The Santa Ana Winds: A Cruel Blow

“It is the season of suicide and divorce and prickly dread, wherever the wind blows.”

That’s what Joan Didion had to say about Southern California’s legendary Santa Ana winds in her classic story, “Some Dreamers of the Golden Dream.” In “Red Wind,” mystery writer Raymond Chandler put it differently, something about the wind-induced fantasies of “meek little housewives”--fantasies involving carving knives and their husbands’ necks.

The Santa Anas, like the planet’s other katabatic or reverse winds--the foehn of Germany, the chinook of the eastern Rockies, the sirocco of North Africa--have long been blamed for making people irritable, although scientists have yet to agree on a specific factor that might cause such a reaction.

In some parts of the world, the effects of the winds are so well-acknowledged that people convicted of murders and other serious crimes can sometimes get lighter sentences if they can prove the winds were blowing at the time they broke the law.

For most of us, of course, the effects aren’t quite so dramatic. Noses get stuffy, throats become dry, eyes burn, allergies act up and skin starts to crack. No wonder we get a little grouchy. But if we can remember to reach for the saline spray instead of the carving knife, doctors say, maybe we can reduce some of that “prickly dread”--at least when it comes to our physical symptoms.

Allergists, pulmonary specialists, otolaryngologists and other physicians say their business tends to pick up significantly during Santa Anas, which are most common in fall and early winter.

“We get people who have put off going to the doctor for a long time, and when the winds blow they just can’t take it anymore,” says Dr. John Chiu, an allergy immunologist in Anaheim.

“It’s strange,” says Dr. Leo Cummins, an allergist in Orange. “Sometimes we start getting calls before the winds even start blowing. Then the winds themselves bring extra problems. And we get another flurry three to four days afterward.”

Emergency rooms also get a little busier, or so it seems to Dr. Barry Pollack, who runs the emergency room at La Palma Intercommunity Hospital. “I haven’t done a statistical survey or anything, but as a gut reaction, I would say, yes, we do get more people,” he says.

Sometimes, depending on the patient’s underlying problems, the doctors treat wind-related symptoms with medication, oxygen or more drastic measures. But for most, they emphasize “just managing and trying to get through it,” says Dr. Lee Hartman, an otolaryngologist based at Saddleback Hospital.

“That’s about all you can do--unless you want to leave Orange County,” he says.

During a katabatic wind, normal wind directions reverse, causing already dry mountain air to descend the leeward slopes, heating and becoming even drier as it rushes downward, with relative humidities sometimes as low as 1%.

That decreased humidity alone could cause plenty of problems, Cummins says, but combined with the higher levels of dust, mold and pollen blowing around, Santa Anas can cause allergy-like symptoms even for those who have no trouble other times. And for those who do have underlying allergies, asthma or other illnesses, the effects are magnified.

“Usually we see four kinds of complaints: nosebleeds, drying of the nose and throat, crusting and stuffiness,” Hartman says. “A lot of people’s symptoms are mild, and for that we may just increase the humidification.”

He and the other doctors recommend using a nasal saline solution, available on the same drug store shelves as the better-known solutions used for a cold or flu. But there’s a big difference. Saline solutions are simply purified mixtures of salt and water, and they are used to increase the moisture level in nasal passages. Those other sprays are vasoconstrictors formulated to dry up nasal and sinus tissues. During Santa Ana conditions, Hartman warns, vasoconstrictors only make the problem worse. If you’re unsure whether a spray contains vasoconstrictors, check with the pharmacist.

Nasal saline sprays are “generally very, very safe,” Hartman says. “The only caution would be, don’t pass the same bottle among members of the family.”

If nosebleeds persist, Hartman suggests using a small amount of petroleum jelly inside the nostril.

Cummins says he advises patients with allergies to stay inside during Santa Ana spells, “if they have a decent inside environment.” But if there are family pets indoors, for example, allergic conditions may be aggravated.

If the problem is more serious, Hartman says, doctors can prescribe decongestants, intranasal steroid sprays or antihistamines, “but unfortunately, they all have a drying effect. For every treatment, there’s a price. The degree of intervention has to be gauged on the degree of symptoms.”

Dr. Raymond Casciari of Orange, a pulmonary disease specialist, says patients with asthma are the most severely affected by Santa Ana winds.

For asthma and allergy patients as well as the rest of us, he has some simple advice. “Pretend you’re a plant,” he says. “You need a lot more water during these winds.”

He also recommends staying indoors with windows closed, using air conditioners at home and in the car and avoiding exercise. “If you must exercise, go to the gym and use the pool. This is not a good time to go on a 50-mile bike ride.”

Chiu suggests using a humidifier as well if a patient has no mold or dust allergy, and wearing glasses outdoors to help keep eyes from becoming dry.

Pollack says the wind victims he sees in the emergency room are usually asthmatics and those with chronic obstructive pulmonary disorders such as emphysema. If they are having difficulty breathing, “we give them oxygen, that’s real important, and try to open up their airways, usually with aerosol breathing treatments, or bronchodilators. In the worst scenario, we can ventilate them by intubation, putting an airway down their throat. But that doesn’t happen too often.”

Smokers are often more seriously affected, he says. “The rest of us, if we’re at 100% of our lung capacity and it drops down to 80%, we won’t notice. But if you’re only at 50% capacity to begin with, you’ll really feel it.”