 It is such a pleasure to do this. I know we were together at the ICI conference this year online, and it was quite an event. We were both just talking before this about, wow, it was like 12-hour days and so intense and so much fun, but it was an amazing amount of information. And I always get excited talking to people like you because we have a common passion for helping patients who have environmentally related illness. So welcome, welcome. I'm just gonna do a little housekeeping, and then I'll introduce you. Very basic here, if you wanna find more YouTube videos, you can go to my YouTube channel, just Jill Carnahan on the YouTube. And Michael has his own program. It's IEP Radio, and where can they find you for more information on what you've recorded? Absolutely, IEPradio.com, if you go there, there's a wealth of information. Awesome, very cool. And so we just decided to do kind of a co-recording here. We'll probably both end up having this on our shows, so you'll get that information in multiple locations. And I want to just introduce Michael Schrantz. He's the founder and operator of Environmental Analytics LLC, comprehensive indoor air quality consulting company that offers a wide range of services. So the thing I wanna say about Michael is there's his website, environmentalanalytics.net. You can find so much great information, a blog, and then of course links to his podcast on all outlets. But what I wanna say is just personal about him. Here I am a doc in mold-related illness, and what I love to do is help patients like my own journey in getting out of a moldy environment and then getting well after that. And I always say, I can diagnose you and treat you in the clinic, but nothing I do is really going to stick or going to make a massive difference in your life if you're still living in a really moldy environment. And that's just the truth. And so I need people like Michael. I value him so much because of his expertise. And what we're so grateful for in ICI is that we have someone like him on board, creating protocols, writing up the latest data and really helping us guide us doctors. So today what we really wanted to dive in to was how do we work together better? How do we, so whether you're a patient listening online and you wanna have your doctor work with an IEP or understand more about what they do or whether you're like me practicing and you're listening if you're a colleague and you're struggling because in your area you don't have a great IEP. We will dive into that and what to do. And I know one of the great things about Michael is he does virtual consults. I would love to be forediving to exactly what you do and some of the questions. I wanna know your story. Like what got you into this Michael and how did you get to where you're at now? Dr. Jill, thank you for having me first off. And I was looking forward to this interview because it's gonna be so rich for people that are in that struggle that you've identified. I'll try to give you the two minute elevator speech. For me it started actually nothing to do with chronic illness. I was 16 years old working for a local air conditioning company. I was at the bottom pole of learning about the basics of airflow. And of course did I know that it would turn into what it is today? No, as I went through high school and college I still didn't think I was gonna become an indoor environment professional. I thought I was gonna be a cog working for some corporate company but just found a passion because while I was doing that I was engaged in the division of the air conditioning company had indoor air quality and we were out looking at things and trying to solve problems that people weren't able to solve. And it was a very rewarding thing where we would go out there and diagnose the home and figure it out. And then fast forward through getting certified and learning more and more about indoor air quality. What had happened is one day a lady by the name of Dr. Mary Ackerly came knocking on my door with a mutual client and said, hey, I saw what you did on this particular home and I like it. Let me explain a little bit about the people that you're dealing with. And fast forward five, seven years later and it's been the most rewarding thing being able to not only understand people who have chronic illness but understand what the concept of low dose environmental exposure means. Because unfortunately the traditional paradigm with a lot of the inspectors out there that even mean well are missing a lot of the low hanging fruits because they don't know that those fruits are there. Oh, I love that. Your initial interaction was kind of like what we're talking about now is how do we actually get together? And I'm sure Mary who I love and appreciate so much it was very similar to me as we realize our hands are tied if we don't have good people in the field and we can learn and understand and do little tiny bits of like guiding them but we are not the experts. Again, by default, we have to learn a lot about it and I've become just enough of an expert to guide them to people like you. But tell us, I wanna know more tell us like what kind of training that you've had or how you get to be what you've done and what does IEP for people who've never heard that term let's go to the real basics. Okay, sure. Well, so IEP stands for Indoor Environmental Professional it's kind of a generic term it's meant to be broad and all-encompassing of people who do environmental work but I mean it can cover a wide range it's not just about mold. You can have people who deal with chemical exposures and that sort of thing. Predominantly a lot of the certifications that I acquired came through an organization called the American Council of Accredited Certification or ACAC.org. And I carry a couple of certifications through them one of them is a Council Certified Indoor Environmental Consultant another one is a Council Certified Microbial Investigator and I carry a couple other certifications one of which is a Building Performance Institute which really is just trying to capture knowledge about how a building breathes, how it operates and so I wasn't, I didn't go to a school of public health I did, there's not a formal degree program that I'm aware of that you can go to a college university level it had to build upon multiple certifications to become where I'm at today. Yeah, I know you are one of the best in the field and that's why I wanted to really bring people's attention to this is not something that is number one the level of information that you have especially with how you work with physicians and patients what I see is I see a lot of people who've been in the field maybe know how to find mold in the wall and they have no clue of how it affects the human body and maybe I can speak to that really quickly because we have these people called Canaries and Mary and I tend to have 90% of our offices patients that are super sensitive and they have mass selectivation so they're extra reactive and so what we deal is with this subset that is say you have a house that has mold and you remediate and you find out the problem in the issue there might be 80% of people 90% of people that can go back in there no problem at all but what we end up having between you and I is the subset of really really super sensitive