The #1 Mold Testing Professional You Need

Intro:

Welcome to Dr. Ruscio radio, providing practical and science-based solutions to feeling your best. To stay up to date on the latest topics as well as all of our prior episodes, make sure to subscribe in your podcast player. For weekly updates visit DrRuscio.com. The following discussion is for educational purposes only and is not intended to diagnose or treat any disease. Please do not apply any of this information without first speaking with your doctor. Now let’s head to the show.

DrMichaelRuscio:

Hey everyone. Today I speak with Mike Schrantz, who is an indoor environmental specialist, and I think this podcast is one of the most important if you are someone who has, or suspects they could have mold in their home. We really elaborate why this is. The loose analogy goes as such: If you went and did a bunch of direct to consumer functional medicine tests, the likelihood that you would make yourself worse and spend far more money than you need to is quite high. This same parallel holds for if you suspect you have mold in your home. It’s crucially important to have a professional trained in history taking diagnostics and intervention to quarterback and lead that charge and not just do testing direct yourself and try to piecemeal together finding your way through the micro toxicity woods. Our clinic has been referring to Mike to function in this capacity, and it’s been very, very helpful to just confidently let go and direct a patient to have this facet of their health care managed.

DrMR:

So if this is something that you think may be impacting you, or you know is impacting you, please listen to today’s episode with Mike because we go over why it’s important to have an indoor environmental specialist leading that charge instead of just going directly to the labs or trying to just do it yourself with whatever you can grab at Home Depot. That is the focus of today’s podcast. I hope you’ll give it a listen. Remember, if you are in need of help with something like mold toxicity and microtoxins, the clinic is doing more and more in this area with every few passing months. And I do feel there is something here, although it has to really be balanced because this does seem to be in some cases, kind of a wastebasket Hail Mary diagnosis that providers make when they’re not sure what else to do.

DrMR:

I think a better way of approaching this is building it into that dashboard of data, assigning it based upon someone’s history, their presentation, and their symptoms, what is the probability of this being the problem so that you can, as one example, make sure that someone isn’t hyperreactive to an otherwise normal environment. And this is why potentially, and as a kind of general rule, you’d want to work to improve someone’s digestive system health first, because that may attenuate this kind of global reactivity, where someone may be having an abnormal reaction to a somewhat normal amount of environmental mold. This is why I would recommend you to reach out to the clinic to get some perspective in case you’re not sure what to do, because different items may have a time and a place, but addressing them at the right time can really make the difference of getting you to the place of healing or not healing, because that sequencing can be quite important. So today’s conversation was with Mike about an indoor environmental professional’s perspective on rectifying any toxins in your environment. Again, if you need help there, I’ll also point you to the clinic who does refer to Mike in conjunction with our care for these services. Okay, here we go.

DrMR:

Hey, everyone. Welcome back to another episode of Dr. Ruscio radio. This is Dr. Ruscio here today with Mike Schrantz and we’re going to be discussing why it’s so crucially important to have an indoor environmental pollution specialist or an IEP help you if you suspect mold in your home. This is something that I really have a feeling that people are taking advantage of probably not intentionally, but there’s lack of regulation here. And that cuts both ways and it can cut the way of spending way more money to determine if there is a contaminant in your home or potentially having a test and the test is negative, but you don’t feel well, and now you’re not sure. And you can kind of keep doing testing until you find something, but then again, is that finding kind of a heretical finding where this particular test finds something in every home.

DrMR:

This is one of the main challenges that I think every clinician grapples with; how to know if you’re getting good testing. How to know if it’s been an appropriate evaluation. This is something that Michael has been really phenomenal with, and I want to credit Dr. Jill from the clinic for kind of discovering him and bringing him into the fold so that we have someone we can refer to, to lead this charge because the thing that I’ve been grappling, with and I think many clinicians do, is when you suspect there’s mold in the home and you ask a patient, but find someone in your area to do a mold inspection. You really have a hard time knowing is this going to be a good evaluation or not. This is why I’m so thankful to have Mike in our clinic Rolodex, so to speak. I’m just excited, Mike, to have you here today to really help enlighten us on how to handle this kind of slippery bar of soap issue, which is, do I have a contaminant in the home or do I not? So welcome to the show.

MichaelSchrantz:

Michael, thank you so much for having me and I totally agree with what you just stated. It is a challenging situation for many people, not even knowing where to start. I’m going on the internet now and doing your own research and asking 10 professionals their opinion and getting 15 different responses. So I look forward to getting into this conversation.

Indoor Environmental Professionals

DrMR:

There’s so many different ways that we can go, but let’s start with what is an IEP and a little bit about your background just in case people haven’t heard the acronym before, and they’re not really sure what that means.

MS:

Indoor environmental professional, IEP, is a generic term loosely used to define professionals in the field. It’s not limited to just mold inspections. It can be somebody who specializes in chemical analysis, or maybe they’re looking at a host of things, even EMF, electromagnetic magnetic fields, that sort of thing. But it’s a broad term to capture the type of environmental work, testing, and assessments that you see people doing a lot of times in residential homes, certainly in commercial buildings. I don’t think there’s really a structure that would be off limits. In terms of my own experience, my background, you certainly can get the full version if you go to environmentalanalytics.net, which is my website. However, I’ll say in short I started when I was 16 years old. Didn’t think I’d be doing what I’m doing today, but I was working for a family-owned air conditioning company, learning about air movement, quite honestly.

MS:

I’d never realized how much that would play a part in what I do now and trying to figure out where there is a problem and where’s it coming from, how’s it getting into that structure. But through high school and through college, I started taking more formal training. Certifications were acquired through that period of time, all towards general indoor air quality type of work. And it probably was around 2013 or 2014 that I was really introduced to a new type of client that I didn’t even really realize existed. Those were people who suffered from chronic illness. It wasn’t just an allergy, it wasn’t just a stuffy nose that we were worried about. These were people that had something wrong, whether it was susceptibility or some issue that caused chronic illness and they were running into walls where their clinician would say, “Well, we definitely suspect it’s environmental.”

MS:

There would be a host of reasons why that might be. Maybe some blood markers or other sort of biomarker testing, but they would go out into the field and hire a mold inspector, and they would always come back and say, “Well, we’re not seeing anything.” So I found that perplexing because how can two different industries be so far off in opinions, and really dove into it and came to realize a real great appreciation for people such as yourself and the work you’re getting into and what you are looking at with these clients. I realized that in many ways, the IEPs that are available out there certainly mean well and have a host of talents, but weren’t really being as forensic as you guys needed. We were overlooking things as non-problems. So really in the last say, five years, my work has been exclusively working with folks who have chronic illness or low dose environmental exposure concerns and trying to figure out why it is that a person’s not getting better despite treatment. And Michael, that’s what I’m doing pretty much, 24/7 it feels like nowadays.

