Pat Sullivan Blog

Jigsaw Health October eNewsletter

This month's Jigsaw Health eNewsletter just went out yesterday.  There were some really good articles about inflammation.  Read it here.

If you want to view previous newsletter articles, you can access those here.

If you want to sign up for next month's newsletter, do that here.

Comment Formatting Update

For the Pat Sullivan Blog regulars, you already know that we've had TERRIBLE problems with line breaks in the comments.  Basically, it has resulted in long blocks of text, no matter how many times you hit the enter key.  While TypePad Tech Support does not yet have a permanent solution in place, we do have a work-around for the time being: the <p> html tag.

Using the <p> html tag to force a line break is actually very easy to do. At the beginning of each new paragraph, you first type <p> and then type the rest of your paragraph. At the end of the paragraph, you "close" that paragraph by using </p>. When you preview your comments, you should see it create line breaks.

Bonus Tips: If you want to bold a word or phrase, put <b> at the begining and </b> at the end. If you want to italicize a word or phrase, put <i> at the begining and </i> at the end.

The secret is don't ever forget to "close" the tag. Hope this helps a little bit until we get the full problem figured out.

RandomJohn tangles with Orac

(This was posted by Patrick Sullivan Jr.)

How many Pat Sullivan Blog readers know how much Pat and I dislike Orac/Dr. Gorski?  I just found someone who may like him even less -- RandomJohn, aka. John Johnson a PhD in statistics.

One of RandomJohn's comments to Orac:

Please, oh Orac, saint of medical scientific research, tell us what proper weight should be given to anecdotal evidence and clinical trial evidence. If thou wouldst but give us thine formula, that we may follow it.

and

More on the “my health care system will kick your health care system’s ass” syndrome

You probably have to wade through all the threads for it to really be funny, but personally, I'm ROFLMAO at those two comments!  Go read the rest of it here and here.

UPDATE 9/30 5:33pm: RandomJohn writes a few more clever things on this topic in Hornets Nest and Thimerosal. 

Funniest line from Thimerosal:

Even more confusing is why people are defending thimerosal so vehemently. I mean seriously, it’s just a compound. It’s not somebody’s son, or a production of literature, or prototype of the next generation flying device. It’s just thimerosal.

Most powerful line from Hornets Nest (emphasis mine):

- [Skepdic's say,] "Your experience doesn’t matter in science"...Read about it here, under the fancified name “pragmatic fallacy.” While it is fallacious to assume that what works for me works for you or anyone else, it’s equally fallacious to assume that what doesn’t work for me will not work for you.

Funniest line from Hornets Nest (no emphasis needed): "This may make Orac barf, but that’s probably for the best."

Runner-up: "And now we know what Orac knows, the view of the world from the ivory tower."

I like this guy.  He's definitely funnier than me!  Blog-roll him! :)

Autism on Good Morning America

(This was posted by Patrick Sullivan Jr.)

I just read the transcript of A Child Who 'Recovered' from Autism which was on Good Morning America today.  (I don't know why the word Recovered was in quotes since the piece clearly talks about Jake Exkorn having complete reversal of symptoms.)

First of all, good on Jake's mother Karen Exkorn for deciding to STOP listening to her excuse-giving pediatrician (see the excerpt of her new book, 'The Autism Sourcebook') and finding some form of therapy to help her son who was clearly in pain and atypical from his peers. 

From the end of the piece:

Jake, now 9, is one of the lucky children. Once again, he is functioning at the level of other children his age, and can even reflect about his experience with autism.

"Because your brain is disconnected, you can't control yourself," Jake said. "It's like something else is controlling you."

Wow...to hear a kid speak about their own experience with autism after they have recovered is very interesting!

Now, something that jumped out at me while reading this piece and the excerpt from Mrs. Exkorn's new book was that there was no mention of mercury or chelation therapy (ie. TD-DMPS, TD-DMSA) which at this point, are what I personally believe are the cause (mercury) and cure (chelation) for autism.  (That comes as no surprise to anyone that has been reading this blog for any length of time.)

But according to the piece, 40-hours a week of applied behavioral analysis (ABA) for 2 years is what 'recovered' Jake Exkorn. I'll be the first to admit that on the surface, it appears that there is ZERO mercury connection here.  I wouldn't be surprised if with a little digging, a connection could be made (mom has a few mercury amalgams, had flu shot during pregnancy, Jake had thimerosal-laden vaccines, etc.), but I would rather take this claim at face value in order to make another point.

