Archive for April, 2012

Stem Cell Transplant for Autism 3

Monday, April 30th, 2012

The condition currently designated as ASD is epidemic. Reports about the alarming numbers abound, but it doesn’t seem to stick. “Is there really an increase in actual cases?” is the most common question that I get asked about my medical practice, even by professionals. From my perspective, media reports and journal articles can’t stop “exposing” the recent increase in measles – 3 times as many cases as last year. The rise in such a preventable infectious disease is regrettable and dangerous. However, it isn’t necessarily occurring in non-vaccinated children, it represents a couple hundred cases – not tens of thousands of patients – and no child has died (or suffered reported permanent damage). That contradiction leaves some families with an autistic child feeling lost and neglected by the conventional medical community and so they seek ‘miracle’ cures.

Stem cells have been successfully transplanted into corneas since 2003. In 2005, the FDA approved, and in 2006, “Neurosurgeons and physicians at Doernbecher Children’s Hospital, Oregon Health & Science University… performed the first transplant of purified human fetal neural stem cells into the brain of a study participant…” who suffered from a rare, inherited brain condition. The material came from dead human fetuses, in the hope that the new tissue would replace a missing enzyme in affected patients. In that study, performed on 6 patients, a billion stem cells were directly transplanted into the patients’ brains and steroids were administered for a year. Although the safety of the project was demonstrated, the ability of the new tissue to reverse that condition has not been documented. Research was discontinued and the company that makes the product hopes to perform the procedure on less-sick patients in the future.

Compare that carefully controlled study to the procedures that are offered at the various Stem Cell Transplant Centers that reside outside the US. Such protocols use cells of various origin (fat, blood) and various injection sites (lumbar puncture, veins) with various additional medications (antibiotics, steroids) on various patients (ages, sex, level of ASD).

Stem cell therapy is experimental and only in its earliest stages of proficiency. Specifically for ASD, which is an enigmatic, multifactorial, multi-system condition with a widely variable presentation and outcome, there is no research to document improvement and only anecdotal evidence that it is either helpful or safe. A conclusion – a scientific one – CANNOT be reached with this level of information. So, the family that chooses this endeavor is working on faith, the (limited) experience of others, and luck when it comes to “the best course of action.”

In addition to betting on “whether” the treatment might “work” (as always, don’t expect miracle cures, just expect miracles), the concerned parent must consider:

1. The cost of Stem Cells and implantation (>$20,000), as influenced by:

a. Which cells lines will be harvested and grown?

b. How the cells are delivered to the patient (artery, vein, spinal fluid)?

c. Other medications, laboratory testing, procedures, or anesthesia if necessary?

d. Complications, and there are never no complications.

d. Insurance – not covered!

e. Travel, including hotel stays.

2. Alternatives

a. Conventional - this should be the first therapy once an autism diagnosis is established or suspected. It includes a neurologic evaluation, a thorough medical evaluation, appropriate laboratory testing and follow-up. This should be followed by Occupational, Speech and Language, Physical and Behavioral Therapy as it applies to your child’s level of function.

b. Biomedical – this will assist many patients, especially the younger ones, toward recovery or significant improvement, especially when accompanied by conventional therapies.

c. HBOT – this therapy may be chosen by many parents as an earlier adjunct to the other biomedical techniques or when they see their child continuing to fail to meet social, academic and developmental milestones and demonstrate significant behavioral concerns.

d. Other – including RDI, Listening therapies, NAETSensory therapies, Neurofeedback, Hippotherapy, etc.

3) Opportunity costs. $20,000 = 3 months of 25 hours/week proven or combination therapies; 4 weeks of summer camp for 6 years; more than 1 year of assistance services (cleaning, caring, tutoring) in your home; 1 used, low pressure HBOT chamber on eBay; 75 high pressure, high oxygen HBOT ‘dives’ in a safe, reliable, clean Center; 4 MNRI™ conferences, many years of neurofeedback, lots of NAET, or ten years of care at The Child Development Center of America (that’s me), including labs, supplements and medications. That dollar figure also equals the low estimation of 1 year of extra costs for each child with Spectrum Disorder.

