Tuesday, July 15, 2014

Tooth Dilemma

The financial stress is causing an increase in symptoms (swollen lymph nodes, sore throat, increased fatigue, cognitive issues).

I saw the oral surgeon today. When he looked at my x-ray he said "how much pain are you in?" I said virtually none. I have intermittent pain but nothing substantial. Nothing like the back pain I experience daily.

He said he didn't see signs of a blatant infection in the x-ray but said "I know Dr. **** and he's very conservative. He wouldn't have referred you if he didn't have good reason". I said but he based his decision on the x-ray.

The surgeon said he must have had a clinical reason and said this tooth isn't viable.  I told him that what started this whole thing was my crown fell off. He said there must be decay or maybe the dentist suspected a cracked tooth. I said "he never mentioned a cracked tooth" and again repeated he based his decision on the x-ray and told me the tips of two roots were infected and it had gone into the bone to which the oral surgeon repeated "he wouldn't have referred you if he didn't think it were necessary". The dentist did mention he could see decay at the top of the tooth and suspected there was leakage into the canals which caused the infection.

Anyway we proceeded with the consult. The oral surgeon said one of the roots extends fairly far into the sinus which might mean that I end up with a hole in the sinus so I need to be careful not to blow my nose for two weeks after the surgery. My anxiety shot up at that point.  He also said because it's an old root canal that he would recommend I go under general anesthesia vs the light sedation because "we have to dig and there will be bone cracking" and more painful so best to be under. I asked what the general anesthesia included and he said "propofal, fentynal, versed" and a couple other things.

The oral surgeon had never heard of POTS so I had to explain it to him. He didn't look like he believed me. He said that makes more of a case to go under general anesthesia because otherwise I would feel it because the options without epinephrine aren't that effective for a procedure like this.

He recommended a bone graft because I don't have much bone there.  My options for what to do in place of the tooth are 1) implants which are ridiculously expensive at over $4000 2) a bridge which means filing the teeth on adjacent sides down. One of them has a crown so that isn't a good option and I'd be at risk for more decay because you can't floss with a bridge so it ultimately might be more expensive plus would last only 8-10 years. I don't think I will be around that long so that part doesn't matter but the discomfort of filing down two teeth doesn't sound fun. Plus I don't think the tooth with a crown has enough tooth left. It was close to needing a root canal about 18 months ago.

The third option is a retainer type device that has a tooth in it. For some reason the sound of it sort of creeps me out. Anyway he said people tend to have a hard time tolerating having a big device like that in the mouth all the time.

The fourth option is to do nothing but it would mean the back molar would start to lean in.  And the tooth that needs extracting a prime chewing tooth.

So I don't know. I contacted the dentist who referred me and said the oral surgeon didn't see the same infection so he reviewed the x-ray again and said "there is an infection and oral surgeon's tend to see very bad infections". But they are contacting the surgeon's office and will wait for their report and contact me so I know how to proceed. They also said I could go to an endodontist for confirmation of the infection. But that would cost more money.

I don't want to get a procedure done that isn't urgent but I also don't want to wait until it's bad enough to need antibiotics. I'm now allergic to Penicillin. I told them that I had a weird reaction to it about a year ago where my lips started tingling as well as my tongue and that I felt like passing out so they said "that's a clear allergic reaction".  Bummer.

The referring dentist said the infection will progress and that my immune system is already fighting it. Not having a very good immune system in the first place doesn't bode well.

The thing that was disturbing aside from the sinus issue is the financial part. It will cost $1385 which isn't as bad as the dentist had said but this doesn't include implants/bridge or follow up appointments.

I asked if I could use my Care Credit card. They said yes but they will only extend payments out for 6 months which means a monthly payment of $280.33. I can't pay that amount. That would mean having less than $75 per month for groceries.  If I don't have a bone graft it's about $400 less.

The other bummer was that I had to pay for the entire consult fee today which means my grocery budget for the next two weeks is down to $50 or less.  I was hoping I could put it on Care credit but they said they only allow that for over $300.  It's crazy.

I'm already paying for medical bills plus the emergency dentist appointment I had last week to put the crown back in. They were clear the crown would last anywhere from 1-3 months.

