DrSclafani answers some questions

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Postby zinamaria » Wed Mar 24, 2010 9:37 am

Thank you Dr Sclafani for this info on vitamin K and coumadin..thought I would post a little info on it and in what foods we find it.
Zina



Definition

Vitamin K deficiency exists when chronic failure to eat sufficient amounts of vitamin K results in a tendency for spontaneous bleeding or in prolonged and excessive bleeding with trauma or injury. Vitamin K deficiency occurs also in newborn infants, as well as in people treated with certain antibiotics. The protein in the body most affected by vitamin K deficiency is a blood-clotting protein called prothrombin.

Description

Vitamin K is a fat-soluble vitamin. The recommended dietary allowance (RDA) for vitamin K is 80 mg/day for the adult man, 65 mg/day for the adult woman, and 5 mg/day for the newborn infant. The vitamin K present in plant foods is called phylloquinone; while the form of the vitamin present in animal foods is called menaquinone. Both of these vitamins are absorbed from the diet and converted to an active form called dihydrovitamin K.

Spinach, lettuce, broccoli, brussels sprouts, and cabbage are good sources of vitamin K, containing about 8 mg vitamin K/kg food. Cow milk is also a good source of the vitamin.

A portion of the body's vitamin K is supplied by bacteria living in the intestine rather than by dietary sources.

Vitamin K plays an important role in blood clotting. Without the vitamin, even a small cut would cause continuous bleeding in the body, and death. Blood clotting is a process that begins automatically when any injury produces a tear in a blood vessel. The process of blood clotting involves a collection of molecules, which circulate continuously through the bloodstream. When an injury occurs, these molecules rapidly assemble and form the blood clot. The clotting factors are proteins, and include proteins called Factor II, Factor VII, Factor IX, and Factor X. Factor II is also called prothrombin. These proteins require vitamin K for their synthesis in the body. The blood-clotting process also requires a dozen other proteins that do not need vitamin K for their synthesis.

— Tom Brody, Phd

Oh, also tomatoes, and eggs
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Postby Johnson » Wed Mar 24, 2010 12:52 pm

Algis wrote:...
But then if stents are placed in jugular(s); too much blood (?) is drained out of the brain during daytime (standing/seated), stents preventing their collapse :?: (not sure I express myself correctly here, pardon me)


Brilliant question, Algis.

How are you doing these days?

Edit - I saw Dr. Sclafani's response just now. I started my response last night, but did not parse the thread before posting. It is still a brilliant question, and perhaps, pertinent to my experience.

Today, I had the Doppler ultrasound, and it was revealed that my jugulars do not collapse when I am upright. I have not had any intervention, so that is my "natural" state. There was a lot more interesting about the US, and even the skeptical-about-CCSVI Dr. thought that there might be some kind of blockage below the clavicle.
Last edited by Johnson on Wed Mar 24, 2010 5:16 pm, edited 1 time in total.
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Postby shye » Wed Mar 24, 2010 1:13 pm

OOPS Zinamaria-
Vitamin K requirements should be micrograms (mcg) NOT grams (gm)
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Postby drsclafani » Wed Mar 24, 2010 5:36 pm

Today, I had the Doppler ultrasound, and it was revealed that my jugulars do not collapse when I am upright. I have not had any intervention, so that is my "natural" state. There was a lot more interesting about the US, and even the skeptical-about-CCSVI Dr. thought that there might be some kind of blockage below the clavicle.


careful about the interpretation of ultrasounds. it is a steep learning curve. hopefully you had someone with experience.....

why would the jugulars not collapse? If there is vertebral vein outflow obstructions, then blood must flow through the jugulars ....its got to get out someway.

The bottom line to me is that all these tests are interesting, but you need a catheter venogram to sort everything out. and that also has a steep learning curve
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Postby Johnson » Wed Mar 24, 2010 5:47 pm

drsclafani wrote:redact

careful about the interpretation of ultrasounds. it is a steep learning curve. hopefully you had someone with experience.....

why would the jugulars not collapse? If there is vertebral vein outflow obstructions, then blood must flow through the jugulars ....its got to get out someway.

The bottom line to me is that all these tests are interesting, but you need a catheter venogram to sort everything out. and that also has a steep learning curve


Of course, I see your point, Dr. The Doc. (not just a technician) has scanned "about a hundred" PwMS. He received training from Dr. Simka a couple of weeks ago, and stated that according to Simka's way, I am a candidate for intervention. I will have an MRV on Friday.

My Vertebral vein outflow was normal. I reckon that if I have an occlusion distal from the clavicle, the IJVs might not drain enough to collapse in the time he spent with the transducer in place. Would that make sense?
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Postby drsclafani » Wed Mar 24, 2010 5:48 pm

Dr Sclafani,
Andrew Fletcher has a thread here at TIMS re: Inclined Bed Therapy--bed raised 6 inches at head, even incline down to none at foot of bed.
Many of us are doing this, and report great results in resolving to different degrees issues of circulation (myself included).

How do you see his theory in relationship to CCSVI?


I could guess.....

