DrSclafani answers some questions

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

Postby drsclafani » Wed Apr 14, 2010 8:56 pm

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?


i do not think that this is an association with ms. if it were about 25% of the population would have ms, given the crappy vein syndrome noted by medical students around the world
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Postby Lyon » Wed Apr 14, 2010 9:07 pm

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Postby drsclafani » Wed Apr 14, 2010 9:13 pm

Dr S
I know absolutely nothing about venous plumbing so I'm wondering if some of these missing jugulars are actually something that have been blocked and unused for so long that they've actually atrophied out of existence?

Additionally or instead, considering that imaging of the veins is such that dye is needed to see the flow, is it possible that some of these missing jugulars are there but impossible to see on imaging because they are blocked and there is no flow to see? I guess what I'm getting at is, would the vein itself show up on imaging even with zero flow?

Thanks,
Bob


bob you have been listening!
yes, it is quite possible, depending upon the testing done to have little flow, and thus little dye in a particular vein. This typically happens in the neck, not the dural sinuses in the brain but i guess it could happen, not sure never saw it
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Chemical Dye Density and altered blood flow.

Postby AndrewKFletcher » Thu Apr 15, 2010 1:50 am

Question for Dr Sclafani

Question regarding this dye that is used in the veins. Do you know if the molecular density or the chemicals and fluid used is identical to the blood density? Is it administered with saline solution?

I ask because it is entirely possible that the introduction of said fluids can affect the flow of blood in relation to posture should the density be either significantly higher or significantly lower than the blood in the veins where it is introduced.

I never did get any comments regarding this simple experiment showing how dissolved substances can change the pressures inside soft walled tubes?
http://www.youtube.com/user/InclinedThe ... NJHChtHklg

One could presume that too much salt is added at the top of this experiment, designed to show how a downward flow assisted by gravity has a direct influence on the return flow pressures and causes the wall on the return flow (representing the venous return) to be clearly drawn in.
Before dismissing this out of hand, let us remember we are not dealing with tubes anywhere near as tough as this silicon tubing with it's 1mm wall. In fact the silicon tube more closely resembles the comparatively robust structures of the arteries.

With this taken into account, the veins in the body would require a comparatively minuscule amount of salt to induce the same narrowing shown on the video, when we alter our posture and make use of gravity acting on density changes in the blood from respiration.

Is it a coincidence that reflux is observed during exhalation?

Do we have any evidence that altering posture alters the shape of veins, not only temporarily but permanently providing we adhere to avoiding the horizontal posture?

The term Chronic cerebrospinal venous insufficiency or CCSVI has been borrowed as you well know from Chronic venous insufficiency in the legs. Varicose veins provide visual evidence of said conditions, both internally and externally.

You say you are a simple plumber of the arteries and veins and I understand your modesty with this respect and your reasoning for this statement.

Physics affords us the simple video model, which incidentally works also in a closed loop suspended vertically. ( I will do another video to show this)

People have argued that this vertically suspended tube experiment is too simple and therefore the shown forces cannot apply to the “simple plumbing” in the body?

I question their logic. One cannot have a different set of forces applying to the body’s plumbing, it is after all a network of vertically suspended tubes.

Another argues we have a pump attached to our circulation. But the question as to why this impressive pressure and velocity in the outward flowing arteries is dampened down in the venous return. I.E. The veins do not normally inflate along with the arteries yet Starling’s law of the heart using the familiar vessel connected to the heart to show a greater returned flow (venous return flow) uses the same simple tubular principles with a huge difference. We do not need to raise the vessel in the body to alter the return flow. The body does not have such a luxury, yet is capable of performing the same improved venous return flow by altering the arterial density with every breath exhaled.
Providing we are correctly aligned with our posture either on an angle or vertical, we can make use of these subtle positive arterial pressure changes and improvements in blood flow, not only in the predominantly downward flowing main arteries.

Here we have introduced not only an improved density flow in the arteries but we have made use of the molecular drag that affects every single fluid molecule in the body by causing an additional momentum (improved circulation) in the veins, without Starling’s experiment. Alter the density and we inevitably alter the circulation and this inevitably alters the shape of the veins.

