When someone is diagnosed with liver disease, the veins are checked. If the hepatic vein is blocked, and there are signs of collaterals and inefficient drainage, the diagnosis is Budd Chiari. In organ failure, the venous system is routinely checked. Blood flow is considered an important assessment.
Hearing Dr. BB Lee in Bologna was a mind-opening experience. Here stood an eminent researcher and physician stating that we had no idea how slowed extracranial venous drainage of the brain affected gray matter. There were simply no studies. And this astounded him. But if we looked to Budd-Chiari, we could see how a lifetime of slowed perfusion could damage the organ beyond repair. And there are no brain transplants.
Marc, I'm sure there are people with blocked hepatic veins whose collaterals are just fine, and they go to their graves with mildly impaired livers. I'm sure there are migrainers who have some venous issues and may show a bright spot on MRI...but this does not mean that venous drainage impairment can be tolerated by everyone . I'm sure the doctors can remove jugular veins in cancer patients, and they can show you another person who has the exact same blockage as you, Marc. But they are not you.
There may very well be some crazy, Rube Goldbergesque process in MS...venous stenosis + EBV infection + blood pressure changes + insufficient vitamin D + a bit of bad luck/genes and you get MS. Who knows? But the fact that venous anomalies are showing up in MS patients and confounding vascular doctors and IRs should give us pause. And if patients want to have their veins opened, they should be allowed to be seen and treated by vascular doctors, just as Budd Chiari patients are. Because the brain is damaged and the veins draining that organ are not working properly.
And I don't see your essay as anything more than your usual thought-provoking and articulate writing, Marc.
cheer, I think we're in agreement on just about everything regarding CCSVI. You may be a less skeptical than I, but it's not as if I'm a doubter. It's really just a matter of degree.
I too believe that patients should be able to address any venous abnormalities found within them. Unfortunately, in order to do that, most now have to fly out of the country to visit physicians in far off lands. That presents problems if they suffer restenosis or some other problem at some point after their procedure. I know you have said that Jeff has had to have at least one "tuneup", and if that tuneup required flying all the way back to Poland or Bulgaria, it wouldn't be such an easy proposition. Even without episodes of restenosis, follow-up care is vital, and I hope that all patients seeking treatment in far from home understand this.
As I stated in my essay, the experience of the doctor doing the procedure is also of critical importance. This isn't a procedure that doctors become instantly proficient at.
Thanks for the comments about my writing, and kudos to you for continuing to lead the charge...