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Desiree Jennings back in the news

26 Jul

Remember Desiree Jennings? She was a cheerleader ambassador for the Washington Redskins who claimed that a flu shot gave her dystonia. She was highlighted by the Age of Autism blog and by Generation Rescue, who connected her with alternative medical practitioner Rashid Buttar. Mention of Desiree Jennings has been removed from the Generation Rescue website. Neurologist and blogger Steve Novella discussed how her case more closely resembled a psychogetic disorder. Dr. Novella’s take on the case prompted the American TV show Inside Edition to take a second look. We discussed the Jennings case then here on LeftBrainRightBrain as Successful blogging by Steven Novella: the Desiree Jennings story
.

Now the TV Show 20/20 has taken a look a the Desiree Jennings story in Medical Mystery or Hoax: Did Cheerleader Fake a Muscle Disorder?

First, one must stress that many people following this case have not been calling out “hoax”. A psychogentic disorder is quite real, just not dystonia and not physical.

That said, here is the trailer for the 20/20 episode:

http://abcnews.go.com/assets/player/walt2.6/flash/SFP_Walt.swf

I find the beginning to be really cheesy. The way they took the video to make it look like it was some film taken decades ago was, well, cheesy. Ms. Jennings is less than 30 years old. Somehow I doubt her wedding was recorded on film and, even if it was, it wouldn’t be so deteriorated in a few years. But, we get the idea–the wedding was in the past.

Ms. Jennings has been used as an example of how successful Rashid Buttar is. One article, copied to Dr. Buttar’s blog, states that shortly after beginning treatment with him:

The good doctor ran to his patient, fearing she had suffered another seizure but instead was elated to find that she was awake, coherent and carrying on a normal conversation with the nurses and her family. By the next day she was walking the corridors with limited affliction. (See the video at: http://www.desireejennings.com.) The AMA has remained silent.

(note–www.desireejennings.com is no longer active).

But just as she was leaving Dr. Buttar’s clinic on her last visit in December 2009 — with “20/20’s” cameras rolling — it all seemed to fall apart. Jennings was in distress again. She could no longer walk forward, and had to be taken out in a wheelchair.

In the early discussions of Ms. Jennings, much interest focused on the idea that she was diagnosed with Dystonia by doctors at Johns Hopkins. People complained that Dr. Novella shouldn’t make statements that contradicted doctors who actually saw Ms. Jennings. The 20/20 story states:

In search of a cure, Jennings and her husband Brendan visited countless doctors and four hospitals, among them Johns Hopkins Hospital. There, a rare movement disorder that causes the muscles to twitch or convulse involuntary. The symptoms resembled her own.

“a physical therapist told Jennings about dystonia”. That’s a bit different from a doctor diagnosed her with dystonia.

Yes, this isn’t about autism at all. But this story does shed some light onto groups like Generation Rescue who supported Desiree Jennings, sending her to Dr. Buttar. The story was compelling for them, even though it was not about autism. It was about alleged vaccine injury. Generation Rescue appears to have abandoned Ms. Jennings now. It sheds light on Dr. Buttar, whose claims of recovery for Ms. Jennings appear to be unsupported by the facts. Dr. Buttar is one of the more prominent names in the alternative medicine community marketing their services to the autism community.

Transcripts of the Rashid Buttar hearings–a peek at how alternative medicine treats autistic children

4 May

Dr. Rashid Buttar was recently reprimanded by the North Carolina Medical Board. The reprimand was basically a slap on the wrist. A weak one at that.

The inquiry into Dr. Buttar discussed a number of his patients. One, patient E, was autistic. Dr. Buttar has allowed us to read about his practice by posting the testimony from the hearings.

