Sherri Oliver lives in a small town on the Eastern Shore of
Maryland. It's a two-hour bus ride to get to the Mount Washington
Pediatric Hospital in Baltimore and she has brought her daughter,
Katie Dail.
Katie has dangerously high levels of lead in her blood.
She's a fast-moving first-grader with copper-colored hair. Katie has
bright brown eyes but has trouble making eye contact. She also has
autism — and she doesn't really speak, but she makes a kind of
whooping sound when she's happy.
But Katie is not here for autism treatment. The treatment she has
been getting chelation therapy is to get her lead levels down.
Although hospitals offer the treatment, some desperate parents are
turning to home-based chelation kits and over-the-counter pills,
which doctors say can be more dangerous.
Chelation And Heavy Metal Detoxification
Lead can cause serious behavioral problems in kids and lower their
IQs. When Katie's lead levels are high, she gets irritable and has
more trouble learning, her mom says.
"She takes all my time," Oliver says.
Katie was first diagnosed with an elevated lead level at age 2.
Lead in the body is notoriously hard to get rid of. It seeps into
the bones to hide, and sneaks across the blood-brain barrier,
affecting mood, focus and sleep.
Last year, Katie stayed in the hospital for 19 days while nurses
worked to bring her lead levels down through chelation.
'Nasty Stuff'
Chelation puts a special chemical into the body that binds to lead
and other heavy metals, and helps flush them out. But it's not
pleasant. And it has to be given repeatedly over the course of the
hospital stay.
"It's nasty stuff. But it had to be done," Oliver says.
Nasty, Katie's mom says, because the chelation pill smells really
bad.
"You ever been near a building when they're getting their roof done,
you know, and the smell just gets in your mouth? That's what it
smells like," she says.
They had to grind up Katie's pills and hide them in apple juice. She
still won't drink apple juice, Oliver says.
But nurse practitioner Barbara Moore, who runs the lead clinic at
Mount Washington, says getting past the smell is just one of the
challenges of chelation.
"A child during chelation needs close monitoring to make sure their
kidneys are able to handle the lead burden as it's being metabolized
in the body, make sure their liver is OK, make sure their white
blood cell count is OK," she says.
Plus, the chelation process doesn't clear all of the metal out at
first — it only brings it out from the bone to the blood. Some
people test higher for lead after the treatment until it flushes
from their system.
And, importantly, it doesn't cure the damage the metal has already
done to the brain.
"What we try to do is prevent any further damage," Moore says.
Less Common Today
In the U.S., about 250,000 kids a year under age 5 have high levels
of lead in their blood. Only a small percentage of them test high
enough to need chelation.
While the overall numbers of lead poisoning and chelation therapy
are going down, it's still a problem in cities with old homes like
Baltimore, and when people get secondhand toys that may contain
lead. It's also a problem in some rural areas where lead persists in
the soil, Moore says.
Moore sees between five and 10 chelation patients a year in her
hospital.
"Things that we look at is how long had they been exposed to lead,
and how high was their lead level," she says.
She says kids who put a lot of non-food items in their mouths have
an increased chance of developing the classic symptoms of lead
poisoning: behavioral problems, headaches and sleeplessness.
The clinic helps educate families on what to do to decrease their
risk of lead poisoning.
"We really do a lot of education on cleaning toys, cleaning
household items ... using vacuums that have HEPA filters," Moore
says.
Extra Challenge With Special-Needs Kids
Moore says it's especially hard to keep an eye on the symptoms of
kids with learning disabilities like Katie. Katie puts nearly
everything in her mouth, from the coffee cup that a stranger left on
a table to the corners of walls in her home.
When Moore brings Katie and her mom into an exam room, Katie watches
TV while Moore listens to her breathing and reads her chart. Moore
talks to Katie's mom.
Moore suggests giving Katie ice cubes to keep her mouth busy and
says Katie's blood count is slowly going down.
But there's still a chance that Katie might have to go into the
hospital for more chelation if things don't improve.
Fly-By-Night Alternatives
Recently, a new challenge has cropped up for Moore and her staff
chelation kits for sale on the Internet. These products which run
the gamut from clay baths to pills to test kits claim to let
consumers cure autism or Alzheimer's or hardening of the arteries
without professional medical help.
One website claimed its chelation product corrects neurological
damage and gets rid of mercury. Some autism advocates say mercury
causes autism, but there is no scientific proof of that. Experts say
chelation is not an effective autism treatment.
Removing Heavy Metals
Moore says the products aren't safe.
"I don't recommend the oral chelation that you can get over the
Internet or over the counter. We don't know what the safe level is
of administering to a child or to anybody else, really," she says.
These products haven't been properly tested for any diseases other
than heavy metal poisoning. In fact, the National Institutes of
Health halted a study of chelation as an autism treatment, citing
too much patient risk. But the NIH is studying chelation for
hardening of the arteries. Results are expected to be announced in
2012.
Recently the Food and Drug Administration sent warning letters to
eight companies that were selling illegal chelation therapies. FDA
labeling compliance chief Michael Levy says the agency is cracking
down.
"We are very concerned that the marketers of these products are
preying on the most vulnerable of consumers," he says.
He's talking about consumers like Sherry Oliver who have very sick
kids without many treatment options. The FDA is concerned that
people will put their health at risk by using the therapies and
delay seeking appropriate medical treatment.
'Can't Risk It'
Before Oliver left the clinic, I asked her if she ever considered
one of those online chelation kits.
"I actually looked into that and, no, absolutely not. Most of them I
couldn't find out what was in them, where they were from, who made
it, nothing," Oliver says.
She doesn't want to give her daughter something she can't check out,
and she doesn't want to make Katie's developmental problems worse.
"I can't risk it," she says.
Katie and her mom bundle up for the long ride home. They'll be back
to the hospital in a month to get Katie's lead levels checked again.
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