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William J.
Meggs, MD; PHD
Neurogenic Inflammation
Hypothesis for Induction and Propagation
of
Chemical Sensitivity
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Stages of “MCS”
Dr. Meggs provides an excellent
description of the observed stages of chemically induced illness
described as the "Hypothetical Chemical Stress Syndrome".
STAGE ZERO -- TOLERANCE: is what it appears to
be, the ability of a person to tolerate their chemical environment.
STAGE ONE -- SENSITIZATION: or the irritant phase, "occurs when an
individual is chemically stressed either by an acute high-dose
chemical exposure, or by a chronic insidious exposure. Individuals
in Stage 1 have symptoms on exposure to chemicals, but no physical
findings on physical examination." Symptoms may include joint pain,
muscle pain, headache, fatigue, flushing, pruritis, nausea, et al.
STAGE TWO -- INFLAMMATION: is when the chemical exposure has led to
tissue inflammation, such as arthritis, vasculitis, some types of
dermatitis, colitis, myositis, non-allergic asthma, multiple
sclerosis and rhinitis. "It is at this stage that both findings in
physical examination appear and a medical diagnosis can be given...
The progression from Stage 1 to Stage 2 again follows increasing
chemical exposures, and if tissue damage has not occurred, the
inflammation can be reversed by removal of the chemical stimuli."
When a person is in stage 2, the symptoms can be controlled through
various medications if a person is not sensitive to those
medications.
However, one needs to exercise caution because the medications are
not a cure for chemical exposure, but rather can mask the root cause
of the symptoms, allowing further subtle cell damage to occur if the
chemicals are not avoided: "That is, progression between Stages 1
and 2 is a two-way process, with regression from Stage 2 to Stage 1
being possible if chemicals are avoided. The inflammation of Stage 2
can be reduced by medications such as corticosteroids and the
non-steroidal anti-inflammatory agents, but these agents are not a
curative. If the chemical stimuli are not removed, there is
immediate relapse of inflammation with discontinuation of
anti-inflammatory medications. Further, these medications do not
prevent the progression from Stage 2 to Stage 3."
STAGE THREE -- TISSUE AND ORGAN DETERIORATION: is when chronic
inflammation caused by chemical exposure has finally led to tissue
damage such as nerve damage, kidney damage, liver damage, lung
damage, autoimmune damage, etc. This stage is irreversible:
"Unfortunately, once tissue is damaged there is little hope in
current medical practice for reversal, and organ function is lost."
This doesn't mean it's time to throw in the towel. It is a point
where patients need to carefully reevaluate their situation and
further examine their environment for possible contributing factors.
They then need to adjust by making the necessary lifestyle changes
to try to prevent sill worse damage from occurring. It is important
to note here that individuals can pass throughout these apparent
stages without ever having developed MCS, or even without making a
mental connection to chronic chemical exposure in their environment.
MCS becomes debilitating for most of the individuals who eventually
progress to stages two and three. Although MCS is very controversial
both the U.S. Dept. of Housing and Urban Development and the Social
Security Administration have recognized MSC as a disability. Many
state agencies will help individuals with MCS by providing
assistance with homemakers, counselors and many other very important
services.
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