DrSclafani answers some questions

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

Postby BBE » Thu Mar 25, 2010 3:15 am

I have a question:
Dr. Scaflani, is it true that some people have and some don`t have valves in jugular veins? It is said that you don`t need a valves above your heart. I wonder what prevents people without valves to get reflux.
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Postby Nunzio » Thu Mar 25, 2010 3:20 am

Hi Andrew,
even though I like the IBT concept, the video experiment did not make any sense to me.
If you add denser liquid on one side of a loop, its weight will pull it down and syphon the other side out. If you seal the opening then the tube will collapse because of the vacuum created.
This is a nice elementary school science experiment but has nothing to do with blood circulation.
Even admitting that there is evaporation from the lungs, the amount is insignificant and the blood from the lung passes to the heart and from there to the brain and then back to the heart without loosing any more water.
What matters is any restriction in the piping , the vertical distance between the heart and the brain and the strength of the pump.
The reason I believe IBT works it is because it shifts the load to the vertebral vein so that less blood needs to go through the jugular veins which helps if there is a restriction there.
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Postby Nunzio » Thu Mar 25, 2010 3:58 am

Good question BBE,
I know some people as Rici apparently had problem after baloon angio destroyed some of the jugular valves, but I thought valves in veins were important when the flow was against gravity, so unless you stand on your head or go in prolonged valsalva maneuver, the hemodynamic effect of loosing your jugular vein valves should be insignificant.
Thanks to Dr. Sclafani for his informative answers.
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Re: TODAY'S DISCOVERY

Postby Zeureka » Thu Mar 25, 2010 5:34 am

bmk1234 wrote:
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.

Yes, also heard of two cases that posted on TIMS, but I think at least in one case the valves had been removed completely (in the right jugular) - the other case destroyed?, and this caused somehow imbalance in blood flow + lead to reflux...in addition, the two MS patients had additional abnormal vein complications not directly related to the valve issue - so these are not very simple example cases. But clearly illustrate that in case of more complex problems of several issues for which treatment still unknown playing together (so cannot be resolved with standard ballooning or stenting) exceptions to improvements for CCSVI treatment at this time of knowledge/research exist.
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Re: TODAY'S DISCOVERY

Postby Zeureka » Thu Mar 25, 2010 5:37 am

bmk1234 wrote:
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.

Yes, also heard of two cases that posted on TIMS, but I think at least in one case the valves had been removed completely (in the right jugular) - the other case destroyed?, and this caused somehow imbalance in blood flow + lead to reflux...in addition, the two MS patients had additional abnormal vein complications not directly related to the valve issue - so these are not very simple example cases. But clearly illustrate that in case of more complex problems of several issues for which treatment still unknown playing together (so cannot be resolved with standard ballooning or stenting) exceptions to improvements for CCSVI treatment at this time of knowledge/research exist.
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Experiment does not relate to circulation

Postby AndrewKFletcher » Thu Mar 25, 2010 6:07 am

Nunzio wrote:Hi Andrew,
even though I like the IBT concept, the video experiment did not make any sense to me.
If you add denser liquid on one side of a loop, its weight will pull it down and syphon the other side out. If you seal the opening then the tube will collapse because of the vacuum created.
This is a nice elementary school science experiment but has nothing to do with blood circulation.
Even admitting that there is evaporation from the lungs, the amount is insignificant and the blood from the lung passes to the heart and from there to the brain and then back to the heart without loosing any more water.
What matters is any restriction in the piping , the vertical distance between the heart and the brain and the strength of the pump.
The reason I believe IBT works it is because it shifts the load to the vertebral vein so that less blood needs to go through the jugular veins which helps if there is a restriction there.




The opening was not sealed in the experiment, yet the tube collapses. It collapses because the downward flowing water molecules and salt pull on all of the molecules contained in the tube experiment.

The experiment at Brixham showed water flowing up and down a 48 meter length of tubing. Try siphoning above 10 meters, it can’t be done.

This is not a siphoning effect because the two open ends of the tube are at equal levels in the bottom of the jars. This can be observed at the start of the experiment by watching the water levels prior to the introduction of an “insignificant amount of salt solution”. Even more insignificant in a 48 meter length of 6 mil bore tubing filled with water. In fact 1 grain of salt can induce a flow!

