Sometimes it helps to look back when discouragement comes knocking. Colin kept a journal in the weeks following the evacuation of our home. I pulled it out yesterday.
He was a month away from his 9th birthday. The rashes on the back of his hands were painful and bloody. He had been to the ER two weeks prior for a migraine. His failing pancreas was the least of his worries.
I am probably the sickest man alive. Boy do I feel bad. Everything started when I woke up this morning. My head was booming inside of me or throbbing is the word I would use but my stomach hurt, my legs and my hands were numb and I could barely even walk up the stairs and I couldn't write of course.
My head, my chest and my stomach are worse than ever. I need your help if you're out there.
Thinking about the house is hard because thinking of all the fun things we did is hard. Thinking about my dogs Pippen and Frodo is really hard. Especially Pippen. He was my diabetic buddy.
Tomorrow is Halloween and I'm not sure I can eat any of my candy cause I'm sick. I've almost missed a week of school because of my exploding head and my booming chest and my buzzing stomach but at least I'm going to get better and maybe next Halloween I'll be able to eat all my candy in one night. I'm sure I'm going to get better journal. I promise you I'll get better.
Colin hasn't had a migraine for almost 2 months now. He doesn't use his reading glasses. He rarely complains of abdominal pain. His rashes are gone.
And he plays on a baseball team.
We've come a long way. I almost forgot.
Monday used to be the day to change sheets but he makes those executive decisions now.
He was on his way to Omaha Steaks. 50% off sale for Father's Day. He's keeping busy but I can tell it's not easy to function without your wife of 50 plus years.
My dad has a good sense of humor. I remember how excited I was to tell them both about our genetic findings. Pieces of the puzzle were fitting together and who better to share it with! I called this past January.
"Dad, I found out why we haven't gotten better since leaving the house."
"I'm double 4353. That means each of the kids has one 4353 gene and you and Mom each have one."
I went on to explain a little about this genotype but it's a lot to take in for someone coming up on his 84th birthday. Mom was approaching her 80th.
Without a moment's hesitation my dad said in his monotone, one-of-a kind, George Kessel way,
"Well, I guess we won't be having any more children."
My dad served in World War II. Lived in foxholes for 67 days before he was wounded. Earned a purple heart. I didn't hear a lot about his experience growing up. I was too young to ask good questions. As the years went by I asked better questions. Still, he wasn't too verbal about his experiences. I was surprised, then, when he told me he had published a book. You can read more on Amazon.
I'm grateful for my dad. I can't wait to see what other executive decisions he makes in the coming months.
4. What is the number one myth regarding mold?
The number one myth regarding mold is that it cannot cause human disease as experienced by a multitude of individuals worldwide. Also, I highly recommend that we quit looking at just molds and mycotoxins and turn our attention towards the complexity of biocontaminants in the indoor environment. The molds and bacteria and their by-products have interactions that are being ignored by the EPA, CDC, AOEC, OSHA and other alphabetic organizations who attempt to control our lives and our health.
5. In your opinion, why is the medical community so unaware of the hazards of mold?
The medical community (i.e. the practicing physician) is under educated. Environmental health issues are not adequately taught in the medical schools. In addition, as result of the cutback of NIH funding for basic and medical research at universities and medical schools , industry, and particularly, the pharmaceutical industry, have become the primary sources for funding research at these institutions. Now, if an investigator has a research grant funded by industry, imagine what would happen if he/she published a paper contrary to the goals of that particular funding source. The academic position of a researcher is secured with respect to the research monies brought into the institute where he/she works. Without research monies, no job. Furthermore, funding sources also have to pay a large overhead into the university, covering the overhead as well as paying salaries of staff of the university.
6. What do you recommend to an individual looking to test their air, either at home or in an office building?
Most industrial hygienists in this country are not doing the correct testing. Indoor air samples vs. outdoor air samples are only good for the time that the sampling was done, i.e. on that day and time. Such sampling does not reflect the history of the indoor environment, which can fluctuate hour by hour and day by day. Further, air sampling will only identify the mold genera released at the time of sampling. Finally, air sampling cannot identify the key mold species, particularly Aspergillus and Penicillium species.
What is the proper sampling? It consists of different types of sampling. This includes but is not necessarily limited to bulk, carpet dust, wall cavities, and indoor vs outdoor air samples. The bulk and carpet dust samples should be cultured for mold and bacteria. In addition, PCR mold DNA testing should be done to identify the dangerous species of molds. The bacteria should be identified to at least the genus level of gram negative and positive organisms. Finally, the bulk and carpet samples should be tested for the presence of mycotoxins.
