MS: Nerves and Veins 2017

[vesta]

MS: NERVES AND VEINS - 2017

An MD Dr. Farough Owiesy in southern California specializing in migraine headaches began treating CCSVI – MS as a dysfunction of the autonomic nervous system as it impacts the veins of the central nervous system. It is clear to me that he has found the missing link to the Multiple Sclerosis mystery and a plausible, non-toxic, inexpensive treatment. Let’s backtrack.

It has been over eight years since Professor Zamboni posted his CCSVI theory on the internet (December 2008) suggesting that MS is in fact a blood circulation disorder of the brain. Since then scientific research has revealed that disruption of ANY fluid bathing the central nervous system (blood, cerebro-spinal, lymphatic, glymphatic) can cause “MS” symptoms. This site is intended to share the “liberation” I feel as an MSer who no longer needs to fear inevitable doom.

I first learned about “Liberation Therapy” on the site Daily Kos summer 2010. Professor Zamboni initially proposed using the Sonogram to diagnose veins running from the brain towards the heart – the Internal Jugular Veins and the Vertebral Veins. Once the narrowings/blockages in these veins were observed he recommended opening the stenoses with balloon angioplasty and, if so indicated by the venogram, the chest azygos vein as well. In his paper “CCSVI – A New paradigm and therapy for multiple sclerosis” posted on July 25, 2010, the Interventional Radiologist Salvatore J.A. Sclafani, MD refers to Dr. Zamboni’s work by writing “Chronic cerebrospinal venous insufficiency (CCSVI) is a hemodynamic condition in which cerebrospinal drainage is altered and inhibited. Outflow obstructions of the internal jugular veins (IJVs), vertebral veins, and/or azygos vein ( AZV) and their tributaries result in stasis or reflux of these outflow veins and redirection of flow through vicarious circuits…

On reading this I immediately asked my husband to massage my neck/back, both of us standing. He was to work from the head down to the waist while we both visualized the blood flowing down from my head to circulate through the heart. I felt better at once as the head congestion lifted. Late that summer stress triggered a MS “attack”. I wondered with a heavy heart how much ground I would lose. That evening I performed a TENS acupressure treatment on myself (see Acupuncture blog). I was shocked the next morning to realize the attack had abruptly stopped. Not diminished, not attenuated, but stopped. Years later when I studied my journals and records I realized a Shiatsu massage had stopped my first major attack in 1980 just when my Neurologist prepared steroid treatment. (See Dr. Pallis blog). Opening the flow of blood/fluids was the best treatment.

In spite of some impressive recoveries after angioplasty, treatment of MS as a CCSVI disorder met with skepticism and eventually strident opposition from the dominant Neurology/Big Pharma lobby. Doubtless these special interests influenced the American FDA to effectively ban the treatment for MS patients. While relatively safe and legal, this meant MSers had to pay out of pocket to get treatment since medical insurance refused to pay for an “experimental” procedure.

There were problems. Outcomes varied. Perhaps one third of patients knew impressive recovery of function, one third minor recovery, and one third none at all. Maybe one fourth of MS patients suffer from skeletal obstructions (bones, muscles, arteries)
of blood/cerebro-spinal fluid flow which means ballooning the veins might injure them without relieving the obstruction. Also venous anomalies aren’t specific to MS patients though scientific research has shown that blood circulates more slowly through MS brains than normals. Once enlarged, the veins could re-stenose thus obliterating the improvements. Joy, relief, heartbreak, frustration - emotions were as varied as the outcomes. I for one didn’t want to take the risk of angioplasty in the USA without American health insurance (mine covers France).. Also, I felt I could keep the blood/spinal fluid flow open through manual treatment – massage and TENS massage. And, as it turns out, I was right.

Dr. Owiesy has observed that when the middle layer of the vein composed of smooth muscles goes into spasms, blood flow is obstructed. Again the problem resides “exterior” to the vein, not “interior”. The veins may be weak or somehow defective, but the mechanism which shuts off the blood flow isn’t “intima”. This corresponds completely to my experience. The treatment? Dr. Owiesy administers a mixture of dexamethasone/lidocaine/thiamine in the area around the Internal Jugular Vein. Outcomes have been impressive, risks and expense minimal.

