Dr. Rust testifies in the Autism Omnibus Hearing

22 May

Today Dr. Robert Rust testified in the thimerosal-only causation portion of the Autism Omnibus Proceedings. Dr. Rust also testified in the Hazlehurst case regarding the combined MMR-thimerosal causation hypothesis. You can find Dr. Rust’s testimony in the Hazlehurst case in the Day 3 transcript from that case. Today is “Day 8” of the thimerosal portion so you can look for the “Day 8” mp3 files on the US Federal Court website.

Dr. Rust has some impressive credentials. He is the Thomas E. Worrall, Jr. Professor in Epileptology and Neurology, and Professor of Pediatrics at the University of Virginia. He had a residency in Pediatrics at Yale University and in Child Neurology and neurochemistry at Washington University in St. Louis. He also had a fellowship in Neurochemistry, Neonatal Neurology, and Brain Metabolism, at Washington University. A University of Virginia website says that he has clinical interests in epilepsy, headache, neonatal neurology and degenerative disorders.

Dr. Rust had a lot of material to cover in his testimony. It seemed to me that he was trying to cover a semester or two’s worth of neurodevelopment and neurophysiology in a couple of hours, trying to keep it simple enough for the needs of the court, and yet detailed enough to make some critical points about how neurons, microglia and astroglia work and discussing what is known about regression in autism and what might cause it. He also discussed some of the particulars of the medical records of William Mead and Jordan King. Their main DAN! doctor is Dr. John Green III of Oregon. Dr. Green is a favorite DAN! doctor as was made clear in the testimony by Jordan King’s mother. She said something like seeing Dr. Green was “invitation only.” No doubt. Many of the lab tests discussed were ordered by Dr. Green, and many of the therapies the boys had were ordered or administered by Dr. Green, including one very traumatic IVIG infusion Mr. Mead described his son enduring.

Bogus lab tests are a huge problem in autism “biomedical” therapies. Not that all of the lab tests used by all DAN! (Defeat Autism Now!) doctors are bogus, but it sure seems like many of those that parents share with the public are highly questionable lab tests such as hair analysis for heavy metals, and urine heavy metals lab tests from one particular lab that was mentioned several times in the testimony. For instance, an image of one of these very lab tests was used as an illustration at the top of a blog entry on a certain autism hysteria promoting group blog recently.

When Dr. Mumper testified she commented about how one of the boy’s lab results had this extremely high level of tin while the other metals were in a normal range. (Keeping in mind that the “normal ranges” on these tests are nearly arbitrary and don’t have much to do with real world levels of anything in healthy or sick autistic children.) Dr Mumper acted as if this was not that weird and she said a couple of times, at least, that when they see such a high level of tin in a child she will ask the parents if the kids are eating a lot of toothpaste or drinking a lot of juice from “juice boxes”. She didn’t offer a specific therapy for “tin intoxication”, whereas if mercury had been that high they no doubt would have all been sobbing over the horror of it all. At any rate, Dr. Rust made an interesting point that high levels of tin are almost unheard of and to get a high enough level of tin to affect health, it basically takes a decade or two of working with tin every day where the tin is exposed to heat and is creating tin vapor and a worker is inhaling it. This didn’t reflect well on the quality of that lab’s tests, or on Dr. Mumper’s ability to think critically about such things as lab test results, in my opinion.

The following is a very rough transcript of one portion of Dr. Rust’s testimony that I found very interesting. I don’t know if the Dept. of Justice lawyer was Ms. Renzi, but I think it was, so I’m using her name for the time being. [Edit: The DoJ lawyer was Ms. Esposito, not Ms. Renzi. This portion of the audio transcript is found in the 2nd file on day 9 the following part is found around a 30 minutes into that recording). The words I added in parentheses are not direct quotes but gives the meaning of what was said. I can’t type that fast and so as I was taking notes I didn’t transcribe portions of it word for word, but got the gist.

Ms. Renz Esposito: I’d like to discuss some of the treatments given to these children.

Esposito:: (Can you tell us if) IVIG therapy (is helpful in autism?)

Rust: t’s been tried along with it’s cousin corticosteroids, but no improvement has been seen bahaviorally, functionally or with EEG.

Esposito:: (Can you tell us about the) supplements (given to William Mead and Jordan King?)

Rust: We don’t hear about most of them probably, to the extent that there is data (these supplements don’t help), to the extent that parents tell us what they are using.

Esposito:: Secretin?

Rust: Secretin was found not to be effective

Esposito:: Chelation?

