Dr. Hubbard, Alarming Comment from Seattle

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

Postby scorpion » Sat Feb 05, 2011 12:37 pm

MrSuccess wrote:first thing - note who is '' all over this '' . The usual suspects .second thing - read ..... reread .... read again , if you must ... Cheerleaders post ...... it is FLOW that is the issue . FLOW

To illustrate : When one is flying ..... we see bodies of water in various shapes and dimensions . Twists ... turns ...... narrowing ..... great widths.....
from such a distance can FLOW be determined ?

Is the water shallow ? Is it deep ? It may be 50 feet wide .... but a mere 6 inch's deep ...... and thus almost stagnant .

Or . A body of water may be 5 feet wide .... but deep and raging .

:idea: MRV's are probably the high elevation evaluation ........

:arrow: :arrow: One must get up close ..... to measure and evaluate the FLOW Rate. :!: :!:

And THAT is what Dr. Zamboni and his colleagues are doing .

Mr. Success

No one is "all over this". If we can not have a critical disussion, without name calling and demeaning comments, then the CCSVI forum on thisisms is worthless. Please show me where the "usual suspects" have said anything that is out of line in this discussion. I hope Cheer repsonds to patientx because I am interested in what they are discussing and not interested in once again making this an "us vs. them" thread. Geeze.
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Postby MrSuccess » Sat Feb 05, 2011 2:17 pm

my posts have two goals in mind .

[ 1 ] bring attention to who is commenting ..... and if there is even a whiff .... of controversy ....... the same usual suspects appear in short order ..... and try their best to put '' spin '' on the discussion .

I have resisted ... naming names . So far.

[ 2 ] provide an easy explanation [ yeah ... I know ... good luck ] to a
complex situation ...... and give hope and encouragement by supporting the amazing and brilliant medical minds exploring the relationship between MS and CCSVI.

If you take offense to that ..... well ..... that's unfortunate.

By all means .... you can continue on with your agenda - thinly disguised as critical discussion ....... but you can be assured.... I will be evaluating your posts ..... in detail.

I think I have stayed within the bounderies of The Golden Rule .

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Postby cheerleader » Sat Feb 05, 2011 2:32 pm

Here is the complete Haacke protocol:
http://www.ms-mri.com/docs/ms-report-in ... mh-9pm.pdf

Here is the explanation of the flow quantification patients receive:

Section 3: Flow information
Flow quantification is performed using a special MRI sequence by encoding the flow inside the blood vessels. This sequence generates two sets of images: a magnitude image and a phase image. The magnitude image shows the vessel anatomy and the phase image can be used to
quantitatively measure the velocity and direction of the blood flow. The phase image contains the phase values of each voxel, which are proportional to the velocity of the blood flow at that voxel location, For a Siemens MRI scanner; if the phase appears dark this implies flow towards
the heart. The darker the phase, the faster it flows toward the heart. If the phase appears bright, this implies flow towards the brain. The brighter the phase, the faster it flows toward the brain. If the data is from a GE scanner, dark means flow towards the brain, bright means towards the
heart. We have developed our own software to process the flow data and to define a number of physiological flow measures to represent these findings. First the user segments the vessels by drawing contours on the vessel boundaries. Then the software reads in the phase values inside each vessel contour. The software can decode the phase values to get the flow velocity of the blood flow through each voxel. Then the following
parameters are calculated: integrated flow, volume flow rate, positive volume flow rate, negative volume flow rate, positive flow volume, average velocity, peak positive velocity, peak negative
velocity, peak to average velocity ratio, average positive velocity and average negative velocity.
The first five parameters have been chosen as most clinically relevent at this time although many other measures are also available and stored for each patient.

Currently, most sites measure the flow at four different locations: 1) the upper neck level, 2)lower neck level, 3) straight and sagittal sinus, and 4) azygos vein. In each subsection (i.e., for each anatomical region), the first set of flow images contains one magnitude image, 1 to 3 phase images, and an anatomical reference image showing where the flow quantification takes place. In the magnitude and phase images, major vessels are shown and indicated by colored arrows. Five graphs are shown including; total integrated flow per cardiac cycle, flow rates in the form of total, positive and negative, and average speed coincide with the magnitude and
phase images. These allow us to determine if there are abnormal flow patterns such as no flow, reverse or reflux flow, and circulatory flow patterns (often the case for widened bulbous lower levels in the internal jugular veins). If the flow curves for a given vein fall through zero and
change direction, then we refer to this as reflux flow. However, on occasion the vessel shows flow in both directions at any given time. This we refer to as circulatory flow.

The flow quantification at the upper neck level usually takes place at the second cervical vertebrae level (C2). The lower neck level is at the sixth vertebrae level (C6). These two different levels helps us to get a flavor for the flow coming immediately out of the brain and the flow at the lower level of the neck just above the confluence of the internal jugular veins with their corresponding subclavians before the blood goes back to the heart. The lower part is perhaps the most important because that is what represents most of the venous blood escaping from the entire head/neck system. The major vessels we can see for the neck include: internal
jugular vein, common (internal) carotid artery, vertebral artery, vertebral vein, external jugular vein, anterior jugular vein, deep cervical vein, as well as the anterior and posterior vertebral venous plexus. In some cases, we can only visualize some of the vessels, and in other cases,
we can see multiple vessels of the same name (such as two right external jugular veins).

This part of the report closes with a table of flow measurements both per cardiac cycle and then translated into flow per second. Data is given for both the left and right sides separately. If there is much more blood flow in the arteries than the veins, this suggests that the vertebral plexus may be carrying that missing load. Azygos flow is also shown along with its own quantitative flow table.

