Posts Tagged ‘Vaccine’

Five Steps to Improving Vaccination Compliance

Saturday, October 4th, 2014

In a recent Wall Street Journal editorial, “The Anti-Vaccination Epidemic”, Dr. Paul I-never-met-a-vaccine-I-didn’t-like Offit whined about the ignorant public, The Wakefield Effect, “fringe” doctors, foolish families and the “inaccurate” media. The subtitle, Whooping cough, mumps and measles are making an alarming comeback, thanks to seriously misguided parents, sums up the position of Dr. He-ain’t-Jonas-Salk.

The mainstream approach to the childhood vaccination-autism controversy is that there is no blame on the part of the ‘experts’ or the doctors who follow the pharmaceutical industry’s dogma. The logic that says,”If you knew how bad those diseases were, you would believe,” doesn’t work on me. I have lived through many previous epidemics.

The major problem is trust. Confidence in the government is at an all-time low. More than half of the population doesn’t trust the FDA. That bureaucracy can’t manage to stop antibiotics in our food, even when there is evidence of negative effects.

The CDC has similar problems. The current whistle-blower incident, involving questionable data inclusion/exclusion affecting an association with MMR and autism in African-American males, hardly discourages vaccine skeptics. Furthermore, the present viral epidemics appear to reinforce public fear about the competence of that prestigious organization. It was media scrutiny that prompted investigators to secure the living quarters of the Texas ebola patient!

How to Improve Vaccine Compliance:

1. It is difficult to believe that an agency has ‘learned from its mistakes’ when they don’t even own up to them. There have been problems in the past. A neurologic illness has been related to some vaccines, and the Swine Flu ‘epidemics’ were debacles. Public trust would best be furthered by declaring, “We understand what happened and those issues are behind us,” if it’s true. If it isn’t, caution is warranted.

2. Pediatricians need to give better advice. Often, the doctor who professes vaccine safety also missed the child’s ASD diagnosis. Parents are not “bad”, “ignorant”, or misinformed. They simply don’t agree, and professionals should be armed with the facts, not paternalistic warnings.

3. Doctors need to listen. A previous sibling or relative with autism is cause for concern. Fevers or illness that followed other vaccinations should be highlighted in the chart, not dismissed. Co-morbidities, such as eczema or asthma need to be controlled, before adding to the immunologic load.

4. Research that challenges the norm warrants evaluation, not immediate dismissal. Instead of proclaiming the autism-vaccination question a dead issue, confidence would be elevated by experts who calmly declare, “That study deserves further attention.”

5. A practitioner’s willingness to agree to an individual family’s reasonable request to adjust the number and frequency of ‘shots’ will be met with more, not less, compliance. Furthermore, kicking an insubordinate family out of the practice is neither ethical nor helpful.

The present strategy of threats and intimidation is not working to decrease the number of families who either choose an alternative schedule, or the risky position of total noncompliance.

Further understanding and kindness is the best prescription for a more successful approach.

Miracle Mineral Solution Treatment for Autism

Saturday, May 24th, 2014

I hadn’t really expected MMS to gain any traction as a viable autism treatment. It seems complicated and scary, and the FDA first issued a warning about it four years ago. Perhaps there is no measurable re-emergence, but it seemed so when I attended the Autism Today Second Conference in Miami this week.

I sat among eighty mostly-bewildered parents, representing children who are so affected that they are attracted to outlier theories and treatments. This is largely because the information supplied by the conventional medical community is so woefully inaccurate, incomplete, and unproductive for many patients.

Due to some scheduling glitches, this conference ended up focusing on the very controversial topic of MMS. The treatment was explained by Ms. Kerri Rivera, “a biomedical consultant for an autism clinic in Puerto Vallarta,” and mother of recovered child. Her experience was then authenticated by Dr. Andreas Ludwig Kalcker, inventor of “The Parasite Protocol,” which is an essential element in the therapy.

The Chlorine Dioxide Protocol is not about bleaching your kid. That was the first message. Well, it’s not about making your intestines white, but the word does mean “to sterilize.” Anyway, that refers to sodium hypochlorite, according to Ms. Rivera, not the chemical that MMS is utilizing. In that sense, it’s not about dipping your child in Clorox. Except that Chlorine dioxide is used in “stripping textiles and industrial water treatment,” and it does involve purging and cleaning the “excess of pathogens.”