If anyone out there knows anything about these things I sure could use some advice about what to do.


Thursday, July 10, 2014

Unbelievable

I apologize for the tone of these posts but I'm so tired of trying to do the right thing or trying get things figured out only to be knocked back down again.

On April 30, 2012 I had a lumbar epidural for my spine. It helped my back but the doctor that performed it works for Northern CA Spine Institute. Good doctors but billing practices are questionable at best. I thought everything was had been worked out well over a year ago after receiving a bill for over $9000.  I spoke with the chief financial officer at the time and we worked out a compromise so I assumed everything was taken care of.

I received a phone call tonight from a COLLECTION agency saying I owed over $8000 for this same procedure and they'd been sending bills to my sisters' house where I was living at the time.  This bill was from the surgery center where the procedure was performed.

Not once did my sister or her husband forward the bills to me so I could have had a chance to get this resolved before reaching collections. Not to mention when I had the money in savings to pay the bill or what would be left of the bill if Medicare pays their share.

I'm so pissed off. This affects my credit. I have Care credit which will enable me to to make monthly payments on upcoming dental procedures. I need to ask for a higher credit limit so I can have the procedures but now I'm worried I'll be denied because I have such a big bill that will show on my credit report.

Do they have such little regard for me that they don't even bother to forward a bill? This is just not okay because it directly affects my credit which could also impact future housing as well as my ability to get a higher credit limit on the Care credit. Since I don't have dental coverage or eye coverage Care credit is what I need so I can see the dentist or get new glasses (which I also need).

Plus I had the money in my savings account at the time had those bills been forwarded to me so it wouldn't even be an issue now!

I'm also completely freaked out that I owe that much money. The guy said they didn't know I had Medicare so they will make a note to bill Medicare but Medicare will only pay 80% which means another medical bill for over $800.

This was from OVER TWO years ago. It's ridiculous. I don't understand. And I don't understand why the bills never got forwarded to me. The guy acted like he didn't believe me when I said I've never received any bills. I'm sure they hear that sort of thing all the time. I never got the damn bills.  I asked him what address they'd been sending the bills to then got pissed off when he told me and said "I haven't lived there in over two years"!

I just can't believe this is happening on the heels of feeling the most depressed I've ever felt while also dealing with other huge financial concerns.  There's simply no way I can pay all of this. Absolutely no way can I afford it. My food budget is about as low as it can go right now.  I don't even eat 3 full meals a day as it is. It's a freaking nightmare that never ends.

Like many ME patients I can't tolerate antidepressants. I've tried all of them. Ones I used to be able to tolerate I can't anymore. I'm on Lamictal but clearly it's not helping anymore. If I had the money I'd smoke pot. I've been reading about some good results some people have had with it on one of the message boards (Healclick--a good message board btw).  All I want is some relief from the depression (it's really, really bad) as well as from the financial burdens.

Last night I had another episode of feeling like I was going to pass out every time I stood up and walked a couple steps.  I don't understand why this is all happening--the money stuff, the wanting to pass out. With the tooth infection I could barely see anything on the x-ray so it can't be that bad to affect my functioning.  It wasn't there when I was at the dentist 18 months ago (different dentist).

I see the oral surgeon Tuesday and will ask him if I can postpone this. I emailed my ME doctor about it and he said I needed to get the tooth out. I know a lot of ME patients end up with this sort of thing--healthy people do too but it seems more rampant among people with problematic immune systems.

I've been beyond fatigued again today but now my nervous system is so riled up I can't get it calmed down. I feel like the only thing I can do is talk about what's going on in this blog because it's something only ME patients can understand. I'm just incredibly stressed out over all of this.


Monday, July 7, 2014

Keep Going?

I've been aware for awhile now that there is a part of me that has wanted to avoid this blog because having regained some functioning I haven't wanted any reminders of how bad things can get. And this blog is a reminder for me of how bad things once were physically and then after the break up how bad things have been emotionally.

Lately I've been experiencing how bad things can be financially. They are beyond bad right now. I'm so close to homelessness at this point.

And then there is the re-experiencing of very, very bad fatigue.  As in I can't even make a phone call today bad. I've been on a downhill slide for over a month in part due to stress about my car and other things. Physically I'm not doing well at all anymore.

