ballooning of nonobstructed jugulars

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

Re: ballooning of nonobstructed jugulars

Postby MrSuccess » Sat Dec 15, 2012 12:08 am

you may want to consider changing your search engine .... Magdeburg Spheres demonstrates the power of .... a VACUUM ....and also .....surface tension.

To understand CCSVI ..... learn some simple hydraulic principles.

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Re: ballooning of nonobstructed jugulars

Postby drsclafani » Mon Dec 17, 2012 11:39 pm

MrSuccess wrote:Professor Zohara Sternberg of the Jacobs Neurological Institute of Buffalo NY .... has given us something of great value in understanding CCSVI. Please read .... and if you have to .... reread her Abstract listed above . It's that important.

The Abstract is written in true doctor-speak .... so MrSuccess will attempt to explain it in plain talk. :lol:

Professor Sternberg is telling us that once a vein is collapsed - whereby the inner walls of the vein come in contact - they cannot disengage from each other . :idea: :idea: :idea:

I agree.

The reason why : SURFACE TENSION ...... MrSuccess would add to this ... .. a created VACUUM also.

CCSVI is the simple concept of a fluid [ BLOOD ] disrupted from returning back to a fluid pump [ your HEART ] . A circuit - heart to head ->>> head back to heart .... is not normal.

Now let me demonstrate the Power of Surface Tension AND the power of a VACUUM.

First: Surface Tension. The most easy example I can give you is the adhesive quality's of two EQUALLY smooth pieces of glass. Slightly moisten both pieces ..... now SLIDE them together .... so that they are exactly one on top of the other . Now try to PULL them apart.

Second : The Power of a VACUUM . Mr.Success offers the " Magdeburg Spheres ".

Professor Sternberg tells us something VERY IMPORTANT .... and that is this .... in the condition CCSVI ..... your heart - a simple diaphram pump - CANNOT create enough fluid FORCE to overcome the collapsed veins .

MrSuccess asks ..... Is CCSVI perhaps truly .....a HEART CONDITION ? :?: :idea:

Is the heart now creating a VACUUM in the vein returning blood from the brain to the heart ? :?: :idea:

DO NOT underestimate the power of surface tension or a vacuum . Dr. Sternberg clearly understands this.


MrSuccess


MrSuccess
i would disagree with the statements that once vein walls touch they cannot separate. i see it all the time, where veins collapse and then expand. it is a natural phenomenon.

it is most apparent in patients who have compression stenoses, such as at the skull base, at C1-2, in J2 with muscle compressions, with the may thurner syndrome and the nutcracker phenomenon. it is clearly proven by viewing the vein in IVUS

DrS
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Re: ballooning of nonobstructed jugulars

Postby Cece » Thu Mar 07, 2013 7:58 pm

There was discussion of HRV or heart-rate variability that Dr. Arata measures earlier in this thread. This is said to be a measurement of autonomic dysfunction.

If you have an iphone and money to waste ($300, which is too much for me to try it), there is an app that measures HRV.
http://www.bioforcehrv.com/
Maybe tracking HRV over time would help us improve our HRV.

One of the best things about HRV is that it’s an incredibly simple and non-invasive test. All you will have to do is stay in a stable, resting position for 2:30 while the BioForce HRV records the intervals between your heart beats. You can even do it while laying in bed in the morning.
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Re: ballooning of nonobstructed jugulars

Postby MrSuccess » Fri Mar 08, 2013 12:04 am

Hi Dr.S - You are the "inside guy " :wink: when it comes to CCSVI. It appears there may be some growth in this area [ IVUS ] with other professionals now using it.

I remain enthralled with Professor Zamboni's great discovery.

IVUS , if I understand it correctly , actually FORCES open collapsed veins as it is guided through pwMS . I suppose webs and flaps and other inner workings .... get plowed through also .

Here is what I don't get .... upon REMOVAL of the IVUS ...... How do you know for sure that the vein has not immediatley returned to a full or partial closure ?

Stents appear to be the solution . However , their composition [ metal ] seems to be the devil in the details ...... the body wants to reject them ..... hence a lifetime on drugs ...

