This Is MS Multiple Sclerosis Community: Knowledge & Support

Nigel, it is always difficult to respond to your hypotheses because they are so complex, filled with wisdom and also filled with concepts that i dont agree with or that are hypotheses that I cannot refute.

_________________
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

I WOUND NOT AGREE WITH THAT. i AM FAIRLY SURE THAT FOR THE MOST PART THE VALVES AND TISSUES CONNECTED TO MALFORMED VALVES ARE WHAT ARE STRETCHED AND TORN



actually, i do not feel like i am in the dark anymore. i am fairly confident that I know what i am doing and how things are opened.

my problem is mostly in predicting who will respond to that treatment




pathology studies require either surgery or autopsy to get the tissue to do pathological studies. The good thing is that most patients with MS do not die at an early age.



nigel, i am sure you are not a willing volunteer for such pathological studies. we want you to keep on living!!!

_________________
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

Nigel, thank you for this discussion. It leads me to discuss what i think it sreally going on with the valves.

Integrating what i see by coppler ultrasound, venography and IVUS, I am of the opinion that there are many variable possibilities. I say possibilities because our imaging is still imperfect, even with IVUS. Perhaps the next iteration of IVUS, the so called high resolution IVUS, will expand our understanding. For the most part i now think that the abnormalities at the valves include stenoses valves of thickened tissue that does not open, thick valves that are scarred together, thick valves with septums attaching to the vein wall preventing opening and closing, valves associated with webs that are tissue bands and cells that restrict flow. true full septums that divide the lumen of the vein into segments and each segment has less flow that their total area. I am sure there are other variations. I agree that pathology studies will provide new insights, but these are are not perfect either because what they show is not identical to what is seen in a living beating flowing vein.



Again, Negel, there are two kninds of reflux, reflux of blood flowing up from the heart and refluxifrom blood flowing down from the brain. Very different ideas.



probably, blut this is not all about flow



only in a general sense. Stroke is so very different from this

Is there a problem remaining with CSF flow that hasn't returned to normal or first treatment quality. The CSF flow and symptoms are very similar to CCSVI and MS symptoms?



yes, in some way, i think that venous outflow obstruction impedes CSF drainage. Dont the ventricles drain through the pacchionian granulations into the veins?



i agree




interesting, can you send me the references



yo no se, mon

_________________
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

yes, if i understand your question correctly


absolutely



what a waste that would be. most of the risk and none of the benefits.

Nigel, you have to explain to m e the rationale for that one. But we should do it in person.

as the Firesign Theater said: You have to stick it out if you want to get a head

_________________
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

cece

when ultrasound echos are put through a computer they created images. These are B-mode

_________________
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

nigel two commends.


I DO NOT TREAT MS; I TREAT CCSVI. IF YOU HAVE SYMPTOMS THAT M IGHT BE CCSVI THEN I WILL TREAT YOU. lET THE CARDS FALL WHERE THEY MAY.


YOU ARE HIGHLY LIKELY TO HAVE VALVULAR ABNORMALITIES IF YOU HAVE MS. DOING A SIMPLE VENOPLASTY WILL DETERMINE WHETHER AND HOW MUCH BENEFIT YOU DERIVE. THIS IS NOT THAT COMPLICATED, ALTHOUGH THE UNDERSTANDING IS PRETTY COMPLICATED. bUT IN GENERAL, M OST OF THIS IS PRETTY STRAIGHTFORWARD. DERRICK HAD SOME STENOSES, THEY WERE TREATED, HE GOT BETTER. HOORAH!

OTHERS DONT DERIVE A BENEFIT: SO TRAGIC, BUT SITTING ON THE SIDELINE NEVER GETS YOU A DANCE.

WITH REGARD TO THE LAST POINT: I AM 65 YEARS OLD. THE ONLY WAY I WILL STOP DOING THIS IS IF THERE IS INSUFFICIENT PATIENT INTEREST TO CONTINUE. IF I GET TOO OLD, I WILL TRAIN SOMEONE TO TAKE OVER M Y PRACTICE.

WHAT IS THE ISSUE? I LOOK AT LIFE AS A SIMPLE PROPOSITION, MADE COMPLICATED BY HUMAN THINKING

_________________
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

ONE EYE

ITS NOT WORKING OR RETIREMENT THAT FRIGHTENS ME, ITS THE ALTERNATIVE

IF THERE WERE ENOUGH PATIENTS, I WOULD HIRE A PROTOGE AND CONTINUE THIS INTO THE FUTURE.

IN THE MEANTIME, ENJOY ME!

_________________
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

just a hunch based upon an educated guess, but YES, i do think second procedures will play a role. we just have to get them funded because who can afford them!

