The mercury in your mouth (continued) BY JENNIFER LUNDEN

Dentists aren’t trained to recognize the signs of mercury toxicity, and their Code of Ethics prohibits them from recommending removal of amalgams. And there aren’t many doctors in Maine who are experienced in recognizing and treating mercury toxicity. Dr. Py was one. But last November, Dr. Py’s Portland patients were surprised to open a form letter explaining that he would be closing his Portland practice. The letter sent shock waves through a community of environmentally ill people who had come to rely on Py for his creative and effective solutions to their very challenging health problems, problems many doctors before him had failed to address effectively. Patients scrambled to find supportive replacements. Some resolved to make the hour-and-20-minute drive to his Amesbury, Massachusetts office.

One patient, who sees Py twice a month and is too ill to drive, called a number of nonprofit and state social service agencies before a Catholic Charities case worker helped her secure a volunteer driver, a Shriner, to chauffeur her to her appointments.

When I asked Dr. Py why he decided to close his Portland practice, he told me a story I could hardly believe. Later, when I interviewed him for this article, I asked him to give my number to Debora Tyler, his patient and a key player in his story. Tyler and I met over lunch at Wild Oats.

Tyler believes, now, that she was poisoned by mercury starting in 1991, when an unethical Massachusetts dentist replaced all her composite fillings with mercury amalgams. Tyler, a former army medic, microbiologist, and lab technician, got sick gradually within a year of having the amalgams put in her teeth. She recites a long litany of symptoms: thyroid problems, ovarian cysts, excruciating pain, sleep disorder, cognitive difficulties, tinnitus, food allergies, nausea, diarrhea, numbness in her feet, bleeding gums, spots before her eyes, and hair loss. She also gained 40 pounds. At her sickest, she couldn’t work at all.

Tyler consulted with three Maine doctors. They focused on fibromyalgia and hypothyroidism and dismissed Tyler’s requests for heavy metal testing. Meanwhile, Tyler got sicker and sicker.

In 1999, Tyler found Dr. Py, who eventually diagnosed her with mercury toxicity after lab results indicated she had "very elevated" levels of mercury in her body. So Tyler had her amalgams removed and began a process of chelation. Over a period of four to five months, Tyler reduced her mercury 14-fold, down to what is considered nontoxic levels. The cysts disappeared, and within two to three months her pain had substantially diminished.

By the time I met with her, Tyler had lost almost all the weight she had gained when she was so sick. She said she rarely suffers from pain. The spots in front of her eyes are gone, so that she can now read and drive again. Playing in an online Spades league is helping her restore her cognitive function. And she is able to work part-time.

But Tyler is frustrated that she was sick for so long with a treatable condition, and she is concerned that the medical system is ignoring a significant public health issue.

So she submitted a complaint to the Board of Licensure in Medicine, naming the doctors who missed the diagnosis and charging them with providing inadequate medical care, ignoring her complaints, failing to do proper testing, and misdiagnosing her.

The board voted unanimously to dismiss the complaints against all three doctors. It did not acknowledge her mercury toxicity. In fact, the board voted to forward Tyler’s complaint to the Board of Osteopathic Licensure for review. And the DO board decided to investigate Dr. Py, who practices complementary and alternative medicine(CAM), for using chelation therapy — standard medical protocol for treating heavy-metal toxicity — to clear the mercury out of Tyler’s body.

The board is charged both with protecting the public safety and upholding the standard of care. In the case of Debora Tyler, there was no patient complaint and no patient injury. It appears, then, that the board’s motive in this case is strictly to preserve the standard of care. The question is: Whose standard of care does the board preserve?

The Federation of State Medical Boards’ proposed guidelines for evaluating CAM physicians recommend including a CAM doctor on the board, or at least consulting with one, in order to perform a fair evaluation. Py says the DO board does not follow these guidelines. "Nor are its members informed about these practices. Yet they’re expected to render decisions in the appropriateness of the treatments given by CAM physicians."

I was unable to obtain comment from the DO board.

Py has never had a patient complaint. But he was investigated by the board once before for his practice of complementary and alternative medicine. And he says he’s not the only CAM physician who has been targeted. After seeing a number of colleagues pursued by the DO board, Py questions whether the board is biased against CAM practices.