Q : Do you think it possible that stents can be produced using ones own body parts ? I threw this suggestion out a few years ago , that something like the plaque on our teeth could be removed , moulded into stents , and then used in veins. :idea: :idea:

As it is already naturally produced in your body ....... rejection should not be an isssue ? :idea: :?: Nice little tubes of natures own concrete ..... :wink:

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Re: ballooning of nonobstructed jugulars

Postby ljelome » Fri Mar 08, 2013 12:23 am

drsclafani wrote:
MrSuccess wrote:Professor Zohara Sternberg of the Jacobs Neurological Institute of Buffalo NY .... has given us something of great value in understanding CCSVI. Please read .... and if you have to .... reread her Abstract listed above . It's that important.

The Abstract is written in true doctor-speak .... so MrSuccess will attempt to explain it in plain talk. :lol:

Professor Sternberg is telling us that once a vein is collapsed - whereby the inner walls of the vein come in contact - they cannot disengage from each other . :idea: :idea: :idea:

I agree.

The reason why : SURFACE TENSION ...... MrSuccess would add to this ... .. a created VACUUM also.

CCSVI is the simple concept of a fluid [ BLOOD ] disrupted from returning back to a fluid pump [ your HEART ] . A circuit - heart to head ->>> head back to heart .... is not normal.

Now let me demonstrate the Power of Surface Tension AND the power of a VACUUM.

First: Surface Tension. The most easy example I can give you is the adhesive quality's of two EQUALLY smooth pieces of glass. Slightly moisten both pieces ..... now SLIDE them together .... so that they are exactly one on top of the other . Now try to PULL them apart.

Second : The Power of a VACUUM . Mr.Success offers the " Magdeburg Spheres ".

Professor Sternberg tells us something VERY IMPORTANT .... and that is this .... in the condition CCSVI ..... your heart - a simple diaphram pump - CANNOT create enough fluid FORCE to overcome the collapsed veins .

MrSuccess asks ..... Is CCSVI perhaps truly .....a HEART CONDITION ? :?: :idea:

Is the heart now creating a VACUUM in the vein returning blood from the brain to the heart ? :?: :idea:

DO NOT underestimate the power of surface tension or a vacuum . Dr. Sternberg clearly understands this.


MrSuccess


MrSuccess
i would disagree with the statements that once vein walls touch they cannot separate. i see it all the time, where veins collapse and then expand. it is a natural phenomenon.

it is most apparent in patients who have compression stenoses, such as at the skull base, at C1-2, in J2 with muscle compressions, with the may thurner syndrome and the nutcracker phenomenon. it is clearly proven by viewing the vein in IVUS

DrS


Pardon me, i think glasses and veins are made from different materials. Won't they have a different surface tension?
Thank u.
Warm regards,
Linda

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Re: ballooning of nonobstructed jugulars

Postby drsclafani » Wed Mar 20, 2013 12:24 pm

MrSuccess wrote:Hi Dr.S - You are the "inside guy " :wink: when it comes to CCSVI. It appears there may be some growth in this area [ IVUS ] with other professionals now using it.

IVUS , if I understand it correctly , actually FORCES open collapsed veins as it is guided through pwMS . I suppose webs and flaps and other inner workings .... get plowed through also .

Here is what I don't get .... upon REMOVAL of the IVUS ...... How do you know for sure that the vein has not immediatley returned to a full or partial closure ?

Stents appear to be the solution . However , their composition [ metal ] seems to be the devil in the details ...... the body wants to reject them ..... hence a lifetime on drugs ...