This, from the opening statements for Dr. Buttar’s hearing:

Patient E is a pattern-in-practice patient. Patient E is an eight-year-old school girl who is severely autistic. Her mother contacted the Board after receiving a solicitation from Dr. Buttar to support him in this matter.
Like the ?- like the cancer patients, Patient E’s mother came across information that Dr. Buttar could help her child’s autism. And without ever seeing the doctor, without ever traveling to North Carolina, Patient E was sent a kit to ?- to basically self-administer a chelation therapy on her own daughter.
And when things started going ?- deteriorating for Patient E, Patient E’s only interaction with Dr. Buttar was through his nurse practitioner or other staff members in his office.
And the nurse practitioner who essentially, from the medical records, as you will see, made all decisions about the treatment and diagnosis of this child’s autism across state lines without personally seeing the patient, has no formal training in autism or oncology, much like Dr. Buttar who does not have any formal training in oncology or autism.
Yet, nonetheless, they convinced Patient E’s mother to take the child off of her medication so that he can apply a transdermal chelation cream on the child. A cream, not so coincidentally, that is developed and invented and sold directly by Dr. Buttar to his patients.
The mother did as instructed and took her daughter off her medication and applied Dr. Buttar’s transdermal chelation cream. Her daughter began to deteriorate. The child began to have violent tantrums. She couldn’t leave the house or attend school. During the weeks and months as the child deteriorated, Dr. Buttar never followed the child.
And when the mother did not get a satisfactory responses to her concerns, she called the office, made an appointment to see Dr. Buttar and drove her family to North Carolina. However, when she got to North Carolina, she did not see Dr. Buttar, only the nurse practitioner.
And the result of that meeting was that the nurse practitioner attempted to convince the patient ?- the patient’s mother that the child needed to be converted to a more aggressive intravenous form of chelation therapy.
The evidence will show that Patient E’s situation mirrors that of the other patients. Little or no physician involvement with the patient. Patients are seen primarily, if not exclusively, by the nurse practitioner. The patients have serious illnesses and Dr. Buttar and his nurse practitioner have no formal training in those illnesses.
The patients are prescribed expensive treatments that come straight out of their pocket because insurance does not pay for the treatments. The treatments are arbitrary, one size fits all. They have no basis or evidence of science. The therapies are ineffective and not been subjected to clinical trials and are potentially unsafe.

Dr. Buttar did not see the patient. She was in a different state, after all. But, her mother drove her to North Carolina to see Dr. Buttar and he still didn’t see her?

Without seeing her, he took her off her other medications and gave her his own–and she became worse.

Here are sections from the actual testimony.

Q And your daughter never made a personal visit to Dr. Buttar’s office prior to these treatments?
A That’s right.
Q When you had these telephone consultations with Dr. Buttar’s office, did ?- was it with Dr. Buttar?
A No.
Q Who was it with?
A With Jane Garcia.
Q And who is Ms. Garcia?
A I understand her to be his nurse.

Dr. Buttar was not in contact with the family. His nurse practitioner was handling the case. Remotely. Without seeing the patient.

Q Okay. Did Ms. Garcia ever make any recommendations about what to do with your child’s medication she was presently on?
A Yes. She insisted that we remove my daughter from the medication or they would not pursue the treatment.
Q What medication was your daughter on?
A Lexapro for anxiety ?-
Q And ?- and how long did ?- how long had your daughter been on Lexapro?
A About a period of a year.
Q And who prescribed that Lexapro?
A Her local pediatrician.
Q Did Dr. Buttar’s office consult with your local pediatrician when they recommended that she be taken off Lexapro?
A No, they did not.
Q And at some point what happened to your daughter after she started ?- after you started self-administering this chelation cream?
A Initially, it was uneventful, but she began to deteriorate, regress is how it’s referred to, and the regression was extremely significant. We were unable to even get her to come out of the home when she had previously been very social and happy. She wouldn’t wear clothes. She was no longer sleeping through the night. She wasn’t eating properly and she was extremely restless.
Q Okay. And did you consult Dr. Buttar’s office about these issues?
A Absolutely.
Q And what was the response?
A That we just needed to continue because this was to be expected, that she was moving metal and that we just needed to keep doing what we were doing.
Q Okay. And ?- and did you continue to do that?
A Yes.
Q And at some ?- and how did your daughter respond even after you continued the ?- the treatments?
A She just continued to get worse.
Q And at some point did ?- what did you do after that?
A Well, we had made an appointment to come to the office in person and we had hoped at that point, with an in-person physical examination by the doctor, we would get some remedy and advice for the significant amount of deterioration we were experiencing.