patients and it's not always mold that's the issue tell us just a little bit about what else can be in the environment that can make this whether it's dust or VOCs from other sources or go through just a little bit of the spectrum because we always think about mold but there's a lot more to it than that, right? There is and I mean to segue into that question real quick I think that's the trigger is a lot of this that we're working on is pioneering work while there might not be a degree what we're learning are from references and peer reviewed studies and consensus among peers of what we're seeing what we know about sampling what we know about an exposure good news is we are actually working in bed with a local university here trying to create a program that will one day provide a certification or degree for IEPs because it is broad to your question a lot of the people that we work with have some sort of immune response or inflammatory response to a whole host of things called a soup and everyone knows when we think of water damage buildings we hear about mold, mold is the celebrity surrogate that can represent a lot of different things including bacteria that we sample for but you also have other things, right? We have things like chemicals, volatile organic compounds we have just general the general makeup of the home it's depending on what reference you look at what you believe in from the standpoint of like say for example, CIRS we know that high particulate counts in a home it's not even limited to say mold or bacteria it could just be the fact that your house was very dusty some of it he could have an inflammatory response to that and then now with the segue of EMF we're looking at those sorts of exposures there is a soup of things that both the IEP is presented with and also the clinician is presented with and we try to work together as professionals to say is there any way we can narrow this down because most people can't have you show up when your vehicle and do $50,000 worth of sampling that's the struggle. Yeah, so I wanna tell you like a clinical scenario that I might have and then I wanna hear like how you would and even if you advise me, hey Jill next time you could do this or that I really am open I wanna hear, that's why we're here is like say here I'm in the office with a patient so a typical patient that would come in you know maybe a 45 year old female who has started to have more fatigue more headaches, migraines, brain fog is this elusive term that is not medical at all but it usually means a troll with word finding or a little bit more cognitive issues with memory sometimes they'll notice like a lack of focus or concentration or like for me when I was in mold what I noticed is I could write a blog article in an hour normally and then all of a sudden with a mold that took me longer to slog through is a more difficult like the concentration it took to sit and read or to write or to do the things that I used to do during the mold exposure it just took me longer and more effort like if my brain was tired so that brain fog is kind of this big term and that's super common I would say the mental clarity the brain stuff is probably one of the number one things we see in a moldy environment but then it can have things like rashes, histamine more allergic responses to food you could have I've had heartburn be an MCAS reaction where people go into a moldy home and have heartburn so again this 45 year woman has a myriad of complaints and I look down her list and like this is concerning 90 to go down this pathway and I might look for metabolic issues, thyroid issues adrenal issues, everything and in my battery of tests one of the things I typically do is I will do some markers in the blood that show inflammation and then I will also do urinary mycotoxin testing and none of these are one size fits all so the markers in the blood things like TGF beta, MSH, MMP9, VEGF and then C4A, C3A and if I see a pattern that's concerning for immune inflammation activation based on an external trigger and then I see urinary mycotoxins that are high I say we need to make sure, we don't know for sure yet but we need to make sure that mold is not in your environment so what I would typically do is say depending on what you can afford you might try just to get your brain around this sometimes what I do Mike is a little secret thing and what it is is whether it's testing them for food allergies or testing them mold in their environment even though I know like an ermine dust sample we'll talk about in a minute and you can speak to that and the validity they're not the best they're just a tiny little sample of one little piece of the environment it does not tell you yes or no there's mold but it's one thing they have control and it's fairly inexpensive and what I see that happens when I do that is they give me the report and I'm like oh my gosh you have 30 ketomium I don't like that that's real or even five sometimes. You're cheating that's a little hanging fruit but I like it very much. So let's say there's 200 aspergillus I'm still like oh. All right, all right. Right okay so but then when I do it's like okay look at this you need to go deeper and then they'll call you or then they'll and so somebody that's like the way to get them to buy in and I'm well I would love to hear your opinion on this because if you have other advice for me but I feel like what happens is on black and white paper then I can make an argument for them going deeper and getting the right inspection because you and I both know if they just do so in a second I'll have you explain the dust plates and the ermine sample but they just do these these are not end all beels and you and I both agree I don't even use the ermine score I don't like it it's not valid but I do look at the individual species and if I see a pattern of one thing that's way off the charts I'm like where did that come from? It just makes me question but then I can usually get them to call someone like you and then you come in and then you can help the process but what would your comments on that process be? What would you change do differently? What would you advise for us? You set the stage up very good for me like you tossed me a lob which so now I can swing away I'd love this salivating see so what you did right selfishly for me from my perspective is that you did the part of the clinician up front and you helped us you were looking at cytokine activity or urine analysis and you were trying to use biomarkers to help justify again nothing's black and white but to support the idea of is my patient being exposed to some sort of an exposure and for the sake of this conversation because both of us know this could go on for weeks if we did everything say it was mold exposure we were concerned about the first thing I would do as the IEP is listen to what those about the patient so you've given us some information here's my background Dr. Jill came back and she says that I have up regulation of these genes she thinks that I'm currently being exposed I'd like to take a look at that home okay thank you that helps me in other words we're not necessarily looking for EMF I'm not saying that you're blind to it but our focus is definitely going to include mold we would normally start with after sitting down