Rust: I’ve seen no evidence that chelation is helpful in this setting…. (recalls when kids with lead poisoning were chelated in a clinic/hospital where he work) considerable pain it caused. Children would be screaming on the way into chelation.

Esposito: Saunas?

Rust: Saunas can help with headaches and stress and tensions but in autism there is nothing to sweat out except some of the notions about treatments that have been offered to the child.

Esposito:: Dr. Green’s therapies…. (for William Mead or Jordan King) included an implantation enema, ideally with a colonic delivery system, using maternal fetal [fecal?] supernate…

Rust: So far as I know that the approach has been around since Roman times, …. used to be a regular feature of childbirth.

Esposito:: Feeding a child fermented vegetables?

Rust: …(doesn’t change autism)…

Esposito: Earthworm eggs?

Rust: No known benefit that I’m aware of. (The discussion changed to something about herbal treatments.) I had a patient with seizures, the parents gave a Chinese herbal (medicine). The Chinese botanical was interesting. We were astonished (the child had a striking improvement in seizures) , we sent a sample of it to a lab and found out it was phenobarbital.

Esposito: Charcoal?

Rust: (No reason to think it would help)

Esposito: Oral baygam (oral immune globulin)?

Rust: I have no information about that.

Esposito: Valtrex?

Rust: I don’t know any reason to think it would work. (a little later he added that Valtrex is a drug used to treat herpes infections.)

Esposito:: Are you familiar with Eskimo oil?

Rust: (slightly amused) No I haven’t heard of that.

Esposito: Actos?

Rust: (I don’t know of any benefit for autism.)

Esposito: If there were a report of improvement would you extrapolate that there was a cause of autism.

Esposito: Is it standard practice to prescribe something to patients and then sell it to them?

Russ: (A doctor’s obligation to the patient) is to listen without repeating their problems… (not to sell the patient treatments) … to keep an office of Amway products. It trades on the prestige we have and the reliance that the patients have on us. It is one of the most grave violations of our code of ethics.

Esposito: Do you prescribe these things?

Russ: No …

Esposito: Do other neurologists prescribe these things?

Russ: No …

The “implantation enema” as I understood it, that was recommended by Dr. Green for one of the boys
was a “fecal enema“.

Specifically, again as I understood it, what was recommended was to take some of the boy’s mother’s feces and mix it with water and infuse that into the boy’s colon or something. From Dr. Rust’s response I got the feeling that he didn’t understand that this particular enema wasn’t just a water enema, but that the idea was to put the germs from the mom’s feces into the boy’s intestines.

Now I thought Dr. Rashid Buttar’s urine injections were bizarre. This one ranks right up there, though, for sheer gross-out factor. And how about those “earthworm eggs”? It’s possible that what Ms. Renzi asked about was “whipworm eggs.” Perhaps I heard what she said wrong, but it sounded like “earthworm eggs” [edit: She said “earthworm eggs”]. Taking pig whipworm eggs orally is an alternative therapy for Crohn’s disease, apparently. I remember reading somewhere that a mom asked Dr. Andrew Wakefield what he thought of giving autistic kids worms to treat their gut problems. He was quoted by that mom as saying that he didn’t think it would work for autistic children’s guts.

I encourage everyone to listen to the recordings of the autism omnibus and to read the transcripts, they are very educational. One can learn a lot about the ‘therapies’ being offered to parents of autistic children as well as some of the best of the best of the science that is known about autism. I don’t agree with everything the experts are saying, such as when Dr. Rust called autism a “disease”, but it’s still very interesting listening if you are at all interested in autism.

13 Responses to “Dr. Rust testifies in the Autism Omnibus Hearing”

  1. Kev May 22, 2008 at 07:57 #

    Fecal enema?

    I really thought I’d heard it all….IV garlic/vinegar chelation, urine injections and now fecal enema’s.


  2. Ms. Clark May 22, 2008 at 09:49 #

    Can you picture a mom handing over a sample of her feces to be mixed (how? in a blender?) with presumably sterile water, or maybe it doesn’t matter if the water is sterile, maybe it’s tap water minus chlorine (don’t want to kill off the good germs in mom’s waste, now)… then… what? They fill some enema bags with the slightly brown tinged water?

    Seriously. Ick.

    But what about those pig whipworm (or earthworm) eggs. I understand that there is a modicum of real science to support the idea that some kinds of intestinal worms can have a beneficial effect, but still how does one get past the idea that one is about to swallow live worm eggs? I guess one does not tell one’s child what is in the drink or pill… but still. Ick.

    As for “Eskimo oil,” one can only hope that no Eskimos were harmed in the production of it.