TD-DMPS chelation therapy costs about $2700 ($150/month for 18 months following Dr. Buttar's protocol) plus doctors visits, plus lab reports, plus the monthly supply of vitamins and minerals that must be used in order to safely replenish minerals while chelating.  This is a biomedical protocol and there are several variations being used by a few thousand parents, rather successfully I might add, to reverse autistic symptoms.

In comparison to the total bill for chelation therapy ($2700 plus doc visits, lab reports, vitamins), how much does 40-hours-a-week, one-on-one ABA therapy for 2 years cost?  That's a full time job for a trained professional that is likely earning anything from $30K - $100K/year, right?

Now the clincher,

"ABA is expensive and grueling, but is considered the "gold standard" of autism treatment by experts. Its success is based on a variety of factors, including the age of the child and access to a qualified therapist.

(snip)

"Most of us in the field would say that occurs in 5 to 10 percent of children, and that is a generous estimate," McCarton said. "There are many children who have the diagnosis who get extensive number of hours of ABA therapy and they won't recover. They absolutely won't recover."

So it's between $60,000 and $200,000 over two years one-on-one with a professional therapist for 40-hours-a-week to give your autistic child a 5 to 10 percent chance of functioning at the level of other children their age?

And Mrs. Exkorn, using ABA to cure her own son, wrote The Autism Sourcebook??  For crying out loud!!  How does a 5 to 10 percent success rate make ABA the "gold standard?"  If her books does not mention mercury and chelation, how could it be the sourcebook??

Orac, Prometheus, Skeptico, AutismDiva, Kevin Leitch, Anne, DD, Kevin Greenlee, etc., I don't mean to switch roles and assume the "skepticism mantle" here, so please chime in and do your regular bashing of anyone who claims to "cure" autism and tries to profit off of it -- ie. write a book, promote expensive therapies, etc.  (Coincidentally, Pat just wrote a post this morning about double standards.)

Much like TREATING cancer, diabetes, etc., TREATING autism through ABA appears to be big business.  CURING it however, yields little but vehement criticism.

RELATED STORIES ON PAT SULLIVAN BLOG:
Autism - If not mercury, then what? (8/31/05)
Dr. Buttar on IV EDTA Chelation and the Autistic Boy's Death (8/29/05)
Dr. Buttar gets mugged by 6NEWS Investigators (9/1/05)
Dr. Buttar controversial? JB Handley of GenerationRescue weighs in (9/1/05)
Dr. Buttar on the Empirical Evidence of Chelation (9/1/05)
Dr. Buttar, *WHERE* is the Empirical Evidence (9/3/05)
Dr. Buttar Provides Numbers (9/16/05)
Dr. Rashid Buttar's Bio (9/25/05)

Tehcnorati Tags: Autism, Mercury, Skepticism, Chelation, ABA

Jigsaw Health in the AZ Republic

                              

Well, it's a good day when you get a feature story in your local paper and it's not because you were arrested! 

Jane Larson of the Arizona Republic wrote Piecing Together Wellness which hit the stands today.

Technorati Tags: AZ Republic, PR

Double Standards and the next SCOTUS nominee

I think one of the things I dislike most is when an obvious double standard is used. 

One obvious example has been the disagreements that I (and my son Patrick) have had with numerous "Orac-ites" who go crazy over the fact that the "snake oil-salesman" Dr. Buttar has not done any peer-reviewed studies on a chelator he uses -- TD-DMPS -- to treat autistic children who he believes suffer from mercury toxicity. 

But these same people simply ignore the fact that there are ZERO toxicity studies proving the safety of mercury amalgams or the mercury-based vaccine preservative thimerosal.  Dental amalgams ("silver fillings") and vaccines effect hundreds of millions, maybe even billions, of people worldwide.  These substances are endorsed, approved, allowed, etc. by the FDA, ADA, CDC, IOM, NIH, etc.  So for the Orac-ites, there is an apparent blind faith in these organizations where in comparison, there is everything from skepticism to pure hatred for Dr. Buttar, even though TD-DMPS is only being used by a few thousand people, it that.

This makes for a strange and aggravating double standard, even in the face of success stories!  (Read more about the Shoemaker's and the Champagne's.)

