10 November 2003
Dear Readers: Sincerely,
Dr. Warren hopes to help all who ask his advice and to enlighten all who read Ask Dr. Warren. For your own well being please keep in mind that
advice you read here may not apply exactly to your own situation, and that if you are sick, no information on the web can take the place of a hands on examination by your physican who knows you and cares about you.
Dr. Warren
-BM
Dear BM: My best guess, based on your spelling of your grandson's diagnosis, is that he has Henoch Schonlein Purpura.
Henoch Schonlein purpura may involve many organ systems. The major manifestations are in the gastrointestinal tract, kidneys, skin, and joints. Henoch Schonlein Purpura (HSP) is caused by inflammation of blood vessels. The cause of the inflammation may be allergy, infection, or idiopathic (unknown). The inflamed blood vessels leak resulting in bruising. Typically, the bruises of HSP are on the lower extremities and buttocks. Inflammation of blood vessels in the kidneys may result in blood in the urine, although it is not usually evident to the naked eye. Involvement of intestinal blood vessels can cause abdominal pain.
There is no specific treatment for HSP. Symptomatic treatment with NSAIDs like ibuprofen is helpful for arthritis, rash, edema, fever, and malaise. HSP is usually a self limited disease with complete recovery. It usually runs its course in 4 to 6 weeks. Serious complications can occur with HSP so close monitoring by your physician with referral to appropriate specialists is essential. Rarely, death may occur during the acute phase from gastrointestinal complications (e.g., hemorrhage, intussusception, bowel infarction), kidney failure, or central nervous system involvement. About 25% of children with initial kidney involvement have persistence of abnormal urine for years; however, most of these patients ultimately do well.
For more information regarding HSP check the NORD rare disease data base at http://www.rarediseases.org/.
Sincerely,
Dr. Warren
-Lee Ann
Dear Lee Ann: Metal clips are used in some types of surgery and are intended to be left in. They generally do not cause any problem for the patient.
Sincerely,
Dr. Warren
We would be very grateful for any helpful suggestions.
-The S's
Dear S's: Persistent coughing certainly could be asthma, but the cough associated with asthma is generally not croupy. If your daughter has asthma, after all this time your pediatrician would have heard some wheezing when he examined her. If your daughter is old enough to cooperate, your doctor could have pulmonary function tests done on her to be sure there is no evidence of wheezing.
Sometimes allergy tests can come out negative and then an allergic child can develop allergies. If you are reluctant to do allergy testing and your doctor believes your daughter has allergies, he could try treating her with a long acting, non-sedating antihistamine such as Claritin or Zyrtec.
Sincerely,
Dr. Warren
Thank you.
If you reply back to me I will greatly appreciate it.
- A Concerned Mother
Dear Concerned Mother: At 14 months, if your daughter is not walking or talking, that may simply be where she is developmentally, but you are right to be concerned about the effect persistent middle ear fluid may have on hearing at this point when she should be learning to speak. Unfortunately, there is no medical treatment which has been shown to be effective for treating middle ear fluid. Antibiotics are only useful for treating infection. They can also be used prophylactically to prevent recurrent middle ear infections allowing time for the middle ear to heal and the fluid to resolve.
I'm not sure what you mean by "no sound waves in the right ear and below normal in the left," but I suspect you're talking about tympanometer readings. The tympanometer bounces a sound wave against the ear drum and measures the amount returned as different pressures are applied to the ear. These readings can detect middle ear fluid which is not visible and can measure middle ear congestion in the absence of fluid. 67 daPa is a tympanometer pressure measurement which is within the normal range. Tympanometer readings don't tell anything about hearing.
Persistent middle ear fluid may require surgical treatment with tubes, but even during the time speech is developing it's wise not to rush to tubes since children may go in an out of having fluid, especially with colds. If your daughter has middle ear fluid which hasn't cleared since August 1998, then she is certainly a candidate for tubes. A hearing test can help make that decision. If her hearing is significantly affected by middle ear fluid, that would favor surgical treatment.
An audiologist who has experience testing young children can use play conditioning to teach a young child to respond to sound, and then use sound field testing to determine the best hearing in one ear. If a child cannot be tested that way, then hearing can be tested with a brainstem auditory evoked response (BAER).
