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        <dd><font size="+2" color="white">The Katrina Cough</font> 
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<h3><B><font size="7" color="#000000">The Katrina Cough</font></B><b><font size="7" color="#000000"></font></b></h3>
  <h3><b><font size="3" color="#000000" face="Times New Roman, Times, serif"><i> 
    by Dr. Murray Grossan, M. D., noted ear, nose, and throat specialist and leading 
    author. </i></font></b></h3>
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  <p><font face="Times New Roman, Times, serif" size="3">On top of all the other 
    disasters hitting that jewel of a city, New Orleans, and surrounding areas, 
    many of those in the area now have to deal the illness informally known as 
    the &quot;Katrina Cough&quot;.<span
style="mso-spacerun: yes">&nbsp; </span>Thanks to the efforts of the city and 
    state health departments, epidemics of the well-known post-disaster illnesses 
    such as cholera or dysentery have been avoided.<span style="mso-spacerun:
yes">&nbsp; </span>However, people in the region are now exposed daily to mold, 
    fungi, dirt, dust, pollen and awful smells.<span style="mso-spacerun:
yes">&nbsp; </span>Worse, the dust that might lie on the ground and normally not 
    be a problem is being stirred up by all the construction going on, getting 
    into the air where it can be breathed in. You can see the dust rise when the 
    trucks rumble by.<span style="mso-spacerun: yes">&nbsp;&nbsp; </span>All these 
    factors can lead to a host of respiratory and related problems. </font></p>
  <font face="Times New Roman, Times, serif" size="3"><o:p></o:p></font><font face="Times New Roman, Times, serif" size="3"><o:p></o:p></font>
  <p class=MsoPlainText><font face="Times New Roman, Times, serif" size="3">It is 
    important to remember that odor or smell is a physical thing.<span style="mso-spacerun: yes">&nbsp; 
    </span>When you enter a room with an open bottle of perfume, those odor particles 
    are physical - they can be weighed, photographed, etc.<span style="mso-spacerun: yes">&nbsp; 
    </span>That's fine for perfume,<span style="mso-spacerun: yes">&nbsp; </span>but 
    the awful odors in the Katrina disaster areas indicate that the air is filled 
    with nasty stuff --<span style="mso-spacerun: yes">&nbsp; </span>spore, dust, 
    mold, fungus, and decay particles, which are the kind that impair cilia function.<span style="mso-spacerun: yes">&nbsp;&nbsp; 
    </span>This is very serious, because sinus and lung cilia function are the 
    key to all respiratory health.<span style="mso-spacerun: yes">&nbsp; </span><o:p></o:p></font><font face="Times New Roman, Times, serif" size="3"><o:p></o:p></font></p>
  <p class=MsoPlainText><font face="Times New Roman, Times, serif" size="3">We 
    have a wonderful mechanism called the mucociliary flow. There are thousands 
    of tiny hairs covering membranes in your sinuses and lungs that act like oars 
    to move bacteria and dust out of the chest, nose, and sinuses. When the cilia 
    of the chest fail, however, the body tries to get rid of the foreign matter 
    by coughing.<span style="mso-spacerun: yes">&nbsp; </span>For example, a person 
    exposed to dust all the time may not cough, because their cilia can get rid 
    of the dust on their own.<span
style="mso-spacerun: yes">&nbsp; </span>However, when the person breathes in an 
    unusually large dust particle, or an unusually heavy cloud of dust, the cilia 
    can't get rid of it, and they cough.<span style="mso-spacerun: yes">&nbsp; 
    </span>Certain infections of the chest also impair cilia movement and so there 
    is coughing all the time to get rid of any inhaled particles. Here the doctor 
    tries to thin the mucus (so the particles do not<span style="mso-spacerun:
yes">&nbsp; </span>get stuck in a thick mucous which the cilia cannot move) as 
    well as get rid of the infection. <o:p></o:p></font><font face="Times New Roman, Times, serif" size="3"><o:p></o:p></font></p>
  <p class=MsoPlainText><font face="Times New Roman, Times, serif" size="3">In 
    the Katrina disaster areas, people are inhaling all kinds of particles and 
    odors and some of these are inhibiting the cilia by irritation, allergy, etc.<span style="mso-spacerun: yes">&nbsp; 
    </span>The particles may also be so numerous that just by their very number 
    they impair the cilia.<span style="mso-spacerun: yes">&nbsp; </span>It's a 
    double whammy though: just as the chest cilia are impaired, so are the nasal/sinus 
