DrSclafani answers some questions

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

Postby drsclafani » Fri Sep 17, 2010 6:20 am

Cece wrote:Here's another quote, katiee, that doesn't directly answer the question but I think the answer can be inferred that he's not worried about a hypercoaguable state being present during the procedure itself (since aspirin creates a hypercoaguable state including easy bruising):


CAREFUL
a hypercoagulable state is one that clots too easily
aspirin is often administered to correct a hypercoagulable state
aspirin reduces platelet stickiness and that reduces coagulability
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Re: Actin

Postby drsclafani » Fri Sep 17, 2010 6:21 am

NHE wrote:
Cece wrote:Actin is the smooth muscle cells that are part of the vein. If they're scarred or solidified in some way, then they don't stretch, then I think that's one of the ways to have a stenosis.


Close. Actin is a cytoskeletal protein found in nearly every eukaryotic cell. It polymerizes to form microfilaments which play an important role in many cellular processes. It also forms the thin filaments in the actin-myosin thin-thick filament system in muscle cells that allows a muscle cell to contract. A general reference on actin can be found at http://en.wikipedia.org/wiki/Actin and more detail can be found in any cellular biology textbook such as Molecular Biology of the Cell by Alberts et al. http://www.ncbi.nlm.nih.gov/bookshelf/b ... book=mboc4

NHE


CORRECT
it is the development of this cytoskeletal protein and its migration that leads to formed veins
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Postby Cece » Fri Sep 17, 2010 6:28 am

drsclafani wrote:
Cece wrote:Here's another quote, katiee, that doesn't directly answer the question but I think the answer can be inferred that he's not worried about a hypercoaguable state being present during the procedure itself (since aspirin creates a hypercoaguable state including easy bruising):


CAREFUL
a hypercoagulable state is one that clots too easily
aspirin is often administered to correct a hypercoagulable state
aspirin reduces platelet stickiness and that reduces coagulability

thanks

I will stick to quoting (and not attempted interpretation)!

8)
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Postby drsclafani » Fri Sep 17, 2010 6:30 am

Johnson wrote:Gee, are we permitted to talk amongst ourselves while the good doctor devours dumplings?

my first night in china, i was escorted to the dining hall of the congress. i did not see another invited colleague, i waited and waited but no one every came. I suspected an error but could not get any clarity from anyone. they all assured me that this was the dining room.
so i ate from the buffet.....but then I RAN into the dumplings, reall, delicious amazing dumplings, that i have never been able to find in a chinese restaurant in new york city (and we have a few)

Must have eaten at least fifty of them mmmm.

then someone found my wife and I and confirmed that we were in the wrong room. We were brought into a more formal and elegant place and then had another delicious dinner

gloriously glutinous

The blood thinner angle is very interesting. The Marshall Protocol to treat disease-causing chronic bacterial infections employs Benicar - which is a sartan drug. Its action is an angiotensin receptor inhibition. It is reported that it alone relieves some symptoms. A shifting mix of low-dose antibiotics is then used to kill off the infection. There was a discussion on TiMS about this back in 2006, I believe. Interestingly, it is prescribed to halt Vitamin D supplementation, avoid foods fortified or high in Vit. D, and avoid sunlight until the infection is killed. There is some interesting research into it, and something I learned is that there are 2 metabolites of D3: D-25 and D-1.25. I cannot relate it fluently because of the pea soup fog in my brain, so here are some links;

Second-guessing the consensus on vitamin D

Presentation - Vitamin D induced dysregulation of nuclear receptors may account for higher prevalence of some autoimmune diseases in women

Professor Marshall is ridiculed because he is not an MD, even though he is published in medical journals. Kind of like our friend Ashton Embry. It can take up to five years to do the job, but what the heck? I am seeing a doctor this month - who has done the protocol on himself, and is also published - to begin after my next balloon job. It makes sense to me, as I have always believed that my own dis-ease was bacterial or parasitic (I've had amoebic dysentery, Giardia, E coli, worked in Lyme-endemic areas for years...). I was going to do a thread on it, but I still haven't even written a report on my first venoplasty, and now it is popping up.