  • The diet – organic vegetables and meats. GF/CF/SF/sugar free (especially fruits).
  • Supplements – Stay away from all anti-oxidants.
  • Main Ingredient – Ocean water and acid (lemon juice, e.g.), to make a dilute solution of Chlorine Dioxide.
  • How it is administered – Doses and administration depending on a pre-established protocol, plus alterations depending on symptoms and response to treatment. In the gut, it is supposed to remove the biofilm and so expose organisms that get flushed through the G-I tract. Breathed into the lungs, it addresses asthma and bronchitis. The cutaneous route helps eliminate bad skin cooties and detoxify. Enemas and rectal suppositories to directly address lower intestinal issues. There is also and Eye and Ear spray form.
  • What happens – The elimination of bad bacteria (and, admittedly some good ones – but they have a product to fix that), viruses, fungi, and worms. Lots of worms. Plenty of worm pics. Worms that no laboratory in the world, apparently, can document.
  • Acceptable additional treatments listed as HBOT, chemical chelation and GcMAF, probiotics, l-carnosine, carnitine, plant fatty acids, GABA, digestive enzymes, tryptophan, DMG and TMG (the last 2 are anti-oxidant precursors).
  • She claims to have helped over 6000 families, and 131 cases of patients losing the diagnosis.

The ‘Parasite protocol’ was presented by Dr. Andreas Ludwig Kalcker, who recommends Chlorine Dioxide treatment.  He lists his credentials as, “… first licensed in economics and later in biophysics and alternative health (Ph.D)
Although his German accent is compelling, the science that he presented was not. He listed the symptoms of parasites and noted similarities to many autistic behaviors (?cause and effect?). He claims that his key discovery was that regressive autism is due to “Parasitological Vaccinosis“. That term describes toxins that are later released by parasites in susceptible children who become vaccinated.
He made many grand overstatements, using real research papers that only prove the one point, frequently mixing apples and oranges. Slides such as “Larval migraines induced by vaccine,” not only lack a scientific citation, I couldn’t find any match over the entire Internet.

In the Q&A session, I asked a simple question, “131 ‘cured’ is the numerator, what is the denominator?” This resulted in Ms. Rivera and Dr. Kalcker blustering about how that number couldn’t be documented, and how it wasn’t really important. That begs the comment, “Well, if you don’t know how many have been treated in this manner, you also wouldn’t really know how many have experienced significant negative reactions.”

As expressed by top autism researcher, Dr. Martha Herbert, I do not believe that parents who attend these conferences are “gullible, dangerous, and/or don’t love their children, and the people who pass them off are snake oil salesmen.” I was there to learn about new ways to approach our most resistant patients, not to simply criticize. Avertising MMS in this manner is not the way to go about proposing innovative and controversial treatments. It promotes The Wakefield Effect.

Dismissing conventional medicine as being completely ignorant and challenging treatments from all sides takes strong scientific proof. Proof of concept in animal models and proof of efficacy and safety in appropriate human treatment trials. To be specific: no, I would not recommend this treatment for my patients. There is simply too much missing information. A few pictures of recovered children and parental testimonials should not sway a prudent professional.

At The Child Development Center, we have improved the lives of many of our patients by addressing and treating G-I health with a proven, safe, well-tolerated protocol. Nutritional status must be evaluated, treated and monitored. With appropriate behavioral therapies, child development gets on the right track.

For successful autism treatment, each piece in the puzzle has to fit into the bigger picture.

A Mother’s Intuition About Autism

Saturday, May 10th, 2014
Mother's Day 2014

Mother’s Day 2014

Every new patient at The Child Development Center has a unique history and physical presentation. Often, however, the children share the experience that their mother:
a. Already knew, or highly suspected, ASD, and
b. Heard the doctors proclaim that they were “reluctant to make a diagnosis, at this time, because the child is so young.”

Is there any other serious medical condition that carries this ‘wait and see’ attitude? “It’s probably not cancer, so let’s wait a few months and see what grows.” “The eardrum looks red and is bulging, if the fever gets any higher we will consider antibiotics.” “I hear wheezing, call us in a day or two.” And vaccinations? The first one is foisted upon newborns, with many more to follow, in order to prevent disease.

Study after study documents important gains that come from early intervention for developmental delays. Despite that, there are neurologists and psychiatrists who continue to claim that “You can’t make the autism diagnosis before the age of 2 or 3.” That imposes a waiting period, postponing intervention at the most critical juncture of development.

In order to assign an accurate diagnosis, both the DSM IV, and the present iteration of the Diagnostic and Statistical Manual of Mental Disorders 5.0, contain the stipulation that delays should be noted in early childhood. The previous manual stated, “Delays or abnormal functioning… with onset prior to age 3 years… ” The present DSM 5.0 describes, “Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).” There is no mention of a waiting period.

Yet, in the midst of this epidemic, and with all of the press coverage about the rise in autism, mother is usually the one who makes the diagnosis. Is it any wonder that the parents go to the Internet to get their information or seek alternative treatments when the doctors weren’t even willing to assign a diagnosis, let alone suggest any therapy?

At our Clinic, there are now many younger siblings of children who carry a ‘Spectrum’ diagnosis. Some demonstrate developmental red flags. A 2 year-old male who doesn’t speak and walks on hs toes but shows good eye contact. A 1 year-old female who turns to her name, but doesn’t stand or vocalize. A six month-old boy who suffers from GERD, eczema and chronic diarrhea.

