This chapter describes the medical treatments used for MCS, reviews the treatment research on people with MCS so that the reader can make better-informed decisions regarding where to put resources, and makes suggestions for investigating practitioners prior to making an appointment.

Excerpt from p. 131-133:

Before Making an Appointment

Before making an appointment with an MCS practitioner, you may want to consider the following:

• Find out what the costs will be, how much you will be expected to pay up front, and for exactly which services you will be billed. For example, will the practitioner bill you for every phone call and letter written, and if so how much will be charged? Will lab test results be forwarded to you at no extra cost or will the practitioner charge to interpret each test? For instance, if you have seven tests and you are charged ninety dollars for each interpretation (even though labs generally include a good one), your bill will increase by $630. (Your insurance company probably will not reimburse this cost.) In addition, if practitioners intend to write their own interpretations, how long will it take for you to receive the report? Some offices take months, and by the time you obtain your test results, they may be obsolete.

• Who will do the billing and is that person accessible? Find out who will be doing the billing, get that person’s phone number, and call. If they do not answer the phone or if you do not get a call back, you have a problem.

• Can you reach the practitioner if you need to? Try calling the practitioner’s office to see if you are able to reach a real person, even just office personnel. In some cases, speaking directly to a person, and not to a machine, is almost impossible. How difficult is it and how long does it take to obtain a quick emergency consultation with the practitioner?

• If you are seeing an environmental medicine practitioner, find out whether the office is a safe environment. This is particularly true if you will be paying the high costs of Provocation/ Neutralization (P/N) testing. (See page 103 for more information on P/N testing.) You may want to ask about the heating source in the office, possible pesticide applications, age of the building, any use of disinfectants and fragrances, new carpeting, fluorescent lighting, and any chemical use that may be a problem for you in terms of exposures. (I have seen environmental medicine practitioners’ offices located in the same building as restaurants that cooked with gas, with nurses smoking in the stairwell on their breaks, where disinfectant was sprayed in the bathroom, and where outside air filled with recently cut grass was circulating through the air conditioner as patients were being tested for grass sensitivity!) All of these exposures can affect your reactions to testing. It may be that the improper control of these exposures is one reason for some of the controversy regarding P/N testing and treatment.

• What EMF exposures will be problematic for you in the practitioner’s office? Although medical equipment is a necessity in a physician’s office, if you are EMF sensitive will you be able to be seen in a relatively safe area away from machinery and fluorescent lights?
• How is your insurance handled? Does the practitioner accept your insurance and file for payment, or will you be expected to pay in advance and wait for your insurance company to reimburse you?

• Is the practitioner a primary care physician or an MCS specialist? Many MCS specialists expect you to have another physician as your primary care physician to take care of general medical problems and emergencies. MCS specialists tend to provide only services relating specifically to MCS.

• Does the practitioner handle emergencies? If you have an MCS emergency (such as a pesticide exposure, a serious work exposure, or some other problem), will you be able to obtain guidance from the doctor in a timely manner?

• If you need to apply for disability, will the practitioner support you?

• Is the practitioner willing to be involved in legal disputes? If you are involved in court litigation and you need medical evidence in your lawsuit, you need to find out—before making an appointment— whether the practitioner will help you. Not all practitioners are willing to provide written or verbal legal testimony.

• Talk to people who have seen that practitioner. You can place an ad in MCS-specific newsletters, such as N.E.E.D.S., asking people who have seen a particular practitioner to call you. The N.E.E.D.S. newsletter is published by the privately owned National Ecological Environmental Delivery System and will print messages from its customers in its advertising booklet free of charge.