Dr. Buttar’s office pulled the young girl off of her anxiety medication. They had the family apply a trans-dermal chelation cream. The girl started to “deteriorate”

Q And I’ll read to you a note and ask you to comment. It says: Discussed plan with Jane, concur on issue regarding Lexapro, reassess patient that worsening is to be expected due to Herxheimer’s response and due to mobilization. Due to age consider IV challenge for best metal yield.
Is that when you talked ?- is that when you and Dr. Buttar’s office began talking about ?-
A I’m sorry, can you repeat that? My phone calling interrupted.
Q I’m sorry. It says: Discussed plan with Jane, concur on issue regarding Lexapro. Is that when you had a conversation about taking your child off Lexapro?
A Yes, but I hope that’s not referring to me concurring.
Q Okay. And above that there’s a typed note that says: Plan to wean off Lexapro, discussed with Dr. Buttar.
But is ?- were you having conversations with Ms. Garcia to take your child off Lexapro and then start this chelation therapy for your child’s autism?

Dr. Buttar suggested a “challenge” chelation test. Here is what the Americal College of Medical Toxicologists has to say about “challenge” testing:

It is, therefore, the position of the American College of Medical Toxicology that post-challenge urinary metal testing has not been scientifically validated, has no demonstrated benefit, and may be harmful when applied in the assessment and treatment of patients in whom there is concern for metal poisoning.

I guess I am curious as to why Dr. Buttar thought an IV chelation was needed for the challenge. If his trans-dermal cream chelates, shouldn’t that be sufficient?

Q I’m sorry. It says: Discussed plan with Jane, concur on issue regarding Lexapro. Is that when you had a conversation about taking your child off Lexapro?
A Yes, but I hope that’s not referring to me concurring.
Q Okay. And above that there’s a typed note that says: Plan to wean off Lexapro, discussed with Dr. Buttar.
But is ?- were you having conversations with Ms. Garcia to take your child off Lexapro and then start this chelation therapy for your child’s autism?
A Yes, we had discussed it twice.
Q Okay. And ?- and then you began the autism treatments in January, correct?
A Correct.
Q And how did the materials get to you?
A By the mail.
Q And ?- and was there any lab testing involved?
A Yes, routine lab testing was urine, stool, hair.
Q And who did this lab testing?
A Either we did or if it required a blood draw, a local phlebotomy clinic.
Q And all this was occurring in Michigan?
A That’s correct.
Q And when your daughter got the chelation cream, who administers that?
A We did, the parents.
Q And how did you do it? Did you do it pursuant to instructions from Dr. Buttar’s office?
A Yes.
Q And ?- and all this is occurring without you ever coming to North Carolina to see Dr. Buttar or his nurse practitioner?
A That’s correct.
Q Did you have to send money to Dr. Buttar’s office before these materials were sent to you?
A Yes.
Q How much money did you send?
A The initial was right at $3,000.
Q Okay. You talked about your daughter deteriorating and then you said you made an appointment to see Dr. Buttar. Approximately when was that?
A Approximately April.
Q And what happened after you made that appointment?
A We were ?- we did another round of testing that was expected to arrive in the office prior to our visit for a review on that and other than that, we simply prepared for the trip.
Q Okay. When you got to North Carolina what ?- did you go to Dr. Buttar’s office?
A Yes.
Q Was he there?
A No, he was not.
Q Who did you see?
A Ms. Garcia.

