Makris - Chicago

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

Makris - Chicago

Postby npost999 » Thu May 26, 2011 7:14 am

I visited Dr. Makris on Tuesday for the ultrasound & consult. Results showed 4/5 on left side & 3/5 on right side of the Zamboni criteria. So I am headed back tomorrow for the procedure & will go from there.

I cannot believe that BNAC had trouble with the ultrasound procedures, that was a cake walk for me. The tech was great & all I had to do was lay or sit there and breath. I guess for someone with a little more disability this is difficult, but I cannot imagine how BNAC had problems preforming these tests accurately. It's a shame.

NP
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Postby Donnchadh » Thu May 26, 2011 10:17 am

Good luck with your procedure!

Let us know how it goes.

Donnchadh
Kitty says, "Take that, you stenosis!"

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Postby rusty2 » Sun May 29, 2011 4:00 pm

Best of luck to you :D
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Postby Cece » Sun May 29, 2011 4:05 pm

Best wishes that the procedure went swimmingly and that you are recovering and feeling well.
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Postby David1949 » Sun May 29, 2011 6:34 pm

I wish you the best.
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Postby munchkin » Mon May 30, 2011 4:42 am

Hope all went well.
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Postby npost999 » Mon May 30, 2011 5:08 am

Thanks all for the thoughts. Well the procedure was a piece of cake really, in & out in 1 1/2 hours. The ultrasound prior to the procedure showed 4/5 on the left and 3/5 on the right of the Zamboni criteria. In the procedure he treated both the Right & Left IJV and the azygous. He said afterwards that there was nothing substantial as far as narrowing, stenosis etc. He used a 14 mm balloon on the IJV's & a 12mm on the azygous. I will say that Dr. Makris & his staff were great, very comforting.

On the trip home (4 1/2 hour drive) it seemed that the numbness I felt in my left foot & toes had mostly gone away. I still felt that way the following day, but this morning when I woke up all my toes were numb. I've also not see any other relief to my symptoms & I have just been laying around the house and resting since I got back. Plus been drinking as much water as possible. I realize many do not see over night changes, so I'll hope I see a little delayed reaction. But, my main hope will be no more progression.

I go back to Dr. Makris in June for the follow up ultrasound, and I guess from that we will be able to see if there is any reflux at that point.

Thanks again for the wishes & luck
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Postby npost999 » Mon May 30, 2011 6:22 am

Thought I'd post the findings from the ultrasound.

The right IJV measures 8.9 mm in the J1 segment and 1.9 mm in the J2 segment. The left IJV measures 8.8 mm at the J1 segment and 1.5 mm at the J2 segment. Both the left and right IJV display reflux in both the upright and supine position. The vertebral veins failed to demonstrate reflux in either the upright or supine position. Visualization of the valves of both the right and left internal jugular veins reveal abnormality consisting of thickening and flap. The cross-sectional areas of the IJV are larger in the supine position than in the upright position. Therefore there is a positive number for the delta cross-sectional area. Of note, intrarachidian veins are visualized suggestive of possible azygous stenosis. The deep cerebral veins failed to demonstrate flow on the left, but are flowing without reflux on the right.
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Postby Donnchadh » Mon May 30, 2011 8:29 am

Take care of yourself and rest. Hoping for improvements to appear!

BTW, a friend just scheduled an ultrasound with Dr. Makris and the first open date was July 5th. So he is starting to get backed up; if you are considering him so might want to contact him soon.

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Postby Cece » Mon May 30, 2011 8:34 am

It can be maddening afterwards, tracking for signs of improvement when there are still good and bad days. It is a good sign that there was an immediate effect on numbness.
He said afterwards that there was nothing substantial as far as narrowing, stenosis etc.

"Nothing substantial"? Do you know the percentages of the narrowings as seen on venogram? Or have you looked at your images, did it look substantial?

It is easy for the IRs to miss the real problem, particularly when not using IVUS or when still on the learning curve....sorry to even bring this up, I just wonder at the "nothing substantial."

Good health and healing to you.
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Postby npost999 » Mon May 30, 2011 11:08 am

I was not told the percentages on friday, but I'm supposed to talk with them tomorrow so I plan on asking that question.

I was going to post some of the pictures I received on a cd, but not sure how to do it here?
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Postby Cece » Mon May 30, 2011 12:58 pm

I use photobucket.com. Resize images using Paint, then upload at photobucket, then click where it says "Image" (it has four choices of coding, one is image coding). It automatically saves the coding and then I paste it here. :)
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Postby npost999 » Mon May 30, 2011 6:50 pm

Testing this out, thanks CeCe for the instruction on uploading...not sure if these are too small or large to tell what is going on w/ the picture

Image

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Postby Cece » Mon May 30, 2011 9:23 pm

I see waisting in the azygous arch balloon, which is then gone in the second image, so that would seem good.

I don't see any waisting in the jugulars. Either you have two good jugulars (which is unusual although not impossible, in MS) or there's something there that I'm not seeing....

Cece
(not an IR but maybe this will draw in the IRs who can give you better commentary) ;)
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Postby npost999 » Tue May 31, 2011 4:42 am

Cece wrote: Either you have two good jugulars (which is unusual although not impossible, in MS) or there's something there that I'm not seeing....

Cece
(not an IR but maybe this will draw in the IRs who can give you better commentary) ;)


I know I had an MRV per the Haacke protocol last December that I had a IR look at along w/ Haacke's group & they talked about narrowing in the transverse sinus. They talked about putting a stent in that, but this recent study didn't talk about any issues there.

Thanks for looking & sharing your knowledge Cece.
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