DrSclafani answers some questions

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

Postby drsclafani » Fri Jun 24, 2011 11:47 pm

Cece wrote:
drsclafani wrote:The more i treat this, the more I believe that i am not treating MS at all, but most of the time treating ccsvi.

How do you untangle the two. If symptoms respond to CCSVI treatment, those were CCSVI symptoms? (And whatever does not respond, that is the MS?)


this is a belief, not a truth.
i look at those symptoms that resolve within 24 hours to be ccsvi related.
I cannot explain improvements that occur so quicklyi as altering the pathology of MS . There can be no basis for a reduction in inflammation, autoimmunity or demyelinization occuring so quickly.

So i suspect that fatigue, cog fog, memory problems, some forms of spasticity, urinary incontinence and balance issues may be related closely to venous hemodynamics and CSF hydrodynamics resulting from venous alterations, rather than due primarily to the inflammatory process

Its just a hunch
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Plavix

Postby sara2407 » Sat Jun 25, 2011 5:47 am

Dear Doctor,

how long should I take Plavix after stent placement in azigos vein?
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Postby Cece » Sat Jun 25, 2011 9:15 am

Sara, what does your doctor recommend?

(Dr. Sclafani typically prescribes Arixtra, not Plavix; there are big differences between the two.)
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Postby Cece » Sat Jun 25, 2011 9:30 am

drsclafani wrote:
Cece wrote:
drsclafani wrote:The more i treat this, the more I believe that i am not treating MS at all, but most of the time treating ccsvi.

How do you untangle the two. If symptoms respond to CCSVI treatment, those were CCSVI symptoms? (And whatever does not respond, that is the MS?)


this is a belief, not a truth.
i look at those symptoms that resolve within 24 hours to be ccsvi related.
I cannot explain improvements that occur so quicklyi as altering the pathology of MS . There can be no basis for a reduction in inflammation, autoimmunity or demyelinization occuring so quickly.

So i suspect that fatigue, cog fog, memory problems, some forms of spasticity, urinary incontinence and balance issues may be related closely to venous hemodynamics and CSF hydrodynamics resulting from venous alterations, rather than due primarily to the inflammatory process

Its just a hunch

It seems to be a logical hunch.

We are certainly familiar with the immediate improvements vs the gradual improvements. From my experience, brightening of colors and some vision issues could be included on the immediate list. :)

What I also see in the statement that most of the time you are treating CCSVI, not MS, is that the CCSVI is significant enough to warrant treating in and of itself.
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Postby cheerleader » Sat Jun 25, 2011 10:05 am

drsclafani wrote:So i suspect that fatigue, cog fog, memory problems, some forms of spasticity, urinary incontinence and balance issues may be related closely to venous hemodynamics and CSF hydrodynamics resulting from venous alterations, rather than due primarily to the inflammatory process

Its just a hunch


Hi Dr. S,
Hope you're doing OK.
Mike Dake has the same hunch as you. He told us he saw similar improvements in patients he treated for vena cava syndrome. He thought it might be increased O2 availabilty/better circulation. Those are all the symptoms my husband had relief from (including heat intolerence) and continues to have relief from, two years later.
Good luck with preparing for the symposium in Manhattan.
all best,
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby DrDiana » Sat Jun 25, 2011 10:11 am

drsclafani wrote:diana
keep up your good work. We share this interest in ehlers danlos. There was a patient who once visited here who showed a mrvenographic image that he thought showed venous stenosis but i thought was an artery. After some conversation, i suggested that he had ehlers danlos or some variant. advised him to get checked out, but he never returned to the site. If you are reading, please share the followup.

but i digress, sorry.
in order to snip off a bit of valvular tissue i would need a special instrument that i do not have. too bad!!! that would be great.


Will do!
Is there hope that your valvulotomy instrument may be able to do that someday? I'm interested in seeing what cells may be actually attached to the veins, causing a possible change in collagen types. Alternatively, I know this is dicey, but could a "mini -swab" of the vein's interior be taken?
Thank you so much for all of your hard work and your willingness to listen to so many people coming from so many different backgrounds. :D
Dr. Diana

Special interest in "brain drains" and how they affect numerous conditions, including MS, Ehlers-Danlos, Parkinson's, Alzheimer's, etc. I am a therapeutic optometrist on professional disability with EDS, POTS, CCSVI, mast cell disea
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Postby drsclafani » Sun Jun 26, 2011 9:57 am

cheerleader wrote:
drsclafani wrote:So i suspect that fatigue, cog fog, memory problems, some forms of spasticity, urinary incontinence and balance issues may be related closely to venous hemodynamics and CSF hydrodynamics resulting from venous alterations, rather than due primarily to the inflammatory process

Its just a hunch


Hi Dr. S,
Hope you're doing OK.
Mike Dake has the same hunch as you. He told us he saw similar improvements in patients he treated for vena cava syndrome. He thought it might be increased O2 availabilty/better circulation. Those are all the symptoms my husband had relief from (including heat intolerence) and continues to have relief from, two years later.
Good luck with preparing for the symposium in Manhattan.
all best,
cheer


thanks Cheer

hoping for a last minute rush in registration, though

iCB Biggs will give some exciting basic lectures on the role of venous drainage on CSF drainage. I think that this also plays a role in rapid improvements.
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Postby jgalt2009 » Sun Jun 26, 2011 11:01 am

drsclafani wrote:The more i treat this, the more I believe that i am not treating MS at all, but most of the time treating ccsvi.

and

drsclafani wrote:this is a belief, not a truth.