My brain is full of pearls...


thanks i have no comment or information as it relates to ccsvi.

it would be helpful if we can keep the questions and comments on CCSVI.
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Re: Bulgaria - Sofia CCSVI

Postby drsclafani » Fri Sep 17, 2010 6:40 am

joana123 wrote:Dear Dr. Sclafani,

as I promised my appeared after the liberation process in Bulgaria - Sofia.
After examination it was found to have stenosis of both jugular veins of 90% and 30% azigos vein. Zamboni '' C '' typ. ( PPMS, dg. 2004. )
The doctors reviewed the discharge summary from hospital Dedinje, Belgrade-Serbia on the basis of which they found a lot of mistakes. I did not have bulbs or malformation of the carotid artery. Do restenosis could not come because they have not done anything to expand the veins.
But it's behind me.
To return to the procedure and the operation in Bulgaria.
So, as the veins of all was fine, successfully made a balloon dilatation in both jugular veins and has established normal blood flow. Discharged with therapy pradaxa and aspirin for a one month.
After 48 hours I felt significantly more energy and after the trip that lasted more than 12 hours I got up from the wheelchair and made a few steps, and so three times in the day. I returned for a period of five months ago. I was excited and a little scared. For the first time after eight years I felt that something is getting better.
And then the next day - nothing, until today when I again felt that I had more energy and again I got up from the wheelchair and made a few steps.
I am aware that it has been just seven days after the procedure and that I feel good that only a substantial improvement ... but I also want to walk again ...
What do you think of your professional experience, what would be my recovery?
Please advice whether it would be good to start off with massage and physical therapy?
Currently with Pradax taking aspirin and vitamin B, D, Omega capsules, and drink green tea to three cups a day.

Thank you and best regards,
A.


PPMS has not been shown to have a good prognosis yet from liberation. however the patient data is too little yet.
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Postby drsclafani » Fri Sep 17, 2010 6:42 am

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Postby Donnchadh » Fri Sep 17, 2010 6:44 am

drsclafani wrote:
snip

Scar tissue or atherosclerosis causes stenosis of arteries and dialysis grafts.

snip



Some follow-up questions concerning scar tissue in veins and a resulting stenosis.

Would the IVUS be able to visualize venous scar tissue in a
stenosis? Can scar tissue be visualized in a stenosis without it?
Can a stenosis be caused by physical injury to a vein?

A number of fellow progressive MSer's have reported to me that they had prior neck/head/chest trauma before the onset of their "MS" symptoms. There seems to be a direct correlation between the severity of the trauma and the timing of emergence, type, pace of symptoms. All reported having no neurological problems prior to their trauma incident.

I suspect that the vast majority of CCSVI cases have a congenital origin, but a small percentage are due to vein injury and resulting scar formation.

Donnchadh
Kitty says, "Take that, you stenosis!"

Got MS?.....Get Liberated!
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Postby drsclafani » Fri Sep 17, 2010 6:46 am

Cece wrote:HappyPoet, that is beautiful, you outdid yourself! My congrats on the milestone as well....

*bump*

Nihao, welcome back, how was your trip? You have missed exciting things....
* Dr. Hubbard found & treated CCSVI in a Parkinson's patient! What does it mean, we do not know.
* The SIRS find-a-doctor website has added 'Endovascular treatment/CCSVI in MS' to its searchable list of areas of expertise.
*


Being listed in the SIR find a doctor website DOES NOT mean that those listed have ANY experience in that area. SIR is not endorsing those doctors in this procedure.

CAVEAT EMPTOR.....buyer beware

SIR is convening a group to establish foci for research and recommendations for training. I have been invited to attend, mid October.

As your partner in crime: please give me some of the things that you want assessed and researched. i will share during the meeting
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Postby drsclafani » Fri Sep 17, 2010 7:09 am

ConstableComfortable wrote:Dr S.

I have been giving myself a neck massage in the mornings (my MS symptoms are generally worse on waking, I guess this ties in with the jugulars kicking in when supine). I do it for about 10-15mins and use just downward strokes. The first time I did this I have powerful sensations in my lower legs and feet and afterward my walking was more fluid and could 'feel' the carpet with my toes (a sensation I hadn't realised I'd lost).

Is there any risk with doing this? (I do take aspirin as a precaution).

If there was a stenosis in my jugulars could this help correct things? (I realise if there are valve issues it probably wouldn't correct that).

When/how do the jugular veins kick in? Does my whole body have to be supine or are they working if I just tip my head back 90degrees while standing?

Would it be better to do the massage in a standing or supine position?

Good to have you back.
Thanks

Jonathan

jonathan
any answers i gave to most of your questions would be speculations and an experience of one is insufficient to draw conclusions.

I do not believe that massaging your neck would be harmful.
i can speculate that how upright you have to go to switch from jugular to vertebral flow is variable and depends upon anatomy
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Re: Old question

Postby drsclafani » Fri Sep 17, 2010 7:11 am

NHE wrote:Hi Dr. Sclafani,
Welcome back :!: I had a question from a little while ago on which I would greatly appreciate your thoughts.