The youngsters were all high-risk and the mom couldn’t sleep, worrying about the future. What is wrong with offering immediate action targeted to specific symptoms? The youngest children can use a probiotic, stop using PPIs and stay away from antibiotics. The older ones need speech and language, OT, ABA and/or PT. STAT.

These are real examples of some brothers and sisters who have gone on to neuro-typical development. Did earlier intervention prevent autism? Bottom line – who cares?

Try this analogy: It is the Middle Ages and The Plague has struck several neighboring cities. The first sign is a flu-like illness that rapidly advances, ending in death. So, when a local sufferer visits the doctor because of a runny nose and sore throat, the physician should be thinking “The Black Death,” not a cold.

Twentieth century poet Helen Steiner Rice wrote, “A mother’s love is patient and forgiving when all others are forsaking, it never fails or falters, even though the heart is breaking.”  When Mom thinks that something is wrong and the doctor dismisses it, saying “It will probably will go away,” families should run, not walk, to a professional who will listen.

Happy Mother’s Day
f
rom Dr. Udell
and the staff at the Child Development Center

The Autism Wars: Frank Bruni vs. Jenny McCarthy

Friday, May 2nd, 2014

Perhaps to mark the end of Autism Awareness month, but seemingly out of the blue, New York Times op-ed contributor, Frank Bruni, decided to weigh in on the vaccination-autism non-connection issue with this April 21, 2014 article. He accused Jenny McCarthy of being an “agitator… the intemperate voice of a movement that posits a link between autism and childhood vaccinations and that badmouths vaccines in general, saying that they have toxins in them and that children get too many of them at once.”

In this corner – Foodie Frank
Who is Foodie Frank to attack Gorgeous Jenny? His bio in the Times describes, “Over his years… he has worn a wide variety of hats, including chief restaurant critic… Rome bureau chief…  also written two New York Times best sellers: Born Round (“as in as in stout, chubby, and always hungry”), and Ambling Into History, (about George Bush)… coauthor of A Gospel of Shame: Children, Sexual Abuse and the Catholic Church.” Wikipedia adds that he “… became the first openly gay op-ed columnist…” of the Times.

Nothing in Mr. Bruni’s curriculum vitae points to any learned knowledge of science, biology, immunology, ecology or child development. The only extant association between Mr. Bruni and autism is this vacuous article that he penned. There is no evidence that he possesses any special information. Oh, that’s right, he did say that Yale’s autism expert, Dr. Fred Volkmar, told HIM that the vaccination controversy “diverts people from what’s really important, which is to focus on the science of really helping kids with autism.” A diversion from the important stuff, huh? As in, this bullshit op-ed story.

And, in this corner – Gorgeous Jenny
And what role does Jenny McCarthy play in this complicated, emotional and misunderstood quagmire that is the present autism epidemic? Her pediatricians didn’t even know what she was talking about when her child was diagnosed with autism. The conventional medical community says that, “Autism is what it is… you got what you got… deal with the situation and get (really expensive and difficult-to-find) therapies. Good luck.”

Parents are admonished not to listen to anyone who says that they can help with medical treatment, other than the standard psycho-stimulant meds. Even if Mom witnesses a change (from a GF/CF diet, e.g.), professionals warn that “It’s probably just a coincidence, like that disproven vaccination theory.”

Ms. McCarthy warned the country and the world that a storm was coming. Regarding ASD, doctors have displayed ignorance at best, and have even caused harm, due to delays and misdiagnosis. And, while we’re on the subject, if it turns out that her son, Evan, has one particular version of autism, that hardly constitutes some sort of fraud for the purpose of gaining visibility. Smack of bullying, Frank?

The child’s complicated diagnosis – made by the doctors –  doesn’t make McCarthy someone “who sows misinformation, stokes fear, abets behavior that endangers people’s health.”
Only the CDC, FDA, and AMA are allowed to do that.

I have been witness to the miraculous improvements served by childhood vaccinations. I recommend them to our patients; perhaps more diligently than might serve the ‘herd’, however, in susceptible individuals, doctors need to be very conservative. It shouldn’t be so complicated for the medical community to produce independent, prospective studies about the present vaccine schedule with 3 year follow-up aimed at developmental outcome, especially as it applies to higher risk infants.

No Winner is Declared
My advice is for Mr. Bruni to go back to his core competencies, Ms. McCathy to continue to fight for her child and help raise money for autism awareness-treatment-and-prevention, and for medical science to work on a better explanation(s) for this epidemic.

An agitator produces lots of heat with little light.
What a desperate mother does, is search for answers why her perfect, beautiful toddler became non-responsive and stopped talking.

Is Tamiflu for You?

