VCS Aptitude Test
January 25, 2011
SurvivingMold.com continues to grow rapidly. We welcome you to our newsletter and to our site. Please share this newsletter with others who might want to keep up to date on what is happening in the busy world of water-damaged buildings.
Paul will be manufacturing a new handheld VCS test device soon as the availability of the hand held testing devices is limited.
The APTitude can be used by groups of patients or just one person at a time. Please let the site administrator know (click here) if you want to access APTitude as a group. A special code can be assigned to your group, bringing a group discount. Packages of several tests for the same individual and a10-test package are available at a discounted rate as well. People using the APTitude test to monitor progress with therapy have found these multi-test packages useful in our “trial runs.”
The website continues to grow in the number of visitors to the site, with many sharing suggestions, comments and even some compliments. We cannot respond to requests for case management or referrals, as the site doesn’t practice medicine, but questions suitable for blogs or newsletter discussion are created from specific requests. Features on the website also are growing, with more comments on Surviving Mold, more academic papers on ERMI, links to other sites and soon, the Remediation Round Table, with Carl Grimes, Greg Weatherman and Ritchie Shoemaker sharing their opinions on cutting edge issues on indoor air quality.
Surviving Mold - Huge Success!"What a fabulous book! You are to be congratulated for the best book ever written on the medical (and political) aspects of mold poisoning.
I want to thank you and Matthew Hudson from the bottom of my heart for the kind remarks you made about me in the book. I use ideas and materials from you in every mold case when I testify in depositions and trials all over the US. In fact, I mentioned you in my testimony in a trial yesterday in New Port Richey, FL...”
Toxicologist and former Univ. Florida Professor, Toxicology, &
Adj Prof, Univ. N. FL, teaching OSHA HazMat certification,
Fla. Comm. College Jax, Institute of Occ. Safety & Health,
Florida Poison Info Center, Jax., Clinical Tox Advisory Comm
New York Report on Damp Buildings - Disappointing
The New York report on Damp Buildings was released last month. We had such high hopes that the report would reflect the current state of the art in diagnosis and treatment, but our hopes were dashed. The report itself pathetically would lead people to think that the last word on moldy indoors was published in the IOM report, written back in the Dark Ages of 2003-4. The NY committee received multiple comments from interested persons on their draft that pointed out the obvious deficiencies and absence of rigor in the draft. If anyone suggests that the NY report was influenced by politics, we’d like to have some specifics. Email us at email@example.com.
Commentary/Criticism of the NY Report
- Dr. Ritchie Shoemaker
Jack Thrasher, Ph.D.; Scott McMahon, M.D.; Melinda Ballard; Policyholders of America; Laura Mark, M.D.; Cheryl Wisecup
- Wayne A. Gordon, Ph.D., ABPP/Cn
- Eckardt Johanning, M.D., M.Sc. (Albany, N.Y.); Pierre Auger, M.D., M.Sc. (FRCPC, Quebec, Canada)
If you don’t trust consensus statements you aren’t alone. Desperation Medicine (2001) has pertinent chapters on The Appearance of Good Science, as does Surviving Mold. Contact the webmaster for availability of Desperation Medicine by emailing firstname.lastname@example.org.
In the Courts and in the Office:
A possible court decision that would have included testimony on the NY report was going to be Holland in Brooklyn NY. A Frye challenge to Dr. Shoemaker’s testimony was mounted but was not accepted by the trial judge. No formal opinion was written, however. As Dr. Shoemaker prepared to testify, the case was settled.
One of Dr. Shoemaker’s patients, sickened by exposure to the Federal Building adjacent to the 9/11 site in New York City, has filed a Federal OWCP case seeking compensation for his lost time and personal injuries. His complaint is modeled on the Haeffner decision from 2009 in which the FAA lost their attempt to deny benefits to a disabled Air Traffic Controller sickened by exposure to the Metro Airport Tower in Detroit. The Control Tower there is still moldy; efforts are ongoing to clean up the building. With its concrete walls guaranteeing condensation problems indoors and central elevator shaft that acts as a piston to drive up contaminated air, I fear flying into Metro, though I must do so on Valentine’s Day to appear in the Aiello case.
