Mold (Biotoxin Illness - CIRS)

Your first appointment with Dr. Berry consists of the following:

• Comprehensive review of your history, with particular attention to exposures to water damage and any prior attempted medical interventions
• Review of your prior medical records
• Ordering labs including diagnostic CIRS labs and other potential testing, as well as other labs to rule out other possible diagnoses
• Discussion of the overall treatment of CIRS

Please note: Only particular laboratories will be allowed for the lab testing, due to special handling required for some of the send out tests and the particular assays used. Dr. Berry will discuss this with you during the appointment.

Our office will send you an email with all the new patient paperwork. You will need to complete the forms one week prior to your visit (our online Biotoxin Illness/CIRS New Patient Questionnaire, as well as the Review of Symptoms Questionnaire).

Additionally, please submit to the office any relevant past medical records (including ER notes, any labs or testing ordered for your symptoms, and progress notes of physicians who have been a part of your care) two weeks prior to the first appointment for review.

If you do not have these records, please sign a medical release with Natural Balance so our office can request these from the specific physician offices and testing locations. This is a mandatory part of the initial appointment with Dr. Berry, so please prioritize obtaining these records.

Additionally, we require you to forward any documents to us digitally to cut down on possible cross contamination from documents in the Natural Balance office.

You will also have a physical exam with another Natural Balance physician. During this exam, the physician will be looking for particular findings often correlated with CIRS. The exam will also help to rule out other possible diagnoses.

This is mandatory and each patient will require an annual physical exam by a Natural Balance physician to continue working via telemedicine with Dr. Berry during each calendar year. This appointment will include Visual Contrast Sensitivity (VCS) testing, as well as MARCoNs testing.

At Natural Balance, we have a passion for empowering patients with insights and understanding. Dr. Berry’s patients now have access to a recording of an informative group talk that reviews the basics of CIRS.

It explains what CIRS is and how it is diagnosed based on the research performed by Dr. Ritchie Shoemaker and his Surviving Mold physicians group. It reviews the basics on the CIRS lab testing, the Biotoxin Illness Pathway (i.e., the underpinnings of what happens inside a CIRS patient’s body during the syndrome), and the first few steps in the Shoemaker Protocol.

Dr. Berry requires that all patients watch this video prior to their first appointment with her.

Depending on the complexity of the patient’s past medical history and prior medical records, the doctor may require additional time to read the past medical record and organize a medical chart summary. A chart review fee may be required, and this will be decided on an individual basis at the discretion of the doctor.

Please note: All the above interactions are part of the “New Patient Bundle.” The bundle however DOES NOT include any additional testing, subsequent visits to review lab results, or follow-up appointments.

After your New Patient Bundle appointments, you will be ready to review labs that have been drawn based on your particular case, as well as any environmental testing or other additional testing ordered by Dr. Berry. This appointment is typically 2 hours long, and it will be scheduled 6-8 weeks after your physical exam.

Step 1 of the treatment is an assessment for possible water damage with mold testing, as well as any remediation of your home, school, and work environment; this can be done while awaiting lab test results.

Step 2 of the protocol (with the use of toxin-resin binders) can be done while patients are working to remove the biotoxin exposure in their environment. However, please be aware that no further steps in the protocol can be done until the patient is in a “safe” environment.

Patients are asked to follow up every 6 to 8 weeks, with the appointments lasting between 60 to 90 minutes. Patients will be expected to have following items available at the time of the consult:

• A log of major symptoms affecting your quality of life
• A log of responses or reactions/side effects to treatments
• Progression of your graded exercises if they were prescribed
• Questions you would like to discuss during your visit
• Local pharmacy number
• For phone consults, a reliable phone line. Landlines work best for extended calls. If using a cell phone, please be in a location with good reception.
• Childcare arranged, if necessary.

Active treatment of CIRS requires retesting about every 2 months at St. Joe’s Reichert Health Center in Ann Arbor and LabCorp laboratories (two separate locations). Dr. Berry has meticulously worked in concert with St. Joe’s hospital to establish many of the specialty CIRS lab tests.

For patients who have a suitable Quest lab near them, there are some labs that can be drawn there, as well. However, Quest has stopped running several of the key CIRS labs, so Dr. Berry has switched to using St. Joe’s Reichert Health Center and LabCorp for now. It is unfortunate that it requires 2 separate lab locations to accomplish the proper testing, but at this point it is out of necessity.

We do not get involved in litigation, depositions, workman’s compensation claims, medical disability claims, or writing for any work restrictions. Therefore, if you are seeking medico-legal support, our office will not be able to assist you but can refer you to an out-of-state Surviving Mold physician who does offer such services. We are more than happy to continue to treat you from a medical perspective.

There is no known cure to CIRS at this moment. Our treatments are aimed to make your condition stable and help you to manage it in the future. Typically, the active treatment phase could last anywhere between one year to a few years, depending on the severity of your own condition. Once the active treatment phase is over, patients will come back to see us about once a year for retesting.