Friday, February 7th, 2014

As a physician who cares for at-risk infants and children, I am frequently asked to weigh in on the topic of flu vaccine and the medication, Tamiflu.

Ever since the introduction of Oseltamivir Phosphate, an anti-viral preparation to ‘cure’ influenza, controversy has ensued. There are a number of websites that discuss the issue in detail, pro and con.

Forbes magazine, which generally takes fairly conservative positions, recently published “The Myth of Tamiflu“. The FDA doesn’t seem to have a problem with it; even recommending Tamiflu for infants as young as two weeks.

Consumer Reports, recently concluded, “Not unless you’re very sick with the flu or … are otherwise at high risk.” That respected medical journal’s opinion was to administer Tamiflu to the group that might get ‘sickest’ from the disease.

Cost(s):
A typical course has been reported to cost $120, more or less. For an entire family of 4 or more, it becomes fairly pricey.
Does Medicaid or insurance pay? If they are willing to cover (call, push buttons, and argue at your own peril), you may have to wait until the prescription is authorized; thus, mitigating the “at the earliest sign of the flu” advice. Co-pays can be more expensive as well, e.g. $25 or more. Keep your Tamiflu coupons handy.

Benefit(s):
Symptomatic relief occurring 1-2 days (out of 1-2 weeks of influenza) sooner is possible, but that is no certainty. The condition may not be the ‘flu’, the virus strain may not show responsiveness, or the patient waited too long to initiate treatment.
Additionally, I am sure that Roche has a ‘Days of Reduced Productivity From the Influenza Virus’ PowerPoint slide to persuade beaurocratic personnel that their concoction is worthwhile.

Risk(s):
Warnings listed in the Physician’s Desk Reference include:
• Severe allergic reactions.
• Serious skin reactions.
• Neuropsychiatric events, signs of abnormal behavior – how can you tell about this in your ASD affected child?
• Dyspepsia (upset stomach), with increased rates of vomiting – which is a common symptom in children, and many with autism.
• Diarrhea – another frequent physical sign in our high-risk patient population.
• “Caution in nursing” –  but it’s recommended if you’re pregnant? Also, most babies should be nursing; so, it’s OK as a liquid, but not OK in breast milk?

The Genentech website cautions:
“People with the flu, particularly children and adolescents, may be at an increased risk of seizure, confusion, or abnormal behavior early during their illness.”
“The most common side effects are mild to moderate nausea and vomiting, diarrhea and stomach pain.”

Conclusions:
So far, the risks appear to outweigh the benefits of Tamiflu. The cost seems high, considering that the drug only results in a possible, slightly shortened course of the flu. There are important lingering questions; including, whether there are fewer complications and deaths.

Long-term outcomes will have to wait until Tamiflu is used long term. This medicine was not available in the last century, begging the question of how there could be truly valid safety information when this antiviral is administered to a 2 week-old infant.

Recommendation:
Healthy older children and adults who exhibit the onset and suffering, or wish to prevent the flu in their virus-ridden environment, and can afford it, might give it a try.

My preference is to prescribe Tamiflu to those who are not pregnant, breast feeding, or very young children, in the hopes of preventing infectious transmission to those who are at increased risk for complications, without incurring the risks of the drug.

The greatest benefit that I see, is to the pharmaceutical company Roche,
and its member company, Genentech.

Autism Review 2013

Sunday, December 29th, 2013

Here is this year’s crop of stories (listed in Medical News Today) that I consider to be the most informative, interesting, and likely to change the knowledge base concerning the epidemic of childhood signs and symptoms presently called Autism Spectrum Disorder.

January
Can Children Lose Their Autism Diagnosis? – Uh, yes. And, many more than this group reports.
New Gene Variants Linked To Autism Discovered – The perfect storm of environmental toxins and susceptible individuals (genetic variation).
Epilepsy Drug Linked To Increased Risk Of Autism – The perfect storm of environmental toxins (medication) and susceptible individuals.

February
Feeding Problems And Nutritional Deficits A Significant Risk For Children With Autism – Ya think?
Attention Deficits Picked Up In Babies Who Later Develop Autism – The ‘Spectrum’ diagnosis involves a combination of signs and symptoms, not just the ‘core’ deficits.
Help Needed For Youths With Autism Spectrum Disorder Transitioning To Adult Health Care – Transitioning in general, don’t you suppose?
Autism Study Finds Behavioral Therapy For Children Can Impact Brain Function – So, the autistic brain can exhibit plasticity. Just like every other human brain.
Brain Connections Differ In Kids With Autism – There were lots of brain connection articles this year. The problem is understanding WHY the brains work that way, since it’s pretty obvious that some circuits are crossed and/or missing.

