Weekly Wrap-Up (21-26 November)

In case you missed it (ICYMI), here’s a list of the links that appeared on One Sick Vet’s Facebook page this week:

Monday: My Pillow

Have you seen the commercials on late night TV and wondered about the My Pillow? “Late-night infomercials and other ads claimed that the company’s pillows could cure not only insomnia but also such ailments as sleep apnea, fibromyalgia, and even multiple sclerosis.

Earlier this year, the consumer watchdog Truth in Advertising (TINA.org) warned My Pillow that it would file a complaint with the Federal Trade Commission if the unsubstantiated claims continued. My Pillow scrubbed its website of any health claims, but others continued cropping up on its social media sites, TINA.org reports.”

http://www.consumerreports.org/my-pillow/my-pillow-health-claims-lawsuit-settlement/

Tuesday: Dry Winter Skin

Helpful information, except that if you have mold allergies, humidity should be *below* 30% in your home.

http://www.consumerreports.org/conditions-treatments/dry-winter-skin-eczema-psoriasis-rosacea/

Wednesday: End-of-Life Planning

“93-year old psychotherapist Margie Jenkins wants you to plan a great party for the people you love, do what you’ve been putting off, and live “bodaciously.” The only catch? You have to think a lot about death first.”

This Therapist Wants to Make End-of-Life Planning Fun

Thursday: How to Make Sure You Are a Designated Representative In Case Your Loved One is Incapacitated

Heads Up! A power of attorney and a medical power of attorney are no longer sufficient. Read this article for other necessary paperwork to allow you to speak on behalf of a loved one (or vice versa):

https://www.agingcare.com/Articles/Make-Sure-You-Are-an-Authorized-Representative-for-Your-Loved-One-202376.htm?utm_source=InsightsNewsletter&utm_medium=Email&utm_campaign=InsightsNewsletterNov

Friday: Substance Abuse

“An estimated 20.8 million people in our country are living with a substance use disorder. This is similar to the number of people who have diabetes, and 1.5 times the number of people who have all cancers combined.”

http://www.npr.org/sections/health-shots/2016/11/17/502402409/surgeon-general-murthy-wants-america-to-face-up-to-addiction

Saturday: Saturday Humor

https://www.facebook.com/HeyHoldMyBeerAndWatchThis/photos/a.123836527758776.24621.123829561092806/852210164921405/?type=3&theater

Weekly Wrap-Up (14-19 November)

In case you missed it (ICYMI), here are the links that were featured on One Sick Vet’s Facebook page this week:

Monday: Don’t fall for the hype – some foods may not be as healthy as you think

“So how do you sort through the nutrition hype of all these packaged eats and treats to find the healthy gems? When checking out nutrition labels, follow these three important rules: 1. Read carefully. 2. Read carefully. 3. Read carefully.

Before loading up your grocery cart, read up on why six of the foods that you think are healthy are far from it, then swap them out with the suggested alternatives.”

http://www.nextavenue.org/fiftysomething-diet-healthy-food-swaps-0/

Tuesday: Delirium: A surprising side effect of hospital stays

“A recent meta-analysis led by Harvard researchers found that a variety of non-drug interventions — which included making sure patients’ sleep-wake cycles were preserved, that they had their eyeglasses and hearing aids and that were not dehydrated — reduced delirium by 53 percent. These simple fixes had an added benefit: They cut the rate of falls among hospitalized patients by 62 percent.”

http://www.nextavenue.org/delirium-a-surprising-side-effect-of-hospital-stays/

Wednesday: 2016 GAO report on health effects of burn pits

“It had been six years since the Government Accountability Office (GAO) last reported on the number of active burn pits in Afghanistan and Iraq and their potential harmful health effects on military personnel.