    The oral immune globulin thing is really weird. They make IG by pooling large amounts of purchased blood and then they filter out the antibodies and do what they can to clean them of viruses and maybe prions, and then sell it. As far as I know the only effective kind of IG is given intravenously. It’s very expensive. The point of using it is that all those people they took the blood from would have made antibodies to many different kinds of antigens and the people who receive the IG can benefit from it if they aren’t making enough antibodies of their own.

    But antibodies are just a very fancy protein, and if you eat them they ought to get digested the way any protein would, and if they get through the stomach, one would think that they’d just keep going rather than entering the blood. Besides there could be infectious agents in the IG (oral or IV) that could cause the child some serious problems. I would guess that it would be expensive, too. So… from what I have gathered from talking to a doctor about it, it seems like a totally crazy idea.

    Of course, somewhere there’s a parent who will swear that one of these therapies was THE thing that helped his or her child make a significant step forward toward recovery.

    Dr. Rust spent quite a bit of time explaining “regression toward the mean” (though the didn’t use that term). He explained that when problems arise people move to fix the problem and frequently, soon after some remedy is tried, the child gets better (or the parents are full of hope so they think the child is better, while others can’t see the improvement). But since so many disorders are cyclical one can’t always tell if the problem was going to get better again anyway. He said in the case of epilepsy, sometimes when the epilepsy comes back they up the dose of the medication, and again when the epilepsy comes back (fairly predictably) they up the dose again, but it can be an illusion that that medication is doing any good at all. Instead there is a waxing and waning of the symptoms.

    The same can happen in autism with “autistic” behaviors. Dr. Rust expressed concern about the therapies that are favored by autism alternative practitioners that they can be dangerous and of no real use.

  3. Ivar T May 22, 2008 at 10:10 #

    I recall having seen this “Dr. Green” on some funny secretin-advocating online page.


  4. Ringside seat May 22, 2008 at 13:29 #

    Leo Kanner gave a very clear report of how his child patients, in the very first autism series, mostly improved as they got older. Recommended reading for anybody (a) getting fleeced, or (b) feeling down about hope for the future.

    What the quacks do is pull out the cases where children make gains, and claim that it was some expensive product/service which has been sold to the parents is what accomplished this.

    If a child receiving an expensive product/service doesn’t appear to make gains, well, they are sold another expensive product/service, or sent on to some other quack on the network, until eventually nature takes its course, or the parents run out of money.

  5. kristina May 22, 2008 at 16:21 #

    I am just trying to sweat out the quackery being described.

    It was bad enough when, in our “DAN! experience,” I was looking through the testing for the Great Plains lab or one of those DAN!-labs and read the instruction for collecting stool samples. (I think–think—they kit included a latex glove, very helpful.)

    I am quite convinced that raids of Chinese herb shops by DAN! practitioners will be happening next (if it has not already) and tiger balm and deer hooves will be next (my grandmother did make something from the latter, but nothing about curing anybody from anything).

    Good to hear you posting, Ms Clark!

  6. Ms. Clark May 22, 2008 at 20:11 #

    Ivar T, that’s a different doctor, but thanks for linking to it.

    Ringside seat, Dr. Rust really covered the idea of the parents being given false hope and the children being experimented on. It was refreshing to hear it being said.


    Thanks for the compliment and for sharing your experience. One of my older Chinese friends was very impressed with the fact that one of my relatives in Montana had deer meat to eat(venison). I think she said that eating it would make a person strong. She might have been disappointed that the hooves had been thrown away when the deer was butchered, but she didn’t say so. 🙂

  7. Ms. Clark May 22, 2008 at 22:38 #

    I am listening to the audio recording of this portion of the testimony (with the earthworm eggs and sauna’s etc.). I edited some of the blog entry to correct a few of the things I was guessing at. The DoJ lawyer seems to have been Ms. Esposito, not Ms. Renzi.

  8. Kristina May 23, 2008 at 02:04 #

    If I can be a bit OT—-my grandmother actually bought the deer hooves in China in Toisan when we visited in 1993. She got stuck in Customs with them……

    So it is earthworms? It’s starting to feel like middle school science.

  9. Ms. Clark May 23, 2008 at 04:45 #


    Perhaps the earthworm eggs are meant to be a substitute for deer hooves…

    Obviously, earthworms can’t live in the intestines, so one wonders if Dr. Green had accidently written “earthworms” or if Ms. Esposito was reading a handwritten note and maybe couldn’t decipher Green’s handwriting.

    Ms. Esposito read “fetal” where it was supposed to be “fecal” when referring to the fecal implantation enema thing. So maybe it’s bad handwriting. ???


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