Heart Failure to Transplant: Should I Stay or Should I Go?

I posted the following on my CaringBridge journal on Nov. 13, 2014:

Since this journey began I've heard from more than one trusted friend that I might want to consider moving out of the Central Valley for the sake of my health.

We have some of the worst air in the nation here in Tulare County, both in terms of ozone and particulate matter. http://m.stateoftheair.org/2014/states/california/tulare-06107.html />

Study after study has shown that worse air quality leads to worse health outcomes (hospitalization, death) for those with pre-existing issues with their heart or lungs. The effects can be immediate as in the same day of exposure or show up days to weeks later.

Last week, the week that ended with me in the hospital, almost every day our air quality here in Visalia was in the red zone (unhealthy for all groups) and even spent time in the purple (very unhealthy) zone.

The link I shared above said that in Tulare County there are on average 242 days of air each year with ozone levels unhealthy for sensitive groups, and 16 days of air with ozone levels unhealthy for everyone. That leaves only 107 days of moderate or good ozone levels.

There were also 15 days with particulate matter levels unhealthy for sensitive groups, and four days unhealthy for everyone. Particulate matter levels have been shown to have a greater impact on worsening heart failure than ozone levels.

But where would we go? What about our house we just bought last fall? Adam's job? All my social support?

The best chance to get the same level of family and social support would be in Southern California where I am originally from. My three siblings all live in Anaheim and my parents live in Santa Ana, and I also have extended family in San Diego County.

Air quality there still gets a failing grade from the American Lung Association, but with only 9 days out of the year in the unhealthy for sensitive groups level for ozone and 14 days per year of unhealthy for sensitive groups particulate matter levels.

Not much better than here and cost of living is prohibitive. Three bedroom apartments range from $1500 to $2300/per month. Adam could possibly work out of his company's Orange County location, but he doesn't expect he would get much of a pay increase.

I still think one or more high quality home air purifiers are a good alternative to moving. I did some research and 3M makes a model that costs only $99 and removes 99% of particles 0.1 micron and larger from the air.