In September, another GAO report found DoD and the VA still have made inadequate efforts to collect data needed to understand burn pit health risks to troops and their families.”

http://www.moaa.org/Content/Take-Action/Top-Issues/Currently-Serving/Burn-Pit-Report-Reignites-Troop-Exposure-Concerns.aspx

Thursday: 5 simple ways to slash your salt intake

“Adults in the United States consume an average of 3,400 mg of sodium a day, more than double the 1,500 that the American Heart Association recommends. All that excess sodium contributes to high blood pressure, heart attacks and an increased risk of stroke, osteoporosis, stomach cancer and kidney disease.”

http://www.nextavenue.org/fiftysomething-diet-5-simple-ways-slash-your-salt-intake/

Friday: Something to consider as you make end-of-life plans:

“For veterans of the conflicts in Iraq and Afghanistan, even a Medal of Honor may not guarantee a spot in Arlington National Cemetery.

That’s according to a report by Arlington National Cemetery (ANC) staff.”

http://www.moaa.org/Content/Take-Action/Top-Issues/Retirees/Arlington-–-Maybe-Not-Your-Final-Resting-Place-.aspx

Saturday Humor:

https://www.facebook.com/Fun.Pics.Stuff/photos/a.547783901915385.146738.342745062419271/1551728084854290/?type=3&theater

Weekly Wrap-Up (24-28 October)

In case you missed it (ICYMI), here’s a list of the links that appeared on One Sick Vet’s Facebook page this week:

Monday: New post

Sometimes the Stars Align – But You Still Have to Check Your Six

Tuesday: More problems at VA hospital in Chicago

http://www.foxnews.com/politics/2016/09/29/new-low-dead-veterans-left-in-va-hospital-morgue-for-weeks-without-burial.html

Wednesday: Wearable tech not shown to help people lose more weight than standard weight-loss techniques

https://www.ncbi.nlm.nih.gov/pubmed/27654602?dopt=Abstract

Thursday: Good news! Tricare has updated preventive screening standards to align with “the American Academy of Pediatrics’ standards for care of well children over age 6.” Tricare will now pay more (and military families pay less) for certain preventive care screenings

http://www.moaa.org/NewTRICARE/

Friday: Since the 2017 cost-of-living adjustment (COLA) is so small (.3%), some retirees may be on the hook for Medicare Part B premium increases

http://www.moaa.org/Content/Take-Action/Top-Issues/Retirees/Diet-COLA-May-Cause-Headache.aspx

Sometimes the Stars Align – But You Still Have to Check Your Six

Just a quick update to explain why it’s been so quiet on the blog this month.

I finally had the “do-over” for the surgical procedure that was cancelled when I had the allergic reaction to the antiseptic.

Because I had lost confidence in the VA hospital, I switched from handling this procedure through the VA to handling it through Tricare.

In an interesting twist of fate, my new doctor has the same rare allergy that I do, which meant I didn’t have to worry about accidental exposure to that substance in the operating room.  Bonus!

However, as it turns out, I still had to remain extremely vigilant.  Although my allergy is clearly marked in my records, few people seem to understand how this allergy translates to real life, which results in interactions such as these:

[Scene: Pre-Surgery area]

Nurse 1:  Hi, I’m Nurse NAME, and I’ll be going over your paperwork with you today.  How did you clean prior to surgery?

Me:  I took a shower last night and a shower this morning.

Nurse 1: With soap and water?

Me: Yes.

Nurse 1: Were you given the pre-surgery paperwork suggesting you cleanse with Hibicleans prior to surgery?

Me: Yes.

Nurse 1: And did you follow those procedures?

Me [mildly sarcastically]:  No.  I’m allergic to Chlorhexidine, so I thought that would be a bad idea.

Nurse 1: Oh.

[Note: This means that the military hospital gave me a standard pre-surgery paperwork package instructing me to clean myself at home with a substance to which I have a documented allergy.  There is apparently no control in the hospital procedures for this mistake.]

[Scene: Pre-Surgery area.  Later…]

Nurse 2 (LPN): Ok, I’m here to get you prepped for surgery.  Do you have any allergies?

Me: Yes, I’m allergic to Chlorhexidine.