with the client and learning that information is doing a very good visual assessment and it's the things that I've heard you talk with a host of other wonderful people on your show you know you're looking at the low-hanging fruits you have a basement across space you know the attics the plumbing leaks the landscaping the swamp cooler the HVAC system and you're trying to see if there's any low-hanging fruit issues that we can point in say you don't need to sample this necessarily for me to tell you you need to remediate it but in a vast majority of times people don't call me up because they have 20 square feet of mold going up a wall and they just want me to confirm it I don't get those easy ones the ones I get are the ones where they're like we either don't see anything or it's always this ominous well we had a leak but it wasn't a big deal or the classic I think it's a problem but my angry spouse doesn't think it's an issue I mean and little bit we know we'd be relationship therapists too right? Oh my gosh as Mary told me you have to have an associates and a degree in that just to have this because it's very real and a big part of what I think is missing in the professional practice is the heart the love the ability to connect with boundaries healthy boundaries so that you can understand truly what this person is dealing with or else you ain't gonna know how to communicate with them but at the end of the day you might end up looking at sampling and I won't go eight levels deep with you but a couple basics IEPs have tools they can use and beyond any visual thing like a pair of eyeballs in a flashlight or an infrared camera or the moisture meter that you're all familiar with we do hear that there's different types of samples I think the takeaway is what can the sample help answer so if you're doing QPCR analysis and a lot of people know that as Hermes or Hertzmes are you working with an individual who can look at it I wanna share if you get a chance let me share my screen I wanna share something with you but can they look at data maybe take control samples outside knowing what they would expect to find inside this home we call that normal fungal ecology the term mold-free is misunderstood by too many people I think what people are trying to say is they don't wanna have mold growing in their house but they're gonna have normal backgrounds from the outside so the ability I'll share this with you real quick for example like this is just a quick sheet of what I've taken of hundreds of QPCR samples where the little gray columns you see flashing by are outdoor control samples and I have a whole bunch of individual species and I've been able to look at that and you see what's normal it's no different than people talking about spore trap sampling and comparing indoor to outdoor here's my point is you wanna work with a professional who can look at the house and use tools that might be able to identify something that might not be able to be identified with other methods I love Petri dish samples I think it boils down to what can you help answer if somebody does a DIY because they initially just wanna see what's up I don't have a problem with that if you're working with a disgruntled husband or you just wanna wake the people up to you know hey you might have a problem here that's great but when you bring in a professional a professional is gonna wanna reference indoor without doors we need to know what's normal so it's using the tools to ultimately help isolate a problem what if the master bedroom comes back elevated one example of a thousand and you find further reflection and investigation you find out that the master bedroom had a crawl space access door and there was a known problem that was identified in the crawl space is the reason why the master bedroom is elevated is because of that potential area or something else so it's working through the minutiae of the history and knowing what's there to figure out can an area sample like QPCR spore trap Petri dish swabs tapes help answer the question or do we need to get into wall cavity sampling or do we need to start punching into walls a little bit to see if we can locate the actual source yeah so oh there's so many questions that come to mind cause I got you here and this is so great and so a couple of things I wanna go through like what I would talk to patients like questions I want you to add if there's any because people listening the first thing I find I found this five years ago if I just say do you have mold in your house almost 100% of the time I'm gonna get a no or no we or even better we've already had three inspections and they've all come back fine or five or more like this is so common the I call it denial because I went through that too and there's a piece of denial and then there's a piece of just the reality that no inspector is perfect and often if they're yeah and I'm same with physicians right we're trying to find answers with lots and lots of data and it's not always easy to come to a really concrete conclusion but what I look for is patterns I know you do too we're pattern recognition detectives so what we're looking for is what do all the clues lead to so when I'm looking at a patient I get this all the time where's what's the one mold test there's no one mold test there's no one environmental test there's so with I'm the physician or you're the environmental air quality professional there's no one test and there's no one way but I wanna go back to questions so what I'm typically doing instead as I'm doing the work around so do you have a swamp cooler do you have any crawl spaces have they been sealed do you ever smell a musty smell have you ever had leakage from your sump pump in your basement do you have a basement do you have a sump pump is there concrete is there carpet is there tile is the tile loose have you ever had leakage of your toilet or bathrooms or under your sinks what about your garbage disposal how about your washer and dryer do you have a front load washer or dryer does it smell bad when you take the clothes out when you open that up if you looked in the gasket is there black gunk in the gasket what about your windows are they sealed do you ever have condensation on the windows is there leakage around the windows what about your attic is that connected the airspace to your home is there dead animals in your attic is there urine issues with dogs or cats in your house or attic and so these are just some of the things that I think about and because when they start to then you get them thinking and they'll be like oh yeah we had my washing machine flooded and it actually went through the floor and down below and we just we put some fans out and we dried it out what would you say to that my instant response in my head was yellow flag and it might be upgraded to a red flag I think that's the issue is and it gets even worse first of all those little nuggets that you gave gave are brilliant not just for clinicians that are listening but for the patients and people that are wanting to learn more maybe they're struggling with their own justification to take the next step which we can get into in a little bit or they have that disgruntled spouse issue which unfortunately is more common than I'd like to admit to everybody I think at the end of the day it's