The Effects of Mold

DrMR:

And so the focus is within the realm of mold or are you looking more broadly for any kind of contaminant in the home?

MS:

Fair enough. Admittedly, with a lot of what we’re looking at, we use the term water damaged building or dampness. When people think of moisture or humidity, you think of mold a lot. Mold is typically going to be a by-product of that, but there’s things like bacteria. Bacteria is now starting to make more and more headlines as well. I mean, it’s always been around, but we’re starting to look at, “Hey, could this be an issue?” So I would say probably 60 to 70% of the work I deal with certainly looks at mold because the default there would be a water damage situation, but we’re also looking at chemicals, off-gassing, new buildings, paints, flooring, cabinetry, things of that nature. In tighter, newer built homes or remodels, you’re seeing this come up as an issue. And then of course we get into other things like EMF, which is also emerging. So it’s probably split that way, and I can’t go too long without saying that pretty much with every other client I’m going to be bringing up mold one way or the other. That’s usually why they’re coming to me. Mold is such a hot topic and it’s also a useful contaminant for us to look at because a lot of us out in the field do understand its physiology and what would be normal in your environment versus not.

DrMR:

One of the things that I think that clinicians struggle with, and I include myself in this, is being open and cognizant of the potential issue of mold on the one hand, but also not having this as “Well, I don’t know what else is wrong, so I’m just going to say mold,” and kind of throw a Hail Mary. The reason why I am becoming progressively hesitant to do that is because this can take a patient down a dark path. Especially if someone has IBS. We know that IBS patients have a higher predilection towards anxiety. So now you pose this mold issue and now this person is feeling threatened in their home, and they may be like I was, having brain fog from things going on in my gut. They weren’t necessarily environmentally induced. I didn’t know that at the time. Now I’m sitting at having brain fog thinking, “Oh my God, there’s mold in the walls.”

A Proper Diagnosis

DrMR:

And there you go down this very dark rabbit hole that we should be careful not to point people to, unless we’ve built the case and/or we can link them up with someone like yourself who can moor them and prevent them from falling into, “Well, it’s got to be mold,” and can do an evaluation and give us the best obtainable degree of confidence in saying there is mold or contaminant, or there is not. So what I’m trying to articulate here, I guess in a little bit of a verbose way, is for clinicians being careful not to just throw this out there when you’re not sure what else to do.

MS:

That is such a valid concern. In fact, the last client I just got off with earlier today, it was a similar narrative. A client lived in another state and the clinician was worried about mold, but chose to be careful with the wording. Whereas that’s not as common with others. I’ve worked with thousands of clients around the globe and I might not be a doctor, I certainly don’t play one, but you see patterns. One of the things you do see is the stress, the anxiety, the interruption in life. I mean, I’ve seen people get divorced right in front of me over this sort of stress of knowing that it’s going to cost this much money. Then there’s the people that take advantage of people that are in that situation.

MS:

What I like to see is starting with the evidence of what we have, even if it’s minimal. Okay, well, they did a urine analysis and it came back positive for some microtoxins that were present as one of many examples, and the doctors really exploring that. And they’ve let the patient know that. They’re saying, “We’re not sure, we’re trying to rule things in and rule them out.” That’s therapeutic to do it that way, because then the client doesn’t go in there thinking that they have to have a mold problem in their house, which is what we also see. We get a number of clients that reach out to us every week, where there was all this momentum, this assumption that there was a mold problem and all the stress that came with it, only to find out later down the road that it appeared that the clinician was really just guessing, but they used terminology and phrasing that made it sound like there had to be a problem with mold. I’m not a limbic system expert, but you start getting into other concerns of what kind of stress and anxiety that adds to these people’s lives. What you need is a balanced approach. The question we pose here to the audience is what is a balanced approach to somebody who maybe you suspect might have a mold exposure, but you really haven’t dialed it in from a clinical diagnosis perspective?

DrMR:

So I think as our audience can see, this is why we get along so well. Because we understand how important it is, what you say, how you say it. And I guess maybe a lesson here is for clinicians just to be a little bit more thoughtful and maybe understate your case rather than overstating your case. If you’re not sure where the optimum balance point is, build the case, but overstate the case until you have the evidence to really back that up, because people do worry and this is important, especially when it comes to your home, that’s kind of your safe space. It can feel very threatening when you think you have a danger where you’re supposed to be safest. So this is a good transition into why someone should work with an IEP. This begs the question of, “Why should I go see a consultant when I could just go right to the lab?”

DrMR:

And to paint a parallel for our audience that I’m sure they can really appreciate, this is one of the reasons why I recommend ardently against people doing their own stool testing, because the interpretation is very, very important. There are false positives. There are certain organisms that we don’t really know if they pose a threat or not, but they’ll still be marked as high or low on the lab reports. And then if you go Google those, you will get hellaciously unhelpful information. So this is why rather than just going right to a direct consumer stool testing lab and getting incredibly confused by that, it’s much more efficient to pay a professional to be the intermediary between you and the available diagnostic testing that’s available. So I guess I’m kind of answering your question for you, but you know, this is at least as I see it, why it’s important to work with an IEP. What’s your perspective on this and what would you offer people in terms of why it’s important to invest in the counseling of a professional to help them navigate this array of available diagnostic tools?

MS:

Well, I’m glad you provided your example because there’s a lot we can relate on. It’s therapeutic for folks to hear this, that the same exact issues exist in the environmental world. Talking about the clinical part as an example, it’s the same thing in the environment. We have a lot of resources, a lot of DIY, do-it-yourself type testing. I think in the right application, therein lies the challenge right there, is that it can be a useful tool. There are many times that I work with patients and clients where we’re guiding them with kind of some DIY sampling. It’s ultimately really hard to replace boots on the ground, having a qualified professional get into your home to do a thorough analysis, a visual inspection and really taking a look at the history and sitting down with the client to figure out what are the concerns and why.

MS:

And then doing sampling to answer questions you can’t point at visually is useful. But the reality of it is while that all sounds all well and good, a vast majority of people don’t have a trusted professional that they can go to, at least initially. So when you’re thinking about, “Well, why don’t we just have them do their own dust sample or their own Petri dish sample?” We see them readily available online. There’s a couple of well-known companies that offers these services. The problem is that a lot of times they have trouble interpreting. So you have this client who collects a bunch of samples because they thought they were saving money, and then they get the results back and go as far as misinterpreting that something growing on a Petri dish must mean there’s a problem. For those of you that aren’t familiar with a Petri dish, it’s an auger plate that is designed to let mold grow.