Nurse 2: Ok, I see that in your chart.  I’ll write that on your wristband.  [Writes on wristband, and attaches it to my arm.]  Ok, now I’m going to insert your IV. [Opens IV kit.]

Me:  Are you going to use an alcohol wipe to clean the site?

Nurse 2: No, I’m going to use the wipes in the IV kit – Chloraprep wipes.

Me [Firmly]: No, you’re not.  I’m allergic to those.

Nurse 2: Really?

Me: Yes.  They contain Chlorhexidine.

Nurse 2: Oh. …  Ok, I guess I’ll go find some alcohol wipes.

[Note: This indicates that the hospital does not have special IV kits for individuals with Chlorhexidine allergies, which is somewhat understandable given that it is a rare allergy.  However, it also indicates that medical personnel are inadequately trained on Chlorhexidine allergies and required modifications to standard procedures.]

Bottom Line: Given the lack of awareness by medical personnel of Chlorhexidine allergy (an antiseptic widely and frequently used in the medical field) and its practical implications (changes to materials used in standard procedures), I am deeply grateful that my surgeon has the same rare allergy and could maintain a safe environment for me in the operating room.  I am particularly grateful for that given that (1) I had to be extremely vigilant to avoid exposure (and another allergic reaction and cancelled surgery) prior to surgery, and (2) I could not maintain vigilance in the OR since I was anesthetized.

If you have a similar rare medical allergy, please learn as much as you can about sources of exposure, and be very cautious to avoid exposure in medical environments.  Do not rely on medical personnel being informed and aware – they probably aren’t.

Note: Check Your Six is an aviation term meaning to watch for attacks from behind.  It more broadly means to be situationally aware and to maintain vigilance.

Weekly Wrap-Up (17-21 Oct)

In case you missed it (ICYMI), here’s a list of the links that appeared on One Sick Vet’s Facebook page this week:

Tuesday: New data may lead to better understanding of Crohn’s disease.

https://www.sciencedaily.com/releases/2016/09/160920151435.htm

Wednesday: When asked about incorrect data on VA hospital leadership replacement, VA Undersecretary for Health David Shulkin responded: “We tend to use lots of numbers and that can be confusing, and what I’m trying to do is simplify the message, so here’s my message: I need help,” Shulkin said. “I need the right leaders to come in and to take these positions of responsibility on behalf of the country, and I don’t care if it’s 90%, 80%, or 60%. I know I have openings and I don’t have the applicants.”

http://www.usatoday.com/story/news/politics/2016/10/18/veterans-affairs-managers-transfer-new-leadership-medical-centers/91965888/

Thursday: Article on living with depression. “For years I believed that I had to surmount my depression, to overcome it, to wrestle it into submission so that I could be normal. The diagnosis has allowed me to accept that “normal” may just mean being able to engage with my loved ones and my work. “Normal” means knowing I have a chronic illness and treating it so that I can do the things that make me content.”

http://www.elle.com/life-love/a39440/double-depression/?src=socialflowTW

Friday: Heads Up! Tricare approved pharmacies changing 1 Dec.

http://www.military.com/daily-news/2016/09/30/tricare-pharmacy-network-adds-walgreens-removes-cvs.html?ESRC=todayinmil.sm

Weekly Wrap-Up (10-15 October)

In case you missed it (ICYMI), here’s a list of the links that appeared on One Sick Vet’s Facebook page this week:

Monday: Dealing with Depression

“I’m writing this now to remind myself how wonderful it is to breathe and live and feel human, both because I need a reminder for next time depression lies to me and tells me it will never go away, and also because maybe you’re in the hole right now and need a reminder that it will get better.

It will.