Yes, Dr. Buttar charged $3,000 for them to work with his nurse practioner. They made an appointment to travel from Michigan to North Carolina (a distance of over 800 miles) and Dr. Buttar did not see them. His nurse practitioner saw them and did not examine the patient:

Q (By Mr. Jimison) Okay. Did you have a meeting with Ms. Garcia?
A We did.
Q Did Ms. Garcia examine your child during that meeting?
A She was in a room, but she didn’t have an examination, no.
Q Okay. And what was the result of that meeting with Ms. Garcia?
A The large part of the meeting was the — for lack of a better word — sell — to first do IV chelation.
Q And ?- and did you do that?
A No, we did not.
Q And why not?
A My daughter was already significantly deteriorating and appeared to be very sick and there was no way we were going to go get a more aggressive form ?-
Q Okay.
A?- when we haven’t even seen the doctor.
Q And how is your daughter doing now?
A She’s fine, she’s much better.

The young girl is doing much better since leaving Dr. Buttar’s care.

I’ve kept the commentary to a minimum. Take a read. Tell me what you think. Take a look at the actual transcripts and let me know if I’ve been cherry picking.

Frontline’s Vaccine War episode ignites…well, a war of words

3 May

I first heard about the Frontline episode on “The Vaccine War“, it was from supporters of Jenny McCarthy. They were online telling us all about this upcoming episode and even providing links to where we could order the DVD.

Times have changed.

The show aired and it was not about how Jenny McCarthy and the rest are right and that vaccines cause autism. Jim Carrey had made a statement a while back, “We aren’t the problem. The problem is the problem.” Aside from the fact that it is a very strange way to phrase what he wanted to say, Frontline showed that, yes, indeed, you are the problem.

The night that The Vaccine War aired, Dr. Jay Gordon (Jenny McCarthy’s pediatrician) blogged about how his interview was left out. Jenny McCarthy followed shortly afterwards. Both were on the Huffington Post. Dr. Rashid Buttar was also interviewed and not shown. He took to a free press release to express his opinion.

Since then, many people have been claiming that Frontline should have given more time and weight to the vaccine-causation side. I guess representatives from a “Parent Founded, Parent Led” organization are not enough weight. They need the opinions of some doctors. As Kim at the Countering Age of Autism blog points out, the Age of Autism blog put their piece complaining about Frontline twice. AoA just changed the title and a bit of the introduction.

The editors of the Frontline episode have responded to the criticisms that some interviews were not aired:

Many thanks for your feedback on the program. FRONTLINE went to considerable lengths to include a wide range of viewpoints, even in the face of very strong scientific evidence against the hypothesized autism link to MMR and thimerosal. Despite the consistent negative epidemiology and the definitive verdict of the federal vaccine court, we included views from people who wanted more and different studies. The program also gave a great deal of time to the arguments of vaccine hesitant parents who think the CDC schedule is bloated. The companion FRONTLINE website contains full interviews with different stakeholders, including Dr Robert Sears, who promotes an alternative spread out vaccine schedule. The website also hosts a robust public conversation where a full range of viewpoints are being aired and engaged.

When making long form documentaries like FRONTLINE, it often happens that some interviews don’t make it into the finished program. Several interviews failed to make the final cut of “The Vaccine War”–not just yours but also interviews with contributors who support the CDC vaccine schedule.

One interview which did not air was that of Arthur Allen. He has commented on a few blogs. Not complaining about his interview being cut, but about people like Dr. Jay who don’t understand that in journalism these things happen. Interviews get cut.

That all said, let’s consider the argument that Frontline should have aired more of the vaccine-skeptic viewpoint. That people like Rashid Buttar should have been given more air time. Dr. Buttar, who was recently reprimanded by his state’s regulatory agency. Dr. Buttar who has used urine injections on autistic children.

For those who would like to have seen more of the opinions of such doctors, consider if Frontline does another episode entirely. This time, instead of “the Vaccine War”, they consider a show on “Curing Autism”, showing alternative medical practitioners.