Q : Do you think it possible that stents can be produced using ones own body parts ? I threw this suggestion out a few years ago , that something like the plaque on our teeth could be removed , moulded into stents , and then used in veins. :idea: :idea:

As it is already naturally produced in your body ....... rejection should not be an isssue ? :idea: :?: Nice little tubes of natures own concrete ..... :wink:

MrSuccess


OUCH

success, IVUS is a very small probe that likely pushes nothing out of the way. It is not a therapeutic device at all. i simply sends high frequency sound waves that reflect off inner tissue and allow visualization of the valves within the vein. it is real time so you get a nice view of the valve motion.

we exchange the diagnostic catheter with the IVUS, then exchange that with the balloon catheter, then we exchange that for the IVUS then the IVUS for the diagnostic catheter. So after balloon angioplasty we use IVUS to see the work of the angioplasty. Any what we see with a successful treatment is nothing. The valve is stretched and not well seen in most cases.

plaque is composed of oral contect including not nice things that i would not want inside my mouth, let alone in my blood vessels.
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Re: ballooning of nonobstructed jugulars

Postby Cece » Thu Mar 21, 2013 12:26 pm

I need an "I <3 IVUS" t-shirt :)

http://www.ncbi.nlm.nih.gov/pubmed/14504339
Neurology. 2003 Sep 23;61(6):851-3.
Fatigue in MS is related to sympathetic vasomotor dysfunction.
Flachenecker P, Rufer A, Bihler I, Hippel C, Reiners K, Toyka KV, Kesselring J.
Source
Department of Neurology, Julius-Maximilians-Universität, Würzburg, Germany.
Abstract
The authors studied standard autonomic function tests and measures of heart rate variability in 60 patients with multiple sclerosis (MS) and correlated results with the Fatigue Severity Scale and the Modified Fatigue Impact Scale. The authors found that autonomic responses correlated with fatigue resembling a hypoadrenergic orthostatic response, possibly due to a sympathetic vasomotor lesion with intact vagal heart control. Treatments to control sympathetic dysfunction for MS-associated fatigue deserve further study.

Has this been posted recently? It was briefly discussed in Dr. Beggs ISNVD abstract 2011: chronic-cerebrospinal-venous-insufficiency-ccsvi-f40/topic15917.html#p157459 Anyway there is support for the correlation between autonomic dysfunction and fatigue in MS. And for the use of the HRV test in MS patients. I would like to see the HRV test included in a randomized controlled treatment trial because it is an objective measure.
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Re: ballooning of nonobstructed jugulars

Postby Cece » Thu Mar 21, 2013 1:04 pm

http://www.ncbi.nlm.nih.gov/pubmed/17503142
Autonomic dysfunction in Guillain-Barré syndrome and multiple sclerosis.
Flachenecker P.
Source
Neurological Rehabilitation Center "Quellenhof", Kuranlagenallee 2, 75323, Bad Wildbad, Germany.
Erratum in
J Neurol. 2008 Feb;255(2):309-10.
Abstract
This review gives an overview of autonomic dysfunction encountered in Guillain-Barré syndrome (GBS) and multiple sclerosis (MS). In GBS, cardiovascular dysregulation is common and may lead to serious bradyarrhythmias that need to be recognised for the early initiation of appropriate therapy. Although standardised autonomic tests were useful for the diagnosis of autonomic failure, they were not able to indicate vagal over-reactivity. In this regard, eyeball pressure testing may correctly identify patients at risk for impending and potentially life-threatening bradyarrhythmias which may easily be administered at the bedside. In MS, cardiovascular autonomic dysfunction is usually of minor clinical importance. However, orthostatic intolerance may be present in approximately 50% of patients and could easily be detected by routine measurements of heart rate and blood pressure during rest and during standing. More subtle alterations may require more sophisticated methods such as autonomic reflex testing or baroreflex stimulation. Several in vitro, animal and clinical studies provide evidence that there are many interactions between the sympathetic nervous system and the immune system giving rise to the hypothesis that autonomic dysfunction in MS may not only be a consequence of the disease, but may in itself affect the course of MS.

Dr. Flachenecker is a German neurologist who has done some good work on autonomic dysfunction in MS.
If autonomic dysfunction affects the course of MS and if autonomic dysfunction is improved by CCSVI venoplasty, then this supports the reasoning that the course of MS may be improved by CCSVI venoplasty.
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Re: ballooning of nonobstructed jugulars

Postby CureIous » Thu Mar 21, 2013 4:53 pm

Cureious as to what drug us stentoteers are supposed to be on "for life". Must have missed that in the post-op handout. Please advise.
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
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Re: ballooning of nonobstructed jugulars

Postby Cece » Fri Mar 22, 2013 11:27 am

Some people end up on long-term plavix or aspirin or stronger anticoagulants if their stents develop clots. I am not sure if it is for life, though.