Whenever I start having an increase in symptoms I review the past few weeks or months to note any changes of activity levels, toxins, change of diet, new treatments, supplements, etc....

I've been out of Imunovir because something is going on at the manufacturer and there isn't any to be found. I've been out for over 2 months.

I've had repeated exposure to toxic car exhaust although I "retired" my car about 3 weeks ago.

There was a pesticide spraying for 2 nights last week. The pesticide was because there has been increased West Nile virus found in birds and mosquitos in the area.  It's called "Trumpet" but is, among other things, an organophosphate. I don't do well with organophospates.

There is also quite a bit of smoke residue from a couple fires.

I had a crown fall out Thursday afternoon about 4:50. Luckily it was on a previously root-canaled tooth so I didn't experience any pain. I did have quite a bit of bleeding when I brushed that night so I knew the gum was inflamed.

I saw the dentist today who said I it appeared as if there was leakage into the root canal leading to an infection in the tips of two roots as well as the bone. He said I have two choices. Another root canal or have it extracted and then said if it were him he would recommend having the tooth pulled.

He wasn't making any money off me because he said he'd refer me to an oral surgeon for the extraction. I asked if the infection would progress and he said yes and that it needed to be taken care of.

I'm so bummed about the money part as well as concerned about the impact of having an invasive dental procedure. I have MCS and dentists offices bother me. Today I had to pull my shirt over my nose and mouth because of some chemical.

Anyway, the money part frightens me. I ended up getting an 18 year old used car. It's a van. It needs new tires and front brakes. I paid a lot more than I could afford but had no choice given my financial restrictions. I had hoped that I could spend the minimal on food and go to food banks and hopefully qualify for food stamps which would mean I could repay my savings account.

Now I'm looking at over $2000 worth of dental work ($5000 if I have an implant).  Plus I have some medical bills.

It's freakin discouraging. My food budget is so low that I can't even afford orange juice or anything. I just buy the basics. My big luxury item is a tin of Peet's tea and every now and occasional Trader Joe's Vintage cola.

I applied for food stamps and had a phone interview. I qualify for $15!!!!!  But that's contingent upon sending in the medical bills. I said "but I have a student loan payment for $300 each month" to which she said "we only count rent, medical bills, and utilities".  Oh, so I just don't pay any other bills then. It's crazy but given the bad economy I guess those Republicans have to blame someone so might as well be the poor people who wouldn't be poor if they just tried hard enough.  Might as well cut back those expenses instead of unnecessary things like tax loopholes.

I'm at my wit's end and have been waking up so depressed every morning it's just not fun. If this is how the rest of my life is going to be, then no thanks.

I haven't been able to socialize in weeks. One of my housemates has a personality disorder and randomly decides to stop talking to me (he does this to his partner to so its not personal--just incredibly uncomfortable). I've tried talking to him about what's bothering him with no result. I feel stuck here. Right now I'm hating living here. Living with people who don't want you there is awful. I did it for awhile after the break up and told myself I'd rather be homeless than repeat that experience.

Things feel grim and pointless and hopeless.  I'm trying my hardest and doing my damnedness to make a good life but it's just not happening.

I so wish I could afford to live on my own. I may end up living in the van so I plan on taking the seats out and converting it so I can sleep in it.  Things are that grim.  I've been doing a lot of reading about life after death experiences. For some reason that keeps me going. Knowing at some point things will get better.

Just likely not in this lifetime.


Friday, June 13, 2014

Time Out

I can't believe it's been almost 3 months since my last post. Still no news on when the Stanford study will be published.  I'm not sure why.

A lot has been happening physically, emotionally, spiritually. I'm in a major transition.  I've been sick 7 years now although the reality is I've been sick since 2002. I just didn't know it.  But it's been 7 years since I haven't been able to function well enough to work.

One of my biggest fears since the break up has come true.  My car is broken. It had been idling rough for awhile and I thought I'd noticed some blue smoke coming out of the exhaust every now and then when I'd start it but I didn't know what it meant.

For the past 3 plus weeks I've been having increased symptoms, particularly increased OI, dizziness, fatigue, chemical sensitivities, increased difficulty swallowing and other neurological symptoms.

