a role for post-procedure oxygenation?

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

a role for post-procedure oxygenation?

Postby Cece » Sun Jan 09, 2011 4:52 pm

Does anyone think there should be a role for post-procedure oxygenation, right there at the clinic or hospital? Normobaric oxygen is simply a mask and pure oxygen. Hyperbaric oxygen is more complicated.

If some of our improvements result from increased oxygenation of the tissues, then couldn't oxygenation speed the improvements?

I've been looking at delayed neurological sequelae of CO poisoning as an analogue to multiple sclerosis. CO poisoning results in hypoxia, particularly of the brain's white matter (and also the heart). CO poisoning can result in inflammation and white matter lesions. There can be a latent period where the patient seems fine for many days and then suffers delayed neurological issues.

CO poisoning is treated with oxygenation, either normobaric or hyperbaric depending on the degree of poisoning. This treatment is to help clear the carbon monoxide from the tissues and to relieve the tissue hypoxia (in the brain and heart). I am looking for anything in the CO research to see if treating with hyperbaric oxygen even long after the poisoning incident can result in improvements. That would be analagous to our situation, I think.

Before CCSVI treatment, getting treated by hyperbaric oxygen would be like getting treated while the poisoning was ongoing. But after CCSVI venoplasty, there may be a role for re-oxygenation.
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Postby dc10 » Sun Jan 09, 2011 5:16 pm

In my balloon angio i was put to sleep with General anaesthetic, after the procedure when i woke i had two small tubes in my nostrils with oxygen coming out, not 100%sure why


also i remember a few years ago when i would go clubbing, smoking was aloud in nightclubs, so my legs would weaken after standing/moving for a while, but when i stud under a air-con unit with the clean air blowing down on me my legs would suddenly become a lot stronger

i guess this was fresh oxygen, and recently have considered buying a hyperbaric oxygen chamber to see if it will improve my mobility due to the fresh oxygen

does that sound likely?
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Postby L » Sun Jan 09, 2011 5:28 pm

In Alexandria they had me booked in at a hyperbaric chamber the day following my procedure and recommended that we go regularly on our return home if possible.
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hyperbaric chamber

Postby jak7ham9 » Mon Jan 10, 2011 9:15 am

For whats its worth I own a hyperbaric chamber. It works well at getting rid of cog fog memory loss and lessening spastisity. It is not a cure for ms but it let the brain still function. When I don't go in I am sluggish and feel like my brain is swiss cheese. I went in this 5am for 2 hours I got out smoothly and limberly the effects don't last but at least you have energy don't sleep all the time and can think. I 100% think it will help repair damage when they've fixed my stensosis for good. Dr thom at univ of pennsylvania uses them for neurlogical and stroke repair he says hbot greatly increases amont of stem cells . Barbara
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I AGREE CECE !! from Wiki pedia http://en.wikipedia.org/wik

Postby Gordon » Mon Jan 10, 2011 9:20 am

Signs and symptoms
The brain requires approximately 3.3 ml of oxygen per 100 g of brain tissue per minute. Initially the body responds to lowered blood oxygen by redirecting blood to the brain and increasing cerebral blood flow. Blood flow may increase up to twice the normal flow but no more. If the increased blood flow is sufficient to supply the brain’s oxygen needs then no symptoms will result. [14]

However, if blood flow cannot be increased or if doubled blood flow does not correct the problem, symptoms of cerebral hypoxia will begin to appear. Mild symptoms include difficulties with complex learning tasks and reductions in short-term memory. If oxygen deprivation continues, cognitive disturbances and decreased motor control will result.[14] The skin may also appear bluish (cyanosis) and heart rate increases. Continued oxygen deprivation results in fainting, long term loss of consciousness, coma, seizures, cessation of brain stem reflexes, and brain death.[15]

Objective measurements of the severity of cerebral hypoxia depend on the cause. Blood oxygen saturation may be used for hypoxic hypoxia, but is generally meaningless in other forms of hypoxia. In hypoxic hypoxia 95-100% saturation is considered normal. 91-94% is considered mild. 86-90% is considered moderate. Anything below 86% is considered severe.[16]

It should be noted that cerebral hypoxia refers to oxygen levels in brain tissue, not blood. Blood oxygenation will usually appear normal in cases of hypemic, ischemic and hystoxic cerebral hypoxia. Even in hypoxic hypoxia blood measures are only an approximate guide – the oxygen level in the brain tissue will depend on how the body deals with the reduced oxygen content of the blood.
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Postby Nasti » Mon Jan 10, 2011 10:02 am

So how much does it cost to get a chamber like that? In my lil country there is only one, used by the recovery patients of plastic surgeries. So I will need to pull a lot of strings to get in...
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Postby Cece » Mon Jan 10, 2011 10:33 am

I believe they're $5000 and up, also they can be rented in some places.
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Postby DrCumming » Mon Jan 10, 2011 7:30 pm

I believe in the animal model, intimal hyperplasia can reduced with high levels of oxygen. Do not think its been shown in humans.
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Postby Cece » Mon Jan 10, 2011 8:44 pm

mjc701 wrote:I believe in the animal model, intimal hyperplasia can reduced with high levels of oxygen. Do not think its been shown in humans.