In case anyone is wondering if Dr. Arata continues to balloon unobstructed veins, the answer is yes. On facebook, he recently answered the question, "Is re-stenosis less frequent in non MS patients?" by saying that stenosis of a vein is uncommon in this condition therefore re-stenosis is also. Relapse is a more accurate descriptor. The treatment, and any chance of relapse, appear independent of associated conditions. Based on [his] observations.
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Re: ballooning of nonobstructed jugulars

Postby MrSuccess » Fri Mar 22, 2013 5:56 pm

CI - not sure of your intent , sport. I do my best to read all posts here at TIMS. Even ones written with "scattered in all direction short thoughts". Must be the MS ..... I often thought.

Anyway ..... I get my CCSVI information reading posts here at TIMS , written by incredibly bright and articulate people. Including those brave enough to subject themselves to uncharted medical territory.First hand information.

To the best of my knowledge ..... stents require medication ..... as the body's immune system see's metal stents, as foreign. I guess this situation does not apply to you. That's great news.

Thanks for correcting me.


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Re: ballooning of nonobstructed jugulars

Postby CureIous » Sat Mar 23, 2013 12:43 am

Sigh. Do pray tell and point me to the variety of posters Mr Success, that both indicate they
A. Have venous stents
And
B. have stated they are on LIFETIME medication requiring prescription.

And that it is due to specifically having stents, and not as a part of any blood cloagulation disorder.

There, matched the coyness, have a nice day.
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
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Re: ballooning of nonobstructed jugulars

Postby cheerleader » Sun Aug 04, 2013 9:30 am

Dr. Sclafani's thread has been busy discussing this topic, and I thought it might be a good idea to bump this thread--
I wrote up my thoughts on transvascular/autonomic therapy on Facebook, and will include here. It's long, but I thought it might be a good idea to share what I think is the difference between treating a condition based on a blog and observations (TVAM) and treating based on peer-reviewed science, for a condition recognized by insurance companies (venous stenosis and insufficiency)

Peer-review means that other scientists look at the evidence and consider if the new theory should be published in a journal. It doesn't mean the theory is 100% accurate, or the science is bullet-proof. It just means that other researchers have looked at the evidence of their professional peers and found something of value in the science.

All of Dr. Zamboni's research was peer-reviewed and published. But it was more than just a theory. He had a diagnostic procedure and medical treatment in 65 patients, with documented changes in venous blood flow before and after treatment. He had discovered a new medical condition he called CCSVI, but it was based on long-recognized venous insufficiency and vascular malformations found in other veins.

That's why the researchers at Stanford gave me the time of day when I sent them Zamboni's papers back in 2008. They saw that other vascular researchers had read his CCSVI research, found something of merit in his science and published it in journals. Jeff was diagnosed and treated for venous malformations seen on MRV and venography.Not for MS, not for CCSVI. His was a real, quantifiable problem. We saw on MRV how his jugular veins looked before and after treatment, and his venous return was measured and had improved after stent placement. Dr. Dake published the results he saw as part of a retrospective study in a peer-reviewed vascular journal.
http://www.ncbi.nlm.nih.gov/pubmed/22496109

Here's a great resource for those who want to read the peer-reviewed papers on CCSVI and MS, from CCSVI Alliance
http://www.ccsvi.org/index.php/componen ... ask=search

And here's Marie Rhode's wonderful book, which used over 400 peer-reviewed and published papers to explain the connection of MS and the venous system:
http://ccsvibook.com

This is very, very different than having a theory which you twitter, or a blog, or a Facebook page. That's why I'm not a scientist, just a patient advocate. It's really easy for me to write on Facebook, not so easy to get published :-) Marie knows how much work it takes to get published! When researchers publish, they build on the knowledge base, and are actually able to help more people around the world. It's a virtuous cycle.