About a month ago my house mate borrowed my car. When he returned he said the car was idling pretty rough and should be checked out. It happened to coincide with needing to get my car a smog check so I took it to a recommended place.  The guy said "save your money-this won't pass smog because of all the smoke coming out the exhaust".  I took it to a smog and repair place thinking it would cost me a couple hundred to fix whatever ailed it.

The smog and repair guy said "your engine is burning oil. It's not worth fixing. By the way-you shouldn't breath it because it's toxic".  He told me about a program here where I could retire the car and get some money.

I consulted with two more mechanics who both said the same thing.

The blue smoke coming out of the exhaust has gotten thick to the point where motorist became angry motioning me to roll down my window and said "You can't drive that car. It's a gross polluter and that crap is poison. Your engine is blown"

My physical symptoms in the car have gotten to the point where driving is not safe. I'm quite light headed and have slowed reflexes along with slight confusion. When I get home I'm absolutely exhausted.  I also get heart palpitations a headache and nausea.

My physical functioning has taken a hit.

I found out Weds that my car was accepted into the program but I have to retire is asap because they might run out of money so yesterday I cleaned out the trunk and the car so I could take it in today to retire it and get money.

For some reason I took all the stuff in my trunk upstairs to my room and put it in the closet. I ignored the fact that the stuff had been sitting there since 2011--that it had been flooded in El Cerrito by underground sewers during bad rain.  I don't know if that accounted for what occurred last night or not.

Around 10:00pm I went to my computer to look up cars on craigslist. I do not have enough money for a decent reliable car which is a bit scary.  I noticed the cord wasn't plugged in so I leaned over while sitting on the chair to pick up the cord and fell. I found myself sitting in an odd position with my knee at a strange angle.  A bit stunned I stood up then suddenly felt like I was going to pass out but managed to make it to the bed where I lay there covered in a slight sweat feeling like the room was about to start spinning.  I was nauseous.

For the next 30 minutes every time I'd try to make it to the bathroom I'd take about 10 steps then feel like I was going to pass out. I glanced at myself in the mirror and saw a white face reflected back at me. I'd lay down and still feel like passing out. It reminded me when I was at my worst with this illness and spooked me badly.

I can only think it had to do with a mixture of the toxic exhaust (I drove my car around yesterday for the first time in a few days) and mold.

My knee is hurt and quite swollen on the outside including the front part of my calf (whatever it's called) so I've been icing it. My back is also injured so I've been icing that as well. I had to drive my car about 1/2 mile to get Advil, an ace bandage and something to help me get up from bed. When I get up or sit down the side of my knee hurts pretty bad on the side where it's swollen. I'm guessing I strained a ligament or tendon. I should go to the doctor but in no way can afford it especially with what's going on with my car.

I'm a bit challenged as far as a buying a car. I can only drive 4-5 miles. I'd like to buy a cargo van however for the amount of money I'll get for my car it's next to impossible to find a reliable one (per various auto mechanics I've contacted).

I have a guy willing to drive 30 minutes from here to show me a car (that I can sleep in) that has less than $200,000 miles on it. He says it's in great shape but they all do. The whole craigslist thing is a trip. A guy responded to my inquiry last night with the following "yeah it's still available but I need money for a lawyer so I have to sell it TONIGHT".  Yeah right buddy. Is that code for it's STOLEN? In another ad the person said all the "bells" have been replaced. Really?  Seems like it would sound sort of pretty.

I have a plan for where I want to go and how I'd get there (it would take me awhile). I just need a reliable vehicle.

In the meantime I'll hope my knee doesn't continue to get worse and that I haven't worsened the already ruptured disc in my back.

Update--I "retired" my car but while there I noticed my left ankle is swollen---not painful at all and clearly edema so I'm not sure what to do. The skin around the ankle is so swollen it's almost doubled over.  I have to figure out if this can wait until Monday. I'm also having some pain in my left calf.  I'm trying to refrain from consulting with google. All that does is cause worry.

Ahhh. Life with a chronic illness and being poor. It doesn't get much better than this.  : )

Wednesday, March 19, 2014

The Stanford Study

The Cytokine Study was presented today (though some results were held back due to publishing). The study has been accepted by a journal but not published yet.