MS:

In fact, mold will grow on it; it’s supposed to. We are all breathing in viable mold spores, even as we’re talking right now. Certainly some of that is going to settle out and grow. That goes right back to Michael’s point. The interpretation matters more than darn near the sample. So if you’re looking at it and you don’t know how to interpret it, you’re going to be left with more questions. It’s like anything else — start with a professional who understands the bigger picture about your environment, who understands the limitations, strengths, weaknesses of different types of sampling, what’s available, who can help you locate professionals, but with guidance who can say, “Here’s what you want that professional to do. Here’s why you can sample that thing first to save on money.”

MS:

I can’t tell you how many times people, as they begin to work with us will send us all the sample data that they’ve collected. After looking at all of them, 70 to 80% of the time, we realized that it has little use to us because they either collected it incorrectly, or they miss vital things like saying, “Well, did you collect an outdoor sample to see what’s normal for your environment?” The molds that are in Texas right now that are proliferating outside are going to be different than what you might find in a Northern state, or that you might find in Arizona, that sort of thing. So these are sorts of just quick examples, low hanging fruit that I can point at of why doing these types of your own DIYs without guidance or understanding is a problem in many cases.

Using an IEP

DrMR:

I just want to second that with my own personal example, because when I moved to Austin, if our audience remembers, I was sleeping terribly. It turns out that as best I’ve been able to determine after years and years of observation, I seem to have a very low-level intolerance or allergy to some air conditioning. I thought it was probably mold that was causing that. It wasn’t really an issue in California because of it’s wonderful weather. There’s a lot of things we can criticize about California, but we cannot say much about the weather there. You hardly ever have to use your AC, hardly ever have to use your heat. So it didn’t really pose a problem. Go to Austin in August and it is a very different story. You must have your air conditioning on. There’s just no way around it. Trust me, I’ve tried.

DrMR:

So I had a company come out and I think they did a thorough investigation, but what I was left with was “Well, there’s some light amount of water damage here. There’s some mold growth, and this doesn’t look to be overtly pathogenic, but it could be something. There is mold and here’s your remediation plan, which is tens of thousands of dollars.” I think that’s what it would have netted out to. And I said, “Hmm, this seems like a lot, especially since my friend I’m living with is exhibiting no ill health effects. Let me run this by Mike.” And you were able to say this is kind of a normal finding, meaning there’s nothing abnormal here. There is mold, kind of to your prior point, but this is essentially ambient environmental mold, and this is normal for us to see. That for me, was massively important because it saved me from going down this witch hunt road of, “Well, there’s some mold on the test.” It’s that kind of perspective that I think is so valuable for an IEP to be the person in between the company doing the assessment and how we interpret the findings.

Remediation Approaches

MS:

Right, exactly. I think to that point, somebody who can quarterback for you. It’s a balance, everyone’s different. There’s some people that need a lot more hand-holding than others, there’s people where their project, their job, their home is more complicated than others necessitating or validating the use of somebody like myself, an IEP who can go out there and be virtual. I know COVID changed a lot of people’s lives. One of the things that actually made virtual consultations more attractive was in 2020. What we were able to figure out through our own experiences is that even just taking the time to educate people on, “Here’s what we mean by normal.” Mold growing somewhere in your home is not necessarily normal, but what can we do about it?

MS:

Is it ripping out duct work? Is it cleaning something? Is it fixing or improving the crawl space because it smells musty, but you understand it could cost $20,000 or $30,000 for a real improvement? How do we prioritize these things when there’s not a playbook? There’s not a one-step fits all for everybody. Then you add into that minutia of complication the fact that one client may be willing to spend $5,000 for anything addressing indoor air quality, and another client may be willing to spend $50,000 or more. It does limit the options of, “How do we change what we do?” Do we want to have boots on the ground? Should we have you try a couple things first? Should you do this one step and then go back to your clinician and, and do follow-up testing and trend data?

MS:

If it’s follow-up urine, if it’s cytokine blood marker type testing, if it’s NeuroQuant, whatever the marker is. What we often find with people who are limited with budget is that it’s the ultimate compass anyway. Obviously different types of sampling in the field have value, but at the end of the day, what I care about is are you recovering or not? Are you heading in the direction that you want to go in? Because if you’re not, I really don’t care what your mold sample results shows. Clearly there’s something not right. So first and foremost is making sure that you understand that as much as we’d like to make this into “Press, one button solve all your problems,” a lot of times in the field an appropriate cadence and approach is a bite at a time. Let’s get some baseline information.

MS:

Let’s see what that shows. Let’s take it back to your clinician. What does he or she say. Okay, still showing a problem. Let’s dig deeper. Does dig deeper mean hire local boots on the ground? Maybe. And then maybe you get some direction by somebody you trust, somebody like an IEP, like myself or others. There are quite a number that are out there. Is it remediation? Is it a problem where we know we were already going to replace that kitchen sink anyway, and we know there’s mold there, so we’re going to go ahead and be proactive? There’s thousands of examples that, in trying to prioritize this in a way that always honors their health, but also acknowledges that not everybody has a checkbook with an unlimited amount of money in their bank. How can we do this without stressing them out? Because Michael, I think that’s probably the second biggest complaint. A lot of the recommendations that are out there are convenient for the person who’s not writing the check.

DrMR:

Right. Well said. That’s another reason why I appreciate the approach that you take. This should sound familiar to our audience, which is this very attentive, iterative clinical process where you’re not expecting just one thing or one test or one intervention to solve everything, but rather an array of various therapeutics or diagnostics on offer. Let’s work through this. I understand that if you’re not feeling well, the most attractive prospect is the one thing that’s going to solve everything. But unfortunately that doesn’t seem to be the way that this plays out. And that’s why it’s important to have someone who’s going to be kind of thoughtful and methodical on this.

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Virtual Consulting

DrMR:

You mentioned virtual consulting. Tell people a little bit more about how that works, because from my understanding, you can do a partial visual inspection on something like a Zoom call. But also important to highlight is that you can also partner up with someone locally and have some testing done, and then you can interpret the testing, which is really nice because it doesn’t require you to have to be in the same city as any patient we wanted to refer to you, which has really made things quite a lot easier, because now you can kind of quarterback from afar and integrate with local boots on the ground like you said.