Sincerely,
Dr. Warren
I would like to seek your advise on the above matter. I had been informed that if the children is too active, they will be recognised as hyperactive category. My problem currently was, my 21month old son, he is too active. He had reduced his sleeping hours. Previously he will sleep twice a day and continue to have a good sleep at night. Now, its very hardly to make him sleep for 2 hour daily. He will only sleep max. 1 hours daily and goes to bed at night around time 9..10pm. Hopefully you would give me an advised since we were worry but the pediatrician said .. that's okay.
Do you have any idea, what kind of education that I should give it to him at his earlier age? Do you advised for pre-school? Right now, he is attached to his nanny while both of us away.
Thank you and regards.
-JP
Dear JP: The diagnosis of hyperactivity is rarely made before school age because young children have very little attention span. While I cannot tell you at this point that your son does not have attention deficit disorder (ADHD), neither is it necessarily suspect just because he is very active and doesn't nap much at 21 months. Some normal children are just very physically active. If your pediatrician says everything is normal and your son's development is normal, I wouldn't worry about it. A high activity level does not cause ADHD. It is just one symptom of ADHD.
If your son's motor and language development are normal he does not require any special education. If they are not normal, you should investigate early intervention programs in your area. I do believe there are intellectual and social benefits to preschool, but there's no rush at 21 months to get him into school.
Sincerely,
Dr. Warren
Also I my daughter drinks Diet Coke all of the time. She can't sleep at night, and she often gets unbearable cramps, or muscle spasms in her legs, also she gets shots of pain up her neck. I recently read an article talking about the aspartame in diet Coke. The article talked about, the "Aspartame Disease." The symptoms of this were spasms, shooting pains, cramps, dizziness, joint pain, and a few others. Have you heard of this before? Should she get it checked out? Thank you for your time.
ASPARTAME : SERIOUS HEALTH RISKBy Nancy Markle
WORLD ENVIRONMENTAL CONFERENCE and the MULTIPLE SCLEROSIS FOUNDATION F.D.A. ISSUING FOR COLLUSION WITH MONSANTO Article written by Nancy Markle (1120197)
I have spent several days lecturing at the WORLD ENVIRONMENTAL CONFERENCE on "ASPARTAME marketed as 'NutraSweet', 'Equal', and 'Spoonful"'. In the keynote address by the EPA, they announced that there was an epidemic of multiple sclerosis and systemic lupus, and they did not understand what toxin was causing this to be rampant across the United States. I explained that I was there to lecture on exactly that subject.
When the temperature of Aspartame exceeds 86 degrees F, the wood alcohol in ASPARTAME coverts to formaldehyde and then to formic acid, which in turn causes metabolic acidosis. (Formic acid is the poison found in the sting of fire ants). The methanol toxicity mimics multiple sclerosis; thus people were being diagnosed with having multiple sclerosis in error. The multiple sclerosis is not a death sentence, where methanol toxicity is. In the case of systemic lupus, we are finding it has become almost as rampant as multiple sclerosis, especially Diet Coke and Diet Pepsi drinkers. Also, with methanol toxicity, the victims usually drink three to four 12 oz. Cans of them per day, some even more. In the cases of systemic lupus, which is triggered by ASPARTAME, the victim usually does not know that the aspartame is the culprit. The victim continues its use aggravating the lupus to such a degree, that sometimes it becomes life threatening. When we get people off the aspartame, those with systemic lupus usually become asymptotical. Unfortunately, we can not reverse this disease.
On the other hand, in the case of those diagnosed with Multiple Sclerosis, (when in reality, the disease is methanol toxicity), most of the symptoms disappear. We have seen cases where their vision has returned and even their hearing has returned. This also applies to cases of tinnitus.
During a lecture I said "If you are using ASPARTAME (NutraSweet, Equal, Spoonful, etc.) and you suffer from fibromyalgia symptoms, spasms, shooting pains, numbness in your legs, cramps, vertigo, dizziness, headaches, tinnitus, joint pain, depression, anxiety attacks, slurred speech, blurred vision, or memory loss - you probably have ASPARTAME DISEASE!" People were jumping up during the lecture saying, "I've got this, is it reversible?" It is rampant. Some of the speakers at my lecture even were suffering from these symptoms. In one lecture attended by the Ambassador of Uganda, he told us that their sugar industry is adding aspartame! He continued by saying that one of the industry leader's son could no longer walk - due in part by product usage!