Let's get our terms and history straight.
What is autonomic dysfunction, also known as dysautonomia?
This is a broad medical term which relates to the malfunctioning of any body system related to the autonomic nervous system. It means a malfunctioning of the systems we don't have to think about, that our body takes care of on it's own, literally "self-controlled"--like breathing, heart rate, blood pressure, and the digestive tract. Pretty broad system, right? Right.

The autonomic nervous system is broken down into 2 sections: the sympathetic and the parasympathetic (see the pic below.)
Here's a great video with info on the differences in these two systems, for those who want to learn more.
http://wps.aw.com/bc_goodenough_boh_3/1 ... index.html

A common form of autonomic dysfunction we may know about is orthostatic hypotension...this is dizziness when we stand up quickly, and the blood doesn't get to our brains in a timely manner, and we feel faint. It's about changes in posture. I have a mild case of this, and sometimes I wobble a bit when I get up. My Dad had it, and we both have low blood pressure. I've had the tilt table test, and got the diagnosis. What works best for me is regular exercise, great nutrition, hydration and good sleep. I'm not medicated for this, and neither was my Dad. It happens a lot in the elderly, and is what causes them to fall. People who have severe cases have neurologic disease, and they can receive medication, but it's a multi-system approach which works best. Here are the A, B, Cs of treating orthostatic hypotension.
http://www.ccjm.org/content/77/5/298.full

+++++++++++++++++++++++++++++++++++

I first heard about this connection of dysautonomia and CCSVI from Dr. Diana Driscoll, who was putting together her theory of CCSVI, based on her personal experience with Ehler Danlos disease, POTs and MS. I met her on This is MS. Dr. Driscoll has spoken at length about her theory, written about it, and made YouTube videos. She has not published anything in a peer-reviewed journal. That doesn't mean she's wrong, it simply means it hasn't been published or peer-reviewed. She has always suggested a multi-disciplinary approach. Here is her website, where she has been discussing her theories for over a decade.
http://prettyill.com

Sadly, Dr. Driscoll did not publish her theory in a peer-reviewed journal, and because of this, it has not been easy for her. The great thing about publishing in a respected journal is that other scientists read your theory, and can expound on it. They can credit you--by using a citation--and build on your work. Publishing really is the key to gaining acceptance and further knowledge.

++++++++++++++++++++++++++++++++++++

Here is a paper on the theory of treating rheumatoid arthritis with vagal nerve stimulators (VNS) to treat the underlying autonomic system imbalances.
VNS is currently an approved treatment for epilepsy and depression. It is an FDA approved implanted device which delivers charges to the vagus nerve. These researchers believe this treatment may be helpful for those with RA. Please note that this is not a one-time bump into the vagus nerve with a balloon---this is treatment using ongoing, electrical impulses. Because autonomic dysfunction is an ongoing problem. Venous malformations can be corrected with ballooning and stenting, but there is not evidence that ballooning does anything for autonomic dysfunction.

Vagus nerve stimulation already is used in patients with drug-resistant epilepsy and depression. The left vagus nerve is stimulated via an implantable electrode. Vagus nerve stimulation had beneficial effects in both disorders without major side effects (99). A recent study investigating in more detail the effect of VNS on the immune system in 11 patients with refractory epilepsy demonstrated that VNS causes a rebalancing of the immune system compared with a control group (102).
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3188868/

VNS devices may well be a viable treatment option for those with CCSVI/MS due to autonomic dysfunction. It is an FDA-approved device, covered by insurance. But there needs to be more published research before it can be approved.

++++++++++++++++++++++++++++++++++++

Dr. Zohara Sternberg, from BNAC, has published her THEORY of the connection between Autonomic Dysfunction, CCSVI, D3 levels and Epstein Barr virus. Again, this is just a THEORY, meaning that it's not right or wrong, it's just looking at connections and hypothesizing. Dr. Sternberg is not suggesting any treatment or way to deal with this. She's just putting some puzzle pieces together.

Let's break down her abstract together. The abstract will be in italics, my thoughts will be in regular text.

Abstract
Multiple sclerosis (MS) is a disease with multiple etiologies. The most recent theory of the vascular etiology of MS, Chronic Cerebrospinal Venous Insufficiency (CCSVI), suggests that cerebral venous obstruction could lead to cerebral venous reflux, promoting local inflammatory processes.