7. If a person needs to choose, would you suggest an ERMI test or an air test?
I highly recommend the ERMI test. This test should be performed on carpet dust and bulk samples, not air tests. The ERMI uses PCR DNA mold procedure and allows the identification of mold species. The presence of toxic species then dictates the ERMI score. This test can be performed for as little as $350.00. Air sampling will only allow identification of Aspergillus and Penicllium as Apergillus/Penicillium-like mold. The reason for this is that the spore morphology of these molds are too similar to separate under the microscope. If cultures are done on air samples, then the mold species must be identified by PCR-DNA tests. I trust this answers your question.
Also, I must emphsize that cultures for potentially dangerous bacteria should be done on the bulk samples. Care must be taken by the microbiology laboratory to identify actinobacter as well as other bacteria.
8.What is the difference between a toxin and poison (if any)?
A toxin is a poison and a poison is a toxin. The term poison arose many years ago in warnings on labels on over-the-counter medications that could harm an individual if ingested. A good example of this type of poison was an antiseptic called "Mercurochrome." Mercurochrome was a liquid form of mercury that one could put on a cut to prevent infection.
9. What is the connection between mold exposure and the mitochondria?
Again, please ask what is the connection between mold and bacterial exposure and mitochondria. I am trying direct your thoughts towards microbial contamination of the indoor environment.
Both mold and bacterial toxins can cause damage to mitochondria. Damaged mitochondria do not produce a sufficient amount of Adenosine Triphosphate (see below answer) that is needed for biochemical reactions in the body. Also, damage to the mitochondria can lead to cell death via apoptosis. In addition, some toxins can adduct to the DNA of mitochondria, causing mutations that adversely affect the function of mitochondria.
10. Is it true that the fatigue that is often incurred is due to the poisoning of the mitochondria?
Yes, damage to mitochondria that interferes with or causes the reduction in the production of Adenosine Triphosphate (ATP) will cause fatigue. ATP is used for almost all energy purposes in the body, from muscle contraction to nerve function. Too little ATP will lead to muscle fatigue as well as general fatigue.
11. If we leave a contaminated environment, why is it important to consider leaving some or all of our possessions?
Fabrics are very porous and have sites where toxins can bind. The microorganisms, particularly mold, grow just as readily on fabrics, particularly if there is a source of carbon. The mycotoxins and other toxins are adductors. They can bind to fabrics, forming adducts, and are almost impossible to remove. Also, their allergens that cause allergies also are present in the fabrics. Thus, individuals who have developed allergies, reactive airway disease and chemical sensitivities of other types will react to biological material attached to fabrics. Also, you will drag mold spores into your new environment, which may allow a cross-contamination from this point of view.
3. Can you briefly describe what mold does to the human body?
This question refers to molds. You should also include the bacteria present in water damaged structures.
Molds can affect humans and animals in several ways. These include infection and/or colonization. The most classic being aspergillosis. These states can lead to mold-related nodules called mycetomas. Molds also produce toxins that affect animals and humans through their toxicological actions. These include inhibition of protein synthesis, mutation of DNA, cancers, severe activation of the immune system and increased production of various cytokines. Also, molds (Stachybotrys chartarum, 11 species of Aspergillus and species of Penicillium) produce hemolytic proteins that can cause bleeding of the lungs, nasal cavity and G.I. tract. Various species of molds can cause reactive airway disease, e.g. asthma and hypersensivity pneumonitis. The corticosteroids used to treat the inflammation associated with these two conditions are risk factors for developing aspergillosis.
Four species of Aspergillus (flavus, niger, fumigatus, and terreus) which can cause aspergillosis have been identified as causative organisms. These four species produce a highly toxic mycotoxin, Gliotoxin. Gliotoxin has been identified in the sera of patients with aspergillosis as well as in sera of animal models of this infectious process. Gliotoxin is a DNA mutagen, suppresses the immune system, causes cell death (apoptosis) and demyelination of the nervous system. Aspergillosis is on the increase worldwide in both immune competent and immune compromised humans. Do I need to say more on this subject?
Bacteria in the indoor environment can also be pathogenic. The bacteria of current concern include three genera of the actinobacteria: Streptomyces, Nocardia and Mycobacterium. Streptomyces and Nocardia produce toxins that cause cell damage and death. In addition. Streptomyces californicus and its toxins act synergistically with macrocyclic trichothecenes in mouse models. Also, various species of Streptomyces are the sources of chemotherapeutic agents and various antibiotic, e.g. Streptomycin. Very little information is available on the toxins produced by Nocardia. With respect to Mycobacterium there is a worldwide problem. Mycobacteria can cause two types of lung infections: tuberculosis and nontuberculous mycobacteria (NTM) lung disease. The American Thoracic Society states in 2007 that NTM (also called Mycobacterium avium complex or MAC) lung infection is on the increase worldwide in immune competent and immune compromised humans. My professional opinion is this has resulted from contaminated indoor air. Finally, the CDC recognizes that these organisms also cause hypersensitivity pneumonitis.. Streptomyces and Mycobacterium can cause nodules (tumors) known as eumycetomas.
