Si­nus is­sues pile on to Har­vey’s af­ter­math

Doc­tors re­port spike in many pa­tients with re­s­pi­ra­tory symp­toms

Houston Chronicle Sunday - - CITY | STATE - By Todd Ack­er­man

Judy Lupo has strug­gled with al­ler­gies and asthma since she came to Hous­ton more than 50 years ago, but the level of suf­fer­ing was never like it has been since her home flooded in the af­ter­math of Hur­ri­cane Har­vey.

She’s a mess of cough­ing, itch­ing eyes, blurred vi­sion, si­nus con­ges­tion, post­nasal drip and gen­eral dis­com­fort, she says, tor­ment that shows no sign of eas­ing. When Lupo goes into her old neigh­bor­hood, devastated still, she wears a mask.

“It’s been a dra­matic change,” said Lupo, 77, a re­tired speech pathol­o­gist. “In the last five years I’d got­ten to the point where my al­ler­gies seemed rel­a­tively mild, but ev­ery­thing that’s in the air now has them out of con­trol. It’s quite frus­trat­ing. It lim­its ac­tiv­ity, life.”

Lupo is hardly alone, ac­cord­ing to Hous­ton-area doc­tors, who re­port a spike in pa­tients with re­s­pi­ra­tory symp­toms. If skin in­fec­tions were the No. 1 health prob­lem in the ini­tial pe­riod af­ter Har­vey, si­nus dis­tress clearly is the big is­sue now, they say.

It is not hard to imag­ine why. Such prob­lems fol­low­ing hur­ri­canes are com­mon be­cause of mold and over­growth of plants that re­sult from the flood­ing, as well as dust and fibers re­leased from dry­wall, plas­ter, floor­ing and other sources dur­ing clean-up ef­forts.

State of­fi­cials also re­port that

re­finer­ies, petro­chem­i­cal plants and other in­dus­trial op­er­a­tions spewed mil­lions of pounds of pol­lu­tants into the air dur­ing Har­vey-re­lated shut­downs and ac­ci­dents in the Hous­ton area.

New Or­leans doc­tors in 2005 re­ferred to the “Ka­t­rina cough.” In Hous­ton, the term “Har­vey hack” is catch­ing on.

Of course, it’s not that sim­ple. For many pa­tients, doc­tors can’t be sure whether symp­toms were caused by Har­vey or sea­sonal al­ler­gies, now in full force.

Rag­weed, the sea­son’s most preva­lent al­ler­gen, has reached “heavy” lev­els in the city’s daily pollen and mold re­port for more than a week. That should con­tinue un­til the weather turns colder in Novem­ber, said Tony Huynh, a lab­o­ra­tory su­per­vi­sor in the city’s health depart­ment. Mold spores, cur­rently at medium lev­els, are a year-round al­ler­gen. ‘Mul­ti­ple fac­tors’

In ad­di­tion, doc­tors are even re­port­ing some pa­tients with the flu, off to an early start.

“It’s a com­bi­na­tion of the three — Har­vey, sea­sonal al­ler­gies, the flu — that’s driv­ing the vis­its, more than one for some pa­tients,” said Dr. Eric Sand­berg, an al­ler­gist at Kelsey-Sey­bold, the health clinic net­work. “It’s hard to dif­fer­en­ti­ate, but I’m con­fi­dent mul­ti­ple fac­tors are at play.”

Sus­pect­ing Har­vey’s role, Sand­berg had re­quested fig­ures for re­s­pi­ra­tory ap­point­ments for Kelsey Sey­bold’s 20 clin­ics around the city. The ini­tial re­turns sup­ported the no­tion, show­ing a 23 per­cent jump in pa­tients from Au­gust to Septem­ber this year, up from a 12 per­cent in­crease last year. A closer look at the data, how­ever, sug­gests 2016 was the out­lier. The Au­gust-toSeptem­ber in­crease was 30 per­cent in 2014, and 28 per­cent in 2015.

Sand­berg said it makes sense that the in­crease is “storm-re­lated, the way pa­tients started com­ing in a week af­ter the storm. But you can’t know.” He added that Oc­to­ber is al­ways Hous­ton al­ler­gists’ busiest time of year be­cause the drop in hu­mid­ity leads to more pollen.

Still, many doc­tors are con­vinced Har­vey is the ma­jor cul­prit these days. They note that a pre­pon­der­ance of the pa­tients they are see­ing are from ar­eas most af­fected by the storm and floods, ar­eas where there still is de­bris out­side.

“These cases are more than rou­tine sea­sonal al­ler­gies,” said Dr. Zeenat Saf­dar, a pul­mo­nolo­gist at Hous­ton Methodist Hos­pi­tal and Lupo’s doc­tor. “Most peo­ple know their sea­sonal al­ler­gies. These cases are more se­vere, more pro­longed. Peo­ple are be­ing ex­posed to too many im­pu­ri­ties and par­ti­cles.”

Lupo waded through knee-high wa­ter to her Me­mo­rial-area home’s sec­ond floor af­ter the Ad­dicks Reser­voir re­lease, was evac­u­ated by boat the next day and was shut­tled from site to site be­fore land­ing at Ge­orge R. Brown Con­ven­tion.

Still, it took about two weeks for her symp­toms to flare up, af­ter she re­turned to her neigh­bor­hood.

Dr. Chase White­head, a doc­tor of family medicine at Me­mo­rial Her­mann Med­i­cal Group Me­mo­rial City, said he began see­ing pa­tients with re­s­pi­ra­tory prob­lems soon af­ter Har­vey hit — peo­ple with runny noses and coughs they could not shake, for­mer asth­mat­ics whose prob­lems sud­denly flared up again. He said there has been no ta­per­ing off in the weeks since.

White­head also noted that it is hard to know what is driv­ing the in­crease. He treated 10 pa­tients re­cently who thought they had up­per-re­s­pi­ra­tory in­fec­tions. Nine turned out to have no in­fec­tion but an in­flam­ma­tion of the lungs, which he treated with steroids.

“I don’t want to send the mes­sage these re­s­pi­ra­tory prob­lems only in­volve in­flam­ma­tion, though,” he said. “I’ve prob­a­bly seen 10 flu cases al­ready.” Bad flu sea­son likely

That could be an omi­nous sign for a flu sea­son ex­perts are say­ing looks like a bad one. Though the flu sea­son has of­fi­cially started na­tion­ally, Hous­ton doc­tors typ­i­cally do not see cases un­til Novem­ber, and the bulk of them un­til Jan­uary and Fe­bru­ary.

The pos­i­tive about Hous­ton’s re­s­pi­ra­tory prob­lems is that they have not been bad enough to war­rant more trips to emer­gency de­part­ments than usual. Hous­ton’s health depart­ment re­ports the num­ber of vis­its to the ER vis­its for re­s­pi­ra­tory ill­ness was no greater in Septem­ber of 2017 than 2016.

To min­i­mize risks, doc­tors urge peo­ple to limit their time out­doors and their ex­po­sure to mold and other al­ler­gens or pol­lu­tants, par­tic­u­larly if they know they have air­borne sen­si­tiv­i­ties or an up­per re­s­pi­ra­tory in­fec­tion. If they need to clean an area that looks or smells like mold, doc­tors ad­vo­cate wear­ing a mask.

Steve Gon­za­les / Hous­ton Chron­i­cle

Judy and Dick Lupo’s Me­mo­rial-area home was in­un­dated af­ter flood­wa­ter re­leases up­stream at the Ad­dicks Reser­voir. In the weeks since Har­vey, Judy Lupo says the in­ten­sity of her al­ler­gies has spiked.

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