1. there is insufficient pressure to get adequately brain venous outflow. Raising the head of the bed might allow better gravity flow?
2. upright position increases vertebral blood flow. If the jugulars are not flowing, perhaps we get more favorable vertebral blood flow when upright

i am sure there are more guesses than there are answers
more flow through the vertebrals
2.
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TODAY'S DISCOVERY

Postby drsclafani » Wed Mar 24, 2010 5:54 pm

Today I learned something new in my treatments. I thought i would share.

I have been concerned about incomplete dilatation of the veins when using venous angioplasty, expecially when i think the problem is incompletely opening valves. Sometimes even with very large balloons, i have been dissatisfied with the amount of widening i achieve.

Today I added a cutting ballloon to my amamentarium of tools for use in liberation. This balloon has some sharp edges of metal attached to the balloon. When the balloon is opened, the metal presses into the tissues. it creates a indentation. After creating the creasing of the vein or valve, I then went to my usual 14 millimeter high pressure balloon and the vein dilated so easily and smoothly. it was like buttah! and created a very large venous confluens.

Is this a consistent benefit? Is there any new risk? Will this reduce recurrent stenosis?

time will tell but I got really excited about this one.
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Re: TODAY'S DISCOVERY

Postby bmk1234 » Wed Mar 24, 2010 6:08 pm

drsclafani wrote:Today I learned something new in my treatments. I thought i would share.

I have been concerned about incomplete dilatation of the veins when using venous angioplasty, expecially when i think the problem is incompletely opening valves. Sometimes even with very large balloons, i have been dissatisfied with the amount of widening i achieve.

Today I added a cutting ballloon to my amamentarium of tools for use in liberation. This balloon has some sharp edges of metal attached to the balloon. When the balloon is opened, the metal presses into the tissues. it creates a indentation. After creating the creasing of the vein or valve, I then went to my usual 14 millimeter high pressure balloon and the vein dilated so easily and smoothly. it was like buttah! and created a very large venous confluens.

Is this a consistent benefit? Is there any new risk? Will this reduce recurrent stenosis?

time will tell but I got really excited about this one.


Thanks for the info.
I have heard of people having issues with valves that are destroyed during liberation. Can you explain, what happens and why it can cause problems?

I'm on your list.
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Re: TODAY'S DISCOVERY

Postby Cece » Wed Mar 24, 2010 8:20 pm

drsclafani wrote:Today I added a cutting ballloon to my amamentarium of tools for use in liberation.


Huh! It has a frightening name but sounds like it could prove useful.
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Postby Algis » Wed Mar 24, 2010 8:45 pm

@drsclafani: Thank you for your time and explanation.

@johnson: I am fine and perfect thank you :) Waiting for the hospital over here to finish its protocol of study; shall have started mid-March but will start effectively March 31st. I will keep a log post as it start - Be well.
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Postby SoberSandy » Wed Mar 24, 2010 9:09 pm

Hello Dr. Sclafani - thank you for your long hours of challenging work - we appreciate all your knowledge and your caring heart. With the thought of genetics and the goal of MS prevention, if CCSVI is the cause of MS, and since twisted or stenosed veins are congential and therefore present in childhood, do you think a child of someone with MS could prevent developing the disease if CCSVI were detected and treated in childhood?
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Postby Johnson » Wed Mar 24, 2010 9:41 pm

I just gotta love a Doctor who uses a word like "amamentarium", with the confidence that the patient is not incapable of understanding (or at least, looking it up - such as I did).

I wonder, Dr. Sclafani, are these discoveries and innovations - such as you are making - disseminated in the IR, Venous Doctor, etc., community, or is that something that needs a peer-reviewed paper?

The Doc. who did my US today was remarking on anomalies in my valves, but he is not involved with treatment, and after Rici's catastrophic experience in having had a valve ablated, I might be a bit querulous with having my own valves trashed. In your view, ought one be cautious in messing with valves? Apparently, Dr. Von Schelling warned against it.
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Postby PCakes » Wed Mar 24, 2010 11:18 pm

Hello Dr Sclafani,
I have a quick and simple question...
Since jugular vein drainage occurs in the prone position... does, or could, a persons 'sleep position' effect performance? Say you sleep on your stomach with your head twisted to the side?

Thank you for sharing your thoughts and wisdom and most important... humour :)
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Circulation theory and IBT.

Postby AndrewKFletcher » Wed Mar 24, 2010 11:50 pm

drsclafani wrote:
Dr Sclafani,
Andrew Fletcher has a thread here at TIMS re: Inclined Bed Therapy--bed raised 6 inches at head, even incline down to none at foot of bed.
Many of us are doing this, and report great results in resolving to different degrees issues of circulation (myself included).

How do you see his theory in relationship to CCSVI?


I could guess.....

1. there is insufficient pressure to get adequately brain venous outflow. Raising the head of the bed might allow better gravity flow?
2. upright position increases vertebral blood flow. If the jugulars are not flowing, perhaps we get more favorable vertebral blood flow when upright

i am sure there are more guesses than there are answers
more flow through the vertebrals
2.



Dear Dr Sclafani, thank you for considering the benefits of IBT and for adding your thoughts and considerable experience to the forum on CCSVI.

