____________________________________

The Icy Numbing

"Imagine a strange metallic taste and magnify it at at least 50 times. Then imagine it pervading your nose, throat, larynx, tongue, bronchi, and brain, smashing you completely."

"A very weird state. Hard to explain. Almost the feeling one gets when exposed to subzero temperatures. Your membranes seem to get anesthesized. Yet, they make their presences known, despite the absence of sensation."

March 2003 Health: fair/fatigued
Emotional Outlook: well/optimistic

She was now practicing Avoidance. This is the practice of avoiding the airborne agents that trigger one's asthma. And it is a practice advocated in Report 4 (A-98) of the AMA's Counsel on Scientific Affairs.

On the woman's mind at this point in time was her plan to go to Huntsville, Alabama, and to search for an apartment there. This created hopeful optimism in her. Job opportunities were opening up for her in Alabama, and a physician told her that moving away from Johnson City could reduce her frequency of asthma. This optimism negates any suspicion that her ills
were triggered by anxiety or depression during this time span.

March 16, 2003

She went to a grocery store, in order to buy some last minute items for her trip. She had been in the store for only a minute, when an asthma attack was triggered. After all, the store was laden with strong odors, and the AMA has already defined strong odors as asthma triggers. On this occasion, her inhaler
took much longer than usual to work. And on this occasion, she became disoriented for the first time. She had entirely lost her sense of direction. An EMS crew had to drive her home.

March 18, 2003 EMS call - hospitalized.
Health: severe illness
Mental outlook: scared after the attack

Being that her trip had been arranged, she convinced herself that she could travel. So, she and her son left for Alabama. En route to her destination, she suddenly became sensitive to vehicle exhaust fumes. Her face seemed to get hot and swollen, while a gland near her tonsils seemed to enlarge. Chest tight-ness & asthma then set in. It felt as if a 10 inch ball of burning fire (exhaust fumes) hit her in the chest, spreading throughout her entire body. She could even taste the petroleum odors.

In having become too weak to continue the trip, she searched for an environmentally friendly hotel. Her son finally located a room that seemed suitable for her. But, the result was that the irritants in the hotel area triggered yet another asthma attack. She was placed on oxygen for six hours, and given breathing treatments with Xopenex, Atrovent, and Salmeterol. She was also given the intravenous form of steroids every four hours. That night, while in the hospital, her blood pressure dropped drastically.

She had been diagnosed with: (a) Acute and severe asthma attack, and (b) Hypopotassemia. Her objective medical findings, as noted on record, were: (a) labored breathing, (b) wheezing, (c) rales, (d) rapid heart beat, (e) gruntled

sounds. This negates the defense attorneys' allegation of mental illness. And the October 2005 rhinolaryngoscopy indicated the presence of a physical illness much more so.

March 20, 2003 Health: debilitated.

She recalled being barely able to function in Huntsville. Yet, she and her son attempted to explore the city. When waiting for a traffic light to change, she started to become hypersensitive to exhaust fumes once again. She had another asthma attack. This time, her inhaler did not seem to help. And when driving back toward the hotel, she completely lost her sense of direction once again. This is the second time that this happened. EMS personnel escorted her back to the hotel.

March 21, 2003 E.M.S call/Huntsville hospital

On this day, she went to a health food store. Her son went inside, while she waited outside. He purchased rosemary juice, and suggested that she put some in her bath water, thinking that a warm bath would help her. And being that she had always enjoyed the odor of Rosemary, she put a small capful into the bath. It was a mistake to have done that. The bath was relaxing, but upon coming out of the tub, she starting to feel warm, and then faint, being unable to take in a full breath. For the third time on this trip, she became totally confused, while feeling very light headed Her son called EMS, and en- route to the hospital, she was administered oxygen and an IV. At the hospital, she was given saline.

March 22, 2003 Health: very bad; EMS call

She realized that it was not possible for her to live in Huntsville, being that it seemed to have a lot more “ vehicular exhaust” than did Johnson City. However, she felt that she had to complete the trip to Tuscaloosa as planned. She did.