--Well, this isn't really a complete review of Dr. Zamboni's research, but it will suffice for the abstract. Abstracts are not complete papers. If we want to read all of the science, we can purchase the full paper through the online website.

This review article offers strong evidence that the route of the observed narrowing of cerebral veins arises from autonomic nervous system dysfunction, particularly cardiovascular autonomic dysfunction.

--Please note that she is talking about CEREBRAL VEINS....this is not the same as CCSVI, which is narrowing of the veins outside the brain, or extracranial veins--the jugular and azygous. She is looking at how the veins inside the brain might be narrowing, due to a malfunctioning of the cardiovascular system.

The dysfunction of this system has two major effects: 1) the reduction of mean arterial blood pressure, which has the potential to reduce the cerebral perfusion pressure and the transmural pressure, and 2) the failure of cerebral autoregulation to maintain constant cerebral blood flow in the face of fluctuations in cerebral perfusion pressure. Alterations in cerebral autoregulation could in turn raise the critical closure pressure, indicated to be the cerebral perfusion pressure at which the transmural pressure will be sub-sufficient to overcome the active tension imparted by the smooth muscle layer of the vessel.

--OK, this is actually a lot more easy to understand then it appears at first glance :) If the cardiovascular system's auto-pilot feature is malfunctioning, this could slow down blood going into the brain, and reduce the pressure inside the brain. If the autonomic system isn't working between the heart and the head, constant cerebral blood flow can be altered, and the system of blood flow between the head and heart can be changed. This will change the lining of the blood vessels, and make them tighter. Just like what we were talking about in orthostatic hypotension above. The cerebral blood vessels are compensating for the slowed blood flow.

These two effects of autonomic nervous system dysfunction (reduction in arterial blood pressure and alterations in cerebral autoregulation), when combined with inflammation-induced high levels of nitric oxide in the brain, will lower transmural pressure sufficiently to the point where the threshold for critical closure pressure is reached, leading to venous closure.
In addition, cerebral vessels fail to overcome the closure as a result of low central venous pressure, which is also regulated by autonomic nervous system function.


--So, what she is describing is a cascade effect. Less blood pressure in the brain means less blood flow, means more inflammation, and will make the blood move even more slowly, causing the veins to constrict even more.

Furthermore, through their neuroregulatory effects, infectious agents such as the Epstein-Barr virus and vitamin D3 are able to alter the functions of the autonomic nervous system, influencing the rate of CCSVI occurrence.
The absence of CCSVI specificity for MS, observed in recent clinical studies, may stem from a high prevalence of autonomic nervous system dysfunction in control groups which were recruited to these studies. Future studies should investigate CCSVI in relation to cardiovascular autonomic function.


--Now she's looking at a couple of things we know thru previously published scientific research are related to MS, and trying to connect the dots. We know pwMS have lower levels of the hormone D3, and we know that the EBV virus has been linked to MS. These factors have been discussed in other research. If we had the full paper, we could read more about her hypothesized connection between EBV, D3 and changes to the autonomic nervous system. WHat she's theorizing is that the fact that CCSVI is showing up in normals is because the control population might have autonomic function problems, which might be right. Again---this is all conjecture. Just a theory.


But she is nowhere near advocating for a jugular ballooning procedure to "zap" the vagus nerve and reset the autonomic system. We simply need more research on this. If patients want to be treated now for this condition, that's their right. And we all hope it brings them relief. But to say that this treatment is the same as what Dr. Zamboni advocated for, is simply not true.

cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Re: ballooning of nonobstructed jugulars

Postby 1eye » Sun Aug 04, 2013 4:26 pm

--Please note that she is talking about CEREBRAL VEINS....this is not the same as CCSVI, which is narrowing of the veins outside the brain, or extracranial veins--the jugular and azygous. She is looking at how the veins inside the brain might be narrowing, due to a malfunctioning of the cardiovascular system.