I have to say that this is the most well-designed and significant study of ME/CFS patients in the history of this disease. It has a large number of patients (200) matched by control patients. They accounted for variables that would make replication of the results easy to do.

We all know the disastrous mark left on ME/CFS research from the WPI XMRV study. This study more than makes up for that.

Dr. Montoya stated that ME/CFS presents the greatest medical and research challenge of our time and that understanding ME will help aid in the understanding of other diseases.

They studied 51 cytokines per patients in 200 patients comparing them to 400 healthy people. Patients and controls were matched according to age as well as other variables.

The current standard markers of inflammation (ESR, C-Reactive Protein) are increased in disease like RA and Lupus but not in ME. The typical inflammatory markers are normal in ME.

Dr. Montoya made the point that there are no inflammatory markers for ME because not enough of the inflammatory markers are measured.

Thus the cytokine study.

Cytokines are small proteins that the immune system uses (and are also produced by the immune system) to communicate between cells and pieces of the immune system.  They can be used to communicate in small areas of the body or across major distances in the body.

Inflammation means fire so at its most basic understanding cytokines can be viewed as one way the body attempts to put out fires.

It's worth noting again that systemic inflammation shares similar symptoms with the flu.

The most immune concentrated areas are the lymph nodes, liver, spleen, bone marrow, thymus as well as other places. These organs produce cytokines that can be exported to other areas of the body.

ME is expressed by multiple disjointed symptoms in the body.

One reason why markers for ME are not picked up in the blood, the Montoya team postualtes, is that the inflammatory markers travel from the blood stream to the organ(s) affected. They shift from the blood to organs because there is inflammation in that particular organ or organs. Dr. Montoya believes the brain has major involvement.

Another interesting finding is that in mild ME cytokines decrease whereas in more moderate and severe disease they increase.

He believes this is the reason for such a discrepancy in findings in previous studies. Because there was no analysis according to disease severity the results of other studies evened out making the results appear deceptively normal. For example, one cytokine called Resistin is increased in moderately affected patients but decreased in the severely affected.

Also interesting is that the fire (inflammation) starts somewhere so the cytokines go there, and then other places.

When there are lower levels of cytokines in the blood it could mean they have shifted to the tissues that are inflamed.

IL-17 in particular is increased in severely affected patients. This is a clue to some sort of autoimmune process occurring.

Dr. Montoya believes there is a genetic factor that predisposes patients to ME.

He stated the the triggering factor could be infections, allergies, the environment--combined with the genetics results in ME.

Dr. Montoya, being an infectious disease specialist. postulates taht ME is the result of a hit and run mechanism. That some sort of insult causes a cascade of events and leaves the body in a damaged state.

He thinks its infection AND other factors,but not purely either, that affect the brain, heart, immune system, and digestive system.

He also believes there are subgroups.

He thinks viral onset patients might have a certain pattern of cytokine whereas other types of onset will show a different pattern.

Although a cure may never be discovered it will be possible to treat this disease thereby allowing us to function better, maybe even near normal and definitely good lives. Similar to lupus and RA patients.

Other inflammatory diseases are treated by anti-inflammatory agents. Dr. Montoya believes that some agents currently in use might be able to be used for treatment but there isn't enough info yet to determine which ones will be effective.

He cautions that the tricky part with ME is that one part of the immune system is overactive but another part is weak thereby leaving the door open to infection. Some of the anti-inflammatory treatments reduce the function of the immune system.

The whole secret will be how to use the anti-inflammatory drugs.

Regardless the stage has now been set for a host of things. Biomarkers for this disease, further research studies, new treatments, validation, and more funding for further studies.

Basically ME is a debilitating chronic systemic inflammatory disease.









Monday, March 17, 2014

Inflammation


I wrote in an earlier post that my symptoms increase during Winter particularly in rainy weather or when there is a low cloud layer also known as tule fog and/or inversion.

An inversion can lead to pollution such as smog/toxins/mold spores/chemicals being trapped close to the ground, with possible adverse effects on health.

When I wrote to my ME doctor (over a month ago) about my increase in symptoms, particularly depression, he wrote back that the weather is causing increased inflammation.  Lisa Petrison, Ph.D and Erik Johnson wrote an interesting article called 'The Depression Response' (found in the blog section of their website). The article links the inflammatory response to toxins and has an interesting take on depression.The website itself (Paradigm Change) is a fascinating read.