I bet at this point many in the biomed community are saying, “yes!”

I put it to them that they didn’t learn their lesson. There is no good evidence behind the alternative medicine used in autism. Just like they thought that “The Vaccine War” was going to finally tell their story, another Frontline episode would not go their way. Yeah, it would tell their story, just as The Vaccine War did.

Let me put it another way. Think of two short words….Trine Tsuderos. I could have just as easily said Pat Callahan, as she worked with Ms. Tsuderos on the articles at the Chicago Tribune, but somehow it is Trine who gets the attention. It is her name that calls up the memories.

For those asking “Trine who?”, Ms. Tsuderos and Ms. Callahan wrote a series of articles for the Chicago Tribune. One article should give you an idea of how that series went: Autism treatments: Risky alternative therapies have little basis in science.

You see, the team of Callahan and Tsuderos took a look at alternative therapies and gave some balance–they asked the experts in areas such as neuroinflammation in autistics whether the alt-med practitioners were correctly applying the science. They weren’t.

So imagine if you will, Fronline putting Dr. Jay, Dr. Bob, Dr. Buttar’s interviews on the air. Together with Dr. Geier and his “lupron protocol”. Together with Prof. Boyd Haley and his industrial chelator turned nutritional supplement. Together with people “treating” neuroinflammation before they know whether it is harmful or beneficial.

Consider that team. Then consider the responses from experts in medical toxicology. Experts in neuroinflammation. Experts in hormones and autism.

Consider how that would play out before the American public.

It would not go well for the alternative medical community. Not because of any bias, but because their “science” is woefully poor.

Major fail by medical regulators: Dr. Rashid Buttar given slap on the wrist

21 Apr

Beware, North Carolina. Beware. Dr. Rashid Buttar is free to practice medicine.

So goes the title of a blog post by Orac at Respectful Insolence.

Background, Dr. Rashid Buttar is an alternative medical practitioner who has, amongst other things, “therapies” to treat autism. He has been a major proponent of chelation. He is also notorious for his urine injections. Yes, urine.

Dr. Buttar was investigated by his state’s medical examiners. Again, from Orac: Rashid Buttar’s going down: The North Carolina Board of Medical Examiners finally acts

From a news report at that time:

The panel also found that Buttar exploited patients by charging exorbitant fees for unproven therapies that didn’t work. The panel recommended that his license be suspended indefinitely, but that the suspension be immediately stayed. Until the board decides, Buttar may practice without restrictions.

from a recent news story:

In that Michigan case, Buttar treated the child without having first performed an exam, a violation of the state’s medical practice act.

Did he “go down”? No. Dr. Buttar was able to benefit from laws he, himself, pushed through his State’s legislature:

Dr. Rashid Buttar, whose alternative medical practice in Huntersville has been under scrutiny by the N.C. Medical Board for a decade, has accepted a reprimand from the licensing agency.

But Buttar, who was facing potential restrictions to his license, instead can continue offering unconventional treatments as long as he asks patients to sign a form acknowledging his practice is outside the mainstream.

“This was a witch hunt from the beginning,” said Buttar, 44, whose practice attracts patients from 42 states and 37 countries. “They were trying to discredit me … but I didn’t do anything wrong.”

The consent order, signed Friday, marks the end of a battle that Buttar had vowed to take to the U.S. Supreme Court. He said he has spent “hundreds of thousands of dollars” defending himself against the board’s allegations that he exploited patients by charging exorbitant fees for unproven therapies that didn’t work and by arbitrarily ordering expensive tests to make more money.

In recent years, Buttar led a successful effort by the N.C. Integrative Medical Society to get legislators to change state law to make it friendlier to practitioners of alternative medicine.

Again, quoting Orac:

But back to why Dr. Buttar might have agreed to this consent decree. The answer becomes obvious if you peruse the actual consent order. All it does is to reprimand Buttar and order him (1) to provide informed consent to his patients dictated by the board; (2) to obey all laws, as well as rules and regulations governing the practice of medicine; (3) notify the board if he changes his address; and (4) meet with the board periodically. In other words, Buttar got a slap on the wrist.