And then maybe it will get bad again. The ups and downs are always there for those of us with forever broken brains. But that’s okay because you come back out. The good is worth battling through the bad. It’s so worth the meds and the therapy and the time and effort and the waiting.”

http://thebloggess.com/2016/10/10/up-and-down-and-up-again/

Tuesday: Traveling with Allergies or Asthma

http://www.michiganallergy.com/travelallergies.shtml

Wednesday: Onset Of Allergies Over Age 40
(Not as uncommon as you think)

http://www.michiganallergy.com/allergyonset40.shtml

Thursday: Relaxation Techniques

http://www.michiganallergy.com/relaxation.shtml

Friday: Article about Paralympian Sgt. Elizabeth Marks (USA)

“When I step onto the blocks, I never think, ‘I want to win,'” she says. “I think, ‘I want to pour all of myself into this race because there are people who can’t physically, mentally or emotionally, do that.’ So it’s my way of performing for them.”

http://www.espn.com/espnw/culture/feature/article/15702441/the-things-carries-story-paraswimmer-us-army-sergeant-elizabeth-marks

Weekly Wrap-Up (3-8 October)

In case you missed it (ICYMI), here’s a list of the links that appeared on One Sick Vet’s Facebook page this week:

Monday:  New Post

Medical Procedures: What It’s Like to Have an MRI (with contrast)

Tuesday: One survivor’s perspective on Breast Cancer Awareness Month

http://gettingthewordswrong.com/2015/10/why-october-is-hard/

Wednesday: A former NFL player created a specialty gym to train and rehabilitate disabled veterans.

Thursday: How the sugar industry manipulated scientific dietary research

” All in all, the corrupted researchers and skewed scientific literature successfully helped draw attention away from the health risks of sweets and shift the blame solely to fats—for nearly five decades. The low-fat, high-sugar diets that health experts subsequently encouraged are now seen as a main driver of the current obesity epidemic.”

http://arstechnica.com/science/2016/09/sugar-industry-bought-off-scientists-skewed-dietary-guidelines-for-decades/

Friday: Airplane Travel Tips for Allergy Patients

http://www.michiganallergy.com/airplane.shtml

Saturday: Humor

 

Medical Procedures: What It’s Like to Have an MRI (with contrast)

The first MRI (magnetic resonance imaging) I ever had was a cerebral MRI in a foreign country.  I hadn’t been in the country very long, and didn’t speak much of the language.  I also didn’t know much about the procedure.  All I knew is these people with whom I could barely communicate were going to look inside my head.

The MRI was state-of-the-art – a small, donut-shaped open MRI machine:

The nurse, however, was another story.  She had no bedside manner, or rather, her bedside manner was very stern and unyielding.

My referring physician had requested an MRI with contrast, which means “dye” was injected into my veins through an IV.  The dye helps the radiologist see certain areas more clearly.

After the nurse inserted the IV and began administering the contrast, I felt a burning sensation in the arm in which she had placed the IV.  I was concerned that I might be having an allergic reaction to the dye, because I had read that was possible.  I asked the nurse if the burning sensation was normal (I rather doubted that it was).  Once she understood my question (it took several attempts, due to the language barrier), her response was “That is not possible.”

It has been over 15 years since this experience, and I still remember it vividly.  I am in a hospital gown in a cold room in a foreign country, and I am having what seems to me to be an abnormal response to this medical procedure, and all the nurse will say is “That is not possible.”  I asked again.  Again she responded “That is not possible.”  I started to get excited:  “It must be possible, because it is currently happening TO ME!”  

I could not believe that I might die of a routine medical procedure because the nurse refused to acknowledge my reality.  I had driven myself to the procedure, and I wondered how long it would take before anyone figured out what had happened to me.

I continued to express to the nurse that I thought I might have a problem and I was not satisfied with her answer.  Finally she snapped, “The only way that would be possible is if I had missed the vein, and I did not miss the vein!”  Case closed, as far as she was concerned.

I finally decided I would either die or I wouldn’t, but I didn’t seem to have any control over the outcome.  So I made my peace with it, and continued on with the procedure.

I was given ear plugs, because the machine can be loud.  After I inserted the ear plugs, I laid back on the patient table, someone tucked a foam wedge under my knees for comfort and placed a thin blanket over me for warmth, fastened a basket-type device around my head (see image at beginning of post), and I was eased into the MRI “donut.”

