While I was out on a late-night walk with my dog during the record heat wave in Los Angeles that helped fuel the West Coast fires, a neighbor pointed to the sky and asked if I’d seen the moon. I glanced upward, looking for a white globular shape.

Instead, I saw what looked like Mars. The moon was red.

Five days later, I was reading through eyes partially swollen shut. I’d gone to bed with a sore throat and woken up with painful angioedema (an allergic, potentially fatal swelling) in my face.

I’m disabled from Sjogren’s syndrome, a systemic autoimmune disease that leaves me vulnerable to angioedema and vasculitis, an excruciating inflammation of blood vessels that often causes them to burst. Both symptoms have been aggravated by the hazardous air quality resulting from the fires in California, Oregon, Washington state and Idaho.

I’m not alone in my misery. Other immunocompromised and chronically ill patients I’ve spoken to are experiencing severe symptoms triggered by smoke toxicity, described as “unprecedented levels of air pollution” by Bonnie Holmes-Gen, chief of health and exposure assessment at California’s Air Resources Board.

Tyra Hanson Burgess, a woman in Idaho who suffers from multiple autoimmune diseases, including urticarial vasculitis, is seeing a huge uptick in her symptoms because of the smoke. She tells me her vasculitis is “going crazy” and that she has “angioedema all over,” with a particularly bad spell of it in her eye sockets and nose.

Burgess’ 10-year-old son, who has Kawasaki syndrome, has also been suffering from angioedema. His flare-up is in his ocular cavity, giving him the appearance of a puffy, bruised under-eye.

In Oregon, Angie Ebba, who suffers from chronic fatigue syndrome and chronic migraines, says she’s experienced increased exhaustion, muscle pain and weakness as a result of the smoke-ridden air.

Talia Miele, a woman in Washington state with fibromyalgia, says the toxic air quality has caused “fatigue, intense pain and the first migraine I’ve had in years.” She also says the smoke has prevented her from going outside, “which is necessary to keep flares at bay.”

I can relate. Here in California, if I leave the sanctuary of my air-filtered home and go out into the smoke – even while wearing my mask with a filter – within seconds, my skin crawls and itches uncontrollably.

Yet the stories of those of us with autoimmune diseases and chronic illnesses who are adversely affected by smoke toxins are often left out of conversations about the damaging effects of wildfire smoke inhalation.

Regular high doses of Benadryl have barely kept my angioedema under control, and my vasculitis is worse than it’s been in six years. I’ve also developed a frightening new symptom: a glare in my right eye that distorts light and makes it feel like a strobe light is going off in my head.

So I will stay home in bed and try to fight a searing pain that leads to crippling, annihilating fatigue. I will forgo my next round of Benadryl just long enough to type a sentence I hope will make a difference to someone reading it.

An election is coming up, and there’s a reason Scientific American chose this year to back a presidential candidate for the first time in its 175-year history. It gave an emphatic nod to Joe Biden, because climate change – and the wildfires it helps ignite – is real. It’s as real as the dangerous ballooning of my face and the blood pooling under my skin.

This election, I will vote like my life, like the lives of many others like me, depends on it. Because it does.