Switching subjects, I believe a major double standard is being applied to the yet unnamed Supreme Court Justice that President Bush will soon name.  Democrats are already threatening terrible things if someone more conservative than John Roberts is named.  Someone more conservative than Robert's has been virtually been pre-labeled by Dems as "UNQUALIFIED!"

And yet just 12 years ago Ruth Bader Ginsburg was nominated to the Supreme Court and was eventually confirmed by a vote of 96-3.  The Republicans at the time did not revert to labeling Ginsburg as an "ideologue", "unqualified", "left-wing kook", or "activist".  They acted with civility because President Clinton had earned the right (by virtue of election) to name whoever he wanted. 

Could the Republicans have gone crazy over the fact that Ginsburg was an ideologue and an activist by the standards that the Democrats are using today?   Consider this small snippet from Wikipedia about Ruth Bader Ginsburg:

In 1971, Ginsburg was instrumental in launching the Women's Rights Project of the American Civil Liberties Union, and served as the ACLU's General Counsel from 1973-1980, and on the National Board of Directors from 1974-1980. In this position, Ginsburg successfully argued several women's rights cases before the Supreme Court, including 1973's Frontiero v. Richardson.

As a legal scholar, Ginsburg was qualified for SCOTUS.  But has she turned out to be a middle-of-the-road judge with closely held views?  No. Does the ACLU known to represent the views of mainstream America?  No.  (Ask the boy scouts!)  Was Ginsburg an activist during her career?  Of course she was.

If President Bush names someone who looks like the opposite of Ginsburg, I think the Democrats may start a civil war, literally!

Does the rational American with common-sense see this double standard?  I think they do. I HOPE they do!

Related Post:  What is Law?

Technorati Tags: SCOTUS, George W. Bush, Ruth Bader Ginsburg, ACLU

Fish Oil from Jigsaw Health

I am happy to announce Jigsaw Health's latest product: Essential Omega-3 Fish Oil.  Because fish oil is such a good form of omega-3 essential fatty acids (which are critical to the body in so many ways!), we were hoping to have this product available when we launched JigsawHealth.com back in April. But we had a REALLY difficult time finding a supplier that could get us what we wanted. 

Thankfully, we finally found a GREAT supplier that allows us to offer premium-quality fish oil -- without any detectable heavy metals or PCBs -- and to sell it at a fair price.

This press release went out on PRweb at 12:00am Tuesday.

At this point, we only have the fish oil capsules in stock right now.  We expect to have the fish oil liquid (which is my personal preference) in stock by mid to late October. 

And for those who have read my book and remember my skepticism of fish oil capsules going rancid, I've had those fears relieved for our product after talking extensively with our supplier.  (And Patrick bit into a few of the sample capsules the supplier sent us to make sure they weren't rancid.  "Tastes like salmon," he said.  So they must be good!)

Technorati Tags: Fish Oil, Omega 3, Health and Wellness

Scott Shoemaker's "Autistic" Son and TD-DMSA

(Posted by Patrick Sullivan Jr. 9/26/05)

Scott Shoemaker emailed me for the first time on August 29, 2005 in response to the post Dr. Buttar on IV EDTA Chelation and the Autistic Boy's Death.  Since then, we've exchanged several emails back and forth.

Scott was the one who pointed me to the Autism Research Institute's survey of parents and the effectiveness of treatments, which he says has pretty much been his guide for treating his "autistic" son, Joshua.

Interestingly, Scott has *NOT* been using TD-DMPS, but has acheived these results using TD-DMSA.  Critics of Dr. Buttar and TD-DMPS should take note of that!

Scott sent the following email to me late last night.  (He also posted it here on the Yahoo! Group ChelatingKids2. Registration required.)  It is a very touching story that offers more anecdotal evidence that when heavy metals are chelated, autistic symptoms begin to abate.  It sounds very similar to Kevin Champagne's story, except of course that Scott is using TD-DMSA and Kevin is using TD-DMPS. 

This was posted with Scott's permission.  Somewhat long, but it's a quick read.  Scroll to the bottom for detailed TD DMSA results after 3 ½ months.