4) Risks, which will be covered at the conclusion of this series.

In the US, a cord blood bone marrow transplant to treat sickle cell disease costs approximately $250,000 to $500,000. Since stem cell transplantation for ASD is not being studied at any US institution, parents seek care in Mexico and other Central America countries, Europe, China, South Korea and the Ukraine (more to follow, I’m sure). Depending on the Centercosts vary, starting at over $15,000 (various sites, parent’s information) for treatment alone (not including travel). Patients are required to remain for between 1-2 weeks for follow-up.

That concludes some basic background information that ought to be considered in order to make an informed decision about this complicated topic. The next post will sum up all of this and offer some advice.

Stem Cell Transplant for Autism 2

Monday, April 23rd, 2012

Previously, I discussed the potential that stem cells can exhibit to differentiate into useful tissue. Families interested in curing, reversing or overcoming symptoms of their child’s autism with this technology ought to be knowledgeable about whether the process works for other medical conditions. Unarguably, even by those who perform the procedure for autism, the evidence is in it’s earliest stages.

Current Stem Cell transplantation that is medically utilized (United States):

Stem cells are useful when bone marrow requires rejuvenation after chemotherapy or radiation to wipe out cancer cells.

Pretty close to acceptance:

Heart attacks with cardiac damage

Ongoing investigations include:

Bladder repair / replacement

Retina repair

Cornea replacement

Strokes

Spinal cord repair. FDA approval for a study. A recent citation entitled, Human Umbilical Cord Blood Stem Cells Infusion in Spinal Cord Injury: Engraftment and Beneficial Influence on Behavior actually refers to rodent recipients.

Central Nervous System Conditions such as Multiple sclerosis or Parkinson’s Disease

Evidence (not necessarily experience) lacking:

Autism Spectrum

Cerebral palsy

Brain injury

Other Central Nervous System Conditions (e.g., Alzheimer’s)

The information will advance at a rapid rate, so my advice is to discuss the information as it pertains to your child, with a knowledgeable, independent and trusted practitioner.

1. Only consider human trials. We’re talking about a loved one here. A recent Cancer Research article was entitled, Human Neural Stem Cell Transplantation Ameliorates Radiation-Induced Cognitive Dysfunction. Although it looks very promising, the procedure was performed on rats. I can’t help thinking how easily someone with a vested interest in influencing a particular outcome might use that headline in order to justify or provide evidence of stem cells’ efficacy.

2. Surf wisely. Do your own research. Since much of that involves the ‘net, you are observing edited presentations of patients who are only like your child in their families’ desire to help heal their child. Are the images you watch of male or female children? What are their ages, and other co-morbid medical conditions? Did they present after vaccination (as always, an impossibility according to the AAP), like your kids, or were the children atypical since birth? Did they have GERD, or frequent antibiotic usage, or abnormal stooling since they came home from the hospital? What other treatments, such as antibiotics or steroids, were given with the transplant? Anecdotal evidence is very difficult to evaluate from youtube.com or parental testimonials. Editing is the whipped cream that can convince hopeful parents to take the plunge (and often, music is the cherry-on-top).

3. Learn when Stem Cell Treatment didn’t work. The first questions I ask when presented with any autism protocol are, “Who didn’t get better?”, and of course, “Who got worse?” These procedures are being performed in foreign countries. Even if, as is the usual contention, the criteria for certification or cleanliness are as stringent as they are in the US, the reporting agencies may not be. Centers should provide well documented outcomes and transparent (and reproducible) statistics. Follow up studies are scant. Since I know that many parents have grave concerns over administering oral melatonin to assist sleep, I can’t imagine how those families deal with this level of investigation.

I am always interested to learn from patients who have had the procedure performed on their children, some multiple times, and some who are looking to do it again. In the limited population that I have examined, the children appear to respond the same as with most biomedical treatments in that the more affected the child, the more treatment(s) is required. I have not yet noted more improvement than in those children who were treated with less complicated biomedical interventions.