His observations are consistent with the following recent research from the Buffalo New York University Department of Neurology.
http://link.springer.com/article/10.100 ... 015-9599-y
Molecular Neurobiology
January 2017, Volume 54, Issue 1, pp 362–37
"Impaired Neurovisceral Integration of Cadiovascular Modulation Contributes to Multiple Sclerosis Morbidités".
“Multiple sclerosis (MS) is an inflammatory demyelinating central nervous system (CNS) disease with an uncertain etiology. MS... we propose that the dysregulation in the neurovisceral integration of cardiovascular modulation can lead to many MS-related clinical symptoms...the manifestations of cardiovascular autonomic nervous system (ANS) dysfunction. The strategies for improving sympathovagal balance would likely prevent and minimize many MS-related clinical symptoms”

Once MD’s catch on to this, MS treatment may well become as simple and effective as an injection in the area surrounding the veins subject to blood reflux. Of course there is always the problem of reconstructing the damaged myelin sheath AFTER one has overcome the blood/CSF reflux. Stem cells may well solve this problem, but my focus now is on preventing the reflux and healing the brain’s grey matter, white matter and the venous system.

The above is a quick overview. Dr. Owiesy has provided the missing link. My original analysis may provide clues as to why MSers are subject to dysfunction of the Autonomic nervous system (ANS) and why their veins are so weak that they collapse easily under stress. So let’s return to my initial observations.

I launched my site MS Cure Enigmas.net March 2012 by writing:

“In Multiple Sclerosis blood vessels "deformed" by childhood stress cannot accommodate the blood flow. I believe the immune system is activated by blood refluxes which injure the brain and spinal cord. The origin of the refluxes may be structural 1) CCSVI stenosis (as proposed by Professor Zamboni) and/or cerebro-spinal fluid pressure or 2) it may be a stress reaction to toxicity.

Epidemiological studies on MS show that those who grow up close to the equator have less chance to develop MS than those living in latitudes closer to the poles. It is the latitude where one lives before age 15 that counts, not where one lives subsequently. It is therefore thought that the lack of sunlight leading to a Vit D deficiency is a factor in susceptibility to MS.

But perhaps an equally important explanation of the geographical factor is Winter Cold.

The shoulders and neck typically tense up under stress thus restricting circulation to and from the brain. Cold weather stiffens the muscles. Winters bring the body aches of colds and flus. Illness itself (e.g. Mononucleosis) may damage the cell walls and valves of the vascular system.

It is also said that MS patients tend to be high powered, ambitious people. Tensed up in other words. MS cases cluster in northern Europe and North America. Let’s say growing up in a culturally demanding family environment (or in any case stressful) while subject to Cold weather and frequent colds and flus actually compresses and deforms the circulatory system in the child’s developing body. By the time he/she reaches age 15, the damaged blood vessels can no longer accommodate the blood flow. MS first appears in adolescents, seldom in children. Let’s compare the deformity to ancient Chinese footbinding where the tiny child’s foot cannot support the adult woman.

Food intolerances, especially to wheat and dairy products, can further compound the stress. The Neolithic agricultural revolution dates back not much more than 10,000 years, a blink of the eye in terms of biological evolution. Bowel problems are a sure sign of food “stress”. The significant increase in MS cases in Japan over the past 30 years points to food toxicity as root cause.

And the disadvantage of being female. While originally there was no difference in MS incidence between the sexes, over the past 50 years women’s share has increased to the point where up to three out of four MSers are female. What changed 50 years ago? The advent of birth control pills (1960) and hormonal therapies which are known to impact the vascular system adversely.

Maybe the real story behind MS is the damage to the blood vessels caused by growing up in a 1) driven, ambitious or otherwise stressful family environment compounded by 2) a climate of Cold winters which contribute to 3) frequent viral illnesses compounded by 4) an intolerance to the wheat and lactose of a Neolithic diet.”

That analysis is a good beginning, but my thinking has evolved since then. Avoiding the damning diagnosis MS, Dr. Sclafani has performed over 500 venoplasties for CCSVI and has found the condition in many more vein types than initially proposed by Dr. Zamboni. He recommends use of the Intravenous Ultrasound (IVUS) to allow the Doctor to best judge the size of the balloon – too small the vein re-stenoses, too large the vein wall may be damaged resulting in thrombosis. For him the gold standard for CCSVI diagnosis is the IVUS venoplasty itself, the sonogram being inconclusive. Thus he has been able to overcome difficulties which tended to discredit early treatments.

Another issue overlooked at the outset was the skeletal factor, that pressure ON the vein by a bone, muscle or artery may be obstructing blood flow rather than a problem IN the vein. Chiropractor Dr. Michael Flanagan, author of The Downside of Upright Posture – The Anatomical Causes of Alzheimer’s, Parkinson’s and Multiple Sclerosis estimated that up to 25% of MS cases fall into this category. In this case venoplasty is ill advised since the treatment will not overcome the obstruction and may well damage a healthy vein.

February 13, 2015 PLOS ONE* published a double blind study revealing that it takes twice as long for blood to flow from the heart through the brain and back to the heart in MSers than in normals, this regardless of the MSers condition. In other words, poor blood perfusion through the brain is a marker for MS, it defines MS.