Medial smooth muscle cells are considered target cells for vascular brachytherapy, and it has
been suggested that most of these targets cells are hypoxic. Several studies indicated that
medial cells of coronary arteries exist at least in part in a state of not only acute but also
chronic hypoxia. Physiologic studies in the late 1970s demonstrated that the entire avascular
media of a human thoracic aorta is chronically hypoxic, and that smoking can further reduce
oxygen tension in the media (Schneiderman et al. 1978). If a stent is deployed to the arterial
wall, hypoxia of medial smooth muscle cells increases, and returns to normal after a period
of 28 days in the rabbit (Santilli et al. 2000). Hypoxia stimulates proliferation of human
vascular smooth muscle cells (VSMCs) (Cooper et al. 1999), while supplemental oxygen
may reduce exaggerated proliferative responses in the vasculature (Lee et al. 2001).


http://www.freidok.uni-freiburg.de/voll ... /diss1.pdf

Arteries not veins but intriguing.

Volume 185, Issue 2, Pages 254-263 (April 2006)

Intimal thickening after arterial balloon injury is increased by intermittent repetitive hypoxia, but intermittent repetitive hyperoxia is not protective
Antony K. Laua, Xavier Chaufourb, Craig McLachlanb, Steven B. Leichtweisa, David S. Celermajerac, Colin Sullivanb, Roland Stockerade

http://tinyurl.com/4bsl55m
Hypoxia makes intimal hyperplasia worse, but hyperoxia does not make it better. If you are a bunny. In a single study.
Arterial intimal hyperplasia after occlusion of the adventitial vasa vasorum in the pig
SG Barker, A Talbert, S Cottam, PA Baskerville and JF Martin
Kings College School of Medicine and Dentistry, Department of Medicine, Denmark Hill, London, UK.

Oxygenation of the arterial wall is provided by diffusion of oxygen outward from the main vessel lumen and inward from the adventitial vasa vasorum. In a group of four Yucatan miniature pigs the oxygenation profiles across the superficial femoral arteries were recorded by polarographic oxygen microelectrodes. The profiles obtained suggested a relatively poorly oxygenated media (a trough value of approximately 25% that of the intimal oxygenation) with a progressive rise in oxygenation toward the intimal and adventitial surfaces. In four other survival experiments, occlusion of the adventitial vasa vasorum by flush ligation of the arterial branches that supply them resulted in the production of a focal, intimal hyperplastic lesion that was absent in control vessels (intimal to medial ratios [mean +/- SEM] of 0.053 +/- 0.008, n = 8, p < 0.001 and 0.013 +/- 0.001, n = 8, respectively). By electron microscopy this lesion was seen to be composed mainly of smooth muscle cells. This evidence would support the hypothesis that arterial wall hypoxia may be involved in the initiation of intimal hyperplasia. It is proposed that human atherosclerosis may be initiated by occlusion of the vasa vasorum and concomitant hypoxia.

Interesting lead (and at first I was doubtful).
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hyperbaric

Postby jak7ham9 » Tue Jan 11, 2011 11:30 am

a good chamber cost about 15k with a good oxygen ststem and a high end condenser. I upgraded mine so i could get more oxygen at a pressure and a higher condensor atmospheric pressure. Again it is helpfl to me. Rather costly i believe a docs office chareges $150+ per session
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Postby vivavie » Tue Jan 11, 2011 1:03 pm

Good timing for this tread! I just learned that I may have to endure another round of hyperbaric chamber (35 -45) treatments. My 1st reaction was NO! This would be my 4th round in 12 years and it is not much fun at all: 2hrs drive, 1 hr preparation, 1/2hr "going down" to the right pressure, 2 hrs treatement with bubble head mask, 1/2hr going up (normal pressure) + 2hrs drive home, EVERY DAY!!! beurk

There is only 3 locations in Quebec; 2 hospitals and 1 university It is used for CO incidents, burn skin, bacteria eating skin and bone necrosis. There is nothing to do during treatment because of the high flamability (special cloths, no hair spray, no ipod, no books, etc), you are stock in a very small chamber with sick people often claustrophobic and noway to "get back up" quickly if there is a fire or a complication with a patient... I had to have tubes installed in my ears to get equilibrium at those pressures.

Because of those pressures I am very afraid of my veins to collapse again!?!?? what about my stents?

