Health
Physical Health
1. PREVENT ASH EXPOSURE
If you get ash on your skin, in your eyes, or in your mouth, wash it off as soon as possible.
People with heart or lung disease such as asthma, older adults, children, and pregnant people should use special caution around ash.
1a. Pets should not be nearby while you clean up ash, and clean ash off pets and other animals. Keep pets away from contaminated areas.
1b. Wear gloves, long-sleeved shirts, long pants, shoes and socks, and goggles to avoid skin and eye contact. Contact with wet ash can cause chemical burns or skin irritation. Change your shoes and clothing before you leave the cleanup site to avoid tracking ash offsite, into your car, or other places.
2. PROTECT YOUR LUNGS
Wear a tight-fitting respirator that filters ash particles from the air you breathe. Wear a respirator that has the words “NIOSH” and either “N95” or “P100” printed on it. These have two straps and are available online, and at many hardware stores and pharmacies.
Buy respirators in a size that can be tightened over your mouth and nose with a snug seal to your face. Surgical masks and one-strap dust masks will not protect your lungs. They are not designed to seal tightly to the face.
If you have heart or lung disease, talk to your doctor before wearing a respirator or working around ash.
Limitations of the AQI in Wildfire Scenarios:
The AQI primarily measures pollutants like PM2.5 (fine particles), PM10, ozone, and nitrogen dioxide. While PM2.5 is a significant concern during wildfires, it doesn’t account for the chemical composition of the particles, which can include toxic compounds like heavy metals, volatile organic compounds (VOCs), and polycyclic aromatic hydrocarbons (PAHs) from burned structures, plastics, & other materials.
Underestimates Localized Hazards:
To Clear Lungs:
Drink fluids: Water, broths, and non-caffeinated herbal teas help thin mucus and keep you hydrated.
Take an expectorant: Expectorants thin mucus so it’s easier to cough up. You can take them as a liquid, pill, or tablet.
Try controlled coughing: Controlled coughing helps loosen mucus and move it through your airways.
Take NAC
NAC (N-acetylcysteine) is a powerful antioxidant and precursor to glutathione, which is crucial for detoxification. NAC helps to replenish glutathione levels in the body, combat oxidative stress, and support lung health over time.
Take NAC orally: It is more accessible, easy to take, and effective for general detoxification and systemic support.
- Dosage: 600-1800 mg per day, split into 2-3 doses.
- Take with food..
Drinking Herbal Teas, like Breathe Deep, can support respiratory health.
Health Links:
Huntington Health Wildfire Community Resources
Mental Health
Substance Abuse and Mental Health Services Administration
Disaster Relief Information
The Substance Abuse and Mental Health Services Administration’s mission is to reduce the impact of substance abuse and mental illness on America’s communities.
It helps prepare states and communities to provide an effective response after a disaster.
If you or someone you know needs help right now, please use the resources below to find help:
988 Suicide & Crisis Lifeline. Dial 988 – If you’re in a suicidal or emotional crisis, please call this 24-hour hotline to reach a crisis center. You may also use the online Lifeline Chat .
• Disaster Distress Helpline 1-800-985-5990
If you’re feeling emotional distress related to a disaster, call or text to talk with a trained counselor. You can get support 24 hours a day, 7 days a week, 365 days a year.
• SAMHSA’s National Helpline 1-800-662-HELP (4357) or TTY 1-800-487-4889 – Get help for mental and substance use disorders, prevention, and recovery. This is a free, 24-hour, confidential treatment referral and information service. (English & Spanish)
• FindTreatment.gov – Find substance use treatment for yourself or others. Learn about types of treatment, payment options, and treatment locations.
• Behavioral Health Treatment Services Locator – Find alcohol, drug abuse, and mental health treatment services around the country.
