Blog #10: Indoor Pollutants

Bryan King 5/15/16
(Note the large white mass in the anterior L.)

I have a particularly sensitive response to reading about indoor air pollutants. In 2013, while I was pregnant with my first biological child, we remodeled our home. It was 35 year old home that had withstood a wild fire in 1997, 2003 and 2007. It had further smoke and water damage in 2009 during another local wild fire. The home had been "fixed up" each time by the previous owners. We bought the home in 2011 for a deal...My husband went room by room, tearing open walls and remodeling the entire home. We only employed contractors to work on the kitchen and master bathroom. 

We discovered layers of smoke damaged insulation, drywall, black mold. We also disposed off all 2,000 sq ft of carpet and ripped out doors that seemed to hold odors. 

We lived with plastic walls and cooked on a camp stove while I was pregnant. The home was in a rural area of San Diego on top of a canyon overlooking avocado orchards and a reservoir. My in laws lived down the block. During my second trimester, my mother in law- an ICU RN, who suffered from severe asthma, became confused and disoriented. My father in law called me at work and asked me to come see her. I was in the emergency room at the time and advised him to call 911. Later that evening, she was in septic shock and died 7 days later. The autopsy revealed systemic fungal infection and sever brain inflammation from fungal spores. She also had ARDS likely caused by Vally Fever. They cultured out aspergillus and coccidiodides from her lungs and brain. This was devastating to our entire family and medical community. She was cared for by the doctors and nurses she had worked with for 30 years.

Fast forward to 2016. We had finished remodeling our home. The death of my mother in law had changed the reasons we lived there. We decided to move and eliminate our 1-2 hour commute each way. We left our beautiful house behind and headed to urban SD. During our move, my husband began complaining of dizziness, headaches and double vision in his left eye. He is a very capable anesthesiologist and DIYer who suddenly could not put together our daughters book shelf. He was at work, and shared his symptoms with a colleague who immediately marched him into the MRI unit. He was scanned. The image revealed is above.  He was diagnosed with a brain tumor. After multiple studies, consults, biopsies, hospitalizations and a near death night in the ED in cardiogenic shock from brain stem swelling- he was diagnosed with aspergillosis in his brain. It was tracking down through his skull base along V2 into his brain stem causing severe pressure and nearly blowing out his orbit. Over the past 4 years, he has had 7 surgeries, multiple de-breeding procedures and nearly lost his eye. He has had PICC lines, port a caths, pacemakers, etc...

All from indoor pollutants.

He was exposed to mold during our remodel. He also helped clean up his parents house after it had been damaged during a wildfire by fire, water and flame retardant. 

I have no doubt this is what killed my mother in law- besides her exposures as an ICU nurse for 30 years. My husband remains on life saving anti-fungal medications that he will likely take for the rest of his life. These pills make him feel terrible and cost $2400 per month. If he goes off of them, he will die. He still has fungal spores on his nerves despite multiple lines of anti fungal therapy. He is a 1% survivor of his disease. There is no data to support him being alive.

We have a entirely new appreciation for mold exposure. Trapped moisture, air purification, soil contaminants, construction materials are all part of our daily thoughts. 

Not everyone has this severe health effects due to mold exposure. My husband and likely his mom, have T-cell deficiency and no immunity to mold. They are a "high allergan" family. Evidence supports this coming from early exposures to poor air quality as children and high dust and mold exposures through development. This matches my mother in law and husbands experience of growing up in dusty, agricultural regions with multiple layers of pesticide, toxic pollutants throughout their lives.

 His doctors never asked him about his early exposures. He told them about his mold exposure after the first MRI, and even the recent death of his mother from aspergillus. No one took him seriously and they went down the path of cancer before they considered environmental exposures. These were otherwise brilliant scientists, doctors and surgeons at premiere academic facilities. No one asked about recent work, travel or health history other than childhood illness. 

We learned alot during this experience. As providers, we both take this kind of assessment more seriously than ever. He and his mom have since been the source of case studies, M & M's and immunology papers.

I worried about our baby girl's exposure during my pregnancy. So far she is healthy with no allergies or respiratory issues. We moved out of the house when she was 2. Praying for health. 

Environmental risks are real. Indoor pollutants and exposures should always be considered. 

A few great links below.

CDC: https://www.cdc.gov/mold/pib.htm

Poison control: https://www.poison.org/articles/2011-oct/mold-101-effects-on-human-health

Keep your home healthy: https://health.clevelandclinic.org/17-simple-ways-prevent-air-pollution-home/

Resting with daddy pirate. We tried to make light of his temporary vision loss.