Thanks, NHE

NHE wrote:Here's a question... I have read that the thoracic pump effect operates on inhalation to create negative pressure in the thoracic cavity to help draw blood down through the cerebrospinal veins and vena cava. With this knowledge, I have tried a little experiment. When laying down, I will take several deep diaphragmatic breaths in an attempt to maximize my blood return through my jugular veins. I should state that I have not been tested yet for CCSVI. The result of the experimental breathing so far is that I typically feel a pressure in my ears and in my neck (the latter is hard to describe but it is similar to what I get when I walk a couple of blocks). Can you offer an explanation for this result? Is it a sign that I might have a stenosis of some sort or is it a normal effect? If someone has cerebrospinal stenosis, would this type of deliberate breathing create more reflux and ultimately have a negative impact?


i hate to speculate on these experiments of one.
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Re: Nattokinase

Postby drsclafani » Fri Sep 17, 2010 7:12 am

error
Last edited by drsclafani on Fri Sep 17, 2010 7:56 am, edited 1 time in total.
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Re: Nattokinase

Postby drsclafani » Fri Sep 17, 2010 7:14 am

NHE wrote:

Effect of nattokinase on restenosis after percutaneous transluminal angioplasty of the abdominal artery in rabbits
Nan Fang Yi Ke Da Xue Xue Bao. 2008 Aug;28(9):1538-41.
    OBJECTIVE: To investigate the effect of nattokinase on intimal hyperplasia in rabbit abdominal artery after balloon injury and explore a novel strategy for the preventing restenosis after percutaneous transluminal angioplasty.

    METHODS: Fifty-six New Zealand rabbits were randomly divided into 7 groups, namely the solvent control group, model group, natto extract lavage group, refined nattokinse lavage group, intravenous refined nattokinse injection group, clopidogrel group and clopidogrel-aspirin group. Balloon injury was induced by inserting the catheter through the femoral artery into the thoracic aorta of the rabbits. The platelet counts were notad and platelet aggregation was observed, and the abdominal artery was taken for pathological analysis. The expressions of MMP-2 and -9 in the abdominal artery were detected immunohistochemically.

    RESULTS: There was no significant difference in the platelet counts, platelet aggregation rate or MMP-2 and -9 expression between the model group and the nattokinse-treated groups (P>0.05). The stenosis index in each nattokinse-treated group was significantly greater and the neointimal proliferation index smaller than that of the model group (P<0.01 or 0.05).

    CONCLUSION: Nattokinse can inhibit restenosis of rabbit abdominal artery after percutaneous transluminal angioplasty, which is independent of its actions on the platelet or MMP-2 and -9 expressions.

Hi Dr. Sclafani,
I've been looking into nattokinase and I ran across the published research below. Do you think that there might some benefit to using nattokinase in the treatment of CCSVI in MS patients?

Thanks, NHE


only if the patient were a rabbit.

anything that inhibits intimal hyperplasia is valuable and should be investigated but its a long way from a rabbit aorta to a human jugular vein
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Postby drsclafani » Fri Sep 17, 2010 7:15 am

saks wrote:Dear Dr. Sclafani,
It's great to have you, Dr. Sclafani, volunteering your time. Thank you also for being willing to help us with MS get liberated.

I'd like to get the procedure myself. I have a faulty valve on top of everything!

What stents are used in our USA? Do they have a name?

Again, thanks for everything.
Regards,
Synthia :)


synthia
there are too many stents approved by FDA to list here
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Postby drsclafani » Fri Sep 17, 2010 7:22 am

girlgeek33 wrote:Can you tell me how common it is to get scar tissue around or near the incision site? When there, what can be done about it? When is this serious? Can this create issues for the blood flow, especially since that's what trying to be corrected?

Thanks! Welcome back! Hope it was a good trip!

scar forms whenever there is disruption of tissue and skin. if you have a long cut, scar will form. how intense, thick, wide the scar becomes is highly variable, as you probably already know.

many IRs make a cut in skin from 2-3 mm to 10mm long. if the edges do not come together, the defect is filled with scar tissue. if the puncture site were to get infected, then the scar might be larger. Some people produce very thick hypertrophied scars called keloids.

I do not make a skin incision. I just put the needle through the skin and then put a wire into the vein and push the catheter over it into the vein without cutting the skin. my argument is that the cut is unnecessary and the likelihood of scar is much lower. it is basically like putting in an IV

nothing wrong with either technique. the cutting is the traditional way. no one ever accused me of being traditional.

however the scar is usually trivial, it is unlikely to cause problems for the veins
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Postby drsclafani » Fri Sep 17, 2010 7:25 am

NZer1 wrote:Welcome Dr. have to say I was a bit worried you seemed to be gone for some time, thought someone may have hijacked you and put you in a sweat shop treating PwMS 24/7. :lol:


i could live with that. I like steam rooms and would love to treat patients ASAP!!
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