Dr. Thrasher ought to be retired. "Too many people are suffering. I can't retire," he says. I'm glad he hasn't. You can find out more at his website.
Before the interview began Dr. Thrasher wanted to make something clear. This is powerful. Slamming a door can dislodge mold spores! In his words:
Let us keep in mind that air sampling does not detect hidden mold growth. Mold growth is hidden in places we do not see: attic, wall cavities, crawlspace, back side of carpeting and wall board. The attic wall cavities and crawl spaces are in communication with the interior of the home/building. Pressure shocks dislodge mold spores from these areas into the interior of the home. The pressure shocks include wind and opening and closing of doors.
1. What is a toxicologist?
Good question. Most lay people do not understand what a toxicologist is. Basically, he/she studies the adverse (sometimes it can be beneficial) effects of organic and inorganic chemicals (heavy metals) on animals and humans. The studies undertaken involve pathology and the biochemical effects of the toxins. For example, it is established that mycotoxins produced by several species of molds can have several toxic effects. These include inhibition of protein synthesis, adduction to proteins and DNA producing adverse effects on the function of these biological molecules, inducement of cell death (apoptosis), toxicity to the immune system and brain, and synergism (the ability of one chemical to increase the toxicity of two chemicals combined). In this latter category it has been demonstrated that mycotoxins have synergism, mycotoxins and endotoxins (lipopolysaccharides) have synergism, and toxins produced by certain bacteria (Streptomyces and Nocardia) have synergism with mycotoxins.
2. Not all toxicologists understand mold the way you do. How did you come to have this area of expertise?
I do not know about other toxicologists, but I pride myself on reading and understanding all of the peer reviewed literature I can locate regarding a given toxic compound. In the case of indoor air there is a multitude of potential toxins. The indoor biocontaminants that occur in relation to water intrusion and microbial growth are an excellent example of this. The media, attorneys, and the medical profession have zeroed in on only two aspects of this environment: Molds and their mycotoxins. In reality the indoor environment is a complex mixture of biological contaminants. These include molds and their by-products, such as mycotoxins and hemolysins; bacteria and their by-products (gram negative and positive bacteria); microbial volatile organic compounds; exotoxins and endotoxins produced by bacteria; particulates, ranging from nanoparticles up to mold spore size, glucans and galactomannans. Dr. Brasel and Dr. Gorny have demonstrated that the particles less than 2 microns also contain a significant quantity of bacterial and mold toxins. These small particles are inhaled deeply into alveolar spaces of the lungs and readily release their toxins into the blood. Thus, Dr. Brasel demonstrated trichothecenes in the sera of exposed subjects, while Van Emon demonstrated Stachylysin (hemolytic protein) in a different group of exposed humans. Also, nanoparticles (part of this fraction of particulates) readily enter the bloodstream from the alveolar spaces. Finally, Dr. Calderon-Garciduenas has demonstrated that particles attached to the olfactory neurons in the nasal cavity travel up the olfactory tract and enter the brain of humans, causing brain damage.
I have reviewed the literature on these various aspects and I have written a paper titled: "The Biocontaminants and Complexity of Damp Indoor Spaces: More than Meets the Eyes." This paper is scheduled to be published in Toxicology and Industrial Health in the September/October issue along with approximately 16 other papers on the adverse effects of exposure of humans to damp indoor spaces.
More next time.
"General Custer believed the story he had developed for himself."
Custer was writing his own story. He was unwilling to listen to those who knew better and lost his life because of it. The soldiers under his command did as well.
I didn't realize it, but I was writing my own story before our tragedy. Nothing was going to deter me. It was a good script. Security for the kids. A life full of friends and activities. A warm, safe home. In my mind, we were going to grow old in that home. Stay until we couldn't climb the stairs.
On October 4th, 2008, two scouts told us that danger loomed. That lives could be lost. It wasn't easy to listen. Everything in me wanted to believe my story and grow old in our home.
Next time I'm going to publish an interview I did with one of our scouts. Maybe someone else needs to hear.
FAQs and Answers
The documentary Under Our Skin is debuting this month. Just on the heels of the Black Mold Exposure documentary which debuted in April.
The buzz surrounds the VIP or vasoactive intestinal polypeptide. The VIP is a hormone. It contains 28 amino acid residues. It plays a crucial role in the nervous system. It increases the amount of water and electrolytes released from the pancreas and gut. It helps break down fat and glycogen. The list goes on.
Dr. Shoemaker is seeing improvements in VIP levels with the drug aviptadil. For more information check out Pat Sullivan's blog.
A new option is mentioned which involves a glutathione patch.
Test your home before cutting into any drywall or lifting any carpet. Disturbing the mold spores can make a situation much worse.
