7 no 1, 1999
Lead Changed My Children DMSA Case Study
By Ann Marie Vella, edited by Anna Priest
Lead-induced learning and behavioural problems
In early 1994 we found the house of our dreams, a charming old Victorian terrace in need of renovation. Little did we realise at the time what a profound effect living in this house was to have on our children. Within twelve months of moving into this house, our three and a half year old son was admitted to hospital with an extremely dangerous level of lead in his body. Our daughter Cassandra, two years older than Dylan, was also affected by lead poisoning, but not to such a great degree.
During the early months of 1995 we began to remove some of the old paint from the inside and outside walls of the house. This was a job that no previous owners had ever attempted, so we were removing paint that was up to one hundred years old. Shortly after work commenced on the house we began having major problems with Dylan. He became emotionally volatile, and would cry without any obvious reason. He fought constantly, hitting and kicking me and his sister, and playmates.
Before very long he became completely out of control. We were bewildered by this behaviour, which was quite out of character for the Dylan we knew and loved. He was also not speaking well for a child his age, and became very slow at meeting normal developmental milestones. A parent at my daughter's school suggested I have him tested for levels of heavy metals. Our local doctor had a heavy metal saliva test kit, which showed Dylan to be positive for lead. A blood test followed, and the doctor said the results would be back in a week's time. Three days later he rang advising me to get Dylan to hospital immediately. Dylan's lead level was 3.12 micromoles per litre of blood, whereas the recommended safe level for lead in children his age is 0.48 micromoles per litre (Ámol/L). So Dylan was almost seven times over the safe level!
We took Dylan to the Children's Hospital at Camperdown in Sydney where he was admitted for one week. During this time he received five days of intravenous EDTA (a heavy metal chelating agent specifically used for lead), to draw the metal out of his bloodstream. The entire week was very traumatic as Dylan had to have general anaesthetic just to get the intravenous line in so that the drug therapy could be given. During this time he developed a severe urinary tract infection which required further investigation on discharge from hospital, to ascertain whether any kidney damage had occurred.
After this treatment, Dylan's lead level came down to 1.3 Ámol/L, but at the next blood test six weeks later it had rebounded to 2.01 Ámol/L. This occurred because Dylan had a large amount of lead deposited in his bones and other cells, and not just in circulating blood. When the lead was removed from his blood by the drug therapy, lead deposited in other areas was mobilised back into his bloodstream.
My husband and I were still very concerned because by now we were finding out more about the dangers of lead, especially in young children. We had discovered the existence of The LEAD Group, who run the Lead Advisory Service (NSW), and who were very helpful with guidance and support. We went back to see the doctor who had treated Dylan in hospital. He was not overly concerned about these rebound levels and informed us that the lead would slowly come down to acceptable levels and that in his opinion no further drug therapy was necessary.
Over the next six months the children and I lived with my mother, while my husband and workmen removed all lead paint from our house using special lead containment methods advised by The LEAD Group. We also had to attend to the garden because of lead contamination throughout the area. All this at a cost of around $30,000.
In August 1996 when Dylan was four, a x-ray was taken of his legs, where distinct horizontal lines above and below the knee joints could be seen. This was explained as being deposits of lead in his bones. The hospital x-ray report reads: "Clinical history: lead toxicity. Examination of both knees: There are dense metaphysial lines affecting the lower femora and the upper tibia, especially laterally in the femora and medially in the tibia. The appearance is consistent with heavy metal ingestion."
During this time Dylan was physically well, but mentally and emotionally he was very much like a child much younger than his four and a half years.
He was still having language and behavioural problems, and was well behind what an average three to four year old should be in some areas of development. He began attending an Early Start Program to assist with language skills. A teacher from the Autistic Association was also seeing him weekly too.
Owing to all the recent upheavals to our family life we consulted a well-known paediatrician several times because of problems with our son's behaviour, hoping he would be able to help us handle the situation in better ways. Perhaps all Dylan's problems may not be due to his dangerous lead levels, but it most certainly exacerbated his problems.
Blood tests every three months showed that the two children's lead levels were coming down very slowly. My husband and I were concerned that long term damage may be occurring because of the prolonged high levels over time. We consulted two more paediatricians who suggested increasing their iron intake which would decrease the absorption of lead. We were certain that the children were not absorbing any more lead from the home environment, and that any damage was being created by their already high levels.
Quite by chance we were given the name of Dr V, a medical practitioner who specialises in environmental medicine. We have been seeing this doctor for about a year now and both children have improved and are doing very well, considering what we have all been through.
The children are now being treated with a combination of nutritional supplements and modified doses of DMSA, an oral heavy metal chelating agent, which is drawing the lead out of their bodies and allowing it to be excreted. They are now on their fourth course of DMSA and we are hopeful that all the lead will have been excreted from their bodies by the end of this course. The supplements are designed to reverse any damage that has been done to their systems, but at this stage we just don't know whether there will be any long term effects from their exposure to lead.
Dylan has greatly improved over the past twelve months. At five and a half years old he is now speaking well and began attending kindergarten this year. Although he is doing quite well at school he still requires additional assistance in the form of a remedial teacher 6 hours per week.
There are times when we reflect back on all the traumas over the past two and a half years and regret buying this house, but we are hopeful for our family's future and the health and wellbeing of our children.
UPDATE: mid 1997 - Cassandra's levels have come down to 0.48 Ámol/L. Dylan is now down to 0.78 Ámol/L (and he's now on his 6th course of DMSA). His behaviour is calmer and he is doing well at school.
2ND UPDATE: September 1998 - Dylan's blood lead level has been reduced even further to 0.56 Ámol/L and he continues to do well at home and school.
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