Brian Millhollon, M.D.
Over the years, it has been assumed that patients suffering with allergies and asthma would do well to “pack up and move out west” to find relief and possible a cure for their misery. Many have headed this “recommendation” in hopes of finding a promised land without allergies. Unfortunately, as many have discovered, such optimism, the result of a successful marketing campaign and a little misunderstanding, is for the most part unfounded.
At the turn of the century it was believed that the right climate, along with good food and rest could cure many illnesses including, tuberculosis, which, at that time was one of the most common and most life threatening diseases. Early experiments in its treatment included convalescent care and sabbaticals to the Southwest because of the benefit of its arid climate. Health-seekers came to the Southwest by rail from all over the country in the hope that the desert air and life- giving sunshine would, if not cure, then arrest, their deadly illness.
In the mid to late 1980s, promotional literature from the cities of Arizona and private sanatoriums boasted of their great locations, temperate climates and wide- open spaces. Others promoted business opportunities for those looking to relocate for health reasons.
With all this marketing, it is not hard to understand why many would come to assume that a miracle-working climate that could cure tuberculosis should also be good for other respiratory ailments such as asthma and hay fever. Sounds reasonable.
Maybe not. To be sure, for some asthmatics, particularly those with mold and dust mite allergies, moving to the arid climate of the desert Southwest did prove beneficial and, in some cases, seemingly curative. For many allergic asthmatics, however, moving to Arizona is anything but a cure.
Currently, Maricopa County has one of the country’s highest numbers of deaths due to asthma. What makes Arizona such a tough place to live for asthmatics? Is it the dust, the heat, the cactus, the endless golf courses? There is no one answer to this question, and a number of factors contribute to the problem.
Asthma is a condition in which the airways, the small tubes that carry air to the lung, become extra sensitive or “twitchy.” This hypersensitivity leads to contraction of the muscle fibers surrounding the small airways (bronchospasm), narrowing the air passageway, and making it difficult to breathe. The big question is what causes the airways to become hypersensitive? Researchers have found that a special kind of inflammation affecting the lining of the airways is the necessary factor leading to asthma symptoms. This inflammation causes swelling of the tissue lining the airways, increased mucus production, and enlargement of muscle fibers surrounding the airways. The inflamed airway is also hypersensitive, and the more inflamed the airway, the more “twitchy” it becomes, leading to bronchospasm and worsening symptoms.
For the 70-75% of asthmatics who have allergic asthma, the inflammation in the airways is the direct result of an allergen. Common allergens include pollen, mold spores, insect droppings, and animal dander. As the airways become inflamedwith exposure to the allergens, they become hypersensitive to a wide variety of non- specific substances and irritants such as cold air, dust, fumes, and cigarette smoke—all of which may then provoke an asthma attack.
After moving to Arizona, many asthmatics look around and say to themselves: “Hey it’s a desert, nothing grows here, my asthma should do great.” However, given a little rain at the right time, those half-dead-looking desert shrubs come to life producing quite a harvest of potent pollen, filling the valley for many months of the year. Add this to the abundant grass pollen from schools, parks, greenbelts, lawns, and golf courses spring through fall, landscape tree pollen including Olive, Mulberry, Ash, and Cottonwood in late winter through spring, and abundant year-round mold spores, and you have the making for year-round misery. As a result of this intense and prolonged exposure to environmental allergens patients become more sensitive to the other environmental hazards common to the Southwest including particulates and dust, monsoon storms, the brown haze of air pollution, and wayward golf balls.
Posted in: Asthma