March
Study By Kennedy Krieger’s Center For Autism And Related Disorders Reveals Key Predictors Of Speech Gains – This is why it’s so important for kids to play with others.
Suicide Ideation And Attempts A Greater Risk For Autistic Children – Why doctors shouldn’t put teenage patients on anti-psychotic medications.
Old Drug Offers Hope For New Autism Treatment – This article covers it all; inflammation, immunity, the environment, mitochondria, stress and recoverability. It’s just in a mouse model, but offers a unifying theory.
One In 50 Kids Has Autism In U.S., CDC – And, we’re still arguing the ‘E’ word (? epidemic ?)
Gaze Shifting Delay Has Potential To Diagnose Autism At 7 Months – Plenty of research about earliest diagnosis, not much about how to intervene.
Multiple Vaccines Not Linked To Autism Risk, CDC – So they keep telling us.

April
Link Between Autism And Increased Genetic Change In Regions Of Genome Instability – The perfect storm… you get it.
Minocycline Show Benefits In Children With Inherited Cause Of Intellectual Disability And Autism – Some assistance for patients with Fragile X syndrome, one of the known causes of ASD.
Study Shows Different Brains Have Similar Responses To Music – Love of music is universal.
Propranolol Could Improve Working Memory In Autism – Several of the older blood pressure medicines perform in some fashion to help affected individuals.
Taking Valproate While Pregnant Raises Autism Risk – Drugs taken during pregnancy may not be good for the developing brain. Well, at least it’s in print now.
A Newborn’s Placenta Can Predict Risk For Autism – Now, there’s an early predictor! Again, what to do about it?
Significant First Step In The Design Of A Multivalent Vaccine Against Several Autism-Related Gut Bacteria – Formal recognition that there is a gut-brain connection in autism.

May
Researchers Successfully Treat Autism In Infant – OK, so maybe you can do something about the earliest red flags.
Early Intervention Program For Children With Autism Found To Be Cost Effective Through School Years – More documentation such as this is needed so that governments, insurance companies, and the like will take notice.
Link Between Epilepsy And Autism Found – The literature reports that 40% – 80% of patients have seizures (much lower at The Child Development Center, however).

June
A Third Of Autism Cases Also Have ADHD Symptoms – It’s not ALSO, it’s an integral part of the picture for some children.
Autism Discovery Offers Hope For Early Blood Test And Therapeutic Options – One of the reasons that I prescribe tryptophan (5-HTP) to address some ASD signs and symptoms.
Racial And Ethnic Disparities Found In Gastroenterology, Psychiatry Or Psychology Care For Children With Autism – Yeah, professionals need to get on the same page.
Air Pollution Raises Autism Risk - The environment. Again.
Single Mutation Can Destroy Critical ‘Window’ Of Early Brain Development – Genes. Again.
Autism In Children Affects Not Only Social Abilities, But Also A Broad Range Of Sensory And Motor Skills – Recognition of signs and symptoms that every parent of an ASD child observes. More such information was published subsequently.

July
The Gut May Offer Clues About Autism – By now, even pediatric gastroenterologists should be getting the message.
Autism Training Program For Pediatricians Meets ‘Critical Need’ For Earlier Identification – Until now, I don’t think that my fellow pediatricians are doing such a great job at early diagnosis.
First Full Genome Sequencing For Autism Released By Autism Speaks Collaborative – This kind of valuable information is why all of the parties in the autism community should work together, rather than criticize each other in public forums.
Early Intervention Benefits Young Children With Autism Regardless Of High-Quality Treatment Model – So, if early intervention helps, and we can make the diagnosis earlier, then the situation should be improving. Right?
Oxytocin not found to offer symptom relief in autism – A bunch of these articles this year, both pro and con. My experience is that it does help in a small percentage of affected individuals.
Fresh fuel reignites Asperger’s debate – Combining two conditions that we don’t understand – couldn’t that make us twice as ignorant?

August
Oxytocin, the ‘love hormone’ may have relevance in autism – This was one of the ‘pro’ articles.
New research sheds light on previously under-researched area of study – females with autism – We really need more information about the difference between boys and girls with ASD.
Induced labor linked to higher autism risk – Here is my advice (as a Board-Certified Neonatologist): Have the baby when the time comes. Sometimes, Mother Nature does know best.
Risk of autism in further children – study findings – This is the type of information that prospective parents frequently seek, and little is really known.

September
Young adults on the autism spectrum face tough prospects for jobs and independent living – This highlights why early diagnosis and intervention are so vital.
Genetic disorder 22q could be misdiagnosed as autism – Or, this could be just one of the causes of autism. No?

October
Improving understanding of brain anatomy and language in young children – This is the type of knowledge that needs to be elucidated as we try to solve this puzzle.
New cases of autism in UK have levelled off after five-fold surge during 1990s – Well, good for England (if it’s true). This is not the case in the U.S., or most other countries, however.
Autistic children look less friendly to peers – And, vice-versa, I would say.
Web-based autism intervention tool shows promise – Lots of tech stuff for autism appeared this year. I still like Proloquo2Go the most.
Link examined between pregnancy weight gain and autism spectrum disorders – An even EARLIER diagnosis. How about a fetal Speech and Language therapist?