_________________
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

my assessment was that the patient i described did not have EDS.

but have no doubt the veins of PwMS are different, thicker, denser collagen in the wall,

_________________
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

I looked up the ultrasound criteria from Dr. Zamboni that specifically mentions b-mode:
http://www.fondazionehilarescere.org/pd ... 5-ANGY.pdf

When I had a follow-up doppler this spring, my local IR thought it was good that he could not see any sign of the previously treated valves in either jugular vein. If he had seen a valve, would that have been a b-mode finding?

Thanks Dr S for all your replies I have been brewing a few more for you but in the mean time I'll put a copy of a question to Dr F that was sparked by one of your answers to me Dr S.

Quote
"Hi everyone,
I have a question that has sparked from reading another thread.

** When the Dr Rosa team do there imaging do they check in several positions of rotation and forward or backward tilt of the head to get the readings regarding CSF flow and hopefully artery and vein flow?
Happy Poet are yo able to help with this please?

I am going to look for the earlier studies on blood pressure if any one has a link please could you let me know. What I recall is that the BP for people with high BP changed when they had an Altas adjustment.

My understanding from watching Dr S thread is that the flow readings will change with head rotation and neck position, which is natural and makes perfect sense. I am wondering if this is taken into account and publicised in the Dr Rosa and the other study on BP changes.

If Dr S is finding positive and negative readings purely because of rotation and position in the jugulars for instance with position and rotation then it will correspond with readings in the flows of all fluids in and out and CSF higher up. Its simply a case of where the hose is crimped, it won't matter where down stream for the testing only up stream position and finding it to check for pressure before and after so that you find the pressure point and the same corresponding zero pressure on the other side of the 'crimp'.

The Fonar study on CSF flow changes because of an AO adjustment;
http://www.fonar.com/pdf/PCP41_damadian.pdf"
Quote
"The first important observation of this study of eight MS patients was that every MS
patient exhibited obstructions to their CSF flow when examined by phase coded CSF
cinematography (ciné) in the upright position (Table 2A, col. 10 & 13). All MS patients
exhibited CSF flow abnormalities that were manifest on MR cinematography as interruptions to flow or outright flow obstructions somewhere in the cervical spinal canal,
depending on the location and extent of their cervical spine pathology (Table 2A, col.
10, 11 & 13). Normal examinees did not display these flow obstructions (Table 2B, col.
10 & 11)."
And from Dr CHU in the same publishing
"If trauma induced “leakage” of CSF proteins into the surrounding brain parenchyma,
and particularly “leakage” of antigenic proteins, is contributing to the formation of MS
plaques, then the vascular expansion stenting of the Azygous and Internal Jugular Veins
recommended by Zamboni et al. (16) could be monitored after installation by UPRIGHT
®
phase coded MRI measurements of CSF flow. Upright phase coded imaging of
CSF flow would assure that installed expansion stents are achieving the corrections of
CSF flow dynamics and intracranial pressure (ICP) that are needed to terminate plaque
generating CSF “leaks”.

Regards Nigel
ps Dr S did you get my questionnaire back?

Found the article that imo goes hand in hand with the jig saw, Dr Zamboni, Dr Schelling, Dr Flanagan, Dr Damadian, Dr Rosa, Dr Zivadinov et tal , in relationship of all flows Blood in/out and CSF. And the crossing of the BBB and CSF is being pumped into the white matter.

http://www.nucalispinalcare.com/pdf/1.pdf
Quote;
"Secondary efficacy end points
A summary of the X-ray changes both pre- and postprocedure throughout the study is noted in Table 3.
It is noteworthy that the difference in both rotational
and lateral positioning persisted for 8 weeks, as did
the reduction in BP, Table 3."

Thought fodder,
Nigel

Dr S this radiology finding where the valve or other issue is no longer visible seems to be important?
Is this what you are finding? and the rest of the IR's of course

If the vein is repairing and not leaving obstructions that could impede flow then there is an amazing positive in the jig saw picture?

Regards
Nigel

Nigel
thank you for this interesting paper. But I do not see the relevance of hypertension to ms or to ccsvi. Not to disparage the theories regarding venous obstruction and atlas malalignment, this paper does not address this issue. It will be interesting to see if realignment of the atlas in PwMS will lower their blood pressures. I find that most of my patients have lowish bp. I am realy curious about atlas realignment's effect upon emissary vein flow.

_________________
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

From conversations with Dr F the BP effect may also be altered by the contact of the Brain stem where the BP is sensed from. If the contact is relieved the BP is effected.
I think that the low BP in MS is more of a clue than we have taken notice of. The balance issues also can be derived from alignment issues because of the disruption to the ear canals. So it seems to me that some more symptoms may be packaged with alignment, some with CCSVI and a combination of alignment and vascular malformation or function tips people into various disease categories/ or dx's.
Parkinson's, Alzheimers, MS, Irritable Bowel, and many more are being drawn into this picture of dx's of these causes (alignment and vascular combined).

**Dr S how long does the research give for internal vascular healing as an average? Double treatment time frames? Broken nose healings are all I know about, lol.

Nigel