Dear Dr. Sclafani,

Please clarify... do you mean to imply that there is mutual exclusion? Isn't it possible that CCSVI is causative for symptoms that can be relieved immediately via treatment, but could also contribute to long-term CNS damage (and therefore MS)? If hypertensive intra-cranial pressure contributes to CNS damage, and is relieved by CCSVI treatment, aren't you also treating MS?

I know my wife has MS. I also know she has CCSVI. I desperately want to have hope that there is some linkage between the two. If we don't see immediate results after surgery, is it too much to hope that we have at least allieviated one causal component of MS?
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Postby fogdweller » Sun Jun 26, 2011 11:54 am

drsclafani wrote:The more i treat this, the more I believe that i am not treating MS at all, but most of the time treating ccsvi.


This seems more true as more evidence comes in, but how do you explain Dr. Zamboni's original findings that sparked this whole issue, that MS was largely convined to those with MS? Even if those without MS and who have CCSVI are a large number of patients, the fact that most MS patients have CCSVI strongly suggests to me that there is a strong link between the two. Maybe not causal, but something. Do you start to suspect MS causes CCSVI sometimes?
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Postby drsclafani » Sun Jun 26, 2011 8:40 pm

cheerleader wrote:
drsclafani wrote:So i suspect that fatigue, cog fog, memory problems, some forms of spasticity, urinary incontinence and balance issues may be related closely to venous hemodynamics and CSF hydrodynamics resulting from venous alterations, rather than due primarily to the inflammatory process

Its just a hunch


Hi Dr. S,
Hope you're doing OK.
Mike Dake has the same hunch as you. He told us he saw similar improvements in patients he treated for vena cava syndrome. He thought it might be increased O2 availabilty/better circulation. Those are all the symptoms my husband had relief from (including heat intolerence) and continues to have relief from, two years later.
Good luck with preparing for the symposium in Manhattan.
all best,
cheer


thanks Cheer

hoping for a last minute rush in registration, though

CB Biggs will give some exciting basic lectures on the role of venous drainage on CSF drainage. I think that this also plays a role in rapid improvements.

This weekend i treated a composer of classical music from Greece. Her disabilities are inhibiting her abilities to play piano.

It made me think of your husband. I hope intensely for results as good as those of your spouse.
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Re: Plavix

Postby drsclafani » Sun Jun 26, 2011 8:43 pm

sara2407 wrote:Dear Doctor,

how long should I take Plavix after stent placement in azigos vein?

i agree with cece..
Before giving my opinion, I would want to know what your doctor has recommended.

Why did you get a stent?

DrS
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Postby drsclafani » Sun Jun 26, 2011 8:57 pm

jgalt2009 wrote:
drsclafani wrote:The more i treat this, the more I believe that i am not treating MS at all, but most of the time treating ccsvi.

and

drsclafani wrote:this is a belief, not a truth.


Dear Dr. Sclafani,

Please clarify... do you mean to imply that there is mutual exclusion? Isn't it possible that CCSVI is causative for symptoms that can be relieved immediately via treatment, but could also contribute to long-term CNS damage (and therefore MS)? If hypertensive intra-cranial pressure contributes to CNS damage, and is relieved by CCSVI treatment, aren't you also treating MS?

I know my wife has MS. I also know she has CCSVI. I desperately want to have hope that there is some linkage between the two. If we don't see immediate results after surgery, is it too much to hope that we have at least allieviated one causal component of MS?


NO, i gave no implication. I cannot prove that CCSVI is causitive of MS or the result of MS.

MS is an inflammatory disease of unknown etiology that appears to have some manifestations of autoimmunity and results in loss of myelin and ultimately death of neurons. i find it incomprehensible to think that opening the veins will reverse that process. Inhibit it , perhaps, but not treat it.
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Postby drsclafani » Sun Jun 26, 2011 9:09 pm

fogdweller wrote:
drsclafani wrote:The more i treat this, the more I believe that i am not treating MS at all, but most of the time treating ccsvi.


This seems more true as more evidence comes in, but how do you explain Dr. Zamboni's original findings that sparked this whole issue, that MS was largely convined to those with MS? Even if those without MS and who have CCSVI are a large number of patients, the fact that most MS patients have CCSVI strongly suggests to me that there is a strong link between the two. Maybe not causal, but something. Do you start to suspect MS causes CCSVI sometimes?


Yes, the associating between ccsvi and ms is quite clear to me. I do not believe that MS causes ccsvi.
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Postby Cece » Sun Jun 26, 2011 11:01 pm

drsclafani wrote:MS is an inflammatory disease of unknown etiology that appears to have some manifestations of autoimmunity and results in loss of myelin and ultimately death of neurons. i find it incomprehensible to think that opening the veins will reverse that process. Inhibit it , perhaps, but not treat it.

This is MS as currently defined. Although it is unproven, the discovery of CCSVI opens the door to the possibility that MS is an inflammatory disease of vascular origin. Then it becomes less incomprehensible that a vascular fix impacts a disease of vascular origin, although the immediate symptom relief would still be due to the direct effects of the CCSVI.
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Re: Plavix

Postby Cece » Sun Jun 26, 2011 11:10 pm

drsclafani wrote:
sara2407 wrote:Dear Doctor,

how long should I take Plavix after stent placement in azigos vein?

i agree with cece..
Before giving my opinion, I would want to know what your doctor has recommended.

Why did you get a stent?

DrS

When you ask why a patient received a stent, which we have heard you ask before, are you looking to see if a patient received a stent unnecessarily?
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