The Aiello case, brought by plaintiffs’ attorneys Vicki and Tim Corr, is marked by the rather miraculous improvement of young Diane Aiello. She had been suffering from profound developmental delay from birth, as she had been conceived and carried to term delivery in a home with massive water intrusion and growth of microbes indoors. Diane was noted by her attending neuropsychologist to be markedly improved for the first time in four years, at a time coinciding with use of cholestyramine as the only changed variable.
In the Office...
Another happy occasion occurred last week when a 7-year old boy, another with profound developmental impairment following his conception and Mother’s gestation in a moldy home, said his first word and began to walk within six weeks of starting CSM as well. That event was just one day before we heard from a patient from New Jersey who had Lyme disease some years ago that occurred while he was living in a heavily water-damaged home. He shortly thereafter developed a dense central visual loss, effectively rendering him blind. He sought care from the finest neuro-ophthalmologists in Philadelphia and Columbia Presbyterian to no avail. He was treated for his mold illness using the standard sequential therapy. Nothing helped his vision in the early sequences of treatment; he became saddened but never gave up hope. He began using vasoactive intestinal polypeptide (VIP) in mid-December 2010 as his ERMI was now normal after remediation and his nasal culture wasn’t scary. By early mid-January he noted his numbness and tingling in his extremities had cleared and his fatigue abated. On a phone call 1/17/11 he said he is now seeing colors. Gold is gold, the sun is bright. Reds became browns and then reds. Truly a magical phone call! He has long way to go but the benefits of VIP are clear. We are not saying that blindness is treated by VIP: this man is responding, however.
The formal paper reporting the IRB-approved clinical trial of VIP in those with profound chronic fatiguing illness should be ready for submission this month.
The genomics work continues; we hope to have exciting news soon on this long-awaited project.
Meanwhile, court cases in the Bahamas, Tortola and Barbados are developing. Moldy buildings in the Caribbean create the same kind of human health effects as they do in the US. I am concerned that the courts in these foreign countries don’t have the precedent that we have in the US. On the other hand, the use of defense-fabricated publications routinely seen in US court cases hasn’t gotten into the precedent-forming decisions either.
Special Focus: What Do I Do if I Think I am Part of a Group of People Sickened by a WDB?
We are seeing a number of questions regarding how to get started when a group of people are ill and their common bond is a moldy building. Perhaps the following will be of interest.
There is an old expression that “one person saying something makes him ill is a complainer. Two people saying the same thing is a conspiracy. Three people with the same complaints make for a cohort.” Said another way, the more people who are shown to be ill from a given water-damaged building the greater the statistical strength that their claim has.
How then do we determine if a person is made ill by a given building? Affected patients must have the grouping of symptoms that are epidemiologically similar to those that are published - click here to read Dr. Shoemaker’s papers. Someone with experience in taking human health histories will need to start collecting rosters of symptoms from people who are in the building as well as people who are not in the building. What we are looking for are symptoms that are "more likely than not, occurring day to day.” It is quite common for people to say that their symptoms are due to one condition or another, even when their assessment of causation isn’t convincing. All the symptoms recorder is trying to do is find out if the symptom is present. After the initial screening recording of symptoms is completed, an Excel data set should be created recording symptoms as present (1); absent (0); or not recorded (.). This Excel sheet can then be analyzed to see if the preliminary history is consistent with physician-collected histories.
The next requirement is to see if the lab findings in the group are similar to those recorded in prior cohorts or published in studies on experimental animals or humans. Here the process gets a bit tricky as people can’t simply walk in and say “I want an HLA DR, C4a, TGF beta-1 and VIP,” for example. A physician has to order the tests. Finding a physician who is informed can be difficult. Unfortunately, given the state of the “Internet Police” we can’t give you a list of docs we know who are trained in my protocols yet. That day is coming!