I don’t remember much from that first MRI, except that it didn’t seem that bad, and it was over fairly quickly.

I didn’t die from an allergic reaction to the dye, obviously.  But I was correct that the burning sensation was not normal.  Miss “That is not possible” was wrong.  As it turned out, she had not missed the vein – she had gone completely through it.  I figured this out the next day, when I woke up with a huge black & green bruise on the inside of my elbow, surrounding the IV site.

Presumably enough dye reached my brain for the radiologist to get adequate images, since my doctor was given results, and I didn’t have to re-do the procedure.

Since then, I have had several more MRIs – a few more looking at my brain, and ones looking at my hand/wrist, elbow, and shoulder.

Here’s what I’ve learned about MRIs:

There is a wide variety of condition of equipment and pleasantness of experience.  The “donut” open MRI was the nicest equipment I have experienced.  Many facilities do not have them, or only use them for certain patients (obese, claustrophobic, etc.).

The nicest facilities now have headsets for the patients to wear during the procedure, and will play your choice of local radio stations or even subscription radio (Sirius XM, etc.).  Time passes more quickly when you are listening to your favorite jam.

The worst experience I have had was at a military facility.  The MRI was in a trailer in the parking lot – it was on loan from the VA.  Yes, I had to walk across the parking lot in my hospital gown to get to the trailer.  The machine was small, so the table that I laid on was narrow, and the machine opening was tight too.  That’s the closest I’ve come to feeling claustrophobic in an MRI machine.  The machine was old and VERY LOUD.  There was no music.  No headsets.  Only ear plugs and disappointment.  And a lot of vibration.

The MRI machine cycles through various “runs.”  In most facilities, the technician will talk you through the procedure while it is happening, informing you when the next run is starting, and how long it will last.

You have two-way communication with the technician at all times.  You also have a “panic button” in your hand that you can press at any time if you want to disrupt the procedure and get immediate assistance.

The machine makes noises at different frequencies and volumes during the different runs.  Some runs are quieter and less noticeable.  Other runs are loud, and you can feel the vibration in your body.  Some feel like thuds.  It doesn’t hurt, but some runs are louder and less pleasant than others.

The contrast agent (“dye”) does not normally burn.  You usually can’t feel it at all.  Sometimes it might feel a little cold initially.  Sometimes you might get an odd taste in your mouth (kind-of metallic).  Side effects are rare, but can happen.

In my opinion, cerebral MRIs are the easiest, because all you have to do is lie on your back and not fall asleep.  (Some people might not agree, as a cerebral MRI guarantees that your head must be inside the machine, whereas if they are imaging your arm or leg your head might not have to be inside the MRI machine, which is less claustrophobic of an experience.)

NOTE: It is very important that you not move while the MRI is being conducted.  Moving can blur the images, and the procedure or portions of the procedure would then need to be repeated to get clear, accurate images.  This is also the reason that the body part to be imaged is typically placed in a surrounding device to help stabilize it.  This is also the reason you cannot fall asleep, as you might move in your sleep.

For me, the MRI of my shoulder was no big deal.  The wrist and elbow were more memorable.

In order to get the images they needed of my elbow and wrist, I was required to lie in less comfortable positions.  Although the techs propped me on various pillows and foam wedges to hold my body in the position they needed, my muscles started to fatigue during both of these MRIs.  I was trying to prevent my wrist and arm from shaking, but the muscles became so fatigued that I was unable to prevent the muscle tremors by the end of the procedures.

In particular, for the elbow MRI, I was positioned with the injured arm straight out above my head, in front of me, like Superman’s flying position.  For this procedure, I laid on my belly, rather than my back.  Despite my best efforts, I could not keep my arm from shaking by the end of that procedure, although the tech said the images came out ok.

The procedure typically takes about 45 minutes.  Afterward, the tech will typically check the images to see if any runs need to be redone.