November
Health-care changes needed to help adults with developmental disabilities – Much more information needs to become available to address the growing numbers of older individuals with autism.
Autism increases risk for synaesthesia – Maybe shedding some light on the sensory issues in ASD.
Relationship between bedroom media access and sleep problems among boys with autism – As if parents didn’t know this! Well, it’s official, now.
Gender differences in gene expression in male and female brains – I’ve described this clinical difference before. There’s the “girl kind”, and the “boy kind”.
Autistic children’s ability to perform everyday tasks improved by occupational therapy – This one should help with insurance reimbursement.

December
Genes and air pollution combine to increase autism risk – Circling back… genes and the environment.
Brain function in children with autism improved by a single spray of oxytocin – It works. It doesn’t work. Which is it?
Autism-like behaviors in mice alleviated by probiotic therapy – Human probiotics, by the way.
Research linking autism symptoms to gut microbes called ‘groundbreaking’ –  Well, it’s important, but groundbreaking? This association has been ‘documented’ since the “Refrigerator Mom” days.
Hospital infection in pregnancy tied to higher risk of autism – Perhaps it’s the antibiotics that are given, not the infection itself?

Hopefully, 2014 will bring more in-depth research with targeted treatments, so parents will have an increased number useful protocols to assist their developmentally challenged children.

The Different Kinds of Autism

Sunday, August 11th, 2013

When medical science finally settles on more precise terms for the epidemic that is presently called ASD, we should also be able to recognize and appropriately treat the various expressions of the disorder. This is important as it relates to interventions that address specific problems, such as in the G-I tract, and their downstream consequences, such as disruptive behaviors. The categories are not exclusive, the list is far from complete, and I hope to expand on this topic in the future.

1. ‘Typical’ (present from the earliest stages of development) and Regressive types. I’m not so sure that the only difference isn’t timing; i.e., when the patient became affected. Parents may be more likely to identify the latter type in association with childhood vaccinations. Otherwise, there aren’t big differences in presentation or the ability to diagnose underlying problems that are amenable to treatment.

2. Girls and Boys. There is a difference because of the amount of aggression in many boys, and the relative lack thereof in the majority of girls. This was previously discussed here.

3. Major system involvement, including:

The G-I system is the most glaring problem. This has been written about at length, and throughout this website.

The CNS shows significant involvement. There could be seizures, staring spells, or other unexplained motor episodes. Treatment may involve anticonvulsants and often becomes fairly complicated.

The immune system is the presenting problem. Some patients have eczema covering their entire body, others may have asthma and many have frequent infections. Laboratory tests may identify an over- or under-functioning ability to clear inflammation. Enabling the patient to achieve better health often helps lessen or even ameliorate behavioral and other ‘autistic’ disturbances. The disorders known as PANS/PANDAS appears to be consistent with such impairment.

The muscular system functions inefficiently; as evidenced by low tone, poor chewing, clumsiness, extremely flat feet and/or poor posture. When patients can tolerate oral glutathione and subcutaneous methyl B12, there is often significant improvement in not only OT, but S&L as well.

4. Variations due to age at diagnosis and intervention. Evaluation and treatment is different for toddlers, adolescents or adults. As patients get older, more patience is required and the coping skills of the individual become more important in addressing and assessing therapies. The age at which children continue to suffer apraxia is especially important. Imagine the difference in outcome for children who have no speech even by 3rd grade as opposed to youngsters who only experience a 1- or 2-year delay.

5. ‘High-‘ and ‘low-‘ functioning individuals. I object to these terms because they are pejorative, judgmental and inaccurate. After all, there are plenty of ‘low-functioning’ neuro-typical people! Many patients have a great deal more awareness and skill than is apparent. More correct designations would be disruptive, aggressive, “extremely sensory” or “prone to wander.” Understanding and treating any identifiable underlying abnormalities often leads to significant functional improvement.

6. Patients who present with genetic variations. There are major problems, such as children who have Fragile X (males) or Rett’s (females) syndrome. Less obvious are copy number variations that may confer an inability to detoxify. Very small changes in genetic information magnify in importance as our environment becomes more polluted. This has been discussed in more detail here. Most of the time, there are no identifiable abnormalities.

7. Significant metabolic abnormalities, evidenced by under-functioning mitochondria, or out-of-range fat, vitamin or mineral levels. Such variations require investigation, and are often amenable to supplemental intervention.

8. Those who look as if they escaped traditional ASD. There is a small percentage of patients presenting to the Child Development Center of America who are brought in by the parents because of behaviors that, “You just can’t put your finger on.” Although these children may not have the traditional criteria of social isolation, repetitive behaviors and speech and language delay, they have other associated difficulties with hypotonia, poor sleep or frequent infections that have resulted in developmental challenges that are often characterized as either anxiety, focus or both.