an assumption that's being made yeah but we put a fan on there we have a little Honeywell fan that we bought for $10 and we blew out this wall it's like well I hate the expression but the devil's in the details I think that the act was great and valiant and I'm so glad and so happy that you were proactive and nobody wants to make this we talk about fears we don't want to make a mountain out of a molehill but we can't just la la la la la and act like there's nothing in that wall because you put a 10 inch circular fan on it blowing on it there's so many different areas that could have stayed wet long enough for microbial growth and that's ultimately one of your concerns as a clinician and an occupant is exposure from that area yeah so talk just a little bit about again this is new to me but I really start to understand whether it's the lights on your ceiling the can lights or whether it's outlets or whether it's your attic space that connects or your crawl space why is it important for people to understand the envelope of their home and keeping that air quality you know basically as pure as you can and without the interference I'll just give you an example I had in my current office before I ever moved in the office below me had a slight mold issue and it got remediated my office was perfect but I realized that actually I'm sealing the outlets all the wall space that connected between my office and any other part of the building I have this like bubble of my office and part of that is very deliberate because there's no air contamination from the other parts of the building why is that important from attic and crawl space etc absolutely I was trying to pull up another photo I wanted to share with everybody just because it will help I stole this obviously here on Google from the website right about leakage so what we have is we're dealing with an issue of a condition space versus unconditioned spaces and I'm sure that if you're an artist you can explain this differently but here's how I explain it you have the most control in the areas that you live and occupy in but there are a bunch of spaces in the home that you don't really condition or control you don't vacuum it you don't control the temperature the humidity that sort of thing and a lot of the attic spaces are a big one crawl spaces are a big one interstitial wall cavities are a big one and these are areas where listen we're not our goal isn't to create a glass house for you I mean there are so many complicated issues that I don't know that we have time to get into about you know the fact that most every house that's got wood framing is going to have some percentage of lumber yard mold on it and we consider this maybe normal here's my takeaway if you can separate and isolate out the non-conditioned spaces as much as possible you have more control so to what Jill was saying earlier you know you have can lights and these arrows they're not meant to be just be one way they can be two ways summertime in Arizona baking up that attic getting that temperature nice and hoth you're going to have a driving force all things other things being equal into the home through these penetrations and that exists even from crawl space to home so beyond identifying a source that is justified by a professional that needs to be remediated you still try and minimize the communication from these area and I'm not talking energy efficiency that's a whole other thing I just mean from an environmental standpoint if you can protect and seal off your environment as best as possible there's some things we need to think about when we do that like ventilation and how about sealing up the house affects ventilation but you'll minimize the communication from these interstitial spaces which can also serve as pathways for the contaminants to get into I have a I had an issue in my wall there was growth that was there never knew about it but there unfortunately I had a very leaky wall and it got underneath and it communicated in my home you know you're not always going no we don't have mold ray vision so even with the best of practices unless we rip that house down to the studs we're going to be relying on ancillary data testing visual evidence history and in a situation like that you may not be able to identify that so quickly so you know thank god that in your situation you were on the later end of your story you were able to seal these things up and all of a sudden it improved not a surprise yeah yeah thanks for speaking to that because I think a lot of people and what I love you and I've talked about this before you're never going to get a perfect space and so we live there's mold there's outdoor mold there's indoor mold and there will be some contaminants in our environment but it's where is that threshold and this may be our next area of discussion is so I'm as a clinician I'm saying how sensitive is this patient and do they have mass selectivation and other things that I can help to moderate so that they actually become my goal is for them to be less sensitive like me years ago I was so sensitive I could barely travel now I travel all over and I get mold exposure and it's not that big a deal I mean I just take some charcoal and I'm better in a few hours but it's not as big a deal as it used to be because I'm less sensitive so the goal is to decrease the sensitivity but usually when you and I first see the client for you and the patient for me they're incredibly sensitive so we do have to figure out the big issues we take care of them you've come in and find and give them advice but there may be some ways to ongoingly maintain their home and get it to a place where they can live and work and play and breathe and survive in it now it's a great topic it's always a tricky one I don't think tricky with us just because of how we are but a lot of people struggle with it to me it's like a bell curve there's a lot of different analogies but like return on the investment and on the backside of the curve is that person that has known issues that you want to take it's like triage they have a moldy crawl space they had a flood in the house in their basement I mean you know and you almost don't even need sampling or maybe you do in a professional is able to find it I think and I presented on this in 2019 at the ICI conference it's such a wonderful topic is what is the goal? I mean really the goal is patient recovery but there's not a set line it's not like Jill or I can say 14 spores of this species are good but 15 in your arms going to fall off what we're looking for is an honest and trustworthy assessment of what that person feels is normal fungal ecology I'd like to expand that to normal microbial ecology as we start looking at other things like bacteria but the point's still the same is what is normal for that home and normal as your outside influences primarily is what we're talking about normal would not be mold growing and releasing structures and other contaminants into your home that's not normal so that's the goal now whether or not if I could go one step further normal is good enough for that person and assuming that you the patient or you the clinician feel that you've had trustworthy eyes on that home to give it an honest assessment you start to you start to wonder well then number one could it be something