MS:

It’s a great question. So in terms of what is virtual consulting, it is true we’re a small community. I know a number of colleagues that offer variations and we’re all close. Some people push more of ,a replacement of a visual assessment or boots on the ground. So they’re walking with you virtually. You’re holding your phone or your laptop and you’re walking through the house. I personally don’t do that. I have a modified version where two people will take either video ahead of time or take photos of areas of concern. Really where virtual consulting has seemingly been the most successful with the people I work with is the fundamentals. Yes, we’re going to talk about those areas of concern. Yes, we’re going to take a look at those videos, but again, it’s hard to beat local boots on the ground.

MS:

A pair of good eyeballs and a flashlight is going to be a lot more powerful than a blurry video feed with a dog barking in the background, which is the life hack realities of what you’re dealing with. So for me, it’s the fundamentals. It’s definitely saying, “Let’s talk about why we’re here.” Well, you have concern for health. Well, what have you been diagnosed with? Well, let’s talk about why we’re looking at your home or your office. Well, because I feel worse. Or my doctor thinks this. Let’s go through the history. We talk about any and all of those things. To transition into kind of how I personally work, you’re kind of at a crossroads constantly. The crossroads is either try something first with the client themselves, with maybe some form of DIY sampling, or getting boots on the ground out there, if there’s enough evidence there, meaning they’ve talked about a number of areas such as, “Oh, well, we had a toilet leak and it went for two weeks in, but we dried it up.”

MS:

I’m thinking about all the walls that were impacted by that Category 2, Category 3 type water that hit it. All the things that could go wrong there. I’m weighing that out as I’m discussing this with people, but ultimately figuring out whether or not the local boots on the ground are knowledgeable. So during the call, a lot of what we’re doing is saying, “Well, let’s pull up Google.” Customizing what specific services they need. Listening to, “This is what I’d like, how much do you charge?” And it’s basically an interview process. By doing it that way, you’re saving a lot of money in the long run. I don’t know what the experience of our audience members are, but in so many cases if you don’t have that guidance, you don’t really know what to ask.

MS:

You don’t even really know if what the mold inspector is telling you to do makes sense to do. For example, there’s the classic scenario of your doctor who thinks there’s a mold exposure and they want you to do ERMI sampling. You’ll call the mold inspector who doesn’t understand chronic illness and says, “I don’t believe in any of that hogwash. And we’ll just take five minutes spore trap samples to address what might be floating around your air.” I can personally tell you that I’ve collected thousands upon thousands of spore trap samples, but spore trap samples miss a lot. In a settled environment, they don’t identify fragments, for example. And to nerd out with you just real quick, for every one mold spore, depending on the study you read, there’s anywhere from 300 to 500 mold fragments. There’s way more fragments than there are spores. It’s not going to identify those fragments.

MS:

This is that guidance without oversight. You could have your client or patient reach out and say, “Okay, thank you, Doctor, I’ll call a mold inspector. Oh, they gave me all the lip service. They had a nice glossy website. They charged me $350. They came out and looked at my house for 15 minutes and took a couple of air samples. One of my master bedroom, one of my living room and shockingly, they didn’t find anything.” Note the sarcasm. That’s my point is that people don’t know how to flag that as a problem. So where the virtual consults are often the most successful is in the beginning before that client ever starts doing anything. The second the doctor has a legitimate concern about a mold exposure in a home or office, the advice we give is, unless they have a local person that they just that’s their go-to, they definitely trust this person, that person definitely gets it, is to reach out to somebody like myself or a number of others who can at least do the fundamentals, the education and the guidance. Then your patient can say, “Okay. I now understand why this is a concern. I understand about how mold works and what I might be looking for and why. I understand that I have options. Oh, and by the way, we found a few people who can potentially help me identify these problems.” That typically is a sure-fire way to address the home one way or the other.

Types of Testing

DrMR:

Many great points made there. One that I’m glad you raised was about the ERMI testing, which there is controversy regarding. I know we’ve discussed the ERMI testing in the past. This to me sounds like a really attractive prospect. At least from watching what you’ve done from when we’ve referred you people, this seems to be something you found to be a good entry point into the diagnostics for the home. Could you tell us a little bit more about what some of your initial thinking is when perhaps a few flags are raised and now you’re suspicious. Are you typically starting with ERMI or a combination? Just to give people a sense for how this typically plays out. I think that would give people some helpful examples, because that for me was really helpful. Knowing that I probably should have started with the ERMI before having someone come out and do air samples for the reasons that you just cited.

MS:

So for those that are less familiar with ERMI it stands for Environmental Relative Moldiness Index. It was commercialized in 2006 with the EPA and all that. I don’t know any one sample that doesn’t have drama or debate, but you are right to say that ERMI has one. It’s ironic that ERMI is really a formula and it comes up at the end with a score. Most professionals I work with, myself included, don’t even look at the score. I do agree that the score, in my experience, doesn’t correlate as much as I would want it to. I’m sure there’s definitely been times where it does, but there’s a lot of false negatives, there’s some false positives which I run into a lot. That leads me to the point of where is it a great tool still?

MS:

Well, one of the pros that we like about that sampling is that it can identify those fragments. Remember we were talking earlier about how many more fragments there are in the environment, and as long as it’s one of those 36 molds and there’s DNA in that fragment, it theoretically is able to be picked up in that sample and then be identified in the report. Using that as a tool and the timing when you sample the environment, like in your case, hindsight being what it is, maybe it was great time to do it when you did it. But there are a number of situations where there are so many obvious issues in the home that even I look at that and go, “Well, I think the person’s wasting their money.” We can stretch our dollar out. It would be nice to have that baseline.

MS:

I’m sure you and I would both appreciate having some baseline information about what is it that they’re currently being exposed to. But unless it’s dire to treatment and recovery, or if it’s some sort of a legal matter where documentation may come in handy of what was in the environment, sometimes we don’t even have them do it right off the bat. The first step really is identifying what is the history in the home. Is it low-hanging fruit or is it just a tiny leak? It leaked a pint of water and we wiped it up right away. That to me is not a big elephant in the room problem. An ongoing leak underneath the kitchen for a month at the sink would possibly be another example where you would say, “Oh, wow, there probably is going to be something in that environment.” Some sort of growth, if you will.

