I was at Kostecki's office on Friday

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I was at Kostecki's office on Friday

Postby greyman » Sun Mar 28, 2010 11:33 am

For a post-op check-up. I was very happy when I heard that everything is ok, meaning that the jugular veins are 100% patent. However in the right jug the valve has some tendency to make an insignificant narrowing. This must be tracked.
I also asked the Dr. what he thought about Rici's case. He was pretty sure that not only the stents were the reason of this problem, he believes that something else must have happened. His advice was to never let one's head lying flat, because this is the only way for the blood to reflux back to the brain.

That's why I'll soon try IBT :).

Regards,
Adam
RRMS, 1998 L optical nerve, diagnosed 2000. Self-assessed EDSS 4.5-5.0
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Postby mswife2311 » Mon Mar 29, 2010 3:05 am

Good to know that everything is ok with you. Can you tell me if you know, how many procedures has Dr. Kostecki done? I know he was working with Dr. Simka and he has started his own clinic in Tychy. Just wanted to know how many patients he has seen.

Thank you!
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Postby greyman » Mon Mar 29, 2010 4:26 am

mswife2311 wrote:Good to know that everything is ok with you. Can you tell me if you know, how many procedures has Dr. Kostecki done? I know he was working with Dr. Simka and he has started his own clinic in Tychy. Just wanted to know how many patients he has seen.

Thank you!


Hi,
I believe that Dr. Kostecki hasn't performed any procedure yet. I might be wrong, though. For the time being he seems to be only an "external radiologist" for Euromedic.
Regards,
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Re: I was at Kostecki's office on Friday

Postby Rici » Mon Mar 29, 2010 1:09 pm

greyman wrote:For a post-op check-up. I was very happy when I heard that everything is ok, meaning that the jugular veins are 100% patent. However in the right jug the valve has some tendency to make an insignificant narrowing. This must be tracked.
I also asked the Dr. what he thought about Rici's case. He was pretty sure that not only the stents were the reason of this problem, he believes that something else must have happened. His advice was to never let one's head lying flat, because this is the only way for the blood to reflux back to the brain.

That's why I'll soon try IBT :).

Regards,
Adam

Hello
I have a stent to the left (19.X.2009), 7 weeks o.k. Balonning right (21.XII.2009) I have turbo M.S. from 23.XII.
Regards
Rici
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Re: I was at Kostecki's office on Friday

Postby greyman » Tue Mar 30, 2010 12:00 am

Rici wrote:Hello
I have a stent to the left (19.X.2009), 7 weeks o.k. Balonning right (21.XII.2009) I have turbo M.S. from 23.XII.
Regards
Rici


Yes, I remember.
But what else Dr. Kostecki said was that it actually doesn't matter if it's ballooning or stenting. Both procedures aim at somewhat (or totally) destroying the valves. The assumption is that even without them reflux cannot happen, especially in the upright position.
Br,
Adam
RRMS, 1998 L optical nerve, diagnosed 2000. Self-assessed EDSS 4.5-5.0
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Re: I was at Kostecki's office on Friday

Postby Johnson » Tue Mar 30, 2010 1:11 am

greyman wrote:
Rici wrote:Hello
I have a stent to the left (19.X.2009), 7 weeks o.k. Balonning right (21.XII.2009) I have turbo M.S. from 23.XII.
Regards
Rici


Yes, I remember.
But what else Dr. Kostecki said was that it actually doesn't matter if it's ballooning or stenting. Both procedures aim at somewhat (or totally) destroying the valves. The assumption is that even without them reflux cannot happen, especially in the upright position.
Br,
Adam


Hi Adam, I'm glad that you are feeling well.

I think that there is something important to be learned from Rici's case, and I am having the impression that it is not being learned. Why not fix the stenosis, then check the valves to see if normal function is restored, instead of assuming that they are the problem? The valves are there for a reason, just as the appendix, or tonsils, etc. are. We can live well enough without them, but homeostasis must be affected. NHE posted an abstract on IJV valvular incompetence in relation to COPD, and such, that is pertinent. We do the valsalva dozens of times a day or more; sneezing, BM, coughing, blowing our noses, bending over, etc. My impression is that we would be refluxing back into the head each and every time, without valves.

"The assumption is that even without them reflux cannot happen, especially in the upright position." You know what they say about assumptions...

I have pathological IJV valves just above a very significant (to me) stenosis, and there was a good deal of reflux (or "turbulence"), both supine and erect. My jugs don't collapse when I am upright. I believe that the stenosis is that the blood either can't drain, or, it takes a very long time to do so. Dr. Sclafani thought that the IJV stenoses (2 each side) were probably secondary to a lower problem. I am not a patient of Dr. Sclafani, nor consulted with him, he just casually commented on my pics.

The valve issue makes me a bit nervous, as I think the learning curve is steep, and we are not yet near the top.
My name is not really Johnson. MSed up since 1993
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