that's not related to the mold or just as an example and the other thing is is that maybe they're hyper sensitive I have lots to learn from you Jill if their bucket overflow with and they have no room for any exposure is it possible that the fact that they live in the surrounded by trees in North Carolina with a river that's 20 feet away that the outdoor ecology is building up in concentration in their home and for that individual this is a question not a statement it's just too much for them and is there a way that we can turn that sanctuary into more of a sanctuary knowing that we haven't identified any actual growth in the home Oh I love that you said that because we always this narrow with the mold which is definitely a big focus but it's bigger than that and I just think of two examples one is after the World Trade Center and the contaminants that rained down after the fire in that building and literally VOCs and everything you could possibly imagine these people got really really sick the respiratory track was affected some of them I have a friend in Boulder who was there at the you know Downing the World Trade Center he still is not the same immune system and respiratory system and clearly mold probably wasn't the main issue was all the other contaminants and and the very fine particulate that got inhaled so that was a situation where the environment was so massively toxic that it permanently affected some of these people the other thing I think about is after like Hurricane Katrina and some of these hurricanes where the environment in Louisiana or some of these places becomes so contaminated and I see your touch there is there anything you want to share like just from the tragedy of how we see it all I'm fortunate to say I don't have direct family I do have friends who were affected by 9-11 but what you actually touched on right here is more to do about the general struggle you get caught up in it and we're human too and this is what you need is you need caring I mean we've got to harness it into when you need us to perform of course but you need somebody who's caring because it does affect you the good news is that you don't have to feel like there's no way out your body is resilient you may not be operating at tip top shape but the fact that you're still alive amidst all these other exposures your body is battling many battles and winning these battles you just need a little bit of help and guidance and understanding and so where it's at for me right now is just understanding a lot of people are stuck most people that reach out to me are kind of like the same story you have you're not the first person you pray and hope you're the last person and when you see the amount of money they've spent when you see and they're not gotten anywhere I don't care if the money was worth it you're worth it but they spend their tires or they get that information or they go on social media groups who mean well but give unqualified advice on things I've seen families uproot their lives get divorces I had one do it right in front of me because of a bad army score yeah and I don't care if it was fill in the blank petri dish mycotoxin dust sample I don't care it's it's it's not black and white folks we live around this stuff and there is some normalcy to it I think it's a matter of working with righteous fighters like GL9 tend to be and trying to guide you through okay well here's the low hanging fruit we agree unanimously that this needs to be taken care of and as you get on the other side of the curve it is a process this journey doesn't take weeks and I want you to hear this this journey takes months or years because you've been this way for if you're genetically like this or you've been dealing with this for most of your life I wish there was a light switch and I'll tell you what if Jill and I find one we'll tell you what it is and we'll have it on Amazon but that it might take time as you recover and as you recover we've all seen this before your road to recovery isn't this your road to recovery is a roller coaster ride and you hope that you're trending good and as you and your clinician are monitoring using those biomarkers that Jill mentioned earlier or the urine whatever the cluster of symptoms whatever that clinician really feels as a good marker for you then we can adjust as environmental professionals how much more aggressive do we need to be do we want to improve the ventilation in the home do we want to add better filtration you know what I think it's time to get rid of those carpets now after all because they're reservoirs we don't just say E all of the above on the backside of the curve let's deal with the obvious and tweak it as we go because there's no textbook that I can find that gives you a how to do in every situation and you'll get be guaranteed success I love that I knew we would get along so well because there's and you know people like well Josh you rid of all my books I have a library in the house no store them away if you're concerned put them in plastic bins in your garage you can always go back later that's what I did I had my whole medical school library and later I opened them up they were still really reactive and I thought you know what for me it wasn't worth it to keep them but that's not the decision you have to always make in the time being and there's valuable things you just store them if you're concerned and I love the stepwise approach because this is that's part of why the denial is there because it affects relationships say one person doesn't believe you you have to actually go up against that in your relationship in order to get well and so that's a hard thing I completely understand why there might be denial and then there's also the denial of it's going to cost money and time and do I have to move not everybody has to move so there's such a varied and I love your sensible approach because I couldn't agree more you know on speaking of social media recently there was someone who was very angry at me and cited me as someone who says that you don't have to avoid mold I've never said that I actually think that mold avoidance is a good starting place for the most part but we live when there's mold end or outdoor and so you have to become more resilient and the the reason they said that was because our group ICIA has been talking about the fact that there's trauma also associated with mold and exposure and then not only do we want to deal with the mold exposure the physical the mental the well-being but how do you give this limbic loop of fear to stop and make it worse and that's a relevant topic it doesn't mean that we don't want people to avoid mold and get well that way and the mold avoidance is such a it's a not a great term because you can't avoid mold completely right so that's just a misnomer but we really like I still believe yeah get out of the mold the environment you won't get well unless you get into a fairly clean environment so two points number one I don't want to forget someone to say it right now limbic system but the first point is also honor health that is the goals that we want to honor the health concerns and so to your credit when we were doing the conference recently for ICI we were doing a little bit of Q&A and it's always tough when somebody throws you the the question of