“A slap on the wrist”.

Wow.

The top treatment listed on Dr. Buttar’s website is IV treatements which, as we know, include chelation. These have been “pioneered by Dr. Buttar” and the fact that the vast majority of the medical establishment rejects his ideas is a selling point:

However, the use of these highly effective treatments, suspiciously unpopular among traditional medicine regulators, is only determined by the medical providers in the clinic (ie, the Doctors, Nurse Practioners or PA’s).

Yes, your young child could sit with 7 other people in a room and stare at pictures of Pooh Bear (I wonder about the copyright issue on that?) while having an IV needle inserted to deliver “suspiciously unpopular” treatments. Here is the picture of his IV suite:

The main change between before the consent agreement and now is that all you have to do is sign a paper noting that you accept the fact that you accept the fact that these treatments have not been proven effective…

Do you think this “consent order” is anything more than a slap on the wrist? Here is a quote from it:

I understand and have been advised that the treatments and therapies that are to be provided by Dr. Buttar have not been proven effective by traditional research studies or conventional clinical trials and may not have been approved by the FDA for my diagnosis. Dr. Buttar makes no specific claims or representations that the treatments and therapies that he will be providing will be effective or cure the condition or diagnosis that I have.

Take a look at Dr. Buttar’s website (or the quote above) again.

However, the use of these highly effective treatments…

Yes, he’s still claiming that his treatments are “highly effective”, even though they “have not been proven effective by traditional research studies…”

Dr. Buttar was a part of the team involved with Desiree Jennings, the Redskins spokesperson who claimed the flu shot caused dystonia.

Dr. Buttar still has his supporters. From a recent story on this case:

Many of Buttar’s patients came to his defense in 2008. Among them was Elrene Thomas of Lexington. When contacted Tuesday, she was pleased to hear that Buttar can continue to practice. A retired nurse, she went to him for treatment seven years ago when she learned her breast cancer had spread to her spine. Instead of going through chemotherapy and radiation again, she tried IV infusions five days a week for months and had hyperbaric oxygen therapy twice a day for several weeks. She paid Buttar’s center $100,000 and said it was worth it.

“I really feel like he saved my life,” said Thomas, 77. “I’m not healthy in that I have stage 4 (cancer), but I’m surviving and I’m doing all these things that he taught me to do. I believe in his treatment.”

Yes, this is one of his success stories.

What do you call therapies a doctor makes up on his own, untested by “traditional” means? I would call that experimental. I think that is being generous.

Medical regulation exists for a reason. Slapping doctors on the wrist is not the reason.

Woman and child hurt in HBOT explosion

1 May

CBS4 is reporting that a woman and child have been hurt in a HBOT Chamber explosion.

There is no indication that the child was receiving HBOT as part of ‘treatment’ for autism. In fact, there’s no indication the clinic in question practice HBOT for autism at all.

Or thats what I thought until I read this page. Recognise the lead name there?

Dr. Rashid Buttar, D.O., FAAPM, FACAM, FAAIM
Broken Pathway in Autism: The Mercury Poisoning of our Children and Their Inability to Detoxify

The very same Rashid Buttar who I wrote about in 2006? Yes. The same Rashid Buttar who has been subject to numerous disciplinary hearings? Yes.

The owners of this HBOT installation describe Buttar as ‘forward thinking’. Hmm.

And so, I have to wonder – was this child autistic and undergoing a totally pointless HBOT session when the chamber exploded? Time will tell..

EDIT

Orlando Sentinel say:

The boy was flown to Broward General Medical Center. Broward Sheriff Fire-Rescue spokesman Mike Jachles said the boy was badly burned and is in critical condition.

If you’re a praying person, then pray for this boy. If you’re not, then hope for the best outcome.