While on insignificant, consider the Atlantic Conveyor System, which drives the Worlds ocean currents and governs the worlds weather. Here the insignificant density change on the ocean surface due to evaporation and cooling is sufficient to drive an underwater river that carries far more water than all of the rivers in the world put together. http://en.wikipedia.org/wiki/Thermohaline_circulation

Next time you take a leak in the toilet pan, decant the urine down the side of the toilet and watch it sink to the bottom of the pan. It does this because the insignificant salts from the blood are sufficient to counter act the density change due to the heat of the liquid. To take this to the extreme, consider a pan filled with water and a kilo of sugar added. The heating of the pan should agitate the sugar and cause it to reach the surface and mix, but it does not, it remains at the bottom of the pan heated and at a greater temperature while the surface water remains unaffected for some considerable time. http://www.youtube.com/watch?v=187awfsgHoY

If you have a thermometer, you could test this using a large vessel of water and add some coloured salt solution that is warm to the vessel. Then test the temperature at the bottom of the vessel and you will find it to be warmer than the surface. It’s just wrong to underestimate the effect of an insignificant density change.

There is no vacuum inside the tube either, just gravity applying a tension to the fluid inside of the tube and the fluid applies the same tension to the molecules of the tube wall causing it to collapse or neck.

The circulation stands around 2 meters tall in a tall person, just like the experiment. To consider that the same forces shown in the tube cannot apply to the human tube networks is ridiculous. Do we have some kind of anti gravity suit?

Instead of blocking one end up on the experiment (which was not the case btw) picture both ends joined together to form a complete circuit / circulation, even though the circulation in our body is exposed to the atmosphere via surfactant in the lungs and fluids in the skin and eyes, so cannot be considered as a closed circuit.

Sweat, saliva, tears are by no means insignificantly altered by evaporation.

Remember also that IBT is not ms specific, but has been shown to affect a whole range of medical conditions that have not had a CCSVI connection made.

Thank you for the post and I look forward to your reply.

It may interest you that in the very first pilot study, two opthalmologists wrote to me within a month of each other, one for Paignton, one from Teignmouth to ask how a couple of blocks of wood can restore someone sight who has supposedly irriversible optic nerve damage.

Andrew
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Postby sou » Thu Mar 25, 2010 6:37 am

drsclafani wrote:
After having balloon angioplasty, could we take any measures to prevent or postpone restenosis? For example, quit smoking if we smoke, take vitamins and antioxidants, reduce stress, follow a healthy diet, etc. Do you think that this could help the venous wall be more healthy?


do not forget that some doctors who perform stenting and/or angioplasty will put patients on anticoagulation. Vitamin K counteracts the coumadin. so make sure you discuss this with your physician when he puts you on coumadin to see whether you should stop vitamin k or reduce your intake of foods with vitamin k


Yes, everything after a long consultation with the vasc. surgeon.

But would you find the measures above effective in postponing restenosis and keeping the venous wall in a healthy state? Or we can't prevent/postpone restenosis anyhow?

Thank you again!

sou
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Postby Nunzio » Thu Mar 25, 2010 8:57 am

Andrew wrote:
the tube collapses. It collapses because the downward flowing water molecules and salt pull on all of the molecules contained in the tube experiment

First of all I want to commend you on your research on IBT.
I am well aware that colder or denser fluids and gasses tend to fall while warmer and less dense fluids and gasses tend to rise and that might be what make limph circulate in plants and create marine currents and hurricanes, but we are not plants and we do have a heart. Keep in mind that if salt molecule would pull on the wall of the tube they would do so also in a horizontal position. One can postulate that the blood flow from the brain is due to the fact that the blood is colder in the vein than the artery. One simple and more relevant experiment would be to measure the density of the blood in the carotid artery compared to the density of the jugular vein. I bet you the difference would be insignificant with the added effect from the osmotic pressure if there was any difference in density.
One easy test would be to stop the heart and see how much circulation is left from the evaporative effect compared to someone with the heart working but immerse in water to eliminate the effect of evaporation and gravity.
I bet you the person underwater with the working heart will have a better circulation then the person with the stopped heart.
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Postby AndrewKFletcher » Thu Mar 25, 2010 9:41 am

No more insignificant than a change in the ocean surface water density around Northern Europe.