It is neither fair nor accurate to state “‘DAN!’ doctors all do the same thing for the patients.” Any professional will have a starting point based on the chief complaint that is specialty-specific and subsequent treatments and labs depend on the response to the first line of treatment. Based on just these categories described above, and the doctor’s experience, there are a number of routes and variations that the workup and ensuing interventions might follow.

Families need an experienced practitioner to recognize the different presentations of autism in order to make sense of the complex matrix of signs and symptoms and to offer appropriate, effective, reasonable, reproducible and verifiable results.

 

More Vaccine Issues

Sunday, July 21st, 2013

This website is written to assist parents in making sense of the millions of ‘informational’ pages advising about the epidemic of ASD and ADHD. At The Child Development Center, childhood vaccinations only play a small part in the chief concern for the vast majority of our parents, and in the rest of the world it seems to present a major issue, so I write about this subject occasionally. However, just after my previous post on this topic, a research paper was published that begs my further attention. It appeared in the respected medical journal, Pediatrics, and is entitled Sick-Visit Immunizations and Delayed Well-Baby Visits.

The point of the article is that, when parents fail to follow the recommended immunization schedule because of a child’s illness, they are less likely to complete the full series (and so, be more vulnerable to preventable diseases). The implication is that, perhaps the ‘shots’ should be given anyway. “The substantial risk that infants will not return for a timely makeup well-baby visit after a sick visit should be included in any consideration of whether to delay immunizations.”

Nowhere in the discussion and conclusions that followed were the issues of fever, febrile seizures, or any developmental followup covered. The is no mention of how high a fever might be tolerable, whether the child was exhibiting other symptoms such as vomiting or diarrhea, the presence of fevers with previous vaccines, or what to do if there were any complications. Even in the full text, there is no advice to signify to parents that ‘vaccination anyway’ is not a recommended course. That isn’t necessary, I guess, since the lack of association between these toxins and autism is already a given for this vaccine Program Director (not a physician), who recommends AGAINST the AAP. Where are the ‘Champions of the Pediatric Way’ standing up to proclaim, “Wait, there is no research about safety and outcome to support your position!”

Such lopsided opinions by professionals are insensitive at best and ignorant at worst, and only serve to enhance the polarization of pro-vs.-con vaccination discussions. Here is some helpful advice to a family / physician who is trying to make sense of the immunization quagmire:

  1. ‘We could get ‘titers’ (levels of antibodies to diseases that the person already possesses) to see which shots are necessary.”
  2. “We could get a blood count and some blood studies to make you feel more comfortable about your decisions.”
  3. “We could take a more detailed history, including sleep, bowel function, eating problems incl GERD, frequent formula changes, other information that the modern mom knows and consider risk in this individual child vs. chance of significant exposure/disease in this child and try to let the present improvement play itself out.”
  4. “We could be part of a medical team that considers other experts, including the parents, in the decision about individuals.”
  5. “We could try to give as few at one time as possible (and, btw, MMR=3, not 1).”
  6. “Let’s talk about your particular child and your concerns and see which vaccinations are most important at this time and try to give the rest in as timely manner as possible.”

Here is my proposal regarding this piece of research:
Let’s do a randomized, controlled, prospective study of babies who get get treated with vaccinations while they are sick (no matter how sick), versus children who wait until they are well, and see if there are any side effects, such as high fever, seizures, other allergic disorders, or ASD.
Who wants to be in the ‘vaccine anyway’ group?

The Vaccination Issue

Saturday, July 13th, 2013

I write this essay with great care and some trepidation, lest readers believe it to be either specific medical advice to patients, or sedition by the minions who worship Big Pharma. Any professional involved in this ASD epidemic can’t help but notice the number of parents who are certain that their beautiful child became harmed shortly after exposure to some vaccination. Traditional medicine remains convinced that any association with delayed childhood development is purely coincidental.

The twentieth century ushered a truly successful attack on feared diseases that gripped previous generations. Most of the well-accepted literature apparently supports the vaccinations, the present schedule, and most importantly, the lack of association with childhood developmental delays such as ASD.

However, I have become increasingly concerned about the quality of the information that the public is served by our government agencies. In giving advice to a national organization, CDC Committee member Dr. Mark Sawyer advised, ““We run the risk of contributing to the already present lack of full immunization if we stress too much on adverse events.”

Querying problems related to childhood vaccinations yields numbers as high as 18% “adverse events” in literature that supports the MMR. Further exploration about the presence of a febrile seizures (fevers are a frequent complication of vaccinations) as it relates to the risk of autism leads to more confusing information. How can pediatricians counsel that we know what we are talking about following the ‘Swine Flu’ Fiasco?