A couple of days ago, I took my (just turned) 6 year old son Jacob to his flag football practice. I usually bring his (almost) 3 ½ year old little brother Joshua with me, and he sometimes gets to run around with the other kids before practice. I was speaking with another parent that was there, and I looked up to see the coach putting a flag belt on Joshua. We laughed thinking that he was putting a belt on him by mistake, and he just did not notice that it was my younger son. Joshua is very tall and stocky for his age and is commonly mistaken for being older. He is bigger than the smallest 5 year old on the team. The league has kids ages 5-7.

After the coach was done putting the belt on him, I called Josh over to me and showed him how the flags worked. I was worried that now that he was wearing a flag belt, he would disrupt the practice by not wanting to leave the field while the team practiced, so I was trying to distract him.

I was somewhat surprised when the coach yelled over to us, "C'mon, Joshua, let's go!" Joshua looked over at the coach, and then at me with these big beaming blue eyes.

I said, "Well go on". I was not sure what was going to happen. He ran out onto the field and kneeled on the ground with the other kids with a smile from ear to ear as the coach spoke to them all as a team. A few minutes later, I was astonished as he got up and ran a few laps around the field hanging with the others as if he had done it several times before.

From there, he stood next to his 6 year old brother in a circle with the others as they proceeded to do jumping jacks and other calisthenics. He needed no direction or help. He watched the others and imitated them. He was one of them.

He practiced with the other kids for a full hour, doing everything that the coach had asked him to do. He would get into a football stance and line up with the rest of the kids and move when the others did. Sure, he struggled with the concept of football and what to do when he got the ball or when to grab the flags off of the guy with the ball, but most 3 1/2 year olds are the same way. He was having the time of his life. He was a football player.

At the end of the practice, I thanked the coach for letting Joshua be a part of practice. I told him that what he did really meant a lot to me and both of my sons.

He said, "Actually he did great out there. He did everything I asked him to. The other kids had a lot of fun with him today."

I then proceeded to tell the coach Joshua's "little secret". I said, "Coach, I do not think you realize the impact of what you did today. You see, Josh was diagnosed with autism 7 months ago, and was barely able to communicate with us until we started treating him for toxic metal poisoning 3 months ago."

The coach seemed a little shocked and taken back at first. He told me that he had not even the slightest clue that there was anything wrong with him. He asked me how old he was. I told him that he was almost 3 ½. He looked at me in amazement, saying that he had a 3 ½ year old son at home that had no interest in going out onto the field with the older kids.

I further explained that this was the same little boy who (until only a few months ago) had days that he would spin himself around in circles all day with his eyes rolled back into his head for entertainment, and had little interest in other children. Back then, he would not even turn his head to look at me when I came home from work if he was preoccupied, not even if I screamed his name a dozen times at the top of my lungs and stood next to him in his peripheral vision.

The coach was shocked and really did not know what to say. He realized that what he did meant a lot to me, and saw how it had impacted me. The fact that he did not know that there was anything wrong with him was also something I was not used to.

The moral of this story...

There are so many times that we do little things that make an impact and touch the lives of others and do not realize it (like the coach). Today, I sent this story to a girl whose 2 year old stopped talking after a flu shot in December. The boy was later diagnosed with autism. The girl forwarded it to some of her friends and family. One girl that she forwarded it to (who does not have any affected children) emailed me and said that she cried when she read it, and thanked me for sharing it. She is the one who pointed out the fact that I, myself, had touched someone else simply by writing this story and probably did not realize it. That is why I edited it and posted it here.

My message...

For the parents out there that are reading this and considering chelation therapy for their "autistic" child and are trying to decide whether it is worth it, let me just say this. Do not listen to the people that tell you that this is BS and that the parents doing this are stupid. Remember one thing. The vast majority of these people telling you NOT to do it HAVE NO EXPERIENCE WITH IT! Instead, listen to the thousands of parents that are doing it now. They do not lie. Get several opinions. Listen to the other parents that are not doing it also and compare the results of the two sets of children. That is why I decided to proceed with this treatment. Out of the dozens of parents of "autistic" children that I spoke to before I started my son's treatment, all of the ones that were seeing drastic improvements in their children had one thing in common.... Chelation Therapy.

Also, listen to the doctor’s who have risked their careers and are sometimes ridiculed by others in the medical field for taking a stance on something that they believe in, and are seeing results. Many of them have done the research themselves unlike the doctors who quickly discount it because that is what they learned they should do in medical school. Look at some of the urine, stool, and hair tests of the children of some of these "crazy" parents that are doing this.