Next up: Choosing a Stem Cell Center

Stem Cell Transplant for Autism

Tuesday, April 17th, 2012

Stem Cells Microscopic View

Parents search the world for answers when their child has a complicated medical condition. The more exotic, enigmatic, or frankly, hopeless the situation seems, the farther that journey takes them. When families consider a medical procedure as complicated as Stem Cell Transplantation, they need to be well informed from an independent – but not necessarily adversarial – source, in order to decide a) a whether to proceed with such a therapy and b) the optimal center for the treatment. Imparting that knowledge in a few concise posts is the goal of these next few blogs. It took me 5 posts to fully explain and give advice about Hyperbaric Oxygen Treatment; my point being, if someone tried to explain such a complicated topic to you with LESS than that amount of information and thought, you didn’t get enough information, or think about it enough.

Stem cells have the potential to differentiate into other cells; to become skin cells to repair a severe burn, bladder cells if that organ is diseased or removed, or neurons in the case of spinal cord injuries. In the earlier years of this research, there was a controversy because this particular type of tissue could only be harvested from embryos (very young fetuses), since that would be the greatest source of this type of material. However, the cells can now be extracted from bone marrow, fat, blood (from another person, from yourself, and the umbilical cord at birth), and amniotic fluid and then kept alive and grown in the laboratory. With the appropriate stimulation factors, the desired type of cell can then be ‘born’.

That background information is particularly paramount when considering this type of procedure for autism because the GOAL of this therapy is to stimulate neural pathways which have not developed or developed incorrectly in your child’s brain. So, when choosing a person’s own stem cells, two essential issues are, “Won’t those cells have the same problem as the child?” or “if something is going on with the child’s system, won’t it also affect the new population of cells?”

I have spoken to practitioners of this therapy who answered, “No, the damage may have really occurred at some other time, so these cells will do the trick.” I guess if you are talking about a child who regressed after a vaccination (though that’s impossible according to AAP), and you have frozen the child’s cord blood cells, you could argue that pre-damaged cells could perform the new tasks – as long as there is no ongoing systemic problem (with the immune system, for example).

If you choose abdominal adipose tissue from the patient (belly fat – a popular new development), you are assuming that those multi-potent stem cells do NOT contain the same “error” in transcription (making a protein from the DNA, pictured), in order that the new cells will overcome the poorly functioning ones. By choosing the cells of other people, the patient is risking tissue acceptance by the their own immune system.

This discussion has only scratched the surface of such a complicated treatment. In addition to considering the desired source of the stem cells, the follow up questions include:

Where to put the cells

How the cells are gonna get to where you want them to go

Who you can trust to perform it

The cost, including opportunity costs

Efficacy, best provided by anecdotal experience at this time

The risks, mostly unknown at this time

Research, experience and recommendations

So far, my advice on the procedure is to find a good Special Needs Pediatrician. Work on exploring sources of reducing inflammation and addressing cellular energy which has been disrupted by this condition. Unless I uncover some fantastic information in my research, there are many other good treatments to be considered when the child is first diagnosed. For severe developmental delays which remain resistant to present protocols (conventional and alternative), “stem cell therapy” will often  surface as an option for the concerned parent and should be considered with a trusted clinician.

This background information will serve as the introduction to my next blog about the present state-of-the-art of this controversial ASD treatment.

Autism Awareness 2012 Part 2

Sunday, April 8th, 2012

Before I settle back down to work on this month’s major feature, Stem Cell Transplants for ASD, I am posting this addendum to my April blog about autism awareness. I wish to comment on the April Issue of the AAP news. The lead piece was entitled, ‘If not vaccination, then what?’ The second headline was, ‘How to end physician-patient relationship legally’.

In the first article, a respected University of Alabama professor, Dr. David Kimberlin, presented the beneficial outcomes that childhood vaccinations have yielded. He detailed  the reduction in childhood deaths before the age of 5, improved health for all, and the proven stuff that the present schedule is perfectly safe for everyone. Oh, that’s right, he didn’t mention the fear of high fevers, seizures, diarrhea, or the specter of autism. As I have written previously, I am old enough (61) to have had a childhood friend with paralysis from polio. I had an uncle who was blinded by measles as a child. And, as I practitioner, I experienced babies suffering the ravages of congenital rubella. I’m not sure what part of the membership Dr. K was addressing in the article, but it wasn’t me. Was he giving younger doctors more verbal ammunition? It would probably be a good idea for the practitioner to be able to answer those additional questions, as well.