We have a very serious problem. Even a stranger came up to Dr. Espisto (one of my speakers) and myself and said, "Could you tell me why so many people seem to be coming down with MS?" During a visit to a hospice, a nurse said that six of her friends, who were heavy Diet Coke addicts, had all been diagnosed with MS. This is beyond coincidence. Here is the problem. There were Congressional Hearings when aspartame was included in 100 different products. Since this initial hearing, there have been two subsequent hearings, but to no avail. Nothing as been done. The drug and chemical lobbies have very deep pockets. Now there are over 5,000 products containing this chemical, and the PATENT HAS EXPIRED!!!!! At the time of this first hearing, people were going blind. The methanol in the aspartame converts to formaldehyde in the retina of the eye. Formaldehyde is grouped in the same class of drugs as cyanide and arsenic - DEADLY POISONS!!!
Unfortunately, it just takes longer to quietly kill, but it is killing people and causing all kinds of neurological problems.
Aspartame changes the brain's chemistry. It is the reason for severe seizures. This drug changes the dopamine level in the brain. Imagine what this drug does to patients suffering from Parkinson's Disease. This drug also causes Birth Defects.
There is absolutely no reason to take this product. It is NOT A DIET PRODUCT!!! The Congressional record said, "It makes you crave carbohydrates and will make you FAT". Dr. Roberts stated that when he got patients off aspartame, their average weight loss was 19 pounds per person. The formaldehyde stores in the fat cells, particularly in the hips and thighs.
Aspartame is especially deadly for diabetics. All physicians know what wood alcohol will do to a diabetic. We find that physicians believe that they have patients with retinopathy, when in fact, it is caused by the aspartame. The aspartame keeps the blood sugar level out of control, causing many patients to go into a coma. Unfortunately, many have died. People were telling us at the Conference of the American College of Physicians, that they had relatives that switched from saccharin to an aspartame product and how that relative had eventually gone into a coma. Their physicians could not get the blood sugar levels under control. Thus, the patients suffered acute memory loss and eventually coma and death.
Memory loss is due to the fact that aspartic acid and phenylalanine are neurotoxic without the other amino acids found in protein. Thus it goes past the blood brain barrier and deteriorates the neurons of the brain.
Dr. Russell Blaylock, neurosurgeon, said, "The ingredients stimulates the neurons of the brain to death, causing brain damage of varying degrees. Dr. Blaylock has written a book entitled "EXCITOTOXINS: THE TASTE THAT KILLS" (Health Press 1-800-643-2665). Dr. H.J. Roberts, diabetic specialist and world expert on aspartame poisoning, has also written a book entitled "DEFENSE AGAINST ALZHEIMER'S DISEASE" (1-800-814-9800). Dr. Roberts tells how aspartame poisoning is escalating Alzheimer's Disease, and indeed it is. As the hospice nurse told me, women are being admitted at 30 years of age with Alzheimer's Disease. Dr. Blaylock and Dr. Roberts will be writing a position paper with some case histories and will post it on the Internet. According to the Conference of the American College of Physicians, "We are talking about a plague of neurological diseases caused by this deadly poison".
Dr. Roberts realised what was happening when aspartame was first marketed. He said "his diabetic patients presented memory loss, confusion, and severe vision loss". At the Conference of the American College of Physicians, doctors admitted that they did not know. They had wondered why seizures were rampant (the phenylalanine in aspartame breaks down the seizure threshold and depletes serotonin, which causes manic depression, panic attacks, rage and violence).
Just before the Conference, I received a FAX from Norway, asking for a possible antidote for this poison because they are experiencing so many problems in their country. This "poison" is now available in 90 PLUS countries worldwide. Fortunately, we had speakers and ambassadors at the Conference from different nations who have pledged their help. We ask that you help too.
Print this article out and warn everyone you know. Take anything that contains aspartame back to the store. Take the "NO ASPARTAME TEST" and send us your case history.