The word 'inflammation' comes from the latin word 'inflammare' which means 'to set on fire'. Everyone who has suffered a skin infection knows about the redness that develops as a result of inflammation. What I hadn't realized until recently is that the redness isn't a result of the infection per se but the body's response to the infection.

The inflammatory response can occur as a result of infections, trauma, and toxins. The symptoms of inflammation are similar to those of an infection (flu like symptoms).

The immune system protects the body from harmful substances by recognizing and responding to things called antigens. Antigens are substances found on the surfaces of cells, viruses, bacteria, and fungi. They are also nonliving substances such as toxins, chemicals, and drugs.


An efficient immune response protects against many diseases and disorders. An inefficient immune response allows diseases to develop. Too much, too little, or the wrong immune response causes immune system disorders. An overactive immune response can lead to the development of "autoimmune diseases," in which antibodies form against the body's own tissues.
Complications from altered immune responses include:
  • Allergy or hypersensitivity
  • Anaphylaxis 
  • Autoimmune disorders
  • Immunodeficiency disorders
There are two main branches of the immune system. The innate immune system and the adaptive immune system.

As its name suggests, the innate immune system consists of cells and proteins that are always present and ready to mobilize and fight microbes at the site of infection. The main components of the innate immune system are 1) physical epithelial barriers, 2) phagocytic leukocytes, 3) dendritic cells, 4) a special type of lymphocyte called a natural killer (NK) cell, and 5) circulating plasma proteins.

Cells of the innate immune system include phagocytic cells (monocyte/macrophages and PMNs), NK cells, basophils, mast cells, eosinophiles and platelets.  

The innate immune system lacks discrimination among antigens and can be enhanced after exposure to antigen through the effects of cytokines.

The adaptive immune system, on the other hand, is called into action against pathogens that are able to evade or overcome innate immune defenses. Components of the adaptive immune system are normally silent; however, when activated, these components “adapt” to the presence of infectious agents by activating, proliferating, and creating potent mechanisms for neutralizing or eliminating the microbes. There are two types of adaptive immune responses: humoral immunity, mediated by antibodies produced by B lymphocytes, and cell-mediated immunity, mediated by T lymphocytes.

ME patients have faulty immune systems. Part of the immune system is overactive as if it is constantly battling some sort of insult while another part is weak which allows infections to reactivate.

I think it's interesting that toxins and chemicals can cause inflammation. I hadn't realized that before. I also find it interesting that constant inflammation can affect the immune system creating a vicious cycle. Inflammation lowers immunity and lowered immunity allows toxins/chemicals/infections to create more inflammation and on and on.  

It seems an ideal treatment would be to dampen inflammation, reduce the toxic load on the body, moderate the immune system, fight infections, and detoxification.

For me I had to leave the moldy environment I was living in. I have to stay vigilant of staying away from other moldy environments (certain molds) or if I notice certain symptoms that indicate I'm in a toxic environment (feeling faint, sensory storms, unexplained swollen lymph nodes, muscle weakness) I need to leave immediately and take other actions. 

I'm also on an immune modulator, antivirals, a low dose antibiotic, support for adrenals/thyroid, and various supplements. 

Treatments did not work at all while I was living in a toxic moldy environment. I have a genetic susceptibility to mold/toxins/infections. Similar to alcoholism once my body reached a certain toxic threshold there was no going back and I lapsed into ME. My body cannot effectively eliminate toxins (especially mold) or infections on its own. 

I've had great improvement by doing the above. I still can't work but I have a social life and am able to leave the house on most days whereas before I my functioning range was bedbound to 90% housebound. Regardless I needed to be laying down 20 hours per day.

Now I can be upright a majority of the day, and as stated above, can leave the house most days. My PEM has lessened considerable as has my POTS.  My digestive system has improved.

I think if I moved to a drier climate where I could be outside for much of the time I would do even better and possibly even be able to stop some of the medications I'm on. 