March 23, 24, 25, 2002

She spent 3 days in Tuscaloosa with friends. And she had trouble breathing outside their house as much as inside of it. Her friend smoked indoors, so she stayed with her friend's sister. She went to a Chinese restaurant with friends, but had to leave it, because of its indoor air quality. It was the now familiar type of irritant airspace.

She and her friends then went to Books-a-Million. This was the store where she would spend many hours when she lived in Tuscaloosa. This time, however, she had been seated for no more than five minutes, when the aroma of the coffee became too heavy, full, and noxious to her.Another asthma attack was triggered. So, she went outside and resorted to her inhaler.

Late that night, her friend's sister turned on a gas heater. The odor made the woman sick, bringing her close to another asthma attack. She had to sleep next to a window, while wearing a filtered mask throughout the entire night. Her friends then took her to church the next day, and she sat next to the open back door, wearing two filtered masks.

She went back to Johnson City that week. And on the way back, she got stuck in traffic. She became ill once again. Whenshe finally reached home, she collapsed out of weakness, a headache, a sore throat, and chest inflammation. This "collapse mode" lasted for the next few years. Since April, 2003, she has had varying degrees of tightness in the chest, along with asthma, nasal pain, burning, and congestion. She took all of her prescribed medications, and resorted to wearing activated carbon masks much of the time. In addition, she has a car air cleaner, as well as dust screens for the car. This helps her a lot. However, she can still smell odors, even through the carbon masks.

There were two doctor's appointments that she was unable to keep. One was missed because she couldn’t find the doctor’s office in the midst of another irritant response to exhaust fumes. And the other physician had his office in a commercial building downtown.As she was approaching the entrance, she caught sight of nurses smoking. She knew that she would not be able to make it down the smokey,fragranced, and cleaning agent laden corridor. Her need to find a primary care physician was pressing.

May 31st, 2003 Health: Depends on exposures.
Mental: Good/Fair

She found two doctors at a nearby university who understand her type of medical condition. And they did all they could to help her. She was very apprehensive on her first visit to one of the newly found physicians because of the indoor air issues. And it was with the utmost self-control that she waited in the waiting room. This was due to her extreme sensitivity to temperatures, fragrances, and cleaning agents. Blood tests were ordered after a lengthy consultation. And en route to the testing area, she started to feel ill again; yet more so than previously.

She was once scheduled to take a CT scan. And the center where the scan was to be taken was a bit worse than the building where she had previously been. The technician had the woman in the machine promptly, and performed the scan. Meanwhile, the woman began to feel light headed. It seemed as if a metallic smell were causing it. She had to be helped out of the room, after the scan. She felt dizzy, even to the point where she felt that she was about to pass out.

She remained ill up to 48 hours after the CT scan. After the scan, she was short of breath. But, this form of shortness of breath was much different than the previous bouts. It appeared to be a tissue reaction, she said; one accompanied by a hollow lack of sensation and even a numbness. This absence of sensation extended to her nose, bronchi, esophagus, trachea, and lungs. She said that her lungs hurt. But, it was a dull chronicinflammation that she felt. And she described it in the following manner:

"A very weird state. Hard to explain. Almost the feeling feeling one gets when exposed to subzero temperatures.Your membranes seem to get anesthesized. Yet, theymake their existences known, despite the absence of sensation."

"All this is very strange. It is anxiety-causing, because if not ameliorated, it leads to a strange sort of “inability" to breath. It's not like congestion, in the usual sense. It leads to the desire to cough, but the cough does not lead to a cessation of symptoms. Also, I feel as if I am in the process off fainting at times. I feel shakey."

June 05, 2003

She finally began to feel better, two days after the CT scan. That “hollow” & “metallic” syndrome finally resolved itself. About this she wrote: "Just that little exposure to the CT Scan environment made me ill for two days!"

She had to go to the bank one day. And it was a hot and/or humid 84 degrees outside. She started to feel ill in the heat, with the activated carbon mask on. The mask itself was starting to emit traces of exhaust odor. She never made it to the bank that day.