Find out more: https://www.disasterassistance.gov/get-assistance/forms-of-assistance/4506
Managing Agency U.S. Department of Health and Human Services
PTSD
For those with PTSD from the fires, this is good info copied and pasted from a private group:
On mental health, trauma, and PTSD
Just want to comment that what everyone in Altadena and the surrounding community has experienced is a profound trauma.
I am a primary care doc who works at the VA. I live in Connecticut now, but grew up on East Palm street in Altadena, where my parents live and where they just lost our beloved home of 50years. I was putting this together for my parents and other close friends who lost their homes, and figured I would share more broadly in case someone might find it useful.. A big part of my job is evaluating and managing veterans who have traumatic experiences and PTSD. And though obviously I can not offer specific medical advice online, I want to make sure everyone is aware of some resources as they go through their stages of grieving and loss.
After an acutely traumatic experience like the Eaton fire, people go through something called an acute stress reaction. So sleeplessness and anxiety are quite common in the first few weeks, as your fight and flight is still activated. In some ways this is your bodies natural response to try to protect itself, and with many traumas, the rawness and anxiety abates after several weeks. Getting sleep is essential. Non pharmacological sleep interventions work the best. The name of behavioral things you can do to get to sleep faster and sleep for longer is called cognitive behavioral therapy for insomnia. There are many free sleep apps available. The CBTi coach is good but there are many other good ones out there.
Short term meds for sleep do work (like ambien, trazodone, mirtazapine (prescription)), and Benadryl (over the counter- only for younger people- avoid in elderly), but they can make you groggy or even cause some mental fog the next day. PTSD is diagnosed if there are ongoing symptoms after about a month after a trauma like the Eaton fire. These occur in four main clusters of symptoms: 1. re-experiencing (nightmares, intrusive thoughts about what happened), 2. anxiety/agitation/edginess brought on by the reexperiencing (fight/flight reactivates), 3. numbing/avoidance (avoiding things that trigger the re-experiencing, or trying to find ways to dull the anxiety, or walling yourself off from others), and 4. depressive symptoms (feeling down, worthless).
Someone else in this group was kind enough to mention an app called the PTSD coach. The PTSD coach is a free app, and though developed by the VA and DOD, it is free for anyone to use. It is evidence based and can help people navigate through their symptoms and provide some self management strategies. It is very well made and I highly recommend it.
Additionally it is very important to grieve with your friends and loved ones and with your community. Schedule a time to meet (best in person) daily. Do this every day. You all lost the fabric of your community. Find a beloved familiar spot outside of Altadena to congregate. Give each other big hugs and share your pain and beautiful memories together.
Deep breathing also really works for anxiety and insomnia. Physiologically this works by turning on your parasympathetic nervous system (which shuts off your sympathetic nervous system and the flight/flight response). I like the breathe2relax app but there are others. Those with more severe symptoms (can measure symptoms on the PTSD coach), or of course those with suicidal thoughts or those in crisis, should get professional help.
Acutely, 988 is the emergency number for those in mental health crisis (like 911 is for a medical crisis).
PTSD is treatable, both with cognitive behavior therapy like counseling, and with meds (SSRI and SNRI). Therapy takes time and efffort- at minimum something like 12-1 hour sessions. But it does work to alleviate PTSD symptoms for sure. Meds (SSRI and sNRI) usually take 4-6 weeks to kick in but they are effective. There are counseling services available online via video visits worth checking out. But check with your health insurance plan to see what is included. Additionally many employers offer independent employee assistance programs that may also help cover mental health support, so it is important to explore that avenue too.
Cannabis products are under researched unfortunately. They all have side effects, and the benefit and risk balance has not been well enough established to give clear guidance on when to use in PTSD. Since there are better researched options that do work (cbt and the meds above), I tend to tell folks to try those instead.
In general, I am not a fan of a class of meds called benzos (benzodiazepines- like Xanax, Ativan, Valium). I avoid prescribing these in my PTSD patients. Usually only a very small handful of my patients with severe refractory PTSD who are well connected with a Psychiatrist and have not responded to alll the other options, end up on them. These work acutely but then cause rebound issues and can be very addictive physiologically and can become problematic. And they also very dangerously magnify overdose risk of pain meds and can interact with other sedatives.
