Mr. Alain M. Mass, MD

Group A is dangerous because of cardiac complications (Rheumatic fever) indeed very rare. The other groups of strep are less dangerous but also have their own symptoms and complications. The truth is that most of the time it goes away on its own without complication. But the one who has a strep B, G, D etc... and suffers or cannot work may justify treatment. The treatment is not considered as medical obligation.

This can definitely be Lyme disease. Any round reddish spot is suspicious especially when the center is darker, the periphery pallor and the line that delineates the spot darker. The Lyme rash tends to enlarge and NOT to be itchy. Most of other insect bites are itchy. Applying hot water with a wet warm towel or hot shower may make the bull's eye rash more apparent. Of course, if you are in an endemic zone, are tired with headaches, joint pain, etc., it would be more suspicious. All agree (but who do not know Lyme disease) that a blood test at this time is FOOLISH and MISLEADING. Within the first two months of a tick bite, the blood test is most often falsely negative.

Alain Mass, M.D.

Fungi (mold) may adversely affect health in different ways. Fungi may cause allergy, infection and toxic reactions. Examples of fungal allergy are allergic rhinitis, asthma. Infections due to fungi may be systemic like histoplasmosis or local like ringworm or thrush. Mold allergy is caused by the presence of mold cells. Mold toxicity is due to the release of toxins, called mycotoxins, from fungi. If you are suffering from the immune response to fungi and have only runny nose, wheezing, cough, difficulty breathing, you may go to the Urgent care to treat the symptoms like for any other allergic reaction or asthma attack. The urgent care can provide the first relieving treatment. It will, however, not address the problem of mold in a comprehensive way. The Urgent care will not advise you how to check for mold and how to get rid of the mold. Checking for mold and remediating an apartment or a house may be very costly but also not well done and not effective. Controversy exists over the way to assess the presence of mold. Some will offer you air sampling that may cost more than $2000 while other mold inspectors will tell you that there is nothing more foolish than air sampling. Expert advice is absolutely required to avoid useless expenses. Also are you also suffering from mold toxicity? The clinical manifestations of mold toxicity can be severe or be readily overlooked and not considered as related to mold. Neuro-psychiatric symptoms are predominant. People may complain of shooting pain, headaches, light sensitivity, burning feeling, pins and needles, tingling, numbness, dizziness, dizziness on standing up, tremor, cognitive disorders like brain fog, memory impairment, learning disability, difficulty focusing.. A new onset of anxiety, depression, mood swings or of any atypical psychiatric disorder may also be the expression of mold toxicity. Chronic fatigue syndrome, muscle pain, joint pain, weakness are commun. The toxic syndrome due to the release of toxins from the fungi (mycotoxins) has only been described for the first time by Dr. Ritchie Shoemaker in 2005. Not surprising that the awareness of this syndrome has not yet well reached out to the medical community. In fact, mold toxicity is commonly confused with mold allergy. Mold toxicity is not even taught in medical school. I was trained in mold toxicity by Dr. Richie Shoemaker and later became a diplomate of the medical mold organization called ISEAI. (International Society for Environmentally Acquired Illness. To date, I am still the only one ISEAI physician in New York State, to say how unknown mold toxicity to physicians and how Urgent Care Centers are not fit to have a comprehensive care of mold toxicity. Keep in mind that one family member may have asthma or just runny nose and cough due to mold and not suffering from mold toxicity while the sibling may be suffering from unexplained depression, anxiety or learning disability or any neuropsychiatric disorder and the grandparent from Parkinson’s disease or dementia due to mold toxicity.

Think of exalate.

Two cases:

1. Weakness meaning abolition or decreased muscular strength. This suggests rupture.
2. Persistent pain may require infiltration with steroid or to reconsider the diagnosis.

This symptom is compatible with Lyme disease among other medical conditions. Of course, one symptom is not enough to make a diagnosis. I have a full screening questionnaire for biotoxin illnesses that include but are not limited to tick-borne diseases and mold toxicity. Both of these conditions may explain any intermittent neurological symptoms.

The main source of Vitamin B12 is from meat. All vegetarians are vitamin B12 deficient. Also, vitamin B12 is better absorbed with stomach acidity. The chronic use of anti-acid medications or a low stomach acidity will drop the level of vitamin B 12.