Bottom line:  MRIs are loud, but the procedure isn’t a bad experience.  They are not painful.  I have never felt claustrophobic, although I came close in the tiny, old military MRI machine.  If you are claustrophobic, make sure you are referred to a facility that has an open MRI machine and has experience with claustrophobic patients.  Also, you can get a mild sedative if you need one to help you get through the procedure.

[If you think you will need a sedative, make sure you bring a wingman/battle buddy to drive you home.]

It is very rare to have an allergic reaction to the contrast agent.  The pre-procedure paperwork will explain the type of agent used and possible side effects.  If you have any concerns, discuss them with your referring physician or with the MRI facility staff.

You can resume your regular activities upon completion of the MRI – it’s not a procedure that requires recovery time afterward.

Don’t worry that you will get a nurse like I had for my first MRI – “That is not possible.” 🙂  Every tech I have had in the US has been very helpful, very knowledgeable, and most of them have been very reassuring.  They know the procedure can be a bit intimidating for many people, and they typically go out of their way to make it as pleasant as possible for you.

Not Mission Capable: Why I Have No Post This Week

I wish I could tell you there is no post this week because I have been hiking in the Rockies and enjoying the flare of golden aspens before winter comes.  Or because I have been scuba diving in the South Pacific.  Or because I have been traveling the world sampling exotic cuisines and learning about diverse cultures.

However, the reality is I am just sick and tired this week and feel too crappy to write a post.

The reality is that I don’t have the energy to leave the house, and I’m currently on a very restrictive diet that my allergist has assigned to help us determine my food allergies.

A friend, and fellow vet, sent me this video clip illustrating how crappy 2016 has been and it got me thinking…

So far, this year, I have seen the following medical specialists:

  • several PCMs
  • an orthopedic surgeon
  • several anesthesiologists & a CNA
  • an occupational therapist
  • a physical therapist
  • a neurologist
  • an allergist
  • a dermatologist
  • several radiologists
  • an optometrist
  • the NP who administers Botox shots
  • a PA in the VA wrist clinic
  • and various medical assistants (LPNs etc.)

I have had numerous diagnostic medical procedures:

  • an EMG/CNS
  • 2 MRI/arthrograms (elbow & wrist)
  • 1 cerebral MRI
  • numerous x-rays (elbow & wrist)
  • a cardiac ultrasound (echocardiogram)
  • 2 allergy skin tests (skin prick and injection)
  • numerous blood draws
  • a 24-hour urine collection analysis

And I have had the following treatments:

Once again, I am tired to the bone.  It has been a long year, filled with poor health and weekly medical appointments, new medications with complicated regimens, numerous corrections of Tricare billing errors, and several rejected requests for therapeutic medical devices.  This is also the year I discovered that I have multiple allergies (I didn’t know I had any),  and these allergies require that I make significant diet and lifestyle changes.

On the bright side, I *do* finally feel that I am getting better quality of care.  I am slowly building a team of competent medical specialists to diagnose and treat my health issues.  I am learning how to get rid of the incompetent ones.  Spousal Unit and I are learning how to navigate the treacherous Tricare healthcare system more effectively.  I am getting diagnoses that explain my symptoms, and I am getting treatment to reduce my symptoms and hopefully address the underlying causes.

I tell myself to frame the situation positively.  Instead of telling myself I am broken, I tell myself I am healing.  Both are true.  But I choose to focus on a positive future, rather than a negative one.  I believe this will help me get better.

2016 has been a crappy year, full of debilitating health problems.

But I am healing.

Crew Dog and the Case of the Faulty Health Paradigm

A paradigm is a model or example of something, or the framework or mindset we use to understand or make sense of things.  When we subscribe to a paradigm, it often means that we choose to see things in only that way.  What do you see when you look at the picture above?  Can you see it in more than one way?*

Often, in business, we hear people talk about a paradigm shift, which means accepting a new way of looking at or thinking about things.  The opposite of a paradigm shift is paradigm paralysis, which is “the inability or refusal to see beyond the current models of thinking.”

