I said
Quote:
But to what degree is it a vascular problem that deserves treatment in its own right? This is an identified severe occlusion in the venous drainage of the head, a head that holds a brain that is struggling with MS BTW, it just seems logical to go ahead and treat that and let the "Causes MS or not" chips fall where they may, feeling confident that on basic physiological principles you have given the brain the best chance for good circulation and thus have maximized the chances for healing.
So far only Dr Dake has been willing to look at the problem that way. Others have insisted on looking at "I don't see that we have proof that this causes MS yet" angle and ignoring the elephant in the room: verified compromised circulation (here I am talking about the tested person with venous abnormality) as if it is totally fine to leave circulation compromised while they have their academic debate about MS causation.
and continued with questions of Gici
Quote:
Just curious: You are not impressed that addressing the circulation itself for its own sake is a good enough argument to make to people and that some might be persuaded by that alone?
The logic that returning good circulation is helpful for its own sake is not persuasive? Would it have been persuasive to you before at all?
Do vascular doctors then only treat diseases and never circulation ITSELF?
My standpoint has been that we do not know if it helps MS but why can't we treat the stenosis for its own sake? I am just asking, curious, because it seems logical.
Because if a doc was in a chest of a person with heart disease in general and found a vessel with a 90% blockage and collateral circulation he would treat it even if that vein would not directly impact the heart itself wouldn't he? No one would question that would they?
I guess that is my deal, I think vascular doctors treat circulation not other diseases necessarily, therefore treating the stenosis seems only ordinary, but maybe that is wrong.
and his answer has come...Thanks Gici!
Quote:
Your comments are spot on. The venous obstructions should be treated indipendently from believing or not that they are the cause of MS. A patent vessel has to be better than an ostructed one: this is not only logic but it is also the medical experience we have so far. In addition venoplasty procedures are, I believe, covered by insurance.
regarding the "medical experience we have so far" I think that what you were saying is that it is known in medicine that improving circulation is already known to be beneficial This is a basic principle of medicine:normal circulation is vital for normal function.
This is the core basis for my feeling so positive about this even though the research is unclear at this point about the extent to which treatment may help...there is a basic principle in question here, ignore the circulation at your own risk... it is REASONABLE to expect at the minimum some benefit from restored circulation and reasonable to expect some negative outcome if such circulation issues are ignored.
Stenoses are not benign.
The comment that venoplasty is covered by insurance is in support of the idea it is standard of practice I believe. The insurance companies cover repair of stenosis (often as long as it is in excess of 50%) because they know it is the medically necessary thing to do.
So the main argument for getting at the minimum assessment and hopefully treatment at this point has to be circulation centered because such a point of view should be considered reasonable....
although the further issue of the location of many of these jugular stenoses, very high in the head, and the concern regarding safety of procedures in that area will not be taken lightly and will continue to be a roadblock until there is clarity about safety.
If I was in charge of the world,
I would like to see the specialties of vascular surgery and interventional radiology speak up on this-look into making a policy statement -- and I'd have them state that treatment for the sake of restoring circulation is reasonable, rather than having them sit back and wait for the neuro research community to finish their debate.
it is hard waiting, but man, really, only 10 months since the December paper!!
Login
Register
FAQ
Search
