DrSclafani answers some questions

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

Postby drsclafani » Tue Apr 13, 2010 3:12 pm

i am going to take the evening off and will answer questions later or tomorrow
i have been told by several private messages that i need to take a break

who am i to argue
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Postby drsclafani » Tue Apr 13, 2010 3:20 pm

By the way, this is the one month anniversary since i started helping with DrSclafani Answers some questions...... More than 50,000 views. Amazing.

Thank you all for the support and appreciation. I have been very fulfilled by helping you understand this stuff.

By the end of the week, I will be posting a quiz on CCSVI through a Surveymonkey survey using a link which I will post here. I hope as many of you take it as can. Let's see what you have learned and how effective I have been. So everybody start cramming :D

promise: Let no one be left behind.
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Postby QueenMum » Tue Apr 13, 2010 3:40 pm

Hi Dr. S,

I know you love this stuff, but we need a healthy, rested Rock Star/Hero/ Saint!!! Glad you will finally give yourself a break. It's a gift to you & us. Thanks for all you are doing for us!

Hugs,

Mum :wink:
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Postby tazbo » Tue Apr 13, 2010 4:42 pm

Hi Dr. Do you have any info as to when or if the approval from the IRB might happen?

Thanks for all you do...John
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Postby LR1234 » Wed Apr 14, 2010 12:15 am

Do we get a certificate if we pass? :wink:
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Postby hope410 » Wed Apr 14, 2010 12:27 am

LR1234 wrote:Do we get a certificate if we pass? :wink:


"Tell her what she's won, Johnny, why it's a free Liberaaaaaaation Treatment!!!"

:lol: :lol: :lol:

PS - Enjoy some time off, Dr. Sclafani. We need you to be healthy, well rested and in a zen-like relaxed state of mind. :D
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quiz

Postby coin » Wed Apr 14, 2010 5:08 am

a good price of the quiz would also be a free treatment plus travel costs from europe to US and then may be a ticket for a good concert (free choice what band) , dinner with Dr. Scalfani and wheelchair kamikaze,-))))))
Dr. Scalfani, you rock and I cannot express how much it is appreciated that you are taking the time to read and answer all questions! Gives hope that not all your medical professionals are a bit "uninspired" :wink:
By the way do you happen to have any contacts to german colleaugues ??

Ciao for now

Ines
Munich. Bavaria , Germany
---------------------------------------
Husband MS
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Postby HappyPoet » Wed Apr 14, 2010 7:39 am

.
Superstar wrote:promise: Let no one be left behind.

Dr. Sclafani, thank you more than words can ever tell.
.
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Live webcast

Postby rettahb » Wed Apr 14, 2010 7:41 am

Still time to register for the NMSS CCSVI web forum with Dr. Zamboni- to start in 30 minutes- (noon EST) TODAY

http://register.mediasite.com/?nd=regis ... yxt6q_yk06
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Re: Only 1 jug-question for Dr S

Postby drsclafani » Wed Apr 14, 2010 5:57 pm

Peaches1 wrote:Dr. Sclafani
I have a question for you - Is it normal and OK to have just one jugular vein? My MRV, from last wk, states "a tiny amount of flow in the left transverse/sigmoid sinus system. The images of hte neck demonstrate no significant flow in the left-sided jugular vein"
Thanks for the input and all that you are doing for this group.
Hugs from TX


it is very uncommon to be born with one jugular vein. It occurs usually when one of them becomes thrombosed usually after a catheter has been placed in it for chemotherapy and dialysis

that being said, it sounds from your mrv report as if you do indeed have a problem with your venous outflow. but it sounds like there is some problem with your dural sinus, rather than your jugular vein. thrombosis of the jugular vein has been reported to result from stenosis of the jugular vein Of course you have told us nothing about your azygous vein. ahaa, the only way to accurately see the azygous vein is via catheter venography. So are you scheduled?
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Postby drsclafani » Wed Apr 14, 2010 6:00 pm

tazbo wrote:Hi Dr. Do you have any info as to when or if the approval from the IRB might happen?

Thanks for all you do...John


no, the IRB proposal has been reviewed by six people with some good suggestions to make it suitable for early review and good chance of approval.
I am awaiting the pre-review interview
s
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Postby msgator » Wed Apr 14, 2010 6:22 pm

Hi Dr. Sclafani,

I just finished watching the panel with Drs. Zamboni, Zivadinov, Miller and Common at the AAN. The comment that caught my attention was that the venous systems associated with CCSVI form between the 3rd and 5th month of gestation. I just lost a pregnancy in February at 16 weeks, but based on the ultrasound the doctors figured the baby died around 14 1/2 weeks.

Do you happen to know if venous malformations can be severe enough to cause fetal demise? At the time I was asked if I wanted an autopsy and was not smart enough to ask for one and to have the veins looked at specifically. The regular pathology that was done showed no chromosomal abnormalities, and no reason could be given to me as to why the baby died.

I do have two healthy children and no other MS in the extended family.

Also, do people with MS/CCSVI have high resting pulse rates? Mine tends to be in the high 80s low 90s with no good explanation. I was diagnosed with RRMS in 1999, but first sought medical help for tingling in my right arm in 1996, and the nurse who examined me said at that point that I probably either had MS or an extra rib cutting off my blood supply. I have not been checked for CCSVI.

I also have always had "crappy veins." Techs have a hard time drawing blood, the flow is often poor and the veins hard to find. Anyone else have this issue?

Thanks again for all the info you provide. I am flabbergasted (and sometimes intimidated) by the incredible medical knowledge of some of the folks posting here. I hope my question are not too simplistic for this thread.

:)

Ann
always look on the bright side of life

Veins opened 10/15/10. RIJV still on the small side. Feeling much better.
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Postby drsclafani » Wed Apr 14, 2010 6:33 pm

what would Hippocrates say?


MODERN VERSION
he Hippocratic Oath (Modern Version)[10]
“ I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.
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Postby dlb » Wed Apr 14, 2010 7:03 pm

Dr. S....
It is apparent that you live by the oath you swore to and we are so blessed to have you as a member of the MS community. THANK YOU
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Postby drsclafani » Wed Apr 14, 2010 7:54 pm

Do you happen to know if venous malformations can be severe enough to cause fetal demise?


Firstly, let me tell you how sad i am that you have lost your fetus.

i am far removed from being a geneticist. I am just a simple plumber of arteries and veins, plugging them and cleaning them out
there are a number of arteriovenous malformations that can lead to fetal demise, but i do not know of any in the neck. The dreaded Vein of Galen aneurysm is a direct connection between arteries and veins draining the brain. it can lead to heart failure and death although it can be treated with good results in some children.
some of my reading also showed a variety of anomalies that led to absence of veins, but they were mostly centered around the liver and the lung veins, rather than the neck veins. Some were associated with heart defects.
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