Resources: Free Apps: Breathe2relax CBT-I coach PTSD coach Crisis hotline: 988
Schedule a time to grieve with your community and friends and family every day. Put this on the check list.
How to Help Victims
If you are saying “MY FRIEND JUST LOST THEIR HOME IN A FIRE" Here is what you can you do to help:
Please be KIND, validate how awful it is and no need to tell them how they should feel or think instead. Let people grieve and feel their feelings. If you are feeling overwhelmed reach out for Mental Health Support.
1. Remember that they don’t realize yet that they don’t even own a toothbrush. The first day is OVERWHELMING to say the least.
2. Respect the fact that they are being overwhelmed by phone calls and text messages and may not be able to get back to you. Be patient.
3. If you want to help, Venmo them money or offer them gift cards to places like Target.
4. Offer to house their pets if they are displaced in a hotel.
5. Do not overwhelm them with a bunch of items they have nowhere to put. Only necessities first. Keep it simple with single store gift cards. I mentioned Target because that store saved us on day 1 when we realized we didn’t own underwear or socks or pajamas or phone chargers.
6. Cash is king. Venmo or Zelle. They will need to go shopping at the places that bring them comfort once they realize what they need. (How can I nicely say….don’t show up with bags of your old clothes unless they request it specifically when you ask them…..you are creating an extra job for them to dispose of what doesn’t fit or they don’t want and they don’t want to hurt your feelings so they take it anyway).
7. Many will refuse help out of pride. Remind them that it will bring you JOY when they accept your monetary gift and not to feel guilty about taking it. I learned the hard way that I was taking away people’s joy by refusing their help. I am not very good at receiving ( still working on that one) I didn’t want people spending their hard earned money on me when I knew we had insurance. I am sorry if you tried to help me and I wouldn’t let you. I was trying to help you before you could help me. Please forgive me, I understand now.
8. Offer to make them dinner and invite them to your home or go to a restaurant. They have nowhere to go. It is nice to feel normal after so much turmoil before deciding what is next.
9. Don’t stop reaching out. The love we felt from friends and even perfect strangers completely restored our faith in humanity.
10. Encourage them to find temporary rental ASAP before they are all taken up.
11. Advise them to hire an insurance advocate so that they will get their full insurance policy. The insurance company is going to try to give an offer that is much less than what is due. Do not let them accept the first offer.
I used John Joubran 714-345-4727. He was probably one of our best decisions.
12. Remind them that if there was not lives lost, then the rest IS JUST STUFF and can be replaced.”
Shared by Kristine Schomaker
Trauma in kids:
My friend is a trauma psychologist with the Peace Corps. She gave me this advice a few days ago:
“The most critical piece is once basic needs are taken care of, kids should start therapy asap. The sooner the better. There’s lots of research supporting rapid introduction of trauma interventions following a crisis – it can really make a difference in kids developing more longer term symptoms or not. If they can find a child therapist who can do virtual sessions if it’s not practical to work with someone in person right now that’s fine.”
She sent me this list of psychologists who are giving pro bono time to adults and children who need help:
https://docs.google.com/spreadsheets/d/1uAMVz8TQMzShQeuEA6kmOP0jyRN7qe1Iiqb6JOLTPqg/edit?gid=303232729#gid=303232729
Free Medical and Mental Health Clinic in Pasadena
The Eaton Health Village, in partnership with the Department of Mental Health, is providing free medical and mental health care every Monday and Wednesday from 11 a.m. to 3 p.m. at the Pasadena Seventh-Day Adventist Church (1280 E. Washington Blvd, Pasadena, CA 91104).
Services include medical consultations, medical refills, mental health services and case management, vision care, and dental care. Questions? Call 855-665-4621, press 3.