I would like an opportunity to talk with you about my research into circulation and neurological conditions.

my number is +44 1803524117 to explain it in more detail.

Gravity assisted flow is a reality. Circulation improving on IBT is a reality. But as you said in an earlier post, we have circulation rather than a one-way flow. Blood cannot drain better without an adequate return flow.

Tilting the bed can only improve circulation if there is a density imbalance between the blood flowing down and the blood flowing back up. This is definitely the case when one considers the evaporative loss from the respiratory tract and the impact the evaporative loss has on the oxygenated blood leaving the lungs.

Ventilatory changes of pulmonary capillary blood volume assessed by arterial density
Journal of Applied Physiology, Vol 61, Issue 5 1724-1731,
Ventilatory changes of pulmonary capillary blood volume assessed by arterial density
J. S. Lee and L. P. Lee

By use of an improved density measuring system, we found that the gravimetric density of arterial blood of dogs fluctuates at the same frequency as the spontaneous or mechanical ventilation. Similar density fluctuations were observed in the blood leaving isolated, perfused lobes of dogs that were ventilated cyclicly. Employing an analysis that balanced the erythrocyte and plasma flows through distensible capillaries containing blood with a tube hematocrit lower than the hematocrit in large blood vessels, we derived a relationship to estimate from the density fluctuation the change in pulmonary capillary blood volume (Vc). For mechanical ventilation, the maximum change in density over one ventilation cycle increased from 0.084 +/- 0.01 to 0.47 +/- 0.05 (SE) g/l as the frequency decreased from 29 to 6 cycles/min. These density changes were estimated to be the result of an 1-16% change in Vc. A larger tidal volume for the mechanical ventilation led to a larger density fluctuation. The maximum density change of spontaneous respiration of 6 cycles/min was one-sixth of the mechanical case, indicating a much smaller change in Vc during spontaneous respiration. When the airway flow resistance was increased for spontaneous respiration, larger density fluctuations were observed.



Dr. Claude Franceschi- Director of the Paris Hospital Vascular lab spoke next on the Hemodynamic Factors of CCSVI ... He believes the answer to CCSVI may lie in postural therapy, or a direct change in pressure via the Liberation technique or stenting.


According to my theory on circulation, 17 years work: Posture should alter the density of blood:

http://hypertextbook.com/facts/2004/Mic ... kler.shtml
Blood density changes with body posture. Venous blood density is higher when a person is standing than when he is sitting. The following charts show the venous blood densities of 6 subjects as they change body positions during a 10 minute period.

I have shown how increasing the density of fluids alters the circulation experimentally using soft silicon tube in a simple experiment and was hoping you would comment on this artificial stenosis model shown in the soft silicon tube, suspended vertically a little over 2 meters high.

The videos along with a brief text explanation can be found here: http://www.inclinedbedtherapy.com as the first two links.

Photographic evidence that chronic venous insufficiency / varicose veins responds to IBT: http://www.thisisms.com/ftopict-6755.html

Recent results using IBT for people with ms: http://www.thisisms.com/ftopict-8535.html

Postural Poll for people with ms: http://www.thisisms.com/ftopic-voteresu ... erasc.html Only 84 votes so far which is pretty poor considering.

Look forward to your reply


Andrew
Find us on Facebook.com/InclinedBedTherapy
IBT website: http://inclinedbedtherapy.com
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Postby zinamaria » Thu Mar 25, 2010 2:14 am

Thank you Andrew! We are even going to raise the bed a few, maybe two inches more than the already six inches, for I don't even feel raised enough! (Frankly, I would love to find a way to sleep upright for a few years and see what the effect of that would have on MS).
But I really believe in postural theory, as I have, per your survey awhile back, and discussion on your thread on IBT, taken more breaks from sitting, when writing or painting, for I sit a lot, and I am getting up to break at least every 45 min, stretching, walking around, and this is making a huge difference in imbalance and weakness issues etc that I usually experience when I get up.
Am also, while sitting, am on a slight incline with knees below my hips, by using pillows to elevate my rump. This is relieving some pain I had been having in my hips.

Well, I don't want to change the track of this thread but felt it important to confirm your research based on my personal experience.

And Shye, thanks..how odd, I cut and pasted the info on Vit K directly from a website, so does it need correcting? Because I'll go back to the site and inform them.

I'm going on repetitious here, but Thank you, doctor for everything; especially that you just shared, in your most recent post, a NEW discovery with US..this is, well, unprecedented. That and the fact that it exposes how you are still learning, rather than, say, all the medical 'professionals' who sit in the seat of their stagnation and 'already know it all'.
I greatly appreciate your trust in the level of need, awareness, and intelligence of all of us, and, like Johnson, love how much I am learning new medical terminology AND how accessible you make this information
I feel less overwhelmed, lately, it is making a huge difference for me to be gaining clearer and further understandings of MS and of what may be at the root of our problems, instead of being uninformed, or worse yet, lost in a sea of misinformation!

Namaste (Which means simply, 'That which is sacred in me, honors that which is sacred in you')

Zina
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