ABPA- Workplace Exposure

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I was exposed to Aspergillus Mold (and perhaps other strains as well) during the course of work as a Registered Nurse for the Dept. of Veterans Affairs in Texas. Although an asthmatic during childhood, mostly provoked by contact in allergens; I did not suffer many asthmatic symptoms and was well controlled without any treatment other than avoidance of environmental triggers.

One year ago I changed positions at the VA and was reassigned to a new office. During the course of the time spent in this new office I began to develop an array of health problems that were attributed to issues such as menopause, anemia, etc. Several months ago when the weather turned warm and the air conditioning air handler on my unit nearby to my office broke, my symptoms amplified and thus began the downward spiral of my breathing.

I developed wheezing, shortness of breath and a violent cough that was only relieved when I was able to expectorate large, hard dark brown mucus plugs. Prior to this new onset I had never expectorated anything like this. The next morning I went to urgent care where I told my story and was mis-diagnosed with acute bacterial bronchitis and given Levaquin antibiotic. Luckily, during my visit I was able to expectorate another mucus plug which I insisted to be sent out for culture. Thus began the journey toward my ultimate diagnosis of ABPA. The culture was positive for colonization of Aspergillus Flavus (1+). The medical nay sayers attributed this to lab contamination and told me to disregard. Being a nurse and having good instincts I sought further evaluation and after the typical work up was diagnosed with ABPA. The source of the exposure was by all accounts my office. I requested air quality testing, which was done inadequately thus alleviating responsibility for my exposure from my employer. My treating physician was very certain that the source of exposure was the broken HVAC system which acted as a breeding ground for mold and other airborne particulate matter. I shared a dozen or so photos of suspicious areas inside my office which were very contrary to normal air quality results. I included one such photo in this post. It is what the inside of one of my Air Conditioning Ducts looked like when I had the outside grid removed. That photo says it all!

My treating physician placed me on indefinite medical leave and warned me not to return to the campus where the VA buildings are located.

I was diagnosed on Sept. 1, 2017 and started on prednisone 30 mg once daily x two weeks and am currently on the down taper dose of 15 mg. daily. I am also on itraconozole 400mg twice daily. I am also trying numerous other supplements and taking stomach protectants. I have not yet had my first set of follow up IgE titers to determine my response to treatment. I will be seeing a pulmonologist for the first time on Nov 1.

Being at home seems to be one of the few places where I can breathe my best. Everywhere else is a gamble, and if I am around any mold I react within hours by coughing and expectorating those dark brown, hard mucus plugs. It's insane how rapidly my respiratory tract reacts to subsequent exposure each time. The first week of medical leave at home brought almost immediate improvement of my respiratory symptoms at least by 70%.

Since starting the ABPA treatment regimen, my main side effects are weight gain, extreme fatigue, decrease in my visual acuity and generalized depression.

I remain actively pursuing advocacy from local regulatory agencies whose hands are mostly tied due to the lack of laws, standards and authority which is very frustrating to say the least. I am hoping to help raise awareness and fight for better oversight to prevent exposure through negligence.

Thank you for reading my story :)