CThe board has changed it purview from protecting the public safety to protecting the standard of care [[says you or says them?]]. While this may sound like a worthy goal, complementary and alternative treatments that that have been shown to improve health are still considered suspect by mainstream medical practitioners devoted to prescribing expensive pharmaceuticals and invasive surgeries. Since the ADA insists that amalgams are safe, and mercury toxicity is effectively ignored by mainstream medicine, it appears that doctors who venture to diagnose and treat it are putting themselves in danger of being disciplined by their licensing boards.

Dr. Py had been through it once. When he was notified of the second complaint, he knew that his practice in Maine would never be safe from the board’s scrutiny. So he decided to pull up stakes and leave his Maine practice behind.

I called up the Maine Board of Licensure in Medicine to try to get some understanding of how it is that a complaint about doctors under its jurisdiction (MDs), ended up at the Board of Osteopathic Licensure, where a complaint was filed on a doctor who successfully treated a patient and with whom the patient was happy.

I spoke with Executive Director Randall Manning, who told me that, even though I could provide a signed release from Tyler (who also was unable to obtain records regarding her case), due to board statutes protecting confidentiality of patients and physicians, he could not provide me with any information specific to the case, other than board minutes.

Since media watchdogs have no meaningful access to the medical licencinglicensing board’s decision-making process, I asked Manning who is charged with its oversight. He told me board members are appointed by the governor. He pointed out that three members of the public are included on the board, ostensibly as counterweight to possible bias. The medical board does not lobby for specific nominees, according to Manning. If a complainant is dissatisfied with a decision, s/he can make an appeal to the board with additional information. Beyond that, there’s no one else to whome s/he can appeal.

In essence, nobody is watching the boards. So if bias exists, frightening physicians from diagnosing and treating mercury toxicity, there’s no way to identify and challenge it. And sick patients are left with no one to tell them what’s wrong or how to get better.

Physicians like Dr. Py are sometimes referred to as "quacks" by those who support mainstream medicine. It is ironic that the term was first applied to dentists who used mercury, or quaksilber (in English, "quicksilver"), in amalgams. Mercury toxicity has been associated, in various studies, with Alzheimer’s, multiple sclerosis, autism, chronic fatigue syndrome, multiple chemical sensitivities, fibromyalgia, and attention deficit/hyperactivity disorder (ADHD). Lisa Marie Presley told Rolling Stone that she believes mercury amalgams were responsible for her health breakdown a number of years ago. Local doctors such as Dr. John Pelletier, a DO specializing in musculoskeletal health, and Dr. Paul Balzer, a family practice MD, had their amalgams removed due to concerns about health effects. And Dr. Py has had a number of patients whose health improved after amalgam removal.

But my own random survey of Maine dentists found that seven of the eight who responded still use amalgam in their practices. They believe that it is a safe product. They cite durability, economy, and ease of use as chief factors influencing continued use. And they worry that low-income people will not have access to alternative fillings — which are more expensive — should amalgams be banned. Even insured patients do not always have access to alternatives; many insurance companies, like the one used by the Phoenix, will not reimburse any fillings but amalgams..

Though I myself fall into the category of "low income," I will never again allow a dentist to put mercury amalgams into my teeth. Removing my amalgams has helped me chelate my mercury, so far, down to a quarter of its highest level. And though, given the gradual nature of my mercury detox, it’s difficult to make a direct correlation, some of my symptoms have abated. I agree with former governor Angus King, who compared current use of mercury in dental fillings with the use of X-ray machines in shoe stores in the ’50s: "Now we realize it was a terrible thing to do, but then it seemed perfectly normal. Some day we will wonder how we could ever have put such a toxic substance into the human mouth," he told reporters when he signed the informed consent legislation into law.

If you have silver fillings in your teeth, you have mercury in your mouth. You may not have noticed any ill effects. While it is apparent that some people are more sensitive to the effects of mercury than others, it is also true that mercury toxicity from amalgams generally develops gradually, and since it expresses itself differently in different people, it is not easily identified.

But evenBut even Rosie Cronin urges caution around amalgam removal. "I caution people, before they go running and have their mercury amalgam fillings out, if they’re suspicious of having mercury poisoning, to get testing first — to make sure that they do have high levels of mercury in their bodies. And if they do, they want to go to somebody who is well-versed in the protocol." Removal of amalgams must be done properly, or worse damage can be done.

If you’re worried that your amalgams might be affecting your health, DAMS can help you find a reputable practitioner who can work with you to assess your options. The Maine contact is Marjorie Monteleon, at (207) 244-5577.

Jennifer Lunden can be reached at jenniferlunden@hotmail.com