DrSclafani answers some questions

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

Postby drsclafani » Mon Apr 05, 2010 10:20 pm

1) Would having chronically stuffy sinuses (for example due to allergies) theoretically increase reflux to the brain, and/or in some other way increase the negative effects of CCSVI?


it is important that there be no confusion about the abnormal sinuses associated with ccsvi. the veins of the brain drain into DURAL sinuses. these are like blood vessels and are distinctly unrelated to the PARANASAL sinuses which are air chambers in your skull.

however sneezing could increase intravascular pressure that might result in reflux
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Postby drsclafani » Mon Apr 05, 2010 10:21 pm

Would being in a head down position, such as hanging upsidedown (using an inversion table) or bending from the waist for long periods of time, (for example to pick things up off the floor or while gardening) be something that should be avoided?


i do not think so
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Postby drsclafani » Mon Apr 05, 2010 10:25 pm

Perhaps I am just one of those precocious patients who is a pain in the professional posterior?


johnson......is this a question for which you want an answer? be careful what you ask for

and yes, academic doctors love to lecture and share knowledge...or at least like to feel superior. so we tend to be comfortable giving advice
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Postby Johnson » Mon Apr 05, 2010 11:14 pm

drsclafani wrote:
Perhaps I am just one of those precocious patients who is a pain in the professional posterior?


johnson......is this a question for which you want an answer? be careful what you ask for

and yes, academic doctors love to lecture and share knowledge...or at least like to feel superior. so we tend to be comfortable giving advice


Ha! I already know the answer. Rhetoric is my friend...
My name is not really Johnson. MSed up since 1993
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keep us in the publishing loop

Postby hwebb » Tue Apr 06, 2010 12:35 am

The azygous finding was quite interesting. We were looking at chest ct scans to understand the variations in the course of the azygous vein. when we studied that we realized that we were not imaging it on catheter venography is an ideal way. We changed the orientation and all of a sudden, we have found abnormal valves in three of the last four patients.

I am looking forward to publishing on this.


Please let us know which journal, when you publish this paper. I'd like to share it with my IR and his team.

Helen
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Postby rettahb » Tue Apr 06, 2010 6:17 am

My medium size town hospital , Lawrence Kansas. Has a way of scanning and digitizing them......... Ask yours.
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Postby Donnchadh » Tue Apr 06, 2010 7:44 am

I was wondering if fear of legal problems are inhibiting doctors from pursing this new procedure to treat MS?

I know that for me, I would be willing to sign an "informed consent release" if that would help make this happen.

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

Got MS?.....Get Liberated!
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Postby drsclafani » Tue Apr 06, 2010 10:34 am

I was wondering if fear of legal problems are inhibiting doctors from pursing this new procedure to treat MS?

I know that for me, I would be willing to sign an "informed consent release" if that would help make this happen.

Donnchadh
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i can think of a few reasons
1. medicolegal risk
2. general unfamiliarity with MS
3. a healthy skepticism
4. an unhealthy skepticism
5. no neurologist partner
6. A resistant neurologist partner
7. waiting to see if reimbursement pans out
8. not interested in venous disease
9. practice too busy to take on another new thing
10. unfamiliarity with ccsvi
11. frightened by the actions of a ccsvi zealot
12. IRB challenges (I refuse to budge)
13. IRB challenges (I refuse to believe)
14. IRB challenges (Idiots run the business)
15. Golf, anyone?
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Postby ozarkcanoer » Tue Apr 06, 2010 10:38 am

:D

Dr Sclafani... I love your last answer !!!

ozarkcanoer
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Postby mshusband » Tue Apr 06, 2010 10:39 am

Dr. Sclafani ... can you check your private messages on here ...

Thanks.
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Postby coach » Tue Apr 06, 2010 11:25 am

I agree OC. and the Dr.'s sense of humor. Although MS is serious, we still need to be able to laugh.
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Postby annad » Tue Apr 06, 2010 11:36 am

Dr. S.
You're the best!
We thank you so much for your persistent effort!
:D
a
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Postby ppicklee » Tue Apr 06, 2010 12:47 pm

I found your response Dr. S absolutely hilarious. Golf! I only started to golf when I could no longer do any other form of athletics. Baseball was out, tennis was out, volleyball was out... and so on... so I started to golf! :-) that I could do with the cart and without much walking. So you can see why I think that was ABSOLUTELY HILARIOUS. Thanks for the laugh!
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Postby Cece » Tue Apr 06, 2010 12:53 pm

What a list...even the "Golf, anyone?" has some truth to it...I imagine most doctors go into the business young and hungry but end up older and sated.

On the flip side, what an opportunity, careers will be made in this.
Last edited by Cece on Wed Dec 29, 2010 3:14 pm, edited 1 time in total.
"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition
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Re-stenosis following procedure

Postby savouryourlife » Tue Apr 06, 2010 3:54 pm

I had the Liberation procedure done on March 10, 2010. I felt good for all of two days when I started to feel ill again. I was told to wait as it takes time.

I had my eco-doppler done today which confirmed the stenosis returned in the same place as it was, left int jugular vein.

I remember you stating that re stenosis does not happen immediately, yet, I'm sure it did.

I was not given blood thinners, and I have read your posts on this subject so no need to repeat. My fear is of course, that the lack of blood thinners lead to the almost immediate re-stenosis. I am not an expert.
I am at a real loss here both emotionally and financially as I can't go back to Germany nor do I know if it would be worth it seeing how fast the vein collapsed, again.

I know you won't comment on this scenario as it wasn't your work. I just wanted to state that re stenosis can happen, almost immediately, following ballooning.
Feb 18, 2010 Eco-Doppler Vaughan, MRV Frankfurt, left INT Jugular valve problem x2, RRMS since 1996, Angioplasty in Frankfurt March 10/10<div>Inclined bed therapy - 09/09/10</div>
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