The Bottom Line, and some final thoughts...

If chelation therapy is quackery, then I will be a quack all day if my son is clearly benefiting from it. If it is a "placebo", as some say, then I can attest that it is the most effective placebo around, and I want more of it for my son. Maybe somebody could explain this to my 3 year old who does not know what a placebo is. This therapy is working for us. I have the evidence running around my home playing with his brother and sister and other children, and now he smiles at me every day when I come home from work as he runs up to give me a big hug when I walk in the door. Three and a half months ago, he would not have even turned around.

Scott

***Notes on Joshua's Progress after 3 ½ months of chelation...

We have been chelating with TD DMSA from the Lee Silsby clinic in Cleveland for a total of 9 rounds, or just over 16 weeks, in a 3 days on 11 days off protocol. He also gets TD glutathione and a slew of supplements on a daily basis.

When he was tested 5 months ago around his 3rd birthday, his comprehension level was that of a 13 month old. He was considered 22 months behind. Two months after he was tested, he had made little progress. That is when we started chelating him. Since then, his progress has exploded. The results that we have seen with him are amazing. He was just retested, and he is now considered only 10 months behind in speech and comprehension (31 months - he is 41 months old). If these tests were accurate, that means that my son's comprehension level jumped ahead 15 months in only a 3 month period of time!

Here is an outline of progress that he has made in the last 3 months.

Before we started, Joshua was afraid of his little sister and would not go near her or take an interest in her. After 3 days of chelation, he started playing with her, giving her toys, her binky and laughing and interacting with her. Now that is all he wants to do! He also gave her a hug and a kiss that same day on his own. It was astounding. (Update -- Now he looks out for her, telling her "no, sissy" when she is doing something she is not supposed to and he walks behind her holding her hands to help her walk. He also tries to have conversations with her.) Besides chelation, she has been the best thing for him.

He stopped spinning himself immediately after his first 3 day treatment, and has not done it since. Keep in mind that this was an every day occurrence.

He learned how to wave hello and good bye, and now understands that when I leave for work in the morning that I am coming back, and he no longer screams when I walk out the door (he gives me a smile and a hug, says good-bye, waves and sometimes says I love you Daddy!). I get choked up every time I leave the house.

His eye contact is EXCELLENT compared to before. It is not even as issue now. Before I would have rated it slightly above average for someone with his condition.

He learned to take off and put on his own shoes and he lets us brush his teeth.

He used to want to watch the same movies over and over again ALL THE TIME. Now, he hardly watches the TV, and when he does, it is usually something that his older brother would watch that is for older kids that would have never interested him before.

He will now turn around immediately if I (or others) call his name at a normal tone on the first try instead of having to stand next to him and scream progressively louder a dozen times.

He no longer has tantrums of any sort.

His comprehension has gone through the roof. I can literally tell him to do anything for me and he understands. He previously only understood a few phrases. I am constantly testing him with tasks, and 9 times out of 10 he will understand and do what I tell him.

His interaction with other children has also improved drastically. He seeks out other kids and tries to play with them on the playground we take him to. He used to just watch them or sit by himself and play with the toy du jour.

He is speaking in longer phrases and picking up more words every day. We are starting to have conversations with him. He maintains excellent eye contact and uses proper facial expressions and voice inflection during these talks.

He has just started pointing, asking questions, and commenting on things that he would have never noticed before. (Example: He walked up to me today and pointed to a cut on my ankle when I was lying on the couch and said, "Oh, No! What happened? Are you alright? You have a BooBoo." I told him that I fell down and got hurt. He walked over to a cedar chest and got a blanket. He then covered up my ankle very gently and said, "There... All better
now".) Three months ago, he would have not even noticed it and would have said nothing. He probably would not have even interacted with me unless I tried to initiate something with him first, and that is a stretch.

His stimming has decreased. He still does the hand flapping thing occasionally, but not as pronounced or as much (I suspect that he either has yeast or the measles virus in his gut like a lot of these kids have).

He attempts to (and sometimes does) get himself dressed.

He washes his own hands.

Please keep in mind that all of this progress has been in the last 3 ½ months. His speech therapist has told us that he has progressed faster in the shortest amount of time than any other child that she has ever worked with (she has been doing this since 1988). She has also told us that he is the only child that she has worked with that has been going through this treatment that she knows of. We originally did not tell her, because we wanted to see if she noticed a difference (she did immediately). She has since sent other parents to us.