MS:

In the cases where IRMI becomes a really useful tool is in talking to that client who’s on the fence, or there’s not any history to support an obvious problem, like a moldy crawl space or moldy duct work, that sort of thing. You’d say, “Well, I’ll tell you what. It sounds like you are kind of on the fence. You’re kind of on the fulcrum balancing whether you’re concerned or not, but your doctor really has shed some light on this. Your husband doesn’t want you to hire a professional because you guys are arguing on finances. Why don’t we start with an ERMI sample and I’ll walk you through how to sample it and things to avoid and even preparing your house to sample correctly.” Then we get that information back, compare it to what we see as normal for your environment, and use that as a fantastic tool to justify diving deeper into hiring boots on the ground. Or perhaps even going back to the clinician and saying, “Listen, we’ve worked with an IEP like Mike, we trust his virtual assessment. We’ve got data for you. It’s not showing anything, clinician.” Is there something else that the clinician is missing, or should focus on before you have that client or patient turn to the next chapter in mold and have them start spending significantly more money searching for a mold problem that may never be there in the first place?

DrMR:

Very well said. Just to showcase something for people, the in-home mold testing, meaning the companies that will come out and do the assessments in your home with multiple air samples, they’ll say something like, “Yeah, it’s $350 to have us come out.” What they don’t really tell you is that to do the actual air sampling, you’re usually looking at between $2000 and $3,000. So, these are not small amounts of money. We do want to build a case and again, I just really appreciate your practicality in that sense. If the history of the home and/or the individual are highly suggestive that there has been water damage and/or contamination, we may be able to go right to resolving that remediation, whatever it may be. Then there’s not a need to do the testing. But if you’re unclear, and this is where I often find myself, because there are some cases where it’s super obvious.

DrMR:

I was living in Arizona. Then I moved to Hawaii. We see mold on the walls all the time. I started feeling ill three months later. I have lots of neurological and pulmonary symptoms. Pretty obvious there, but there’s a number of cases where, “You know, every once in a while the crawl space, I think it smells a little bit moldy. I’m not sure. I don’t think we’ve had any water damage, some of the symptoms were present before I moved, but some got worse after I moved.” It’s really hard to read the history and environmental cues to know. That’s where I see the ERMI making a lot of sense as a springboard. Again, I just really appreciate the pragmatic and practical approach that you take toward these things.

Oversampling Issues

MS:

Absolutely. Just a final little touch up on that one too, is if it’s obvious, if it’s low-hanging, “Oh, by the way, we forgot to tell you there’s 20 square feet of mold growing on our bedroom wall,” unless there’s something that we can go to, it’s not that sampling, wouldn’t be helpful. I think the problem is that you have a lot of professionals that are out there that are just sleepwalking in their efforts and they’re not really doing a good visual assessment that could save that person thousands of dollars. But you’re right, when you get into the minutiae, when you get into the gray areas where you’re not really sure, that’s where this type of sampling can be really useful.

MS:

And to your point about getting the foot in the door for $350 and then charging more for sampling, we see that all the time. So you have things such as oversampling. There’s companies that are well-known, unfortunately, out there. You could get a $6,000 to $8,000 bill, and they tell a story about how these different samples will test for different things. And it’s so important because so many things are toxic and dangerous. They really just kind of run that whole angle, which I’m highly against. Then on the other hand, you will have a company that literally will only charge you $350, and that includes the samples because the quality of the sample you’re getting is very limited. You’re not getting a report with interpretation, just maybe base findings. Now you have a client that’s left with the report that says, “Looks like you have a mold problem.”

MS:

I feel like the conclusion should say “Good luck,” because they don’t really provide you with any direction. My point is to work with somebody in the beginning, before you get eight steps deep with your patient and get them all frustrated and spending thousands of dollars to where now they don’t even trust you to spend a dollar. Get somebody who understands the environment involved upfront, because they might spend a few hundred dollars upfront, but they’re going to save thousands of dollars. They’re going to be empowered with information. I don’t even know what the value of that last point is, but it’s got to be worth it to say, “Yeah, we don’t want these people to be hitting walls and spinning their tires. We either want to rule in mold or rule it out, within reason” We understand there are no guarantees. There’s not a mold whisperer that I’m aware of that’s offering services who can just find mold anywhere.

MS:

Plus each one of us are different. For those of you listening right now, you might be able to go in the same environment as the next person and have a reaction, whereas they did not. So it’s all about honoring what is the basic, what’s our normal fungal ecology. What should we have in this home if mold wasn’t growing in the house anywhere. Then we look at that against your health and quite simply say, “Is this good enough for you? Do we need to improve the environment? Is the evidence suggesting that?” And do it in an interval, at a pace that makes sense with your life, your finances, and the stresses you’re dealing with. And that’s what we’ve seen has been the biggest concern and need from our clients, people reaching out and saying, “The problem is when I go online, I read things that everyone would have me burn my house down, throw away everything, and basically walk around the desert with a loincloth until I get better.” And that’s just not realistic.

A Comprehensive Approach

DrMR:

It’s well said. Yeah, fully agreed. And again, hopefully for our audience, we’re impressing upon you something that I think can be a little bit frustrating when you’re not feeling well, which is a simple answer. This one test, this one treatment and everything’s gone and done. That’s attractive to the degree to which it works, but usually it doesn’t work. So what ends up happening is you come back to there being a few different ways this could play out. There’s a few things that could be causing this. So let’s organize this, let’s prioritize and execute. It’s a little bit of an iterative process. Sometimes just to acknowledge this, it may feel a little bit more tortoise, like out of the gate where you say, “Well, I want the person to come out and do all the testing and just rip everything out.”

DrMR:

But you know, that may be overkill. That may be not needed. It’s kind of like the person who says, “I just want to carpetbomb my gut and get rid of all those critters.” Well, it’s not quite that simple. It’s more like an ecosystem it has to be tended to. So just a word of encouragement and patience, that you’ll get over the finish line usually more quickly, if you’re a bit more kind of patient and measured out of the gate. Albeit that can feel challenging when you just want to get well as quickly as possible.

MS:

Well said about everything you said about the challenges. But I believe in the story, the tortoise did win in the end and it was for that very reason. We’re using examples here. It’s because you are faster in the end. It doesn’t feel that way out of the gate, but it’s because you’re slowing down to speed up. You’re saying let’s not panic. Let’s not make assumptions. You will be your own worst enemy. Obviously, I don’t want that to be the case, but that ends up being the case because you wanted to take out your sword and start chopping through all this minutiae of information overload and just do it yourself. That’s where a lot of people go wrong. And why wouldn’t they feel like they could have done that? I mean, the industry even presents itself with, “Oh, just do this kit or just spray this stuff.” The problem is we have parts of our industry that I think are really not helping. For probably a number of reasons, including ignorance and greed, they want to sell you this product. It’s natural for most people to say, “Why would I hire somebody like Mike or yourself to do professional work, which they’ve taken years, decades to learn, when I can buy this ‘miracle solution’ for $18.95 plus shipping?”

