahead, doctor.

Yes.

So, briefly, it sounds like you had asthma, that it was not being controlled by regular inhalers.

And so new collar is a medication that blocks and interleukin IL five that helps, you know, reduce the any eosinophilia in your body.

Eosinophilic are cells that respond to allergens and can, worsen asthma, certain types of asthma.

So, it's a targeted medication to the cellular processes in your body, whereas the inhalers work more physiologically with your, with your, airways to open them up.

So they work.

They work hand in hand there.

They, work together very well.

Okay.

Greg, thank you.

I hope that answers that question.

And I'm going to squeeze two from Jillian in real quick.

Jillian wants to know, does taking antihistamine before allergy attacks help doctor.

the pretreatment.

So that's interesting.

Is she trying to predict the future a little bit?

but in theory, yes.

You could try to get ahead of it.

It would be a little tricky.

Some people just take it every day, right?

During allergy season, they take and, antihistamines, just on a daily basis.

So that prints.

So that's the principle there is trying to get ahead of it.

It'd be a little hard to predict exactly what's going to happen.

Sure.

just take it spot.

But yeah daily antihistamines people do that.

Okay.

And Jillian says in 2023, she was in Niagara in Toronto during the wildfires but didn't know about the wildfires.

And, essentially, she ends up with, breathing deteriorated since then.

Says, could my lungs have been damaged further?

I'm asthmatic and I've had a collapsed lung in 1999.

That's from Jillian.

it's and this is the tough part because, as I mentioned, that expose, the cumulative exposure of your entire life, it's hard to attribute one event, to your current issues.

We've been through a pandemic.

You may have had other infections.

so it's it's a little hard to say, but single it is true.

I treat patients that have occupational lung disease in my in my clinic, single high dose exposures to air pollution can cause lasting or chemicals can cause lasting effects.

so I would say it's possible, but it's really hard to tease out.

and Jeff, our colleague says, I've got a picture of my dad smoking a cigaret in the hospital room when I was born.

Oh, yeah, that happened.

I remember them in the emergency room while I was being treated for asthma.

Emergency room.

This is, there are some changes that are undeniably progressed.

I'm proud of that.

No doubt.

And, doctor.

Thank you.

You're brilliant.

Oh, my gosh, so much.

Yeah, I want to I want to thank our guest boy, Doctor Daniel Croft, a pulmonologist and researcher at the University of Rochester Medical Center.

Thank you for the expertise.

let's hope to have as good a summer as we can.

But thank you.

And we appreciate helping our listeners out here.

Doctor.

You're very welcome.

Stay safe everyone.

Doctor Daniel Croft, time priority.

Here's to many more birdies on the golf course.

Yes, this summer, maybe even a couple of eagles.

I hope so.

Why not?

No I don't don't kill the birds.

Well, no.

No, I just mean.

Yeah that's right.

Yeah.

Well live the birds are.

Here's to good health to you.

Thank you for being here.

Yeah.

Great having you.

And thanks to Eric Snyder from WBtv as well earlier this hour.

We've got more connections coming up.

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