Sometimes a physician will agree to help out by running a clinic in which multiple people are seen in one location on one day to have symptoms recorded, labs done, as well as PFT and VCS testing. Such a clinic permits rapid accumulation of a data base that can be analyzed statistically to see if the group of people has the expected findings if a given building makes them ill. The data are recorded on an Excel sheet with statistical analysis of the results supervised by an experienced physician.
If the labs are obtained one at a time the analysis is done in the same way but the time to complete the task will be increased. Make sure that whoever draws the blood pays attention to proper protocol for obtaining the assays; processing is vitally important.
VCS testing is best done in-person with an experienced person performing VCS. We have used the on-line screens in the past as long as they are backed up with an in-person VCS test. Make sure that the test is done on people who have visual acuity better than 20:50 in each eye, tested one at a time. Some people might have special contacts for near and far vision such that the VCS, done at 18 inches, might be done on one eye but not both. Use a light meter to confirm that the available light on the test card exceeds 70 foot-lamberts. Double check the endpoints of each row as you do the test, mixing up the rows to be double checked as you go. Doing VCS testing demands attention to little details (as does all of medicine!) but when done properly it creates a powerful tool to assist in both diagnosis and in following response to treatment. New relapses, for example following re-exposure, can be supported by acquisition of new VCS deficits. Note that no one using VCS has ever said that the VCS test is the only test needed for diagnosis.
One of the problems in developing a cohort (say of school teachers in a large school) is sorting out where their exposures might have occurred. If there is a room, say the auditorium or gymnasium, with visible mold growth, sampling of the mold and of the room, preferably with a mold-DNA test like QPCR (see the ERMI sections of this website) we can satisfy the need to show presence of the potential exposure to a WDB. Otherwise, the testing will almost have to be room by room.
In litigation the other side will bring forth a host of blather regarding testing, so whatever is done by the plaintiffs will be attacked. Don’t worry about the attacks! Showing water intrusion, bacterial growth, actinomycetes growth and fungal growth is routinely accomplished if the testing is done. Air sampling is basically a waste of money if it is done in the center of a room, once or twice, comparing indoors to outdoors. You will see such absurd excuses for science from defense almost all the time. Don’t be persuaded that such sampling has any validity.
You will likely hear even more blather from officials representing the building in question. They will make idiotic statements about mold not hurting anyone and allergy is the only problem. Be sure to read the POA Report of Treating Physicians to print out rebuttals for all those who might be persuaded by the other side. Truth is truth.
You need to read, and disseminate, the WHO report and the US GAO report to help you withstand the onslaught of misinformation that the other side will bring. As soon as you hear the names of ACOEM and AAAAI being thrown around by the defense you know you have them on the run. These references are not just flawed they are just pure junk science. Don’t forget that the defense has nothing else to use so we hear remarks designed to make a judge think that these documents came down from on high along with the Ten Commandments. They didn’t: what is in there is just plain garbage (remember the Commandment to not bear false witness?).
If you are involved with a WDB problem, it may help you to contact us at www.survivingmold.com. We have done several hundred cohort evaluations and several hundred legal cases. We have documents on just about all the defense consultants used in the US.
The owners of a building have a duty to provide a safe environment for the inhabitants. You have a right to a safe school and a safe workplace. You do not have to live in a WDB apartment: the landlord has duty to make the living space safe. Be sure to document what you said to whom about the water intrusion and microbial growth. Be sure to write down when a given symptom appeared and what the circumstances were. Take lots of photos and document what time, where and what the photo shows. Organize your medical records as if your case depended on such organization (it does). Make sure YOUR home isn’t making you ill!
A cohort study when done right is a powerful roadblock for those who would try to steamroll you out of your rights. Such a study will also bring cooperation from building owners when they have a conscience. When that happens, please let us know so we can post the story on this site. When pitted against the resources of an insurance company with multi-billions in assets, one person is often crushed. A cohort gives people the strength of David, a strength that Goliath-size companies have learned to fear.