So I guess sonographers not trained by Zamboni can't detect Budd-Chiari or May-Thurner? I've linked to studies about detecting jugular thrombosis before and before Zamboni those sonographers seemed to have no trouble detecting an occlusion. What makes this different?
Hi Concerned, I think you like to debate!
As far as I know, sonographers who detect Budd-Chiari and May-Thurner have been trained in how to detect Budd-Chiari and May-Thurner. Despite some similarities, those are different viens in different locations with different issues.
Its very hard for me to understand why others can't accept that finding a particular condition, in this case a very complex condition involving veins that change dimension depending on the patient's position, as well as have a wide variety of issues, such as malformed valves, stenoses, webs, septums, reflux, etc, would not require specialized training to detect.
I pretty much take Dr. Sclafani's at his word when he says that his sonographer who is an expert sonographer, had difficulty finding CCSVI until he went through the training, and now he finds it quite readily. This is no different than learning any other new skill. It is not a sign that the condition is imaginary. Its a sign that its a specific learned skill.
What we really need in order to be able to determine to everyone's satisfaction if CCSVI is real, is a study where the sonographers have recieved extensive training from Dr. Zamboni, and THEN have the sonographers test a number of patients in a double blind fashion, where half have MS and half do not, and see what they find.
I'm not opposed to skepticism, it can be healthy. But in order to get past the skepticism, to determine whether Dr. Zamboni's protocol is or is not effective, one must use that protocol, test that protocol. In order to test the protocol, you have to train the sonographers in the protocol.
By the way, I remember reading in Dr. Sclafani's thread that thrombosis of the IJV'is very easily found with standard ultrasound, it does not require additional or specialized training beyond what sonographers learn in sonography school. Some techniques just are simpler, others are more subtle and complex, requiring more training.
I think its a little like learning to play chopsticks versus a sonata on the piano.