Mold, mildew exposure can impact your health

Dear Dr. Roach: I lived in southwest Florida for 13 years and was exposed to heavy mold and mildew due to heat and humidity from a leaky roof. About a year ago, I gradually became quite ill – fatigue, weakness, irritable bowel symptoms, insomnia and symptoms of a urinary tract infection. Six months ago, I moved out and have slowly regained my health, with the exception of the UTI symptoms and insomnia. Could the mold and mildew exposure have caused my symptoms? – I.L. Answer: The adverse health effects of exposure to molds, a subset of fungi, are a frequent cause of concern. There are some health effects that are very well accepted, and some that are controversial. Although people with a weakened immune system are more susceptible to the effects of mold exposure, even healthy people can be infected with certain pathogenic species. The majority of molds do not infect healthy people, but they can cause symptoms without infection, and those symptoms can be serious. Infection or not, in some cases, it is the body’s overaggressive response that causes more problems than the actual germs. One example, which I believe may the case with you, is hypersensitivity pneumonitis. In this condition, it is the immune response to the offending agent, such as a mold, that is responsible for the symptoms rather than growth of the mold itself. The most common symptoms of hypersensitivity pneumonitis include cough, shortness of breath, fatigue, loss of appetite and weight loss. When cough and shortness of breath are not prominent, the disease can be very hard to diagnose. Given your history, with the benefit of hindsight, I think you may very well have had a sensitivity to the mold in your home. Urinary symptoms and insomnia are not common symptoms of hypersensitivity pneumonitis, and the fact they haven’t gotten better when the rest of the symptoms did suggests the mold wasn’t responsible. Other symptoms, including chronic sinus inflammation, immunodeficiencies and neurologic symptoms have been reported, but are not accepted by most authorities as commonly caused by molds. Dear Dr. Roach: At my most recent physical, my general practitioner told me that because I am 81 years old, he no longer would order mammograms or colonoscopies, which I have been regularly getting. I’ve never had any abnormalities in the breasts, but have had some benign polyps on colonoscopies. My father died at 83 of a heart attack and my mother at 95 of kidney cancer. I am not at ease with discontinuing these tests. – M.L.W. Answer: I believe individuals have the right to weigh in on the decisions affecting their health. Accasionally, there are times when doctors and patients will disagree, and times when it’s appropriate for a doctor to push back against a decision the patient is making that he or she feels isn’t the right one for the patient’s health. This is a time when reasonable people can disagree, and when patient preferences are critical. I wouldn’t recommend a colonoscopy for most 81-year-olds, but it is reasonable to consider in an exceptionally healthy one, provided she understands the risks, especially of damage done by the colonoscopy. Neither a colonoscopy nor a mammogram makes sense for people whose life expectancy is short, but based on your family history, you still may benefit from these procedures. It’s time to have a frank discussion with your doctor, and have him explain why he has made this ultimatum, which is certain to put stress into your relationship. Questions about breast cancer and its treatment are found in the booklet on that subject. To obtain a copy, write: Dr. Roach – No. 1101, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.