You'd expect most little girls go crazy at the sight of pretty candles and sparklers but even watching them in film gives eight-year-old Siya anxiety attacks each year.
The cause is not a nervous temperament but the trauma of reliving an asthma attack on Diwali day three years ago that left her being hospitalised for almost a week. It was very bad, we almost lost her, recall her parents. Now she's so scared that she shuts herself in her room and plays loud music to block out the noise of crackers and festivities till she falls asleep.
Shutting out winter smog full of noxious fumes regurgitated by factories and vehicles and sooty smoke from candles and crackers is a good start because it chokes the air with suspended particulate matter (SPM), which triggers wheezing and coughing in people with asthma. The only way Siya survives is by using a nebuliser - a device used to deliver mediation quickly into the lungs in the form of a liquid mist - at home to help her breathe when the air gets muggy.
November is a cruel month for people with asthma and other respiratory problems. This year, with smoke and fumes choking most of north and central India with smog that resembles a brown cloud, even people with healthy lungs are considering a day or two away from the town.
Asthma attacks occur when an allergic reaction to a pollutant causes the walls of the airways - which take air in and out of the lungs - swell up and the muscles around them tighten, reducing airflow to the lungs. Allergic reactions also cause cells in the airways to make more mucus than normal. Since mucous is thick and sticky, it further clogs up the airways and makes breathing difficult.
One in ten people have asthma in Delhi, with the smoke and fumes affecting young children more than adults. The smoke, coupled with the increasing chill in the evening air, also causes frequent chest infections, which worsen symptoms of breathlessness and in some cases, cause respiratory failure even in people who are not chronic asthmatics.
So don't assume that your lungs are safe just because you don't have asthma. Sustained exposure to smoke and fumes reduces lung capacity and threatens everyone's health, though children, people over 65 years, smokers, and people with heart and breathing problems have higher chances of infection and lung damage.
If you are an asthmatic, the most effective way to protect yourself is to stay away from direct exposure to smoke and fumes from lit candles, diyas and crackers. Also make sure you are well stocked up on asthma medication. In an emergency, visiting big hospitals with 24-hour chemists is the best option as many small chemists shut shop for Diwali.
A big setback in asthma management is that many asthmatics use their inhalers wrong. Most doctors prescribe medicines without giving thought to teaching people how to use it, which leads to the vital medicines not reaching their lungs in time to give instant relief.
If using an inhaler provides little or no relief, consider using a corticosteroid to relieve symptoms, such as an inability to walk more than a few steps without getting breathless, inability to speak more than one or two words per breath or signs of blueness around the lips.
Since children are often oblivious to their own symptoms, you must ask them - even if they don't have asthma - to report signs of chest tightness, burning eyes or a cough while running or playing. Babies and small children with respiratory distress may just breathe fast, appear restless, or may have problems feeding due to shortness of breath.
Given the air quality, everyone's lungs are at risk of some damage, so do what you can, when you can to help them breathe easy.