I was stuck in a paradigm, or suffered from paradigm paralysis about an aspect of my health for many years, and it basically took a whack upside the head (figuratively speaking) to make me change that paradigm.

The paradigm I was stuck in was this: I don’t have allergies.

I never had any health problems when I was growing up.  I was blessed with excellent health until my mid-thirties.  I didn’t wheeze and sneeze like the people in the allergy commercials.  Surely I didn’t have allergies.

Not only did I believe that I had no allergies, but the one time I went to a (military) doctor because I wasn’t feeling well and I described my eyes as “itchy” the doctor quickly reprimanded me to never say that, because itchy eyes were a symptom of allergies and aircrew could not have allergies.  Since I didn’t want to lose my aircrew status, I never again described my eyes as itchy.

Years later, I started having very concerning symptoms.  I suddenly developed vertigo, which was quite alarming.  I was sitting in a chair reading when, out of nowhere, it felt like I did a front cartwheel.  My inner gyros completely tumbled.  I felt like I had moved violently, even though I hadn’t moved at all.  I dropped my book, grabbed the arms of my chair, and tried to figure out what the heck had just happened.

As it turned out, it took quite a while to figure that out.  I saw lots of specialists during that time.  I had diagnostic tests to rule out brain tumors, inner ear tumors, and…allergies.  The allergist administered a skin prick test, left me sitting in the waiting room far too long, and had trouble reading the results on my arm.  I, of course, didn’t think I had any allergies, and wasn’t expecting them to find anything during this test.  I had noticed one area on my arm react strongly, but the allergist smugly informed me that that particular area had been the control – it was pricked with histamine.  Of course I had reacted to that, I was told disdainfully.

The allergist peered at my arm, ran their fingers over and over the area, and finally pronounced that I was probably allergic to birch trees and penicillium mold.  I asked if that meant I was allergic to penicillin (it runs in my family).  The allergist said it was possible.  [I learned many years later that being allergic to penicillium mold *does not* mean you will be allergic to penicillin the antibiotic.]**

I asked about the allergy to birch trees, and was told to just avoid being around them.  I was given no other information or guidance.***  I decided the allergist wasn’t very competent, and went on with my life.

Next I developed frequent excruciating headaches.  Eventually the headaches and the exclusion of other causes led to a diagnosis of migraines and migraine associated vertigo.

I began to learn about migraine triggers – things that can contribute to having a migraine, such as barometric pressure changes; bright, flashing, or fluorescent lights; and foods.  People with migraines have reported that they were more likely to have migraines after eating certain foods, although not everyone responds to all of the same foods.

Known culprits are red wine; aged cheeses; processed meats; chocolate; citrus fruits; and foods containing MSG or aspartame.  (There are more, but these are some of the biggest culprits.)

I started eliminating many of these foods from my diet, and my symptoms abated somewhat.

During this time, I had also developed a perpetually stuffy nose that seemed to get worse prior to and during a migraine.  I saw an ENT, and was diagnosed with chronic sinusitis.  For years afterward, whenever I mentioned to a new doctor that it seemed to be linked to the migraines, I was told that stuffy nose was not a migraine symptom, and the doctor ignored that symptom.

Fifteen years after my trip to the allergist, I had an allergic reaction to a medicine (Chlorhexidine) I was administered in a hospital.  Since Chlorhexidine is an antibiotic that is widely used as an antiseptic and disinfectant in medicine, dentistry, and  in pharmaceutical and cosmetic products, I figured I’d better see an allergist to discuss how I was going to avoid Chlorhexidine for the rest of my life.  I also wanted to know if I was allergic to any other antibiotics, since I still didn’t know whether I was allergic to penicillin or not.

This allergist was very thorough, and asked me a lot of diagnostic questions.  We discussed my Chlorhexidine allergy.  And then he said, “You probably also have a mold allergy.”

Here’s where the paradigm paralysis makes me look pretty stupid.  Even though I had been diagnosed with an allergy to penicillium mold, and even though I had known for years that I was sensitive to mold in my environment (moldy basements, moldy government buildings, water-damaged areas in homes), it had never occurred to me that I was *allergic* to mold (because I don’t have allergies).

