John: Smoke from the record-setting Canadian wildfires is again making the air hazardous
to breathe this weekend across the northern plains and upper midwest.
Dealing with this summer smoke is a new experience for many outside the western united States,
where it's all too common.
And as the smoke triggers breathing problems for many, it also highlights the fact that
more than 5 million Americans don't have easy access to a respiratory specialist.
For Walt and penny Copeland, the small town of Hayden, Colorado has been home for 5 decades.
Set high in the rocky mountains, they're that much closer to the deep blue skies and puffy
white clouds.
Maybe take a bunch of deep breaths.
Don't cheat on your oxygen test.
I didn't.
[Laughter] John: Three years ago, they were comfortably
settled into retired life when Walt began having breathing problems.
I was having a checkup after my heart valve.
Once a year, I'd go for a checkup.
They found a little spot on my left lung that was kind of cloudy.
John: He was diagnosed with pneumonitis -- inflammation of the lung tissue, also called farmers lung.
There's hundreds of different types of farmer's lung, which are mold, sawdust, you know, all
kinds of stuff.
I grew up with parents who smoked and I worked out at the coal mine and I hauled fuel and
stuff like that, but no scarring, nothing showed up.
John: Retired from long-haul trucking, Walt thought he was done with long, regularly scheduled
drives.
But from his home in Hayden, going to a pulmonologist every three months for check-ups meant a round
trip drive of eight to ten hours.
10 hours for a 15 minute visit.
That's why we always waited for him to come up here.
Let him do the driving.
[Laughter] John: You've done enough driving over the years.
[Laughter]
I have.
John: Instead, the pulmonologist comes to him.
No sign of a flare up?
Not yet, not that I've seen John: Once a month, Dr. James Hoyt of U.C.
Health, a not-for-profit regional health system, makes the trek to a medical center in steamboat
springs from his office in fort Collins.
During each visit to the ski resort town, he has 9 hours of patient appointments over
two consecutive days.
180 miles each way with a 1300 foot elevation change, Dr. Hoyt's been making this monthly
trip for the last decade.
It's about 4,000 miles a year.
So 40,000 miles, 50,000 miles.
And I've gotten one new windshield, one new bumper, a whole new front end when I hit a
deer.
I've only for weather not made it once.
John: For hundreds of Hoyt's patients across northwestern Colorado and southern Wyoming,
it's a life-changer.
Walt Copeland gets to his appointments in just a 30-minute drive, usually combining
the trip with other errands.
Many parts of the country, especially the rural west, have limited access to pulmonologists.
According to telehealth and prescription discount provider goodrx, more than 5 million Americans
are more than a one hour drive from a respiratory specialist, living in pulmonology deserts.
Respiratory specialists have been in high demand in recent years, as an aging population
has a higher risk of COPD.
Then came covid-19, and the
damage it can do to the lungs of those infected with the virus.
Burnout from the pandemic has led to pulmonologists retiring early or changing specialties.
There were two really hard times.
The first time was when it first came and there were 14 or so of us all got in a room
and looked at each other and wondered who's going in first, because there were no vaccines,
there was ppe that we didn't really know for sure if it worked or not.
The second really hard time in covid was when our health care teams were exhausted from
18 months or so of grinding, and there were more than enough vaccines for everyone and
patient after patient after patient we took care of was unvaccinated by choice.
John: Climate change plays a role, too, helping make wildfires bigger and more intense, and
the air more hazardous to breathe.
Last summer, this beautiful vista was obscured by smoke from wildfires in California, Oregon,
and Washington state.
In fact, wildfires can lead to air quality alerts hundreds of miles downwind.
And as the fine particulate matter in that smoke drifts
across the country, it can leave a trail of people headed to doctors' offices, urgent
care clinics, and emergency rooms with respiratory problems.
Walt Copeland's wife, penny, has asthma.
Smoke is one of the things that I am allergic to.
So when the valley would fill with smoke, I basically had to stay indoors with the windows
closed.
It would make it difficult to breathe at night.
When you don't get enough air, you can't, you don't function.
You just basically have to sit on the couch and that is it.
Over the last few decades, the west has been seeing, you know, this just gradual uptick
in the number of fires, how large they are and how severe they are.
John: Jennifer Stowell is a researcher at Boston university school of public health.
She says wildfire smoke from Canada and the western united States will continue to affect
parts of the country unaccustomed to it.
What's the effect on health, on public health?
A lot of that depends on, you know, what is burned and how far it gets.
It affects people who already have sensitivities.
And generally the big one is respiratory that we would expect.
For instance, if I had asthma and I have you know a significant exposure to wildfire smoke,
the likelihood that I would show up at an er because of my asthma is probably about
8% more likely on a day that I'm exposed to smoke than on a day when I'm not exposed.
John: And that, Stowell says, means more hospital visits.
The important thing for people to know is to remain indoors if you can.
Especially if you look at the air quality colors, if it's worse than yellow, you want
to stay indoors.
If you have underlying conditions like asthma or COPD, you want to stay indoors as soon
as it gets out of that green area.
And if you have to go outside, definitely wear a mask.
John: Penny Copeland doesn't need a researcher to tell her what the shortage of respiratory
specialists means -- every time her asthma gets bad, she feels it.
Usually when you have a flare, it's good to be seen by a pulmonologist so they can kind
of help you through that and give you more treatment.
But when we have a pulmonologist only here once a month, your asthma flares usually don't
come along when he's here.
John: And the asthma doesn't pay attention to Dr. Hoyt's schedule.
No, it does not.
[Laughter] John: At uc health's medical center in steamboat springs, clinic operations director
Ryan Larson recognizes the need.
He's begun the challenging task of hiring a full-time staff pulmonologist.
We started recruiting in January 2023.
And we're looking to have a full time provider starting next summer, July 2024.
John: And how hard is that?
So far, it's been pretty hard.
We have had quite a few candidates come through, but no one's been a great fit for the community.
I've walked out of the office, sat in my car and called them for an appointment and I -- and
they said I don't have , his appointment schedule ready yet.
So I said, ok, I'll call back later.
Then when I do, they say it's filled up.
John: And as Dr. Hoyt's limited appointments become harder to get, Walt and penny Copeland
hold their breath, waiting for the right candidate to come along to fill the gap. ♪♪