Tuesday, February 11, 2014

Inversion Layers and 1099-C's

Obviously I'm skipping the next piece on Orpheus. I also cannot comment on the results of the Stanford Study. They are holding a cytokine conference in March. Although it is geared toward medical professionals I think it would be of interest to patients. I would encourage people to print out the pamphlet and give it to your doctor to attend. One incentive is they get CME credits. If I can I plan on being there. All I can say is that it's important. 

On to the crazy things. First the area where I live has been grey and cloudy for about 10-14 days (I can't remember). For the past week I've been having shortness of breath, dizzy spells, very low heart rate, blood pressure instability (going from low 110/50 to higher 148/90). I take Ivabradine to slow down my heart rate and Prazosin which lowers blood pressure but both my heart rate and blood pressure have been stable until recently.

I had to kneel down in Rite-Aid to avoid fainting. I pretended I needed to look at something on the bottom shelf. I've felt like passing out while at stop lights-always an indication the POTS has gone whacky. My headaches have been bad. The shortness of breath has been driving me crazy-it's worse in the mornings. The fatigue has been bad also.

I emailed my ME doctor who said the weather is likely causing an increase in inflammation.

Makes sense so I looked up air quality here in the area. It hasn't been good-"considered unhealthy for sensitive groups".

Other notable incidents. My housemate developed pretty bad food poisoning that kept him down for a week. I noticed he was/is coughing a lot. I've been worried he's had the flu rather than food poisoning. Then I realized I was coughing a lot.

Also, two people had heart attacks requiring stents. This in and of itself is not notable. However I know both of these people. One of whom I spent Christmas with.  That is notable.

I've been reading  comments on Facebook of people I know in the area such as:  "killer headache from allergies". "My allergies have been driving me crazy". Or, "now I know why I've been feeling so shitty-I forgot to take my allergy medications". And so on...One of the unusual comments I've gotten from people when I tell them I recently moved here is "do you have allergies?" "No" is my reply (except for mold and chemicals). "You'll get them here!"

On the 'Spare the Air' page I looked up symptoms associated with various pollutants:

Ground-level OzoneGround-level ozone is formed when volatile organic compounds (VOCs) and oxides of nitrogen (NOx) react with the sun’s ultraviolet rays. The primary source of VOCs and NOx is mobile sources, including cars, trucks, buses, construction equipment and agricultural equipment. 
It is a strong irritant that can cause constriction of the airways, forcing the respiratory system to work harder in order to provide oxygen. It can also cause other health problems: 
  • Aggravated respiratory disease such as emphysema, bronchitis and asthma
  • Damage to deep portions of the lungs, even after symptoms such as coughing or a sore throat disappear
  • Wheezing, chest pain, dry throat, headache or nausea
  • Reduced resistance to infection
  • Increased fatigue

Particulate Matter (PM)Particulate Matter is a complex mixture that may contain soot, smoke, metals, nitrates, sulfates, dust, water and tire rubber. It can be directly emitted, as in smoke from a fire, or it can form in the atmosphere from reactions of gases such as nitrogen oxides. 
The size of particles is directly linked to their potential for causing health problems. Small particles (known as PM2.5 or fine particulate matter) pose the greatest problems because they can get deep into your lungs and some may even get into your bloodstream. Exposure to such particles can affect both your lungs and your heart. 
Scientific studies have linked long-term particle pollution, especially fine particles, with significant health problems including: 
  • Increased respiratory symptoms, such as irritation of the airways, coughing or difficulty breathing
  • Decreased lung function
  • Aggravated asthma
  • Development of chronic bronchitis or chronic obstructive lung disease
  • Irregular heartbeat
  • Nonfatal heart attacks
  • Premature death in people with heart or lung disease, including death from lung cancer 
Short-term exposure to particles (hours or days) can:
  • Aggravate lung disease causing asthma attacks and acute bronchitis
  • Increase susceptibility to respiratory infections
  • Cause heart attacks and arrhythmias in people with heart disease 
Even if you are healthy, you may experience temporary symptoms, such as:
  • Irritation of the eyes, nose and throat
  • Coughing
  • Chest tightness
  • Shortness of breath

I'll have to do a separate post on the 1099-C craziness. It's important information for anyone who has had debt forgiven especially those of us who have had student loans forgiven.  It's absolutely absurd.