I assure you that MONSANTO, the creator of aspartame, knows how deadly it is. They fund the American Diabetes Association, American Dietetic Association, Congress, and the Conference of the American College of Physicians. The New York Times, on November 15, 1996, ran an article on how the American Dietetic Association takes money from the food industry to endorse their products. Therefore, they can not criticise any additives or tell about their link to MONSANTO. How bad is this? We told a mother who had a child on NutraSweet to get off the product. The child was having grand mal seizures every day. The mother called her physician, who called the ADA, who told the doctor not to take the child off the NutraSweet.
We are still trying to convince the mother that the aspartame is causing the seizures. Every time we get someone off of aspartame, the seizures stop. If the baby dies, you know whose fault it is, and what we are up against. There are 92 documented symptoms of aspartame, from coma to death. The majority of them are all neurological, because the aspartame destroys the nervous system.
Aspartame Disease is partially the cause to what is behind some of the mystery of the Dessert Storm health problems. The burning tongue and other problems discussed in over 60 cases can be directly related to the consumption of an aspartame product. Several thousand pallets of diet drinks were shipped to the Dessert Storm troops. (Remember heat can liberate the methanol from the aspartame at 86 degrees F). Diet drinks sat in the 120 degree F. Arabian sun for weeks at a time on pallets. The service men and women drank them all day long. All of their symptoms are identical to aspartame poisoning. Dr. Roberts says "consuming aspartame at the time of conception can cause birth defects". The phenylalanine concentrates in the placenta, causing mental retardation, according to Dr. Louis Elsas, Pediatrician Professor - Genetics, at Emory University in his testimony before Congress.
In the original lab tests, animals developed brain tumours (phenylalanine breaks down into DXP, a brain tumor agent). When Dr. Espisto was lecturing on aspartame, one physician in the audience, a neurosurgeon, said, "when they remove brain tumours, they have found high levels of aspartame in them".
Stevia, a sweet food, NOT AN ADDITIVE, which helps in the metabolism of sugar, which would be ideal for diabetics, has now been approved as a dietary supplement by the F.D.A. For years, the F.D.A. has outlawed this sweet food because of their loyalty to MONSANTO. [You can obtain Stevia now in natural foods stores in either cut & sifted dried leaves or in powder form. I use it and it's great.]
If it says "SUGAR FREE" on the label&emdash; DO NOT EVEN THINK ABOUT IT!!! Senator Howard Hetzenbaum wrote a bill that would have warned all infants, pregnant mothers and children of the dangers of aspartame. The bill would have also instituted independent studies on the problems existing in the population (seizures, changes in brain chemistry, changes in neurological and behavioural symptoms). It was killed by the powerful drug and chemical lobbies, letting loose the hounds of disease and death on an unsuspecting public.
-(unsigned)
Dear Parent: I suspect your daughter's aches and pains are all due to high activity level and the injuries that result from them. A knee brace may be helpful, but what your daughter really needs is a thorough exam by an orthopedist to determine what injuries need treatment and what limitations if any she must place on her activities until she fully heals. Aggressive athletes can get into trouble because they re-injure tissues before they are fully healed and they put themselves at greater risk for serious injury because of the way they move when they play while injured. Because most avid athletes insist that they can continue playing even when it hurts, all but the most minor athletic injuries deserve thorough evaluation.
With regard to the use of aspartame in children, I would have to urge moderation just because there's no good reason for kids to drink tons of soda. Aspartame appears to be safe, but it provides no benefit to the average child, and the safety profile of any material is always open to revision when new information becomes available. I think moderation is just common sense, but I still have no basis for considering aspartame responsible for your daughter's symptoms. If she drinks a lot of cola, she may be getting excess caffeine.
The article you sent me sounds pseudoscientific because it cites the opinions of physicians, but it fails to cite any research that backs up these opinions. While I won't say that means their opinions should be dismissed, I'm wary of any article that gets on a soapbox trying to blame a substance like aspartame for everything from multiple sclerosis, to lupus, to birth defects, to neurological conditions, etc. and then claims that this information has been kept from the public because of collusion between the manufacturer the ADA, Congress, and physicians. Even if I were paranoid enough to believe that reputable organizations were involved in a conspiracy to fatten their coffers at the expense of our health, independent researchers would still be publishing articles showing the evidence for their concerns. If big money could effectively keep the truth from us, we'd all still think tobacco was safe.