I don’t have a TheAutismDoctorVaccineSchedule.com website. I believe that, in today’s toxic world, it is possible that some vaccines have led to, or triggered, behavioral diagnoses in susceptible fetuses and infants. In my skewed population, only 1/20 parents harbor that impression. Over 90% of our families either aren’t sure, or do not feel that it was the cause of their child’s (children’s) condition.

Our approach is to evaluate the family and the individual child upon whom the traditional vaccine schedule is about to be foisted, and make decisions based on present health, risk of illness, and risk of interfering with recovery. What are the child’s red flags? How old is the child and when did symptoms begin? How severely affected is this patient? What are the present primary behaviors and is the child improving? What other conditions does the patient exhibit? Are there any affected siblings or cousins? Has the child had any recent illnesses, and were there any unusual reactions to previous ‘shots’?

Let’s take the poor parents, who have no idea about the correct vaccine course for their precious offspring’s present and future health, out of the debate, and ask your doctor’s opinion:

Little Johnny is 39 months old. He had loss of eye contact and disappearance of some late babbling in the month following a 15 month set of vaccinations including an MMR. Recently, he has been doing well in therapies, especially S&L, OT, and ABA. The child also happens to be followed by a holistic pediatrician, using a unique workup and simple medical interventions to address his autistic signs and symptoms – those same concerns that, last year, you dismissed.
Anyway, lately, Little Johnny has woken up from the fog, started to exhibit an increased level of speech, is interested in toys and other children, and shows genuine signs of improvement for the first time in what seems like years (well, it is a lifetime).

Should he get his booster shots now? Don’t try to argue with the professionals who would have you belittled, even by their staff, for being so ignorant as to question Medical Science. Just present this case (or explain your child’s particular issues) and ask god what he would do if this were his child. Better yet, ask god’s spouse.

Chelation Therapy for Autism

Saturday, July 6th, 2013

I routinely check autism websites and chat groups to gauge the landscape and better understand the community of families seeking relief from this devastating epidemic (and if you don’t think that autism is an epidemic, you have been living on Mars). On one listserv, a parent recently wrote, “I’m looking to start chelation on my daughter. Can anyone recommend a good DAN dr?” This request and the several responses that followed have led me to want to further explain my position about this popular autism treatment.

The first issue that I wish to comment upon is the precarious position that families are facing when THEY are the ones asking for specific treatment regimes, rather than seeking knowledgeable physicians who can offer various options their children. This is entirely the fault of the medical community who have been so slow to recognize and respond to the condition. When the only explanation for the child’s condition is that “It’s genetic” and the only treatment is “Find some good therapists,” desperate caregivers are sure to explore other options.

What parent of a child who has leukemia, for example, seeks out doctors for radiation treatment, even though the experts may counsel that chemotherapy is preferable? Sure, a sufferer of prostate cancer may choose microsurgery over radioactive seeds. But that is because there is an abundance of choices in a well-known condition, with documented evidence of outcomes in the various treatment alternatives. The patient in that case may wish to choose preservation of function over decreased risk of recurrence. Given so few choices for ASD, and so much information appearing on Internet websites, chelation will surely seem to be a reasonable treatment. The fact that the conventional scientific community is either ignorant or dismissive about removal of poisons only serves to steer the concerned family toward a different medical option.

We live in a toxic world. There are 85,000+ substances in the air, food and water that were not present (or only present in small amounts) in previous centuries. Unnatural material gets into fetuses as they develop, and the fragile infants and children have become the ‘canaries in the coal mine‘. On one hand is the growing number of children with ASD and ADHD and on the other hand is our poisoned environment – and medical professionals don’t see the relationship? Exposure to pollution and increased risk are reported over and over. There shouldn’t be an argument about this any longer. Which poisons, various combinations, at what levels, and the timing of the exposure(s) upon which susceptible individuals should be the subjects of intense study and treatment options.

There is more than one way to get rid of heavy metals. Chemicals are how we got here, so perhaps using chemicals such as DMPS, DMSA, or EDTA may not be the best method of detoxification. The body has a better way. It’s called glutathione, which is a natural protein that detoxifies – and not only metals, but all of the products that enter our body and cause tissue damage or prevent recovery. I have been using an oral glutathione preparation for years that is both safe and effective. There are various discussions about the ineffectiveness of the oral form, but The Child Development Center has seen over 1,000 children improve both signs and symptoms of their autism. Likewise, there is debate about increased yeast growth with such a preparation. However, antibiotic overuse is one of the most suspicious roads to the present epidemic, and anti-fungal treatment is often a successful method to treat that unnatural imbalance of gut flora.

The bottom line is not whether or not I am a fan of chemical chelation. What is most important is whether there are safer, less expensive, less invasive and more effective means to arrive at the same goal of detoxification to decrease the disorders and maladaptive behaviors that we call autism.

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Brian D. Udell MD
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