This report is compiled from the tests taken....it takes Dr. Haacke many hours to compile the data. He had not done the flow quantifications when the Hubbards saw their venous anatomy MRVs, and they saw their venous anomalies...I was there at the house the day we looked at the MRVs, and the anomalies were real. The flow quantification, which came later, did not show CCSVI.

I don't know how to be more clear. I'm sorry not everyone is able to sit down and talk with these doctors...but I will ask them to be more specific when speaking to the general public. It's very difficult when comments are taken out of context, and rumors start. That's why I keep coming back to this site...to try and separate fact from rumor...have a great weekend all...I've gotta get on with my day.
Last edited by cheerleader on Sat Feb 05, 2011 2:36 pm, edited 1 time in total.
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
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Postby concerned » Sat Feb 05, 2011 2:34 pm

Analyze away.... I take no offense to it, but it is... unfortunate.

It has nothing to do with the discussion at hand.

You've stated your.... suspicions... many times before... to "spin" the conversation.... and discredit those with whom you disagree.

(Is that within the boundaries of the Golden Rule enough for you?)


Postby Lyon » Sat Feb 05, 2011 2:53 pm

Last edited by Lyon on Fri Jun 24, 2011 8:21 pm, edited 1 time in total.
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Postby eric593 » Sat Feb 05, 2011 2:58 pm

cheerleader wrote:I'm sorry not everyone is able to sit down and talk with these doctors...

That sounds a tad condescending to me as though you are "superior" and thus, we 'peons' lack the "privileges" that you are entitled to. Thus, you have to be "dragged" back here to explain things to us even though you have better things to do... you sound like an annoyed parent who has to waste your time explaining something to your 'simple' children.

cheerleader wrote: It's very difficult when comments are taken out of context,

I don't think the comments were taken out of context so much as the good doctor was very misleading in what he actually said and did not clearly clarify the differences between his family's results and Devin's results.

I'm not sure why you would attribute blame to the recipients of his comments for the confusion rather than to the one MAKING the comments. Whoever here who has the 'signature' from Albert Einstein that says (to paraphrase) if you can't explain something simply, you didn't understand it well enough yourself, got it right.

I don't think anyone here deserved the condescending attitude, cheer. Bringing this up was important and it is a very valid point of discussion/debate since the differences/similarities between healthy controls and MSer's is at the very heart of this theory: it's important.

I'm sure someone here could have directly asked Dr. Hubbard to clarify, and we would have gotten to the bottom of it; your condescension and explanation weren't absolutely necessary. The explanation was appreciated, but not at the expense of having the "attitude" that came along with it.
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Postby Lyon » Sat Feb 05, 2011 3:27 pm

Last edited by Lyon on Fri Jun 24, 2011 8:21 pm, edited 1 time in total.
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Postby MrSuccess » Sat Feb 05, 2011 3:56 pm

you are mistaken . there was no condescending attitude nor words .

like I said ...... the usual suspects ...... one after another .............

with little ..... or no value .... to contribute .........

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Postby newlywed4ever » Sat Feb 05, 2011 4:11 pm

Really? Condescending? It's interesting how written words can be interpreted. I not only don't see it but I also know after months of reading TIMS, cheer has always had our best interests at heart.
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Postby Lyon » Sat Feb 05, 2011 4:23 pm

Last edited by Lyon on Fri Jun 24, 2011 8:22 pm, edited 1 time in total.
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Yadda yadda yadda

Postby Gordon » Sat Feb 05, 2011 6:50 pm

JThe usual suspects ios correct. The most experienced Dr is Simka

He has said many many times it is CCSVI and something else.

thickness of blood, blood type

yadda yadda yadda

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Re: Yadda yadda yadda

Postby Lyon » Sat Feb 05, 2011 7:04 pm

Last edited by Lyon on Fri Jun 24, 2011 8:22 pm, edited 1 time in total.
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Postby Drury » Sat Feb 05, 2011 7:10 pm


Cheer is an extraordinary person who goes to great lengths to keep us informed - I have never found her to be anything but respectful.

Perhaps you are a little too sensitive?

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Postby drsclafani » Sat Feb 05, 2011 9:45 pm

Lyon wrote:I often have to grin......despite the fact that everyone seems convinced that placebo effect couldn't possibly play a part in any of this, that the wishful thinking involved with the theory of CCSVI is so strong that all this rapid explaining away of any possible negatives insures that there is, and never has been, any way in any aspect that the theory of CCSVI could possibly get a failing grade.

That's all fine if everyone wants to concede that this is all nothing more than an exercise in self fulfilling prophecy and that any real science fell by the wayside a year or more ago.

I agree that using first degree relatives in an official study would skew results enough to not justify the cost and efforts but it sounds like Hubbard had the resources and curiosity and the results are admittedly a point of interest.

Are the results enough to credit/discredit the theory of CCSVI? NO. Are the results faulty enough to make extreme efforts to discredit/discount them as is happening in this thread right now? Hell NO! Yes, first degree relationship is a concern but Hubbard, his wife and daughter were tested and all had some kinds of obstructions. To try to explain that away and go on our merry way is the height of foolishness and after that feat any mention of "science" is just laughable.

Did i miss something? when was MRV proven to correleate with ccsvi? Was venography used to compare it? when and where was it publishd.
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Postby 1eye » Sat Feb 05, 2011 10:52 pm

Yes, Dr. Sclafani. Diagnostic tests are all very interesting, and Doppler Ultrasound has mostly been preferable in the past to static MRI, but I don't see why anyone would waste time (either learning the hard way how to do the tests, by writing hasty public papers in peer-reviewed journals, or by running two-year trials designed to disprove the existence of a known fact using diagnostic tools) without actually touching a catheter or injecting some dye. Kind of boggles, doesn't it? Or am I in the wrong universe?
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