how do you deal with contents and you were my wing woman and you kind of helped me on a couple things one of which was mattresses and I thought you knocked it out of the park when you look at the intimacy of the item and how much you might be exposed to them in the certain situations it first of all there's going to be a general agreement that you don't want to have a multi-bed but we don't just trip over ourself without consideration of its history so people need to hear that for those of you that say well they just say get rid everything well no we don't say get rid of everything let's talk about it first and see what that item is how easy or challenging is it to clean and and and how you might be able to either get rid of it or get it out of your environment the analogy used was store it in a secure location get it out because I use this analogy all the time and for some people it clicks really well your life you're the patient who's struggling it's not x plus y equals z your life is x plus 99 other variables equals u and we are trying to remove the variables the unknown ones without you getting having to get a second mortgage or get a divorce so that we can get you out of the fog that you're in and start your life it might cost you a lot to throw away that thousand dollar mattress but I don't got my handy dandy calculator here but I'm guessing you spend a lot more in treatment and other ancillary costs that we haven't even touched on so for the first part just on contents real quick and I'd love to get your thoughts on this is the limbic system issue the PTSD because I'll tell you if people asked me Mike in 2019 what was the biggest thing that you saw that was the most improvement like was it a special test was it a special remediation technique or what was it Mike none of the above for me what the biggest thing was was dealing with the limbic system it doesn't get rid of your core diagnosis you're still going to have CIRS if you have CIRS but I saw people who I had worked with over months and years where all of a sudden they took a couple of the well-known programs that are out there and they were a different person and it was like their utility came back the smiles came back they were just a different person where do you see that fall into your your experience oh love that because again my experience one thing too is I don't ever if I talk about my experience it doesn't mean I think that all my patients are like me I never I treat people so individually but all I have inside me is what I experienced to go on as far as to tell you this is what I felt and how I and I say that because this was actually a massive aha for me personally to realize there's this tagging of trauma and mold and mold itself stimulates through trichocytidines this is science-based guys like this is not esoteric what you know whoo whoo there is science that shows that these some of these toxins that are produced by mold called mycotoxins will actually stimulate areas of the brain like the amygdala like the hippocampus and we can actually see on MRI imaging and other ways where there's atrophy or hypertrophy of the different areas usually more hypertrophy of amygdala which is your fight or flight or you know scared type of response and more hypertrophy of something like the hippocampus which is memory and word finding these are objective findings and what I realize is in treating we can take away the get the environment clean we can detox the patient do all the things we need to do but there's still a lot of fear around re-exposure and around their health and I experienced it way back five years ago I remember that like being terrified of getting sick again or getting re-exposed because just to validate you if you're listening out there and have had mold it is so hard you get so sick and you can't think straight and you are spending money that you don't have and there's so many things that are very difficult about this and you don't it is so mysterious and because you look okay on the outside a lot of times people don't believe you so then there's this this crazy bits of this combination that make it a really difficult illness so I have great compassion if you're struggling with that and I promise you look at me right I am not telling you it's all in your head it's not in your head but your brain has received a signal of danger and that danger signal will keep stimulating your body and creating the cell danger response which causes all kinds of havoc in your cells and if you don't stop that signal and try to help to rehab that signal to say hey it's safe it's okay through some program there's hundreds of things you can do and some of the ones you mentioned DNRS is out there Goopters program and there's many many other somatic based therapies craniosacral therapies even biornal beats which is a type of music that can calm the brain so there's lots of things you can do but any way that you address this over activation of that fear response will help you get well and that's just it's proven I've seen it over and over and it is not saying this is a chemical response that causes a fear response so it's a real response it's not in your head but if you address that you're going to get to the next level yeah it's it's not the crazy common it's not the psychosomatic no not at all it's the opposite of that it's actually saying because if you think about it from different perspectives it's kind of because you've gone through the legitimate stuff you've gone for you've created this new environment it's just your survival this is how you've adapted perhaps not the best way anyways it's yet another example of the challenges we deal with in trying to help prioritize both environmentally and clinically what makes the most sense on that bell curve for that patient to get better because at every step of the way we know that you're spending money time and resources and big word here trust and it gets overwhelming you need to align yourself with people who if they can't help you they can at least direct you to other professionals that they know can get the job done and that's what I found myself doing for the last couple two three years exclusively yeah so you do so tell us a little bit about you actually get on the phone and are you online like zoom where you could have them take walk you around the house or how does that work with your consultations yeah so probably the last two or three years I've been doing a lot of zoom virtual actually it's the same platform I use the same microphone some people recognize it right now and but it starts a lot the same way it's a questionnaire client intake give me the history give me the diagnosis give me the areas of concern a lot of times what myself for my my office manager will have them do is you know give us photos or short videos of the areas of concern yes you're right there are certain times where if they have zoom on their phone or their laptop they can come over and bring it but to a little side tech case you a lot of times we find that that's distracting and blurry and the lighting's not right so to me program main the biggest takeaway of the virtual consultations that we've got in terms of positive feedback is the quarterbacking the education the guidance when they don't know where to start and in many times it's