The dysfunction of this system has two major effects: 1) the reduction of mean arterial blood pressure, which has the potential to reduce the cerebral perfusion pressure and the transmural pressure, and 2) the failure of cerebral autoregulation to maintain constant cerebral blood flow in the face of fluctuations in cerebral perfusion pressure. Alterations in cerebral autoregulation could in turn raise the critical closure pressure, indicated to be the cerebral perfusion pressure at which the transmural pressure will be sub-sufficient to overcome the active tension imparted by the smooth muscle layer of the vessel.


This makes me think about capillary loss, reported by Dr. Zivdenov. Why capillaries? Capillaries are the place where there is the highest per-segment resistance to flow, due to a few things, like diameter, length, surface area and viscosity. That is unimportant in non-pathological conditions, due to massive parallelism, but resistance is still highest there.

She said "transmural pressure will be sub-sufficient to overcome the active tension imparted by the smooth muscle layer of the vessel." This seems to imply that the vessels, whatever their size, have a smooth muscle layer.

I read it on the internet, so it must be true... Brain veins: do they or do they not have a smooth muscle layer? Capillaries: do they or do they nor have a smooth muscle layer? Endothelium?

Anyway, if venous pressure at the heart is low because of an upstream stenosis, and the compensation for this by the heart is absent because of a vagus nerve problem, won't that lessen the capillaries' chance at being above the critical closure pressure, so they have the least chance of survival?

*********************************************************************************************************
I may sound like I am arguing against dysautonomia, or for CCSVI. I realize this is an area where a lot of confusion is possible. There are no very clear-cut answers. For instance, I was thinking: there is possibly a direct connection that is affected by one thing, and not the other. I am no expert on eyes. it seems to me that this vagal nerve ballooning can have no effect on the eyes, because the nerves that connect the brain with the eyes do not pass through the neck. That would be an argument as much against dysautonomia as the CCSVI procedure because, how does ballooning affect the eyes either? Answer: it affects all blood flow to the brain and the eyes. Also, the eyes are on that chart of the autonomic nerves, aren't they? Well, yes, but the ocular connection to the brain surely doesn't pass through the neck? Well, why then do we see eye symptom improvement from CCSVI procedures?

These two systems (autonomic nervous, and circulatory) are both so all-pervasive, that it is an extremely difficult job to separate them. Maybe Dr. Arata can do that. Like Dr. Sclafani I do look forward to his publication, because I want this question to be resolved as much as the next guy with "MS". The confusion comes not only from their pervasiveness, but from their being interconnected, in that the heart, not just the balloon, is involved in both. Nerves need oxygen too, don't they? There are always arguments on both sides. Experience eventually may cause one side to be more convincing. Ballooning unobstructed jugulars may be less effective for pw"MS". It might be more dangerous than other means of treating dysautonomia. Personally, given the length of time since I saw Dr. Zamboni on CTV, I don't have time to wait for dysautonomia to be proven to be more the culprit. I probably can't wait for that to be proven of CCSVI syndrome, either.

I think both areas are equally interesting and related (maybe a new discipline needs birthing). I will continue to be interested. In my case, time is of the essence. Both areas of treatment have the forces of the dark side mobilized against them. The battle between good and evil will inevitably last longer than I will. I should ask them to hurry up, but I can't seem to get their attention. It's probably for the best. I know nothing. I am not wise. I can't get millions of Canadian or US dollars, to study stuff I have been on public record and on TV and radio and newspapers, speaking of as a hoax, or nonsense, or maligning protagonists of. Others can, somehow, so their opinions are obviously more reliable, less conflicted than mine. Yes, I am bitter that the "MS" society would give so much money to the most outspoken critics of this area of research.

Right now, I ask, does anyone in the "MS" business test for dysautonomia? Anyone besides Dr. Arata use HRV testing? Can an ordinary mortal, who has heart problems, ask an ordinary doctor to do this? Do you have to ask a heart specialist? Is there any (better) way to test the connections between other, non-cardiac symptoms and autonomic nerves?
"Try - Just A Little Bit Harder" - Janis Joplin
CCSVI procedure Albany Aug 2010
'MS' is over - if you want it
Patients sans/without patience
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