The Missing Factor? Not only are the veins weak or deficient, the Autonomic nervous system is dysregulated so that the smooth vessels of the veins go into spasm and obstruct the blood flow.

Consider first that neck/back massages can apparently release venous muscle tissue spasms to get sluggish blood flowing in my case. Why should the blood vessels in MSers be so weak that a muscle spasm can disrupt blood circulation? Recent research by Professor Zamboni has found that the endothelium – inner vein wall - cells are absent in the Internal Jugular veins of MS subjects. Without sturdy walls the veins could collapse like a flimsy garden hose. Why are these cells missing? Childhood illness, poor nutrition owing to food sensitivities, insufficient Vitamin D ( a form of vein rickets perhaps? A genetic factor specific to MS reinforces the need for Vitamin D.) Whatever the reason, a damaged endothelium is a vital factor. So the slightest tension may impede blood circulation.

Foods can act as toxins which cause body tension, glutens being a classic example. Antibiotics as well. The flu can cause the entire body to seize up in cramps which seem to shut down my entire body’s fluid circulation leading to terrible MS symptoms. Anything which causes the body to tense up may trigger venous smooth muscle spasms i.e. MS attacks. I don’t think one need look any further than that.

And Latitude? It's the Sun which brings health through Vitamin D AND the release of Nitric Oxide. Nitric Oxide is a vasodilator critical to the development and function of the vascular system. (Research into Cardiovascular disease – not MS or CCSVI – led to these insights.) A properly functioning vein wall so critical to blood circulation depends on a healthy life style (diet, supplements, exercise, stress reduction, UV rays). These factors missing during the critical growth period could well lead to a deformed, poorly developed and poorly regulated vascular system. The evidence pointing to MS as a circulatory system disease is overwhelming. And the epidemiological factors fall into place.

However, blood is not the only fluid impacting the central nervous system. Obstruction of cerebro-spinal fluid (CSF) which bathes the spine and brain can lead to MS pathology as well. The International Society for Neurovascular Diseases (ISNVD founded in 2011 has done pioneering research into the “interaction between the CSF system and the cerebral venous drainage system”.

I’ve come to think that the 10% PPMS cases exhibit primarily obstructed cerebro-spinal fluid (CSF) or direct pressure on the spinal cord itself owing to a damaged, degenerated spine. And the more common RRMS (RelapseRemissionMS) is transformed into the Progressive form as the disease process damages the spine and body structure in general.. (See January 21, 2015 Blog “How RRMS progresses to SPMS”). A complicated interplay of CSF circulation and venous blood circulation suggests therapies other than angioplasty.

The MS-UK site’s succinct definition of PPMS.
Primary Progressive MS (PPMS) concerns about 10 to 15% of MS cases. In contrast to RRMS (RelapseRemission) cases, the PPMS disease progresses continually without respite after striking an older population (age 40’s to 50’s). Unlike RRMS, there is little to no inflammation, there are fewer brain lesions, the lesions which do exist present fewer inflammatory cells, and more are found on the spinal cord than in the brain which leads to mobility problems. While PPMS cases exhibit less inflammation, there appears to be greater damage to the axons.”

PPMS patients are not included in MS drug research and treatment because both target the myelin damaging inflammation of RelapseRemission MS observed on the MRI, that is to say, the blood reflux (CCSVI).

A point also missing from my original paper is the observed atrophy of brain grey matter as the disease progresses. Blood refluxes damage the myelin white matter which are revealed as MRI lesions during early stage relapses. Eventually the relapses recede as the grey matter deteriorates. (Recent research reveals that MS disability is related to microbleeds in the brain – another manifestation of the critical importance of a healthy endothelium to prevent breach of the blood brain barrier.)

And finally we arrive at an understanding that increased disability is less caused by white matter lesions than grey matter atrophy, a shrinking brain. This puts in doubt the entire immune suppression drug protocol for MS. (See Professor George Ebers' conclusions after 40 years of recognized MS research.

So consider the factors. Is blood flow from the brain impeded by a venous obstruction? Or does a dysregulated autonomic nervous system cause the smooth muscles of the vein to go into spasm, thus sending refluxed blood into the CNS? Will simple body tension cause the veins to seize up and impede blood flow, tension caused by emotional stress, the flu, toxins, poor food? Has stress re-activated a dormant EBV Herpes virus lodged in the autonomic nervous system causing the veins to seize up in spasm? Is there a bone pressing on the otherwise healthy vein? Does cerebro-spinal fluid flow obstruction damage the axons, the spinal cord? Where is the principle obstruction to the free flow of central nervous system fluids? How should it be treated?