What evidence do we have to show that veins can learn to become normal veins given sufficient relief time from the direct pressure changes applied to them where no gravity assistance is applied to the said density changes from exhaling (Horizontal bedrest) ?

As it happens we have some very good examples right here in this forum, provided by Alun as photographic evidence showing how avoiding sleeping flat over many months has assisted his veins to return to more normal looking veins without the need for surgical intervention.

VV before IBT
Image
VV 6 months of IBT

The link below shows the same varicose vein 6 months later after avoiding sleeping flat using Inclined bed therapy
http://i209.photobucket.com/albums/bb31 ... lf-dec.jpg

How long will the medical profession keep ignoring these simple facts and fantastic results?
Find us on Facebook.com/InclinedBedTherapy
IBT website: http://inclinedbedtherapy.com
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Re: Chemical Dye Density and altered blood flow.

Postby drsclafani » Thu Apr 15, 2010 11:46 am

AndrewKFletcher wrote:Question for Dr Sclafani

Question regarding this dye that is used in the veins. Do you know if the molecular density or the chemicals and fluid used is identical to the blood density? Is it administered with saline solution?


The contrast media that i use is a non-ionic low osmolar contrast agent.

I never did get any comments regarding this simple experiment showing how dissolved substances can change the pressures inside soft walled tubes?
http://www.youtube.com/user/InclinedThe ... NJHChtHklg


I am sorry Mr Fletcher. This topic is not my expertise. Nor is it my interest. I am trying to answer questions regarding CCSVI but the questions you ask are highly technical and should remain on the topic thread that you have already initiated. I fear that your "questions" are more advocacy than questions and that the audience that is viewing DrSclafani answers some questions can also seek your thread on IBT which I enjoy periodically visiting.


How long will the medical profession keep ignoring these simple facts and fantastic results?

is this really a question?
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Postby drsclafani » Thu Apr 15, 2010 11:53 am

By the way do you happen to have any contacts to german colleaugues ??


I have several German colleagues who have collaborated with me over the years. I do not know if any of them are performing CCSVI or planning or participating in a trial.

I know that Tomas Vogel in Frankfurt is performing this procedure but I do not know him personally.
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Postby Nunzio » Thu Apr 15, 2010 1:45 pm

Hi Dr. Sclafani,
I had an MRV a week ago and this is the result:
IMPRESSION-
1. Patent sagittal and left transverse sinus with normal sigmoid sinus
and normal left internal jugular vein.
2. Occlusion of the proximal right transverse sinus with
reconstitution of an atretic right transverse sinus, sigmoid sinus and
internal jugular vein.
In reality I think what is wrong is the left jugular vein; the doppler showed a large diameter; about 1.4 cm. in both the sitting up and supine position.
I think this can only happen if the valve at the junction with the brachiocephalic vein is non functioning. The right jugular is narrow from lack of flow and not from stenosis
I would really appreciate your expert opinion if you are allowed to answer this kind of questions.
Molte grazie.
Nunzio
Everybody here brings happiness, somebody by coming,others by leaving.  PPMS since 2000<br />
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Postby cms1233 » Thu Apr 15, 2010 2:23 pm

Dr Sclafani, I have read all your answers to everyone and I can't thank you enough for taken your time to do that. I am looking for an explanation as to why my feet turn bright red or almost purple when I am sitting or standing. My feet immediately go back to normal as soon as I start moving. I know that others have complained about that also so it seems to be a common problem of MS. Is there a connection to CCSVI and red feet when standing or sitting? I hope this question makes sense because I have a terrible foggy MS brain. I would love to be liberated some day so I could think clearly again!. Thanks.
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Dr. Sclafani

Postby ppicklee » Thu Apr 15, 2010 3:13 pm

Thank you so much Dr. Sclafani for keeping this on-topic. You are HIGHLY VALUED as part of this forum and I would hate to have you deterred for any reason. Thank you for answering our questions. THANK YOU!
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Postby NZer1 » Thu Apr 15, 2010 3:52 pm

Hello Dr. I have been reviewing the recent media release by AAN and the National MS Society. In the reply from Dr Zivadinov to Avis Ferera from CTV (1:07mins in the recording), he speaks about the thalamus and other areas of the brain that are showing iron deposition. The imaging available now appears to make it possible to implicable processes in the brain that before this imaging became available were not possible.
In my research of my earliest MS symptoms I found they have thalamus function in all their processes.
My questions are:
Is a possible thalamus link something you can comment on?
Who has this area as a speciality?