I was showing how warmer fluids can also fall in cold water by altering the mineral content.

We don't need to show that the density of all the blood in the arteries has changed, all we have to show is where tiny insignificant pulses of more concentrated blood are released into the arteries after passing from the lungs via the heart.

The horizontal molecule is still a vertical molecule in relation to the direction of gravity and in a horizontal body the influence of such salts in this case is going to be perpendicular to the horizontal arteries, so gravity is not going to assist the movement through the vessels and alter the tension and pressure. Here we rely entirely on the heart to get us through the night.

The heart being a pump, applies pressure to both the arteries and the veins, causing the veins to inflate in some people prone to chronic venous insufficiency and no doubt CCVI.

I repeat, the only way gravity can have any affect on the circulation is if it has a density difference to act upon.

Without the density difference, no matter how small it is, gravity must act equally on all vessels and all fluids.

This cannot be the case with IBT as varicose veins return to normal veins without surgery, confirming the applied tension and pressure changes due to gravity influence.

1 grain of salt added to the top of a 24 meter closed loop of water filled tubing will cause the entire contents to circulate.

Siphon flow is completely different to the observed flow rates using salts. (siphon is much faster) and can be compared with density flow easily below 10 meters.

My late grandmother refused to lay down flat for many years. The cardiologist said he could not hear or heart and he was mystified how she remained alive, but live she did for many years, finally succumbing to cancer.

Embryology is another avenue. A chickens egg is disconnected from the hen, yet the hen knows it must rotate the egg in order for the chick to develop. There is no heart in the early stages of development. And circulation is in place long before the first heart beat. So I guess we didn’t rely entirely on the heart then either.
:D
Last edited by AndrewKFletcher on Thu Mar 25, 2010 11:15 am, edited 1 time in total.
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Start a new thread !

Postby larmo » Thu Mar 25, 2010 11:04 am

We need to keep this thread on topic. Although your information is great, it has little to do with asking Dr. S. a question that relates to CCSVI.
I don't want this thread to be 'hijacked' and consequently lose Dr. S. We NEED him, start your own thread.
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Re: Start a new thread !

Postby Mutley » Thu Mar 25, 2010 11:07 am

larmo wrote:We need to keep this thread on topic. Although your information is great, it has little to do with asking Dr. S. a question that relates to CCSVI.
I don't want this thread to be 'hijacked' and consequently lose Dr. S. We NEED him, start your own thread.


Agreed. I think the place to debate Andrew's experiments is probably on the IBT thread.
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Postby patientx » Thu Mar 25, 2010 11:16 am

For once, I agree about trying to keep a thread on topic. Why does this inclined bed stuff seem to show up in almost every thread, always with these 1000 word posts?
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Postby PCakes » Thu Mar 25, 2010 5:14 pm

my question was drowned in the ibt wave.. apologies for repeating myself..

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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Postby bluesky63 » Thu Mar 25, 2010 5:50 pm

Dr. Sclafani, I want to thank you and everyone for this great thread -- educational, eye- opening, and who could have guessed it could be so emotional and funny.

I think that somewhere in here you indicated that the venogram is a steep learning curve. By that, do you mean it's success is going to be dependent on the experience of the person doing it? I think what I'm asking is, if a person has a venogram to assess for CCSVI, how critical is it to go to someone who has already been working with this issue?

Or would you safely assume that any competent vascular specialist would recognize these malformations and be able to treat them?

We worry about these details as we bring this stuff to local vascular specialists.

Thank you from the heart for your thoughts and time. :-)
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Re: DrSclafani answers some questions

Postby Hopeful10 » Thu Mar 25, 2010 6:13 pm

Dr. Sclafani,

I want to express my gratitude for your willingness to take your precious time and share your knowledge and expertise with those of us dealing with MS.
Last edited by Hopeful10 on Mon Apr 12, 2010 9:29 am, edited 2 times in total.
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