DrSclafani answers some questions

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

Re: Naysayer question

Postby Lyon » Mon Dec 20, 2010 9:07 am

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Postby Cece » Mon Dec 20, 2010 9:08 am

Lyon, I did a search on "not inflammatory," here are some of his previous responses:
http://www.thisisms.com/ftopicp-103128.html#103128
http://www.thisisms.com/ftopicp-130197.html#130197

and perhaps this one too, it includes the phrase "so you win lyon":
http://www.thisisms.com/ftopicp-103222.html#103222
;)
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Postby Lyon » Mon Dec 20, 2010 9:11 am

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Postby Cece » Mon Dec 20, 2010 9:21 am

Lyon wrote:I didn't ask anything about "Inflammatory" and what I did write seemed to be addressed to Dr Sclafani.

He said one day that he is toxically overextended until Christmas. Toxically! I like words but that is a strong word. So until Christmas I am being more obnoxious than usual in my fielding attempts.

Also if he is toxically overextended, it's on our behalf. Not here in this thread, but there in the real world at AAC in Brooklyn.

Without the inflammatory component, I don't see that you have any argument for how a CNS autoimmune attack could progressively cause malformations of the valves?
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Postby malden » Mon Dec 20, 2010 12:39 pm

Cece wrote:He said one day that he is toxically overextended until Christmas. Toxically!


I was toxically overextended last nigh too, celebrating the birth of my niece ;)

Salute!
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Postby Lyon » Mon Dec 20, 2010 2:59 pm

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Postby Cece » Mon Dec 20, 2010 3:49 pm

Because, Lyon, you didn't ask anything about inflammatory.
Lyon wrote:I didn't ask anything about "Inflammatory" ....

Dr. Sclafani, I have been wondering about something I read in a patient's blog of her procedure done by you. She said she was asked to raise her hands over her head (or maybe straight up?) when the azygous was being imaged. Did this help you see better? Does it increase blood flow to the azygous? I thought it was an interesting detail.
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Postby drsclafani » Mon Dec 20, 2010 4:42 pm

Cece wrote:Dr. Sclafani, I have been wondering about something I read in a patient's blog of her procedure done by you. She said she was asked to raise her hands over her head (or maybe straight up?) when the azygous was being imaged. Did this help you see better? Does it increase blood flow to the azygous? I thought it was an interesting detail.


the answer will amuse you,
when we take the xray of the azygos, the best views are a straight up lateral view from right to left. IF the arms are left at the side they block the view of the azygos. So in order to get an unobstructed view, i have the patient put their arms above their head, away from their side and out of the field of view.

i know, it might not be an uplifting answer (or is it?) , but at least it isnt toxic
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Postby drsclafani » Mon Dec 20, 2010 4:44 pm

Malden wrote:
Cece wrote:He said one day that he is toxically overextended until Christmas. Toxically!


I was toxically overextended last nigh too, celebrating the birth of my niece ;)

Salute!


if she was named sally, then i'll tip one for the girl too!
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Postby drsclafani » Mon Dec 20, 2010 4:50 pm

Lyon wrote:Dr Sclafani,


It comes to mind that I don't and couldn't know the entire list of reasons behind the IUP's conviction that the problems are congenital and not accumulative damage, possibly even created by another aspect of the immune system attacking "self".

Obviously veins being crowded out by bony protrusions, muscles etc.. are just fate and human imperfections but, despite your not being part of the IUP decision, I'm wondering if you are aware of reasons which would absolutely preclude the possibility that a considerable number of venous obstructions couldn't have been the result of lesions formed by a progressive situation, such as an autoimmune attack?


Well, we have to distinguish a variety of circumstances
first the question of whether we are speaking of patients with MS or patients with ccsvi.
1. there are genetic markers on chromosomes near genetic markers for MS that have been associated with venous abnormalities of ccsvi.

2. Anatomical specimens of patients with ccsvi have not demonstrated inflammatory fibrosis in the vein.

3 analysis of the tissue shows an abnormal location of collagen and the collagen is less elastic than normal collagen in vessels. one would think that this is developmental.

but what do i know, i am toxically overloaded working two jobs on weekends to treat ccsvi
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Re: Naysayer question

Postby drsclafani » Mon Dec 20, 2010 4:51 pm

MarkW wrote:What a loaded question..............MarkW


no, malden is the one who is loaded
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Postby drsclafani » Mon Dec 20, 2010 4:55 pm

Lyon wrote:
Cece wrote:Lyon, I did a search on "not inflammatory," here are some of his previous responses:
http://www.thisisms.com/ftopicp-103128.html#103128
http://www.thisisms.com/ftopicp-130197.html#130197

and perhaps this one too, it includes the phrase "so you win lyon":
http://www.thisisms.com/ftopicp-103222.html#103222
;)
I didn't ask anything about "Inflammatory" and what I did write seemed to be addressed to Dr Sclafani.


i would ask all to try to be less inflammatory. This site is about learning, teaching questioning and answering

no question is too offensive, although my response might offend the excessively offensive questioner.

thanks everyone in my behalf but i have been taught to expect the unexpected.

lyon, no offense heard, the question is a reasonable one
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Postby Lyon » Mon Dec 20, 2010 4:59 pm

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Postby drsclafani » Mon Dec 20, 2010 5:00 pm

Lyon wrote:
Cece wrote: Without the inflammatory component, I don't see that you have any argument for how a CNS autoimmune attack could progressively cause malformations of the valves?
"without the inflammatory component"? It's already been ascertained that there isn't?

Cece wrote:He said one day that he is toxically overextended until Christmas.
I can wait for his response.....or he might decide not to respond at all.


lyon, it really doesnt act inflammatory. Most of the narrowings are focal right at the annulus of the valve. , certainly upside down valves are NOT inflammatory, they are developmental.

my oriiginal thought was indeed that the stenoses were going to be inflammatory and autoimmune, but they respond too well to balloon angioplasty.

another possibility could be post-thrombosis recalnalization, but again, it just doesnt fit
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Postby drsclafani » Mon Dec 20, 2010 5:03 pm

Lyon wrote:
drsclafani wrote:but what do i know, i am toxically overloaded working two jobs on weekends to treat ccsvi
:lol: Thanks for the response. Their use of the term "lesions" made me wonder, that's all.
Bob


"lesion" is a commonly used term in medicine. It is a catch all phrase used not only when the cause of the abnormality is unknown, but also in many other circumstances

bony lesion, breast lesion, cancerous lesion, benign lesion etc
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