A Product of Her Environment

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Class of ’82 | Lisa Lavine Nagy C’82 is keenly aware of the ironies. That she was working as an emergency-room physician when her own health became a conundrum no colleague could solve. That she is an MD who often can’t get the medical establishment to take her cause—environmental medicine (EM) and environmental illness—seriously. That she is a highly intelligent, rational thinker who has been accused of being hysterical.

“It’s like returning from the Twilight Zone,” she says. “No one believes you when you come back to tell your story.”

But Nagy knows what she went through, and has no doubt about what saved her. As a result, she is spreading the word about EM: on Nightline, in The Cleveland Plain Dealer and other publications (including the Gazette), and as head of public relations for the American Academy of Environmental Medicine (www.AAEM.com), whose goal is to increase awareness about “the need to appropriately refer sensitive or fatigued people to an environmental physician and teach them the basic techniques of avoidance of chemical exposures in the meantime.” She is also launching the Preventive and Environmental Health Alliance, a fledgling nonprofit that “hopes to be a collection of groups and individuals with an interest in advancing the clinical message that it is necessary to take current knowledge about the causes of disease and bring it to the populace now.”

Environmental illness, or chemical sensitivity, as it is sometimes called, is a controversial subject in medical circles. In 1990 TV’s Northern Exposure introduced viewers to a (fictional) chemically sensitive character named Mike Monroe, whose health suffered at the faintest whiff of perfume or other toxins, and who sequestered himself in a sterile environment and obsessively monitored the air quality of the remote Alaskan village. Monroe’s health problems were dismissed as a byproduct of neurosis by the show’s resident doctor, Joel Fleischman, whose skepticism has been mirrored by many in the medical community today. But for many thousands of people, including Gulf War veterans and Katrina survivors sickened by mold- and formaldehyde-laced FEMA trailers, that skepticism is unwarranted and ultimately cruel.

Eight years ago Nagy, who earned her medical degree from Cornell Medical College, was living in the Los Angeles suburb of Palos Verdes and working in the ER of a nearby hospital when her world began collapsing around her—or she began collapsing inside it.

“I became progressively weaker and less able to intubate or push the ultrasound machine in the ER,” she recalls. “I had to quit working. I couldn’t hold a smile for a photo, brush my teeth, fold a towel. I began weeping at the slightest stress. I developed dizziness on standing, due to low blood pressure; hyper-pigmentation of the face; and increased sense of smell—as well as headaches in response to everything I ate and smelled all day long. I became hung-over minutes after having an occasional drink. I had blurry vision that prevented driving at night. The tags in my clothing started driving me so crazy that I had to cut them out. I was exhausted inside stores and felt like lying down in them—improving when I went out for fresh air.” Even proximity to books in the medical library made her feel “sleepy,” while newspapers and the mail often triggered “red itchy hands and instant migraines.” But because she wore perfume and used traditional fabric softener, she says, “I couldn’t tell I was chemically sensitive.”

Nagy now believes that the main culprit behind her physical breakdown was the 5,000-gallon aquarium built into the living-room wall of her California home, and that the vast amount of hidden mold it spawned gradually overloaded her immune system and made her (as well as her husband and her dog) seriously ill. While her own symptoms mimicked those of Lou Gehrig’s disease, she believes that environmental illness includes everything from chronic fatigue syndrome and fibromyalgia to various neurological and immunological problems, including “viral, rickettsial, and fungal as well as chemical etiologies.” Symptomatic warning signs include an aversion to perfume, diesel exhaust, tire stores, and many other odors; fatigue; frequent headaches, “especially after drinking red wine”; short-term memory loss, balance problems, and blurry night vision.

 “The immune system becomes too sensitive to the exact substance to which we were overexposed,” Nagy says. “Once overloaded with something, the detoxification systems of the body break down, and we react to everything—like smoke, air fresheners, and formaldehyde in new clothes or in stores, as well as pesticides in foods and buildings.”

It wasn’t until she found Dr. Bill Rea and his Dallas-based Environmental Health Center that she began to get relief. Rea tested her for environmental allergies, and found that her clothing contained alarming amounts of a mycotoxin called trichothecene. A diagnosis of Addison’s disease, treated with cortisol and adrenal hormones, proved to be “just the first layer in my medical onion.” (Her husband, Wes, and their dog were also diagnosed with Addison’s.) The next layer was that she had muscle weakness from “severe anoxic (no oxygen) mitochondrial damage which I had proven by electron microscopy.” Many of the 20 doctors she had seen didn’t believe she was really ill, she says, “because I was so ‘wacky’ and so sick in so many organ systems at the same time.”

Rea’s treatments are as controversial as the field itself, as he injects his patients with a small amount of antigen—a diluted amount of the relevant allergen—in order to trigger an immune-system response. (Rea tests for a wide range of allergens, including perfumes, fabric softeners, diesel fuels, even toxic terpenes from pine and cedar.) He then puts them on a “detoxification program”—saunas, purified air, and carefully controlled food intake—designed to cleanse the body of toxins.

At first, Nagy became so sick that she was admitted to a traditional Dallas hospital, where she says the doctors “disbelieved” her and took away her “essential medications.” She was briefly committed to the psychiatric ward (as has happened to many other patients before her, she notes). But after two months of treatment at the clinic, she had improved dramatically. Nagy and her husband moved to Martha’s Vineyard for the clean air, and created a home that is relatively free of pollutants. Whatever the reason, she is back to something like her old high-energy self—and on a self-appointed mission to help others (many of whom are women) who may be suffering from various environmental illnesses, especially mold exposure.

“We are all on this continuum from one to 10 in terms of being environmentally sensitive,” she says. “And no one is a zero.” In her view, “educated women are the answer,” since for some reason, “most men just don’t understand the subtleties of cause-and-effect as readily as women, and they wait till the very last minute before going to the doctor. None of them believe mold can make you sick, for example.”

The bottom line, she adds, is: “We must fix this problem now—for the sake of those who deserve to know what to do to survive.”

—S.H.

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