clients who reach out to us and say the classic we've had two professionals give us different opinions and one is recommending $50,000 with the work the other one says there's not a problem we'd really like you to give your opinion and knowing and I am by no means I admitted first one to raise my hand of not being perfect I'm that's what I'm surgical at doing is being able to at least acknowledge the information we do know about chronic illness but at the same exact moment being able to say well we don't know this and here's why however let's honor the health and what the ultimate goal is and let's find a way that fits your finances your logistics and your I mean I can't tell you the number of times where people will send us in their questionnaire and at the bottom they'll say please don't say anything but my husband doesn't believe anything in this and I will tell them if it's at all possible please have that husband show up and it's classically in an engineer background and I can I can because they don't have nothing they don't have nothing to defend I want to listen to their concerns and I want to give them that science they want to know more about the methodology of the testing they want to know about what is CIRS is that some bar napkin idea that you or Jill came up with we give them the science and that way they understand that this isn't some guy selling snake oil we acknowledge what we know what we don't know folks if you're that husband that's listening that doesn't believe anything this is not a this is not a test code that you get prescribed with conventional medicine you are off the grid dealing with chronic illness functional diagnostic medicine things that are new that are paving the way that are identifying the thing that 50 years ago your old man told you just to shut it up and take an Advil and quit your complaining where we're learning more and more and you have incredible people like Jill who's been there who can help you get out of the weeds when it's not black and white because sometimes we deal with people who think that in order to have a problem of mold exposure it needs to be that 20 square feet of mold growing up the wall I mentioned earlier yeah yeah and like you said it's so not often I mean not always the case sometimes it is let's go to after so say they found the 20 feet of the wall they took out the wall they did everything right to me the reason why some people can't stay in that immediate home is what the after care it's like after surgery what do you need to do and I want to talk a little about that because I think that for me has been a big eye-opener and getting them to a safe place in that remediated home so what would you recommend like small part to get clean HVAC system what would be your order of operations after remediation to make sure that that home can be the cleanest it could be for that patient sure so to me if I'm hearing you write the term is how can we create and or maintain sanctuary at that point all right so that's helpful so there's four if I do my math right fundamental things that we will talk about with people to do and one of them depends on where they live for sure and that is certainly housekeeping removing reservoirs so this is an issue of cleaning dust cleaning vacuuming damp wiping dry wiping getting rid of reservoirs if possible like carpets and rugs rugs are easier to deal with I listen I don't like to walk on hard floors that much either so I get it and then the next level of course we talk about is filtration and so there's all sorts of options there there's question on the first one I'm sorry what about plants or water features what would you say about are those it goes back to that equation issue where you know you'll have somebody that raises their hand and say well we saw this thing from NASA that said that it's good at removing certain VOCs and I go that might be the case but your clinician is telling you that you're having up regulation of your genes from mold and I see a planted tree in your living room so let's minimize the variables and let's get it out of that environment for now if you want to be a green thumb after the fact let me honor that I'll buy you all you know I try to I try to humor them and say I'll help you with that but I would stay and water features is the same thing they're prevalent especially larger features for biofilm production and let's be clear we're not saying just because you have biofilm production that you're automatically going to have an exposure but it's kind of an elephant in the room concern to answer that question when you get to filtration it can either be portable systems or whole house systems whole house or just kind of what you might have under your air handler some people have a standard one inch filter they'll upgrade it to a more robust higher Merv rated filter and we can get into some of those details after I give you the overview portable systems we're familiar with a sleuth of them I'm a big fan of air filtration I more hesitant to initially recommend purification only because of what we don't know and I've interviewed a company on IEP radio I think there you have wonderful products it doesn't change the variable equation that we talked about and then we get into mechanical ventilation mechanical ventilation is bringing in air mechanically properly when you feel like that house that you just got done sealing up is built too tight and you need to help remove contaminants that won't otherwise be removed with the former two methods those are or three methods two methods those methods are the big boys the one thing of course is moisture control so if you're in a humid climate let's pick on Florida you're gonna likely have to have some sort of additional mechanical ventilation I'm sorry dehumidification system to regulate those moisture levels because with the exception of a few cases your air conditioning system is not going to be able to get you in that target relative humidity of somewhere between say 40 and 50 percent and so that might mean getting supplemental dehumidifiers some people roll their eyes and go I don't got time to deal with that I don't want to have to work with that so they'll look at getting whole house dehumidifiers that they can integrate into their system when you do those four things and again your example was you've already dealt with known sources on the inside of the home I think that's a great it's a big but a great starting point to maintain that sanctuary where the minutia starts to come pouring out is every home is different and you might have other underlying issues that need to be addressed first what if they cleaned up the remediation in the or the mold in the crawl space but they didn't address the moisture that was getting in there in the in the first place to make that happen sounds to me like they may need to have some drainage improvements and I would be helping them get on that before I have them upgrade their mechanical ventilation system in a mold complaint yeah so it depends that's so helpful Michael that's what I want to do is kind of do it's and I think you kind of mentioned it in the very beginning there because that was so thorough but one of the things I find is that after the remediation getting a really really deep we call it small particulate clean it can be