    cilia as well, and both the chest and the sinuses are susceptible to disease, 
    will have thick mucous, etc. This happened to 9/11 rescuers, some of whom 
    haven't recovered yet. <o:p></o:p></font><font face="Times New Roman, Times, serif" size="3"><o:p></o:p></font></p>
  <p class=MsoPlainText><font face="Times New Roman, Times, serif" size="3">Katrina 
    Cough symptoms include a dry cough, runny eyes, runny nose, nasal / sinus 
    headache, sore throat, chest tightness, and fatigue. <o:p></o:p></font><font face="Times New Roman, Times, serif" size="3"><o:p></o:p></font></p>
  <p class=MsoPlainText><font face="Times New Roman, Times, serif" size="3">One 
    approach for Katrina cough is to use cough suppressors to stop the patient 
    from coughing.<span style="mso-spacerun:
yes">&nbsp; </span>This may not be a good idea, because you do want to get the 
    particles of nasty stuff out of your lungs. <br>
    <br>
    A better recommendation is a two-step approach, reduce the number of particles 
    inhaled by using a mask or nasal filter, and in addition, wash out the particles 
    from the nose and sinuses with <a href="faq.html#irrigation">pulsatile irrigation</a> 
    (or at least a saline wash until you can get <a href="faq.html#irrigation">proper 
    pulsatile irrigation</a>). <br>
    <br>
    For filtering, an N95 filter mask in essential.<span style="mso-spacerun:
yes">&nbsp; </span>Some N95 nasal filters are also avilable which allow you to 
    speak and breathe normally. A painter's mask is worse than no mask, as particles 
    may be trapped in the mask, and you just collect and re-breathe them. <br>
    <br>
    Why <a href="faq.html#irrigation">pulsatile sinus irrigation</a>? You can't 
    do anything for the chest if the nasal and sinus cilia are unable to filter 
    out new material being breathed in.<span style="mso-spacerun: yes">&nbsp; 
    </span>Also, pus from the nose can eventually irritate the lungs. If you can 
    get the cilia of the nose and sinus back to proper function, then the body 
    can start filtering out some of the nasty stuff, giving the lungs a break.<span
style="mso-spacerun: yes">&nbsp; </span>Blowing your nose, decongestants etc. 
    may get rid of some symptoms, but they aren't effective at getting the cilia 
    moving.<span style="mso-spacerun: yes">&nbsp; </span>Anything you can do to 
    increase cilia movement is also helpful.<span style="mso-spacerun: yes">&nbsp; 
    </span>Drinking warm tea with lemon and honey, though not high-tech, is an 
    effective means of speeding ciliary motion.<span style="mso-spacerun:
yes">&nbsp; </span><br>
    <o:p></o:p></font></p>
  <p class=MsoPlainText><font face="Times New Roman, Times, serif" size="3">For 
    persistent cough, steam inhalation with your tongue out gets warm moist air 
    into your lungs and may be helpful.<span
style="mso-spacerun: yes">&nbsp; </span>On the other hand, using a steamer in 
    your home in these areas may add moisture and encourage the mold.<span
style="mso-spacerun: yes">&nbsp; </span>If you are trying to fight mold in the 
    house, you might try to get one of the steamers that fits over your nose and 
    mouth and prevents much steam from entering the room. <span
style="mso-spacerun: yes">&nbsp;</span></font><br>
  </p>
  <h3> What Can I Do About My House?</h3>
  <p class=MsoPlainText><font face="Times New Roman, Times, serif" size="3">Mold 
    is a major problem after a hurricane.<span
style="mso-spacerun: yes">&nbsp; </span>A good exhaust fan is the best mold reducer.<span style="mso-spacerun: yes">&nbsp; 
    </span>Heating the basement helps too. Do not attempt to salvage and keep 
    rugs.<span style="mso-spacerun:
yes">&nbsp; </span>Most experts feel these can't be saved. <br>
    <br>
    A light bulb in the closet is a mold reducer. Use Clorox and bleach for removal 
    of mold from surfaces, but be sure to wear gloves and an N95 mask when you 
    do this work.<span style="mso-spacerun: yes">&nbsp; </span>Be sure to run 
    the fan during and after shower or bath to avoid feeding moisture to the existing 
    mold.<span style="mso-spacerun: yes">&nbsp; </span>The fan should be an exhaust 
    type to remove the condensation (don't just blow the moisture around your 
    house, get rid of it).<span style="mso-spacerun: yes">&nbsp; </span>Make sure 
    there are no leaks into the house from sprinklers or rain.<span
style="mso-spacerun: yes">&nbsp; </span>An exhaust fan in the attic is a must. 