It is true that formaldehyde and methanol are by products of the metabolism of aspartame, and that is a good enough reason to be cautious about overusing it. What most of us don't give any thought to is that the metabolism of many medications and even foods produce toxic byproducts. These are handled by the liver. When the liver doesn't work, many of the things we feel comfortable with would become unsafe. To emphasize my point, consider that a perfectly safe drug like Tylenol is toxic to cats because their livers can't detoxify it. Now, to emphasize the need for caution and avoidance of unnecessary medications and additives, consider that aspirin is no longer used in children because after a long history of being apparently safe, it was linked to Reyes Syndrome.
Using aspirin as an example, the link to Reyes Syndrome was discovered epidemiologically, however, it didn't remain simply someone's opinion that there was a link. Studies confirmed that there was a link and the mechanism by which aspirin caused Reyes Syndrome was established. Same thing with regard to tobacco and lung cancer. The link was established by research. These links were not just somebody's opinion. An opinion, no matter how educated, remains just an opinion unless cause and effect can be established.
I did several Medline searches to find articles linking aspartame to lupus, multiple sclerosis, chronic fatigue, and poor diabetic control. I didn't find any such articles. The absence of these articles does not constitute proof that there is no link. That would require a study showing no epidemiologic link or explaining the reasons for an apparent coincidental link. One article noted an increase in the frequency of brain tumors after aspartame was introduced. It didn't establish cause and effect and suggested a need for further study.
In summary, I have no reason to suspect your daughter has symptoms related to aspartame, but it would be desirable for her to decrease her intake of diet cola. I am not in a position to refute the article you sent me, first because I haven't read the work of any of the physicians cited and don't know what if any research they did, although I didn't find any reference to their work in any reputable medical journals, and second because I have no independent knowledge on the subject of aspartame's safety, but the article strikes me as a hysteria piece with no real evidence which blames the lack of credible evidence on a preposterous conspiracy theory.
Sincerely,
Dr. Warren
What I would like to know is:
Regards,
-Krys
Dear Krys: The tumor you are referring to is caused by bleeding into the sternomastoid muscle, or the fibrous scar caused by such an injury. The condition is known as torticollis (wry neck). Congenital torticollis is generally present at birth and develops before birth or at the time of delivery from stretching the neck. The kind of tightness of the sternomastoid that results from sleeping on the back does not generally cause a lump, although, if the muscle spasm is tight enough, it could feel like a lump.
Treatment involves stretching the tight muscle. This can be done by an osteopath or a physical therapist. I don't know if the osteopath is including spinal manipulation in the treatment. Neither am I aware of any recommendation to do spinal manipulation for this condition. The primary treatment is stretching the affected muscle. It would also be beneficial for you to be taught how to do sternomastoid stretching exercises with the baby to keep the muscle loose between treatments.
I cannot quote you any figures, but most infants do well with vigorous, regular physical therapy. Without adequate stretching, the infant will always lie with his head to one side and develop flattening of the skull on that side. If therapy cannot stretch the muscle adequately, surgical treatment may be required.
If you are looking for additional information on this condition your search term should be "congenital torticollis."
Sincerely,
Dr. Warren
Have you heard of this, and if we don't take her for surgery, will she have problems in the furture---thanks for your response
-GB
Dear GB: The main reason appendicitis is an urgent problem is that it's important to make the diagnosis before the appendix ruptures and get the appendix out. After an appendix ruptures, there is a risk of developing peritonitis which can be serious, or even fatal if not properly diagnosed and quickly treated. The less serious possibility is that the ruptured appendix will form an abscess which contains all the toxic and irritating materials rather than having the material spread out and cause peritonitis. Once that happens, there is no urgency to get the appendix out if the patient responds adequately to antibiotics. In fact, it is preferable not to operate in the contaminated area. Therefore, the usual approach is to treat with antibiotics and do an appendectomy later, unless the patient doesn't respond adequately to antibiotics and requires surgical drainage of the infection.
Since the appendix isn't removed at the time of the rupture, once it heals there is a risk that appendicitis could develop again. In addition, the ruptured appendix is likely to heal adhering to the tissue surrounding it. These adhesions could result in the bowel twisting and becoming obstructed. Therefore, it is advisable to have the appendix removed once she has recovered.
Sincerely,
Dr. Warren
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