DrMR:

It’s one of the most frustrating things. We don’t encounter it very often, but every once in a while, a patient just cannot accept that when we explained this high on the test doesn’t actually mean anything. “What do you mean?Then why would it be high?” It’s really hard sometimes to educate people up to the fact that a lab can say high and low, but the reason why we actually need clinicians is because they actually interpret those highs and lows and assign value and meaning. We’re seeing eye to eye on this point. You reminded me of another question I wanted to ask when it comes to mistakes and challenges that require this thoughtful process. How often in your observation do people move and then they move out of the moldy home but the mold goes with them in books and bedding and furniture? Is that something that’s common? What insights do you have to offer our audience about that?

Mold Proliferation

MS:

When we think about cross-contamination, I’ll first answer your question directly. It’s probably subjective. Obviously people calling me up usually have concerns, have problems, have the history. But that being said, where we’ve worked with a client who’s done what you’ve said and ended up ruling that it was the contents, probably 5 or 10% of the time. The reason for that is because most people, first of all, are aware. They’re like, “We have this sofa in the basement and it was moldy and it smelled musty. We just decided to get rid of it.” So they’re trying to make pragmatic steps. Call it an excuse for new furniture, whatever you want to call it, but they got rid of it. So it’s no longer a concern.

MS:

The other thing is an indirect example. If you think about it mold’s everywhere. We’re breathing in right now, as we’re talking, as we’re listening. Without mold, ironically, we wouldn’t be here. It’s a normal part of our ecosystem; we need it to do its job, and that sort of thing. The same molds that might’ve grown in your moldy basement or in your HVAC duct work, underneath the kitchen sink cabinet, insert any example you want, where do you think it originated from? The quick answer is outdoors. The mold may have grown inside, and there’s no argument about that, but there is no God or Buddha defying mold that only grows in a man-made structure. There’s no Mold Fairy that just generates out of thin air a mold sport to grow because you’ve had a water leak. In plain English, all molds that you see in the environment that you’ve been reading about originate from outside, which is interesting because we’re kind of prejudiced.

MS:

My point on this is if you’re exposed to Aspergillus penicillioides in the outside environment because you live in Houston, Texas, or in some sort of tropical climate where Aspergillus penicillioides, a well-known water damage mold, is present outside. You don’t have any problem with it? You’re fine with it. That’s your normal background. You’re not calling up your friends or going on Facebook with concerns, chatting about that exposure. But the second it grows inside your home. All of us have seen some of the extreme responses and unfortunately it’s like plutonium. It’s one spore, oh my God, get out, throw everything out. And I see the disconnect. People understandably, in their concern, they’re the ones that are suffering, have this lack of education of what is truly normal.

MS:

We don’t respond so quick if contamination into a new building was a one-way event. Think about it. If you move from Point A to point B and you brought over a moldy mattress, you’re not going to ruin the house because if that was the case, statistically, probably every building in the United States, heck the world, would be contaminated. How many FedEx boxes do you have? How many UPS boxes, how many trips to the grocery store? What about your Aunt Caroline that visited for the weekend with her moldy luggage? You’re going to have exposure or mold contamination from other events and it doesn’t ruin the home. So going back to the original question, why I said 5 or 10% is because I think it’s also about identifying what does contamination mean? Unfortunately, mold doesn’t come with name tags.

MS:

They don’t say “I’m Aspergillus penicillioides and I came from the bush or I came from underneath the kitchen sink cabinet.” The test will just say what the mold is. It’s up to the professional to try and figure out where it came from. If you do have a mattress or something that’s expensive, we will take a look at that and say, “Well, in our experience, you might want to err on the side of caution, and if budget allows, maybe you don’t bring those items into the new home or at least hold off it.” In other words, it’s consideration. It’s like saying, “Well, we don’t know that it is a problem. And we understand that you just bought yourself a $2,000 avocado mattress last year, and you’re hesitant to throw it away.”

MS:

So why don’t we start not bringing it into the new building, tracking your progress? There’s a connecting of the dots again. Let’s track your progress clinically and see if you’re heading in the right direction, AKA recovery. And if you are heading in that direction, then we can choose to look at some of those various suspect items like the porous furniture, the clothing, and reintroduce those items in a controlled manner so that you see whether or not you can turn this new place you’re wanting to stay in without having adverse reactions. Mold is not plutonium. It’s obviously a concern. I shouldn’t be saying this; this is what I do for a living. We give too much fear credit to mold, and it causes a problem where people think that the only solution is living in a glass house on Mars. So no, I’m not overly suspicious about cross-contamination. I do agree that if you have a big ugly box that was in storage, do yourself a favor and don’t bring that into the new home.

DrMR:

Just your perspective, I think is so valuable and it’s such an important reminder for people that mold isn’t exclusively bad. There’s this environmental mold, which I’m sure if we looked long enough, we could probably find some correlation between exposure to environmental mold. Just like when we say environmental dirt and improved health outcomes of a variety of measures and why we may see people who have more contact with green zones, blue zones, or just the natural environment, having better health is probably in part due to having some mold exposure and how that attunes the immune system. Again, just why I think it’s so important to work with a professional who’s not going to look at it like you said, all mold as being plutonium, because when you’re not feeling well, it’s so easy to get scared into just not really thinking through a problem. Especially if there is a lab that says, “Hi, mold!” It can be really disconcerting. Again, why I think it’s so important, Mike, the work that you’re doing to prevent people from just falling over the edge into worry, fear, and over treatment so to speak.

MS:

It’s the balance. It’s those two percenters that I know are listening right now, and they’re twitching right now, because what they want to hear is that they’re acknowledgement that they’re heard. And let me be clear, you absolutely are. What we’re talking about, what I’m stressing to are the remaining balance of people that are taken advantage of. Obviously if you have a mold source that worried about we’re not going to say “Don’t worry about it, it’s green in color.” If you’re having an inflammatory response to a mold, really the color doesn’t matter. To be honest with you, I don’t know any doctor that I worked with, and I work with a lot of them, that says, “Oh, well, this mold is white in color. So we’re not worried.” A lot of the doctors are worried about it inflammatory response. When you think about cytokines or NeuroQuant, that sort of thing, inflammation, that sort of thing.