One other note... This child has never had any other behavioral therapies other than one hour of speech and OT a week. He is not on a GF/CF diet because he is not g&c intolerant. There is nothing else that I can attribute his progress to. My wife and I make it a habit to constantly challenge him and test him, and he never ceases to amaze us.

Hopefully, someone will be able to get something from this post. Feel free to contact me if anyone has any questions on this.

UPDATE OCT 6, 2005:  "Until someone can prove to me that chelation is NOT what is making my son better, I am in it for the long haul. You see, proof goes both ways ;~)"  Read the rest of what Scott Shoemaker had to say in that comment.

UPDATE NOV 14, 2005: Read the latest update from Scott about his son Joshua. 

UPDATE MAR 4, 2006: The Shoemaker's story is syndicated nationally to all NBC affiliates.  (Days before the story airs, the Shoemakers get rail-roaded by a clinic trying to capitalize on their story.  Read Scott's clarification.)

RELATED: Read about Kevin Champagne's "Autistic" Son.

For more info on mercury poisoning and what you can do about it, please visit www.GenerationRescue.org, a group founded by parents for parents. 

Technorati Tags: Autism, Mercury Autism

Dr. Rashid Buttar's Bio

(This is Patrick Sullivan Jr. posting.)

I just came across this bio for Dr. Buttar.  Why do his detractors so swiftly and easily apply the "snake-oil salesman" to him?  It just doesn't equate for me.  Unless this bio is totally fabricated.  And in that case, it's very well done!

Rashid Buttar, D.O.
Visiting Scientist, North Carolina State University, Dr. Buttar received his undergraduate degree from Washington University in St. Louis with a double major in Biology and Theology and then attended medical school at the University of Osteopathic Medicine and Health Sciences, College of Osteopathic Medicine and Surgery in Des Moines, Iowa. He trained in General Surgery and Emergency Medicine and then served as Brigade Surgeon for the 2nd Infantry Division, Republic of South Korea and later, as the Chief, Department of Emergency Medicine at Moncrief Army Community Hospital at Ft. Jackson in Columbia, South Carolina while serving in the US Army.

Dr. Buttar is board certified in Preventive Medicine and Chelation Therapy, is board eligible in Emergency Medicine and has achieved Fellowship status in three separate medical organizations (Fellow of the American College for Advancement in Medicine, Fellow of the American Academy of Preventive Medicine, and Fellow of the American Academy of Integrative Medicine).

Dr. Buttar practices in Charlotte, NC, where he is the medical director of Advanced Concepts in Medicine, a clinic specializing in treating cancer, heart disease, and other chronic conditions in patients refractory to conventional treatments. He also serves as Director of Clinical Research and Development for V-SAB Medical Laboratories, where he is extensively involved in research with polypeptide sequencing and identification technologies as well as innovative methodologies for drug-delivery mechanisms. Dr. Buttar has lectured worldwide on these subjects at medical congresses, symposia, and to lay audiences. He also continues to teach actively as faculty for mainstream medical courses, such as Advanced Trauma Life Support (ATLS) courses for physicians through the American College of Surgeons as well as teaching Pediatric Advanced Life Support and Advanced Cardiac Life Support courses to other physicians, nurses, and emergency response personnel.

RELATED STORIES ON PAT SULLIVAN BLOG:

Dr. Buttar on IV EDTA Chelation and the Autistic Boy's Death (8/29/05)

Dr. Buttar gets mugged by 6NEWS Investigators (9/1/05)

Autism - If not mercury, then what? (8/31/05)

Dr. Buttar controversial? JB Handley of GenerationRescue weighs in (9/1/05)

Dr. Buttar on the Empirical Evidence of Chelation (9/1/05)

Dr. Buttar Provides Numbers (9/16/05)

Technorati Tags: Autism, Mercury, Dr. Buttar

Lester Crawford resigns from the FDA

Commisioner Lester Crawford to resign fom the FDA. 

Read more about the secrets of the FDA in an interview with Dr. David Graham.

Read more recent news about the Vioxx/Merck cover-up.

Technorati Tags: Lester Crawford, FDA, David Graham, Vioxx, Merck