I see right and it doesn't have to be like there are companies that come and charge a lot of money for that you I believe you can do this yourself or get your person as long as you give them good instructions this is not a difficult thing it's just a detail thing is that right would you comment on that it is when you said remediation in my mind I was thinking the cleaning everything that should go with it right but I think some people don't so you're right a good remediator will actually include the clean right but not a newer right a newer age chronic illness aware new paradigm way of thinking would probably talk to you about whole house cleaning interview there's there's politics involved and other things that might they would be specific to the areas they're working on but here's the takeaway the small particle cleaning that you're talking about you're right you don't have to have a professional deal do it beyond any additional costs it's going to be a matter of like logistics can you physically do it I don't really want somebody who's got CIRS as just an example right to be doing the work but but you there are there are a couple different DIY small particle cleaning that involves a process of misting to drop particles out of the air followed by rounds of cleaning that a person can probably get done in their house for less than $1,500 comparatively to a professional who might bring with them that experience that efficiency you don't gotta some of this requires that you move contents out of the home I'm looking at your screen right now those books would have to get moved out all those books yeah but but when money is an issue yeah what I would recommend clients do is they look at these options but do yourself a favor if you're going to spend the money reach out to an IEP like myself it doesn't have to be me there's plenty of people on ICI's website we can talk about that in a second that you can reach out to let them be your quarterback and make sure that whatever process you're doing not only is seemingly appropriate but the timing of it is appropriate you get done telling me that you're going to do a remodel in the kitchen a week later why don't we wait until the the remodel is done you know like that has to come kind of last after you not last last but like you don't want to do a big clean oh and you don't want to tell me maybe I'm wrong on this but HVAC system shouldn't that be cleaned either simultaneously before you do the small particulate because that's just going to disperse yeah now you're right it's just because HVAC systems get their own topic to discuss about and it's one of those things where there's the challenges of of of duck cleaning but yes if you're going to do duck cleaning let's just assume that was the decision to be made I would normally have them do that before they do the final clean because you know there's going to be a little onesie twosies that are going to escape out of that okay I want to make because that's what I tell patients I want to make sure we are aligned with that with order and it is all perfect world that doesn't always go like that but right well good well as we wrap up what's some fun first of all I just want to acknowledge I love your heart Mike I love what you bring to this I love that the passion and the purpose because you are so above and beyond just the technical details you really bring like you've clearly shown us here even in the interview but I just want to acknowledge who you are as a human being and your character and what you bring to this and that is so rare and we appreciate you so much so thank you that same compliment has extended your way I've seen tears and I've seen and that's what's missing you don't our job isn't to fall apart on the job site but our job is to care if you can't if you can't empathize at least sympathize and and be able to realize the struggles these people are going to because it's it's a cadence that you have to figure out with these patients you just can't come in there all militaristic with all wealth of information and think that everyone's going to jump in line behind you so thank you for your kind you are welcome so let's share our you know mutual organization ICI we're both on the board so that's our only connection as far as just it's a great great non-profit group with physicians and IEPs and information it's really geared towards teaching the clinician so if you're a clinician you should join but if you're a patient or client you might find resources there or people to to call and then we've given go ahead and give your website again Mike where people can find you and anything else you want to say about yeah absolutely a couple quick things if you're wanting to reach out to me professionally environmental analytics dot net environmental analytics one big long word dot net not dot com and you can reach out you can look at all the information my background there's a contact page that's how we filter in 99% of our clients because we want to honor your concerns and not get you lost and in the phone calls and all that for free resources topics we've talked about air conditioning we talk about remediation those things are covered great interviews IEP radio dot com IEP radio dot com take a look up there it doesn't just have video cast where you can see us talking and bringing up references and all this good stuff there's also audio cast so you can or podcast so you can listen in your car and also there's references a lot of times it's like well what study you keep claiming a study why I've listed it there for you so there's a dedicated page for you to reference it in case you are a data driven person and you want that science and then finally I'll plug ICI for those of you who are looking for resources actually let me do this real real quick with you right here is a find get help page this is from their website ICI dot org you say click help you go here you can find people that are members clinicians and IEPs who might be in your area and help you for the clinicians who are wanting to build a network of professionals and IEP if you already have one God bless you if you don't and you're looking for guidance consider reaching down to a couple professionals that are on here some of these professionals provide virtual services and they can guide you and help you build that network there's a great free resource of you know how to pick an IEP a free document available high level stuff for free to explain a little bit more about IEPs ICI is doing the best they can to teach people as rapidly as we can but to honor the science and not get ahead of ourselves and that's what I love about this organization me too and Michael we are so fortunate to have you as part of it you've just been spearheading these efforts and I'm beyond grateful so I want to publicly knowledge all of your work thank you so much for your time today better than I hoped we'll have to do this again so hope you all enjoyed this you can re-listen here you can check out IEP radio for more and then you can also go to my YouTube channel for more videos I will be sure and include the links we mentioned on the Facebook live as well so if I'll hop in there in a few minutes and make sure those are all included and thank you so much for joining us today thank you Dr. Jill appreciate it