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PPMS, CCSVI, and what Dr. Zamboni said in the CTV interviews

Posted: Sun Nov 22, 2009 7:00 pm
by EnjoyingTheRide
What I understood about PPMS and CCSVI up until I watched the CTV interviews was this:

1. PPMS progression takes longer to stop- about 18 months.
2. PPMS stenosis is located in different areas than RRMS, including more often the azygos veins.

But in one of the post production interviews I heard Zamboni say,

"not all of the narrowing of Primary Progressive people can be treated"

and then he was abruptly cut off. Does anyone know the whole story here? This is the first time I heard that I might be untreatable.

Posted: Sun Nov 22, 2009 7:06 pm
by Rokkit
I caught that too, and I figured it would be coming up soon enough on here. Although I haven't been diagnosed, I'm almost certainly PPMS. I'm definitely not RRMS. And my jugulars were pinched in the same places as all the RRMSers. And my azygos was fine, just like almost all of the RRMSers. So I have no idea what Dr Z was talking about, but would love to know more. Hopefully he's talking about in the rarest of cases. Or maybe he just meant the angioplasty wouldn't work in whatever locations he's referring to.

Posted: Sun Nov 22, 2009 7:16 pm
by zap
Does Dake test the azygos in the upright position? Is the upright position where Zamboni sees problems with doppler?

Given the way blood flow changes when upright and prone, it seems quite possible to me that this could be the source of the apparent discrepancy.

Posted: Sun Nov 22, 2009 7:32 pm
by cheerleader
Dr. Zamboni has not been able to help relieve all stenosis with ballooning. The very, very high jugular blockage is one such type. My Jeff- even though diagnosed as RRMS- would not have benefited from the Liberation procedure. Nor would rokkit. The stenosis which can be helped by ballooning only are the azygos and the lower jugular stenosis. Dr. Zamboni has seen stenosis in all MS patients, but has only treated 100 or so out of the hundreds he has tested with the Liberation procedure. This is because, as Dr. Dake has learned, ballooning doesn't help everyone. Most patients will need stents for the veins to remain open.

All tests are done prone, with the exception of the dopplers of head and neck, which are done prone and upright. Azygos is always flat, to my knowledge. We still do not understand the discrepancy in what Dr. Zamboni and Dr. Dake are seeing in the azygos-
cheer

Posted: Sun Nov 22, 2009 8:18 pm
by radeck
123

Posted: Sun Nov 22, 2009 8:35 pm
by Rokkit
When I was with Dr D (7 weeks ago) he said he had no idea why the discrepancy with Dr Z regarding azygos.

Posted: Mon Nov 23, 2009 4:33 am
by EnjoyingTheRide
Thanks to everyone for your responses. I'll definitely ask Dake about this when/if he calls me for a consultation. I'm still waiting for the other shoe to drop- for everyone to say "sorry, this works only for RRMS". I'm particularly concerned about this in February with the preliminary Buffalo report.

Sorry for my pessimism, but you get that way after years with PPMS, listening to all the buzz about advances in RRMS treatment.

Posted: Mon Nov 23, 2009 4:49 am
by Loobie
I've been out to Stanford three times and asked him about their discrepancy all three times. He says he doesn't know why. I sense from Dake the collaboration may not be as fully enthusiastic as we would all like to see as Dake doesn't understand why Z doesn't use stents since all of the restenosis. Not that they don't talk, but I think that Z doesn't seem too crazy about the use of stents. Just a feeling I got, nothing he directly said.

I was really sure he would find azygous involvement on me as my MS has been mostly spinal, but alas he really thoroughly showed me that there was none on the MRV. Prone or upright? Maybe that's why, but at least on my MRV, my azygous did not look like it was malfunctioning at all. However, I am not PP, but SP and clearly started out RR.

Posted: Mon Nov 23, 2009 5:44 am
by wonky1
I fully understand the frustration that comes with PPMS.
I too have PPMS and was at first reluctant to raise my hopes, just in case they were dashed yet again.
However I have decided to see Dr Simka and get scanned and if anything is found, have it "liberated".
This quote from GiCi is hard to disagree with.
GiCi wrote:Hi Wonky1,
I do not think that anybody could answer your questions, not even Zamboni.
It is true that improvements following the liberation procedure have been observed, but the evidence is still being accumulated. If you decide to have the procedure you should do that on the basis that a normal drainage of blood from the brain is very likely to be better than a faulty one.
GiCi
So I've decided that I would be better of with correct drainage.
Anything else is a bonus.
Of course, I'm sure a positive attitude (again) will I'm sure help, even if improvements do take a lot longer than in RRMS people, I've nothing to loose and the possibility of huge gains. Given time of course.

Posted: Mon Nov 23, 2009 6:13 am
by Loobie
wonky1 wrote:So I've decided that I would be better of with correct drainage. Anything else is a bonus.
Of course, I'm sure a positive attitude (again) will I'm sure help, even if improvements do take a lot longer than in RRMS people, I've nothing to loose and the possibility of huge gains. Given time of course.
That is exactly the attitude I went out with. I had my hopes dashed before as well during my stint with Tovaxin, so this is how I set up the expectation in my head. I can't deny I'm walking better 5 months out. That is obvious even to me. Do I still feel MS'y? Sure I do, but I am definitely functioning at a higher level than before the surgery. Not in all the areas, like my damned bladder, but in my legs and also cognitively for sure.

Posted: Mon Nov 23, 2009 9:00 am
by radeck
123

Posted: Wed Dec 02, 2009 3:00 pm
by nomorems
Does anyone know how to get involved in the Clinical Trials at Stanford. I read somewhere that the cost is $80,000. Is that true?

Posted: Wed Dec 02, 2009 3:10 pm
by magoo
If you decide to have the procedure you should do that on the basis that a normal drainage of blood from the brain is very likely to be better than a faulty one.
GiCi
So I've decided that I would be better of with correct drainage.
Anything else is a bonus.
[/quote]


Exactly how I felt going into this! I wanted my blocked veins opened. The benefits are the icing on the cake!

Posted: Wed Dec 02, 2009 3:16 pm
by mrhodes40
not all of the narrowing of Primary Progressive people can be treated"
In todays released paper he said some PPMS patients had agenesis of the lumbar plexus--it never developed. Obviously you can't balloon something that is not there.........

Posted: Wed Dec 02, 2009 4:51 pm
by EnjoyingTheRide
In todays released paper he said some PPMS patients had agenesis of the lumbar plexus--it never developed. Obviously you can't balloon something that is not there.........[/quote]

I still don't understand this. Can you explain further?