    <o:p></o:p></font></p>
  <h3 class=MsoPlainText><font face="Times New Roman, Times, serif" size="3"><br>
    More You Can Do for Your Cough<o:p></o:p></font></h3>
  <p class=MsoPlainText><font face="Times New Roman, Times, serif" size="3">If 
    you have the Katrina cough, smoking and being around construction will make 
    you worse.<span style="mso-spacerun: yes">&nbsp; </span>If you must do construction, 
    you must wear gloves, use an N95 mask, and you absolutely must do nasal irrigation.<span style="mso-spacerun: yes">&nbsp; 
    </span>I recommend every four hours.<span style="mso-spacerun:
yes">&nbsp;&nbsp; </span>Irrigation will remove the dust and other particles from 
    the nose and encourage cilia function.<span style="mso-spacerun:
yes">&nbsp;&nbsp; </span>If you do not have access to a pulsatile irrigator at 
    the construction site, use any kind of saline nasal irrigation at the very 
    least, but get to a pulsatile machine as often as possible.<span
style="mso-spacerun: yes">&nbsp; </span>Remember, some molds can affect the skin, 
    with itch and rash, hence the need for gloves. <o:p></o:p></font><font face="Times New Roman, Times, serif" size="3"><o:p></o:p></font></p>
  <p class=MsoPlainText><font face="Times New Roman, Times, serif" size="3">Persons 
    who already have allergies and asthma are much more liable to get symptoms 
    by returning to New Orleans. Health authorities advise these people to stay 
    away.<o:p></o:p></font><font face="Times New Roman, Times, serif" size="3"><o:p></o:p></font></p>
  <h2 class=MsoPlainText><font face="Times New Roman, Times, serif" size="3">Treatment</font></h2>
  <p class=MsoPlainText><font face="Times New Roman, Times, serif" size="3"> If 
    you exhibit a tight chest, you MUST get medication. Usually a bronchial dilator 
    does the trick.<span
style="mso-spacerun: yes">&nbsp; </span>For chronic nasal symptoms, <a href="faq.html#irrigation">pulsatile 
    irrigation</a> with a proper, purpose-built machine is the best treatment 
    for stimulating your sinus cilia.<span style="mso-spacerun: yes">&nbsp; </span>If 
    this is not available, at least irrigate with saline until you can get this 
    treatment. The primary disorder of the Katrina cough is most likely to be 
    impaired cilia and the longer they remain impaired, the more possibility of 
    long term nasal/sinus disease. Many persons after 9/11 did not use <a href="faq.html#irrigation">pulsatile 
    irrigation</a> or other means to restore cilia function and are still symptomatic 
    today. <o:p></o:p></font></p>
  <p class=MsoPlainText><font face="Times New Roman, Times, serif" size="3">Don't 
    forget that warm liquids such as hot tea and chicken soup stimulate cilia 
    function, but that smoking inhibits this function which is essential to your 
    health, and essential to getting rid of your Katrina Cough. <o:p></o:p></font><font size="3"><o:p></o:p></font><o:p></o:p></p>

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  Last Update 2005 Nov. 28<br>
  <address> <a href="cv.html">Murray Grossan M.D.</a><br>
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