MS:

We really aren’t narrowing it down to just, “Oh, it’s not the black type known as Stachybotrys and because it’s not that mold, no other mold is current.” That is absolutely a false statement. I think it’s just a matter of understanding. Well, what is normal for this environment? What do we know? And more importantly, what does the clinician not know about set exposure and then what can we do with that? So if we don’t know this, then can we assume and just remediate it, or can we try something else first and see if that improves? And the answer is, yes, there’s more than one way. If there’s a mold problem, there’s different speeds. It depends on your unique situation. And our job is to honor that and not go backwards with your health. We always want to put health first. We just don’t want you to jump off a cliff because someone on Facebook said you should.

Remediation vs. Cleaning

DrMR:

Very well said. You mentioned remediation a few times and obviously this could be a whole long call in and of itself, but it sounds like remediation isn’t always necessary, which I think is one of the things that people get concerned about, which is, “Oh my God, if there is mold, does that mean we’ve got to do $20,000 worth of work or just move completely?” How often is there, as you said earlier, some low-hanging fruit. Stop this source of moisture, clean some of this up here, and then otherwise you’re pretty good, as compared to more of a kind of triage the whole home that occurs?

MS:

To clarify the difference between remediation and cleaning is when we think of remediation, it’s some physical removal perhaps of a building material. Wall insulation, that sort of thing, moldy cabinets. Cleaning can be stuff that you do on a surface, cleaning up your contents. That being said to your question, probably 60% of the people I deal with, there’s going to be some level of remediation. Again consider to the audience that that’s biased. I mean, the people that are reaching out to me are not calling me because they’re bored and want to waste money. They’re usually because they know they have a problem that has to be addressed somehow. Are there a couple of great examples? Sure. It might be the kitchen sink cabinet. It might be a moldy set of duct work or an evaporator coil.

MS:

This would be something that people in hotter climate deal with. It could be a moldy crawl space. And in terms of dollar figures, following industry standard, doing it the right way, proper remediation, proper engineering controls, all of that good stuff. You could be anywhere from $3,000, $4,000 all the way up to $15,000, $20,000, if you’re talking about real big improvements to crawl spaces. In a number of cases we work with, there’s also an issue with first of all, finding out that they didn’t really have anything to be concerned with in the first place. Second of all, there’s other people like yourself even, where one of the challenges you run into in your climate is just condensation mold. So it’s typical growth occuring on various surfaces. HVAC registers are a great example. The top of the bathroom ceiling is another example and it’s growing and usually limited to growing just in that area, because you’re not maintaining the moisture levels, the humidity in the house for a number of reasons. Maybe one of your kids takes 30 minute hot showers.

MS:

And even if they had an exhaust fan running while that was going on, it’s not enough to overcome that moisture and the buildup. And in those cases, we’re able to walk through the client say, “Well, this appears to be topical based off of the pictures, based off of the history and why and how it’s occurring, where it’s occurring,” and walk them through more of an easy, straightforward way of cleaning that area themselves. There’s always considerations. Do we want that client to clean? This is the same person that has concerns for mold exposure. Do we want them on a ladder cleaning? And also, what are their other options? Do they have an uncle or do they have a brother, family, friends who can come over and help? And also other liability concerns. Does it make sense for that person to do it, or should we hire the professionals to come in and do that work? The pearl to take away from this part is that yes, 60% of the time we get into remediation, but a 100% of time we’re walking with the client saying, “Here’s why we think a professional should do it. Here’s why we think you can do it. Here are the pros and cons if you do it.” And then walk that person to see what fits well for them.

RuscioResources:

Hi everyone. This is Dr. Ruscio. In case you need help, I wanted to quickly make you aware of what resources are available to you. If you go to drruscio.com/Resources, you will see a few links you can click through for more. Firstly, there is the clinic, which I’m immensely proud of. The fact that we deliver, cost-effective, simple, but highly efficacious, functional medicine. There’s also my book, Healthy Gut, Healthy You, which has been proven to allow those who’ve been unable to improve their health, even after seeing numerous doctors, to be able to help them finally feel better. There’s also our store where there’s a number of products like our Elemental Heal line, our Probiotic line, and other gut supportive and health-supportive supplements. We now offer health coaching. So if you’ve read the book or listened to a podcast like this one, or are reading about a product and you need some help with how or when to use, or how to integrate with diet, we now offer health coaching to help you along your way. And then finally, if you are a clinician, there is our clinicians’ newsletter, the Future of Functional Medicine Review. I’m very proud to say, we’ve now had doctors who’ve read that newsletter, find challenging cases in their practices, apply what we teach in the newsletter and be able to help these patients who were otherwise considered challenging cases. Everything for these resources can be accessed through drruscio.com/Resources. Alrighty, back to the show.

Failed Remediations

DrMR:

Now with remediation, a friend of mine is working with the clinic right now. And it’s always challenging when you work with friends because they will follow your advice, but sometimes I think just the proximity of being a friend, they tend to not do so great of a job. I try not to usually treat friends or family, but I will obviously, if someone’s in need. I would never turn anyone away. But he was a good example of someone who I think was feeling unwell and wanting to get things done really quickly. So he kind of bowled through the recommendations instead of being methodical. One of the things that he just followed up with me to inform me about is how he cut out some of my recommendations to meet with you first and kind of do this in a measured way. He went right into remediation because there was mold found in the home, but apparently his ERMI test got worse post remediation. Now, I’m not sure if that’s something that happens sometimes, or if maybe that’s a symptom of kind of rushing the process. But is that something that you see very frequently is an ERMI getting worse post remediation?

MS:

Two responses. Number one is, yeah, it’s very possible. Especially if it’s the same type of molds that were flagged on the first test, and now we’re seeing it a lot higher, one could argue that there was an issue with the remediation or cleaning. Maybe there was some cross-contamination, but I got to tell you when you were telling me that example, the other thing that popped into my mind is that you’ve also got to consider the time of year when the sample was collected. Again, if I take a sample in North Dakota right now, the outdoor ecology, given the snow on the ground, is going to look night and day different than in the middle of the summer. And you can apply that example to anywhere really. My point is that if the sample came back what they call worse, and then you ask them, “Well, what do you think is worse?”

MS:

And they’re going off of their ERMI score, which I think is horrible idea. And you find out that it’s “worse” because you sampled this in a part of the year where there was just a lot more outdoor molds contributing to your total indoor load. And actually, if you look at the indicator molds that are more indicative of having grown in the inside of the house, you actually improved. You just stress yourself out for no good reason. So it’s making assumptions about these tests when they’re not qualified to do that.