There are several options for testing. Mold plates found in hardware stores do not "pull" the air and provide a limited picture of your air. A toxic mold issue can easily be missed when using this product.
Initial testing can include an ERMI test (Environmental Relative Moldiness Index). This involves a dust sample. Two companies which offer this analysis include EMSL Analytical, Inc. and EMLab P&K.
The ERMI kit offered by EMSL has a 5 day turnaround time and costs $150. Click here to order.
Another option is an air test, which is less optimal than a dust or tape sample. An air sample taken in Chris' office showed no mold contamination. The dust samples showed high levels of aspergillus. Enough for him to vacate the office.
A third option is a tape sample. This can be used if the mold is visible.. EMLab P&K charges 30 dollars per sample with a 50 dollar minimum. Click here to see more.
A fourth option is a combination of carpet dust samples, air samples, and tape lifts done by a hygienist. If you believe litigation will be involved, it is important to hire a hygienist.
Questions to ask before you hire a hygienist:
1. Do you believe mold is harmful? (The answer must be yes.)
2. What constitutes a "safe" level of mold? ( In an air sample, mold counts should be equal to or below outdoor counts. There should be no stachybotrys. Not one spore. Aspergillus should be present only at negligible levels. The standard in Belgium requires no more than 2 1/2 percent aspergillus in the total count. Our hygienist cleared our home with 40% aspergillus. I wish I had known to look for this.)
3. Can I see the report? (Do not rely on a hygienist's word. It's important to see your counts for yourself. Especially when it comes to levels of aspergillus.)
If you've had mold remediation in the home and feel unsure about the air quality, consider a high-volume air sampler. This equipment draws large volumes of air using a high-speed rotary motor. One source of information on this option is available through Real Time Labs.
If your symptoms are severe, consider leaving the environment to see if you feel better.
The cost associated with mold testing is often a stumbling block, but it can save you thousands of dollars later. And think of what you would save if you have this kind of test done when buying a home! Our family's story is proof of this.
Where do you begin medically? You can take the VCS tests available through Dr. Ritchie Shoemaker. This is an affordable way to determine if mold exposure is making you ill. There is a urine test available through Real Time Labs. This urine test is also available through Direct Laboratory Services, Inc. Look for the aflatoxin, ochratoxin, and tricothecene tests under the allergy heading. It can be difficult to find a physician who understands toxic exposure. The American Academy of Environmental Medicine has a list of doctors who may or may not be familiar with toxic mold. The American Board of Environmental Medicine is preparing an Internet list of physicians. Another option is the Institute for Functional Medicine. If you have a primary doctor willing to consider mold exposure as a cause of illness, ask for specific labwork such as c4a, VEGF, MSH, and leptin. Or ask for the full set of labs. Alternative health care offers a wide range of diagnostic and de-tox options as well.
The mold journey is a daunting one, but knowledge is power. It is better to deal with mold than ignore it. Our story is extreme. I know of "happier" mold stories where mold was suspected, testing was done, and remediation performed. No one got sick, because the mold was dealt with quickly and thoroughly. I know of others who suspected mold and found nothing harmful.
We spent 8 years without the knowledge that our home was making us sick. We've spent the time since vacating our home (October 2008) with it. Believe me, it's much better to choose knowledge. It's painful, but with truth there is freedom.
Barbara Dell was born May 30, 1929 in Cleveland, Ohio. It was a tough time in history and her childhood was equally hard. Alcoholism brings little stability to a child's life. In her teens, her refuge became Dana Hall boarding school for girls in Wellesley, Massachusetts. She went on to Hartford Junior College. While in Hartford she met a future insurance executive named George Kessel. They met on a blind date. He was tall. She was tall. He had earned a purple heart in World War II several years earlier. They fell in love.
After graduating from Goucher College she relocated to Milwaukee, Wisconsin to be near the tall guy who had captured her heart. She worked in administration at a local radio station.
They married in November of 1953. She faced her own opportunity for heroism in the fall of 1975 when she was diagnosed with breast cancer. As my brother said in his tribute on Saturday:
"She beat cancer before cancer had much to worry about. She was a woman of extraordinary courage. She had willpower that would challenge Lance Armstrong."
It's true, though I didn't always recognize it. I went through a season where I struggled with her limitations. The same limitations my children must reconcile in me.
We made it through and our relationship grew. During our mold journey she did nothing but give me strength. Not an easy task when your daughter is calling from emergency rooms, hospitals, hotels, and rooms filled with air mattresses. It would have been easy for her to begin sentences with:
"Why don't you..."
"Have you tried..."
"Are you sure about..."
"Surely there's some alternative..."
"I don't understand why you don't..."
She never did that. Not once. The only words I ever heard were, "I admire your attitude. You're doing great. I think about you all the time."
I'm going to remember that next time I have a "suggestion" for one of my children.
Thanks for the legacy, Mom. I miss you so much.
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