Thanks for being there for us and your continued commitment to answers
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Postby drsclafani » Thu Apr 15, 2010 3:58 pm

Nunzio wrote:Hi Dr. Sclafani,
I had an MRV a week ago and this is the result:
IMPRESSION-
1. Patent sagittal and left transverse sinus with normal sigmoid sinus
and normal left internal jugular vein.
2. Occlusion of the proximal right transverse sinus with
reconstitution of an atretic right transverse sinus, sigmoid sinus and
internal jugular vein.
In reality I think what is wrong is the left jugular vein; the doppler showed a large diameter; about 1.4 cm. in both the sitting up and supine position.
I think this can only happen if the valve at the junction with the brachiocephalic vein is non functioning. The right jugular is narrow from lack of flow and not from stenosis
I would really appreciate your expert opinion if you are allowed to answer this kind of questions.
Molte grazie.
Nunzio


nunzio
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Postby drsclafani » Thu Apr 15, 2010 4:00 pm

Thank you so much Dr. Sclafani for keeping this on-topic. You are HIGHLY VALUED as part of this forum and I would hate to have you deterred for any reason.


it would take a lot to deter me
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Postby drsclafani » Thu Apr 15, 2010 4:29 pm

cms1233 wrote:Dr Sclafani, I have read all your answers to everyone and I can't thank you enough for taken your time to do that. I am looking for an explanation as to why my feet turn bright red or almost purple when I am sitting or standing. My feet immediately go back to normal as soon as I start moving. I know that others have complained about that also so it seems to be a common problem of MS. Is there a connection to CCSVI and red feet when standing or sitting? I hope this question makes sense because I have a terrible foggy MS brain. I would love to be liberated some day so I could think clearly again!. Thanks.


i can think of several causes for this. neurological and vascular.
As MS is a symptom complex resulting from demyelinization, there is always the possibility that the neurological consequences involve the autonomic nerves These nerves are used as part of the autonomic nervous system, an involuntary defense mechanism that has developed as a response to danger, that is, the fight or flight mechanism. It increases and decreases heart rate and function. it slows or stops the bowel or causes the bladder to contract. it also works on blood vessels.

So if the normal tone of your arteries is controlled by the autonomic nervous system, it is possible to lose control and have too much blood flow into your legs, thus they become swollen and have too much blood in them turning them red or purple. Some people call this erythromoelalgia, or painful red feet. It has several causes but MS can mimic this.

Another possibility is that you have insufficiency of the valves of your leg veins. that will also allow pooling of blood at the blood backs up

A third possiblity is that your secondary venous pump, namely your leg muscles are week and not squeezing the blood up your legs. That can cause blood to pool too.

Sorry i cannot be more definitive. If you want to share pictures of your feet, we might all start to clarify what we are talking about here.
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Postby L » Thu Apr 15, 2010 6:12 pm

Hello Dr Sciafani, hello all.

I would like to know if vasodillators might be able to alter the effects of CCSVI to any worthwhile degree.

My body has become thoroughly addicted to Chilli, a vasodillator. A bottle of Frank's hot sauce lasts me 3 days and my local curry house doesn't have the ingredients to produce a curry that's hot enough. I am starting to feel a little abnormal : ( But I can't help but feel that perhaps my body knows what's good for it.

Just typing this is making me think about the kitchen where there's a new bottle of a Jamaican hot sauce. I tried a little on the way back from the supermarket and it's pretty good..
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Postby ikulo » Thu Apr 15, 2010 6:21 pm

Dr - I am curious about the IRB process. Is IRB approval required for non-research procedures? Why are angioplasty procedures being required to get IRB approval if they are not being done for research purposes or in a research setting? Or does an IRB have wide discretion in deciding what requires approval? Thanks for your time!
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