DrMR:

I guess that reinforces my posit of making sure you have a professional as yourself integrated into that process so that you’re not making these fumbles. And to your excellent point Mike, we are hearing patients when they have complaints 1000%, but there’s also this need to be measured because unfortunately, I have a feeling my friend is going to end up adding three to six months to the process just because he was so eager to get it done quickly. He didn’t want to say, “Oh, well, I got to call up Mike, call this guy, make an appointment, wait a couple of weeks to see him. Whereas this local company could be here in two days.” And I get it. I get you just would do anything to have it out, but it’s not always that simple. And when it’s not, now we go from having a baseline pre-post and kind of good organized data to now we’ve thrown a little bit of a monkey wrench. Things get harder to read. He’ll probably have to end up following up with you and triaging. Again, I hope it don’t sound too redundant here, but one of the things that’s unfortunate is watching people you care about in this case, my friend, potentially making his healing take longer because he really wants to just get there right out of the gate.

MS:

In your friend’s defense, the problem is there’s just not enough educated IEPs. I certainly don’t claim to be perfect; very far from it. I’m still learning a lot as I go. If you had a thousand more Mikes or John Banta’s or Larry Schwartz’s, and there’s a host of other professionals out there we could name, perhaps your friend wouldn’t have had to wait. And so that’s the dilemma we face right now is we’re preaching the good word about slowing down to speed up. But admittedly, the supply is not where it needs to be. And it seems like we’re busier more than ever. So I hear the pain of your friend. I acknowledge it. I understand that. And that’s a lesson learned and we’re continuing to try and educate so that folks like your friend don’t have to wait so long to work with people like myself, if they ever need to.

DrMR:

I appreciate the note of encouragement and acknowledgement. I think everyone wants to be out of the suffering boat as quickly as possible. And I’m glad you guys are trying to get more of you out there so people don’t have to wait, because you’re right. It’s one thing that I cringed about at the clinic when at one point I think there was over eight months of a wait to be seen, and why I’m so glad at the clinic now we have other clinicians so that people can be seen more timely. Because gosh, how much would that stink when you feel like you finally find someone who can help you and then it’s eight months. That’s not a really attractive prospect.

Episode Wrap-Up

DrMR:

So yeah, I feel your pain there. I guess we just need more and more good people in the healthcare space to help people get well as quickly as possible. We’re definitely unified in that objective. I feel like we just scratched the surface and I wouldn’t expect us to be able to solve all of the world’s mold-related problems in one phone call, but I hope that we’ve given people a few keystone examples and motivated them to get a professional integrated into the process. If this is something that they’re potentially dealing with or dealing with. Is there anything else that you want to leave people with and will you again, please tell people your website?

MS:

Yeah, sure. First of all, my information, let’s get that out of the way first. Environmentalanalytics.net. That’s a dot net. If you go on there, you can learn all about me and my services. Also wanted to mention, a free resource, IEPradio.com, the letters I E P and then radio.com. There’s a lot of free information on there. We get into topics like air versus dust sampling. There’s a four-part remediation series on there. A lot of good stuff there. If you’re just wanting to become a more aware, educated patient, that sort of thing. Closing thoughts for me is really just to maybe take what we’ve talked about today and polish off with this big thought. So much of what I work with are people that come into our door that are kind of like what Michael’s friends are, the people that have already been there.

MS:

They’ve made mistakes. They’re not getting anywhere, and oh by the way, they’ve spent $20,000, $30,000. I’ve worked with a number of clients that are well over half a million dollars in their journey, whether it’s treatments flying around the country, moving, throwing this stuff out and replacing it all off of a whim, off of a concern, but really lacking the science. And slowing down to speed up I think could probably be a hashtag for 2020 and 2021, where we’re seeing that the biggest thing here is for people just to say, “This whole thing about your health is a journey.” If it was quick and easy, you would’ve popped whatever the prescription pill was that you got and you’d be on with your life. You’re here listening among other reasons because it’s something that you’ve been dealing with, which means that as sad as it might be, your problem is not going to probably be resolved.

MS:

And that you hope that in your journey that might take you 6 months, 18 months, who knows. It might take you a year or two to get better, is that you’re not getting worried or sucked into the rush feel or the panic attack. I’ve seldom seen a case where, I gotta be honest with you, if somebody calls me up and it’s that bad, we kind of say, “What are you still doing in the home? Go find yourself temporary shelter for now.” And then let’s take a deep breath and then deal with the home. You take it a step at a time. Reach out; you can find me on my website, but you know, there’s other professionals. The International Society for Environmentally Acquired Illness. ICI, the letters are ISEAI.org. There’s a get help page.

MS:

And there’s an IEP section that you could look up. There’s a number of professionals on there that can offer virtual consultation services. Survivingmold.com, another great resource you can look at for professionals. These are the go-tos. There are probably hundreds of other qualified environmental professionals who aren’t on these lists that you can go to and seek help for if you’re looking for it. But these are the people, these are the resources I know you can go to quickly. Start there, please do it. You might think that spending a few hundred dollars upfront to talk with a professional who can educate you and talk about the specifics of your unique situation is a lot of money, but just wait until you make a $5,000 or $10,000 mistake. And that’s the takeaway for those of you that feel like that is accurate.

MS:

That’s what you’re dealing with. Please consider looking up us for resources. We’d be happy to guide you, point you in the right direction. It will save you the most amount of time. It saves you the most amount of headache, and also builds your confidence that you’re heading the right way, either ruling in mold, ruling it out. And that really is good because as you’re continuing your treatment with your clinician, you don’t want to have to wake up in the middle of night and wonder whether or not the reason why you’re not feeling that good on a Tuesday is because there’s still a mold source that you didn’t really address, or it’s just a normal part of the recovery process. So absolutely agree with slowing down, getting professionals in at the very beginning, and being careful not to over or even underestimate these DIY types of sampling that you can do either on the body or the home. We see a lot of people make mistakes with that.

DrMR:

I love that hashtag. We should make a t-shirt with that. Mike, I just really appreciate the work you’re doing. You’ve helped me learn a lot and it’s really been reassuring as a clinician to be able to hand off the baton of figuring out what’s going on in the environment to you. Because as I started looking into it, I realized quite quickly that, sure I could have people do testing at home, but there was just so much that I didn’t know, I’d really be doing my patients a huge disservice in trying to interpret their ERMI or have them do at home sampling and try to interpret that and guide them. So you’ve really made the clinical process for me a lot easier because you’re able to lead that charge. Then I can focus on doing what I’m doing and you can focus on what you’re doing and together, I think we really provide those who have, or may have some type of mold in their environment, the resources that they need. So just a personal thank you on my behalf and that of all the patients over at the clinic. You’ve really made things a lot easier for us. Thank you very much, Michael. And thank you for the opportunity.

Speaker 1:

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