Saturday, April 19, 2008

Their psychopathic ways

Where I used to live, I had more neighbors, and better ones, too. Where I live now, there are several around the block, but they are far enough away that it is hard to socialize with them. We wave, or wave not. Some of our kids play together. For all practical purposes, I have to deal with two of them.

The neighbors across the way occasionally assault us with drunken parties with all of their friends - I think in a hot tub. Mostly I could care less, I only ask that the party and its accompanying music move inside around 3 a.m. Really, they are getting old for the Miller High Life; their livers or pocketbooks are going to give out soon enough. (Honestly, I don't recognize them unless they're holding large cocktails).

Next door, there is "Carl." Carl is a sociopath. This week, Carl started to burn leaves in his front yard. This normally does not bother me, but the smoke came to my house - literally. I noticed that I was coughing, but I had no idea the smoke was slowly seeping in until it was too late. I found out when I walked out the front door and took in a lung-full of thick, white smoke.

I have asthma. Mine is triggered by smoke. I called Carl (got voice mail) and asked him if I could please haul his leaves away at my own expense, as his smoke was entering my home. At least three members of my household have asthma, including my 6-year-old. I also know of other families with asthma on the block. Luckily, everyone else seemed to cough a couple of times, rub their eyes and stay stable. In my case, my asthma was quickly becoming life-threatening.

I started heavy-duty medicines as soon as I knew it was the smoke that made me cough. In spite of five drugs, I got progressively worse.

As it turns out, Carl lit another leaf pile and the smoke was again coming for us. I put on a NIOSH respirator and asked him in person to put out the fire. I asked if he got my message. He said "no." I said, "I wanted to offer..." and he said "No, you may not take away my leaves." Meaning to me that he did indeed get my message and was lying.

As I stood there dumbfounded, pleading for my health, he proceeded to rant about long-term habits and his right to burn leaves (in between drags on his cigarette). His argument was that he had done this every year, long before most of the houses in the area were built. He seemed completely to miss the point that now that there are other houses, there are also breathing families within those houses. I was coughing, literally gasping, but it just never seemed to register with him.

Rob came after me and brought me home, and got some photos of the fire.

At this point, my asthma was in full attack. I called 911. In the ambulance, they could not find my left lung sounds and fretted about my heart so they fussed over stabilizing me before we even left the driveway. The sheriff that came along asked Carl in terms something like "don't be an ass," to put out the fire. The sheriff recommended to Rob that we pursue a civil action.

I spent several hours in the hospital with IV steroids and inhaled medicines. I dislike hospitals. I learned very early in my medical training that hospitals and patient care were never going to be for me. We discussed my admittance several times. I talked the doctor into letting me come home since I have equipment here, too, and the fire is out. I have had the maximum steroid dose for 12 hours anyway. I finally managed to take deep breaths after my fourth full breathing treatment and the steroids started to kick in. The doctor said, relieved, "You are moving air! I can hear your lungs." My heart calmed, and my O2 levels rose.

I explained about the fire. The doctor was angered by the story, and it turns out he is a trustee for our town. He immediately e-mailed other trustees and said he was sure the leaf burning violated an ordinance agreed to by all the bordering towns, even for unincorporated areas. He even wrote a terse note on a hospital prescription pad to give to the neighbor, full of terms making it clear that Carl's actions "precipitated a life-threatening attack."

OK, so, the moral of the story is two-pronged. One, if you have asthma that is normally so well-controlled that you don't take a daily steroid, you have to be twice as careful to notice the warning signs of an attack. Paroxysmal coughing, throat clearing or light wheezing means "take action immediately!" For a patient with constant, chronic asthma, the attacks are not as violent and sudden so they are not as suddenly life threatening. Ironically, the well-controlled population, especially children, are at high risk of sudden death.

Two, think twice about burning leaves, even if your area allows it. They are always a bit moist, so the smoke is thick and cool. At very cold temperatures the smoke may well rise straight up, but in the spring and fall, especially during low barometer days, it is just as likely to hug the ground and injure people you do not know. Even brush fires tend to be hotter and less smoky (the smoke rises with the intense heat). Many towns and townships do offer some free composting options if you cannot afford to have landscapers take your leaves away. Some even offer free low-odor compost bins free or at a discount (leaf compost may well filter out sulfur compounds from wastewater and when mixed with coffee grounds decompose into a garden-rich mixture).

More and more people will get asthma, as pollution is making several cities (and downwind of power plants) danger zones for previously healthy lungs. This is going to be a problem more often, for more people.