I'm confused about the best position..

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

I'm confused about the best position..

Postby CD » Mon Feb 07, 2011 11:14 pm

I need confirmed advice please.

I'm hearing, and reading, all sorts of different information on what is the best position for draining the brain after successful Venoplasty?

Do you drain better while laying down (supine), or sitting up? Even standing upright with gravity, makes sense to me. :?

Most I have read says laying down is best. :? If that's the case what's with the incline pillows or wedges, or raising the bed's head legs? Is that theory gone with the wind now?

The heart pumps blood up to the brain in the arteries, and the veins drain blood back down. How does it help if you are laying down? Anyone have the real scoop on this? Which is correct?

I saw Dr Sclafani's interview video and it seems laying down is preferred? I don't understand the logic, but hey, what do I know?
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Postby PointsNorth » Mon Feb 07, 2011 11:23 pm

Hi CD,

I don't know what current wisdom is on this but in Albany (October) I was flat on my back for some time (2 hours?) after the procedure. And I remember getting in trouble for trying to sit up!

Best, PN
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Postby CD » Mon Feb 07, 2011 11:38 pm

Hi PN,
Thanks for answering. But..
I had it done in Albany, and stayed flat too. They said if you lift your head up you contract your stomach muscles and the Femoral Vein might bleed again.

They keep you flat so the bleeding stops after they have put pressure on it, and then lay you flat for two hours and then sit up up for the next 1/2 hr to an hour. This is for the catheter site opening.

I am talking about for life after Venoplasty. Do we do better to prevent re-stenosis when laying flat (with regular pillow) or when we are sitting?

What position drains the brain the best?
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Postby Cece » Tue Feb 08, 2011 8:43 am

There's no clear answer post-venoplasty.

Pre-venoplasty, it would seem that inclining the bed at an angle of 5 degrees (by putting 4 - 6 inch blocks under the head of the bed) helps recruit the vertebral veins and other cerebral drainage routes, so that it's the sweet spot with the most possible drainage. I've had my bed raised for a year now, I found that I was sleeping and dreaming better from the very beginning.

Post-venoplasty, though, the jugulars should be wide open and we want them to stay open. With the bed flat, that would require flow to go through the jugulars which would keep them the widest during that stretch of night. By having the bed flat in an attempt to maximize flow through the jugulars at night, the idea is that the better flow would minimize the risk of clotting and perhaps help heal the endothelium.

So, it's unknown, but my plan is to lower my bed after venoplasty for at least a few months of healing.
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Postby davmets2 » Tue Feb 08, 2011 9:39 am

Cece wrote:
Post-venoplasty, though, the jugulars should be wide open and we want them to stay open. With the bed flat, that would require flow to go through the jugulars which would keep them the widest during that stretch of night. By having the bed flat in an attempt to maximize flow through the jugulars at night, the idea is that the better flow would minimize the risk of clotting and perhaps help heal the endothelium.


Hmmm, maybe that's why I clotted. Since my procedures I've been trying to keep my head and neck area elevated with a couple pillows. Just thought that was the way to go as far as drainage. It's been a month since my first procedure...guess I'll try laying flat at night to promote better flow through the jugulars with the help of the blood thinner.
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Postby CD » Tue Feb 08, 2011 10:32 am

I think there should be a little booklet or even a sheet of paper or two, with the do's and don'ts for pre and post CCSVI procedure. In the back can be some special information that may involve your personal procedure, as most are a little different.

The post information the doctor discusses with you should be written in there too. Half the time you are too woozy to comprehend the information right after the procedure. I know having someone with you is very important, but many thoughts and questions get forgotten and go by the wayside.

It should not be necessary to call or email your doctor every time you have a question, unless it is extreme. These IR's are very busy, but will answer you. I had to look up when to stop my LDN for MS, pre-procedure. I just took a guess and stopped over a week before to be sure the meds would work to sedate me enough.

That said, I just wish I had a little reference sheet or booklet to refer to when necessary. Like with this question above and a few other questions I have. I will wait until my 3 month check-up to discuss them, but it may be too late by then to get the correct information that I need now. (sigh)
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