In fact, the magazine never said a word about Autism Awareness Month, or even autism for that matter. This is in the same month when the CDC has pronounced that 1/88 children suffer from the disorder. There is this disconnect between what my Society is espousing and what my patients are experiencing. If there is an autism activist on the Editorial Board, it wasn’t evident. Apparently, April is also ‘Child Abuse Prevention Month’. I know this because there was an entire page devoted to that tragedy.

The other thing that irked me about this month’s magazine was the second lead article, entitled, ‘How to end physician-patient relationship legally’, written by the Committee on Medical Liability and Risk Management. It was ostensibly about patients who continually miss appointments. What’s the problem, doc, you will only see 5 instead of 6 patients that hour? Instead of writing about ways to gain patient confidence, educate and encourage good health (as the AAP recommends), and do a great job of taking care of children, the article explains how to safely get out from under an unreasonable or demanding family. ”Perhaps the patient is non-compliant… does not share fundamental health care principles such as the need for… immunizations…”

Now, maybe I’m the only one to see a conspiracy here; one article was about vaccine efficacy and the other about how to fire your patients. Who could they be talking about, huh?

There is confusion on the part of the patients which is, perhaps, being fueled by the dogma that exists on the part of conventional medicine. There must be some common ground where we all can meet to 1) help patients feel confident that the doctors understand what it is like to be a parent in today’s world and 2) have physicians who respect that modern parents are reading the Internet and are better educated than ever before. In the first post on this topic I was concerned that ‘awareness’ wasn’t enough. Certainly, for the AAP, it would be a start.

Got that off my chest.

Autism Awareness 2012

Sunday, April 1st, 2012

It is not enough to merely be aware. Perhaps by employing the “E” word, there will be a greater effort to find the cause(s), the treatment(s), the cure(s), and prevention.

Even though recent statistics confirm that autism rates have risen dramatically, there seems to be a reluctance to apply the word ‘epidemic‘. This is important because once the public is alerted to an epidemic, such as “Swine Flu” or “West Nile Virus” or “Flesh Eating Bacteria”, people take notice, resources are mobilized, and things seem to get done (for better or for worse). Wikipedia defines the word as “… new cases of a certain disease in a given human population, and during a given period, substantially exceed what is expected based on recent experience.” Since rates are certainly more than expected, there should be no controversy. Yet, as I have written previously, the powers-that-be can’t figure out whether there will be more or less diagnosed cases of autism with the new criteria in the DSM V.

So, here are my top ten reasons proving there is an autism epidemic:

10. I say so

When I saw my first patient with autism in 1975, the condition was said to occur in 1 per 5,000-10,000 children

  9. The CDC says so

Prevalence rates for eight year-olds has just been reported to be one in eighty eight

  8. The World says so

Autism rates around the world have increased dramatically

  7. Therapists say so

ABA therapists are highly sought after, even though this proven therapy is often not covered by health insurance

  6. Experienced professionals say so

Ask any teacher, S&L, OT or PT over the age of 40

  5. The WWW say so

There are over 80 million Google Pages concerning the search term “autism”

  4. The media says so

There have been featured stories by television doctors such as Drs. Gupta, Oz, and Phil

  3. Practitioners with treatments say so

The Child Development Center, my medical practice, has continued to build dramatically over the past several years, as have other Complementary and Alternative medical treatments

  2. Parents (and families) say so

Seminars and conferences about the condition are in high demand and well-attended by families seeking answers

  1. You are all READING ABOUT IT!

Everyone knows a family who has been touched by the ASD diagnosis

So, let’s stop debating whether the increased percentage of children suffering from this developmental disability is real, and start searching for the reasons for those alarming numbers and seeking therapies that really work.

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