Since my tongue cancer, the high radiation had as secondary effect jaw bone necrosis. I am down to 3mm on one side. Everytime I have a tooth that dyes or an apectomy (when root canal doesn't work) I need a round of hyperbaric room before and after dental procedures to prevent more bone necrosis.

From what I am reading here it seems to be a more in deepth treatment than those portable chambers.

Every time I had treatment I saw improvements in my ms symtoms, especially fatigue but only for the duration of the treatment, it goes away within days.

dental visit: Oct 28
last CCSVI procedure: Dec 13
MEGA Dental neuralgy: Dec 17 for 15 days (as if my jaw was pushing all my teeth out)
Dental exam Jan 10: 1 dead tooth + 3 apectomy necessary!!!

Having so much pain come and go within 15 days just after having the Procedure I found that very strange! I did not have any treatment on my teeth done yet but the pain is gone, I first thought it was an ms flare. This is a very contradictory result, I would have expected that once the jugulars are open the blood to my jaw should be more oxygeneted hence less chance of necrosis???

I have to decide: the jaw bone or the jugular??

It is very hard not to get suck to the dark side... I wish I had a break!
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Postby cheerleader » Tue Jan 11, 2011 1:23 pm

Hi Cece--

Interestingly, Dr. Philip James of Scotland MS Therapy Center has been a major proponent of hyperbaric oxygen treatment and has written about HBOT and MS for many years. He actually likens what he sees in MS to what he sees in those who suffer from divers' syndrome. Here's one of his many papers on this linkage.

http://www.mstherapycentres.org.uk/Phil ... _Paper.pdf
I got in touch with Dr. James a year or so ago, and he reached out to Dr. Zamboni. Here is Dr. James statement on CCSVI-

The recent publicity given to the work of Professor Paolo Zamboni has highlighted a growing disaffection with the concept of ‘auto’ immunity which has dominated MS research and treatment for more than half a century.... However, the use of an animal model for MS research after WW2 led to the concept of auto immunity where, it is claimed, the immune system attacks normal tissue. Despite sixty years of research there is no evidence of this and it remains just a theory.

What is certain is the damage in MS involves veins and inflammation and Professor Zamboni has focused on these proven observations. He noticed, when using ultrasound scanning of the neck in a Multiple Sclerosis patient, that blood flowed the wrong way in a vein and also that the vein appeared to be constricted. After more investigations he has used the same procedure used to stretch arteries in the heart to relieve the vein constrictions. Several patients have found the procedure beneficial, greatly reducing their symptoms although stretching the veins will not affect existing scarring.

Professor Zamboni’s work has highlighted the importance of the blood-brain barrier. Oxygen is responsible for the genetic control of inflammation and lack of oxygen has been shown in affected areas in MS patients by brain imaging. Neurologists are likely to remain sceptical of vein stretching until a ‘controlled’ study is done in which a sham procedure is used and compared to a group of matched patients who have the real procedure undertaken.
Philip B James MB ChB DIH PhD FFOM
Emeritus Professor of Medicine University of Dundee
Honorary Medical Adviser MS Therapy Centre

link

Here's what I'm thinking...
If hypoxic insult is due to hypoperfusion (or slowed blood flow thru the brain) than HBOT won't really be of any lasting help. The real issue seems to be getting adequate blood flow to the brain. And after adequate bloodflow is established, O2 levels will be increased with better perfusion, and HBOT is not necessary. I think this is why Jeff had immediate and profound relief of his fatigue, and so does Dr. Dake. Dr. Dake has seen this in patients with central venous stenosis of the vena cava--and similar immediate relief. If blood flow can be repaired, no need for HBOT.

I think the Haacke protocol will shed more light on O2 levels before and after angio. More to come!
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby vivavie » Tue Jan 11, 2011 2:30 pm

Cheerleader,

I agree. From my experiences the improvements never lasted.

What about the high pressure of hyperbaric chamber on vein previously treated by angioplasty? Does it increases the potential of vein collapsing? Some people questionned the pressure during the flight back home after treatment oversea, this is way more intense.
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Postby silverbirch » Tue Jan 11, 2011 3:34 pm

I attended the chamber for 3 weeks daily diveing at 16 ft . I now attend the chamber weekly diveing at 23 ft for 70 mins . I have been doing this since Sept 2010 . I had the CCSVI procedure LIJ balloned I have just had my 7 monthly check up and all is clear in my neck area.

The top gun mask is just awful and remember to bring that warm jumper as it can get cold
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Postby EJC » Wed Jan 12, 2011 8:23 am

Did you feel the oxygen treatment helped?

Emma and I are talking this through between us, we've had so many reports of this treatment helping people that it's something we're trying to organise.

Nearest centre to us is a 45 minute drive, which is fine except they only open during working hours and Emma can no longer drive.
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