I didn’t even know that mold was a common allergen.

I told the allergist that I had never even considered that I might have allergies, because “aircrew don’t have allergies.”  He laughed, and said, “At least, not until after they’ve retired, right?”

My new allergist gave me a mold elimination diet to follow, for diagnostic purposes.  It sounds crazy, ‘cuz we don’t go around knowingly eating mold, right?  Well, actually…  That penicillium mold I’m allergic to?  It’s used to create Brie and Camembert cheeses.  Two of my favorites, that I started eating right around the time my migraines became frequent and have been eating ever since – because the first allergist *never told me* I should stop eating them!

Penicillium mold is also used to create “veiny” cheeses, including Roquefort, Blue, Gorgonzola, Stilton, etc.  While I ate these cheeses much less frequently, I did like to have Gorgonzola (often found in four-cheese blend) on my pasta.  Fortunately, these cheeses  were all categorized as “aged” cheeses, which I had eliminated from my diet early on because they are known migraine triggers.

Back to the mold elimination diet: Anything pickled, fermented, cured, aged, or cultured contains mold.  Dried products (fruit, nuts, coffee, tea) may also be contaminated with mold.

The cultured yogurt that I was eating because it contained “good” bacteria and was good for my health – was making me sick.  Before I began the mold elimination diet, I ate yogurt for breakfast one last time and my nose got so stuffy that I had to breathe through my mouth.

After three days on the mold elimination diet I could breathe better than I had in fifteen years.

After two weeks on the mold elimination diet, I felt better than I had in many years.  My energy level was much higher, and the incidences of “brain fog” were much lower.

I also don’t think it’s a coincidence that the mold elimination diet prohibits me for eating every food that is a known migraine trigger.  I am currently exploring the possibility that my migraines are linked to this underlying allergy.  [Update: see this Migraine diet]

I have subsequently returned to the allergist for two rounds of testing: skin prick and injection (blog post to follow).  Of the identified 100,000 types of mold (there are 1.5 million, but many are unidentified), there are allergy testing samples for 15 types.  I reacted to Penicillium and Aspergillus, which are both common indoor molds.

My allergist tells me that it is less common to do allergen elimination diets these days, particularly for something like a mold allergy.  In fact, it’s hard to find much information about mold elimination diet on the internet (see below).  I’m glad I happened to get an allergist who had this in his “bag of tricks,” because this diet has already had a radical impact on my health.

Are there assumptions or paradigms about your health that might be false?  If you are dealing with a chronic health condition and you haven’t had success treating it, it may be time to go back and challenge previous assumptions and paradigms.  After all, I “knew” I didn’t have allergies…

*This is a classic perception image.  You might see a duck facing left or a rabbit facing right.  Many people have trouble being able to see both, or switching from seeing one to seeing the other.

**NOTE: For more information on Penicillium mold, and supporting data that “hypersensitivity to Penicillium mold bears no relationship with hypersensitivity to the antibiotic Penicillin,” see this article.

*** My new allergist informed me that if you are allergic to birch trees, you may have cross-reactions to certain foods, including celery, apples, or carrots.

NOTE: For more information on mold in general, see these Centers for Disease Control (CDC) FAQs.

NOTE: For more information on mold allergy, see this page on the Asthma and Allergy Foundation of America website or this page (and associated pages) on the American Academy of Allergy, Asthma & Immunology website.

NOTE: For more information on the mold elimination diet, see this example.  [This is not my allergist or ENT and I am not endorsing this practice or being compensated by them in any way.]

P.S. – Have I had a mold allergy my whole life, and just didn’t know it?  Or did it develop in adulthood?  I don’t know.  Either is possible, although adult-onset seems more likely, given the lack of symptoms prior to my thirties.  Here’s a good article on adult-onset allergies and asthma.  [Again, this is not my allergist and I am not endorsing this practice or being compensated by them in any way.]