At this time, Chiropractors familiar with spinal structural conditions are probably best equipped to study, diagnose and even treat skeletal obstructions of blood and cerebro-spinal fluid flow through the central nervous system. Dr Michael Flanagan “upright doc” on the Thisisms.com website (CCVBP), (tragically for MSers now deceased,) recommended use of the COX Technic Flexion-Distraction tables (the most advanced is now version 8) to treat spinal conditions. NUCCA (National Upper Cervical Chiropractic Association) Chiropractors specialize in treating the Cervicals and the Atlas Orthogonal (C1). Italian teams of vascular specialists are now studying the phenomonena.

The ideal diagnostic equipment is the FONAR upright Cine MRI invented by Dr. Damadian – inventor of the original MRI idea - because obstructions in cerebro-spinal fluid flow are less likely to be observed by MRIs when the patient is recumbent. Also, this is a CINE MRI. Rather than a static image, the fluid flows are FILMED to measure speed of flow as well as any obstructions. For diagnosis of CSF flow there are apparently 15 FONAR sites in the US and one in London. (http://www.fonar.com/news/052114.htm

Osteopaths work to get the body fluids circulating. Doubtless the treatment releases muscle spasms as well. My Osteopath thinks MSers need the combined skills of a Chiropractor – to free any obstructions by manipulating the skeleton – and an Osteopath - to get the fluids circulating. This would include the newly discovered Glymphatic fluid which cleanses the brain during sleep, not to mention the brain’s lymphatic fluid discovered summer 2015.

And now one can foresee treatment of the autonomic nervous vascular system as a means to stop the blood refluxes and stop the relapses. Until that technique becomes available, optimal nutrition, supplements, blood circulation therapies and simple relaxation therapies should be employed to strengthen the veins’ endothelium, nourish grey matter as well as the myelin sheath, and stop the blood refluxes.

According to the Neurologist Dr. Robert Zivadinov of NYU Buffalo N.Y., all MSers have a history of Mononucleosis which means they harbor an Epstein-Barr Herpes virus (EBV). Did the initial infection damage the veins and/or the autonomic nervous system? Does the dormant virus hide in the autonomic nervous system to re-activate under stress? Does this stress send the veins into spasms which trigger blood back-jets into the CNS, hence MS “attacks”? Or do the “attacks” re-activate the virus because poor perfusion through veins leads to oxygen deficiency? (I don’t favor trying to “kill” a dormant EBV Herpes virus with anti-viral drugs. The original illness may have already damaged the veins and the drugs will only weaken the immune system further. Also, I would never try the HSCT stem cell therapy – recently in the news - in which the immune system is destroyed with high dose chemotherapy after which stem cells are administered to “reboot” the immune system. Better strengthen one’s overall health to keep a dormant virus at bay rather than damage the immune system – or risk death - with drugs. That strikes me as an unnecessarily drastic way to detoxify.)

In the meantime, anyone who seriously seeks to heal MS can’t ignore nutrition. Proper diet serves 4 purposes: 1) to prevent body stress - on the vascular system i.e. the blood reflux and/or on the cerebro-spinal fluid 2) to heal and reinforce the endothelium of the vascular system at the cellular level 3) to nourish the brain cells (white matter, myelin sheath, axons, grey matter) especially important if there has been some brain damage and 4) to re-inforce the immune system in order to de-activate a latent virus or bacteria. One note: before diet change and supplements could work for me I had to go through a profound detoxification and I needed the help of a naturopath/kinesiologist to do it.

One final note: Consider that one may have Lyme disease or a serious Vitamin B12 deficiency which can mimic MS symptoms. See Resources section for blood test suggestions.

Even though Dr. Zamboni's insight has come a bit late for me, it has given me a new lease on life. I used to live in constant fear of a debilitating relapse. Now I know what to do to head off a breakdown. Having embarked once again on my diet I feel better and hopeful of improvement in the future. I know that anything which improves blood/brain fluid circulation (swimming, acupuncture, acupressure, massage, kinesiology, osteopathic, chiropractic, any energy therapy – AND fifteen minutes of Sun a day) will make me feel better and prevent a relapse. As I’ve gotten control over the blood reflux into the brain, I’ve come to see the importance of keeping my spine strong and stabilized. Optimal nutrition and supplements and oxygen can keep blood vessels as well as the brain’s grey matter healthy. And I need to be ever vigilant in avoiding illnesses which might trigger the latent EBV virus.
I hope other MS patients will reflect on their history and that my experience will be of use in their Healing.

Previously published on my site MSCureEnigmas.net http://www.mscureenigmas.net/ms-blog

http://www.mscureenigmas.net

Best regards, Vesta

[hmacoli]

HI Vesta

Congratulations for your excellent resume and reflexion about MS nerves and virus. It has also been very interesting Dr Owiesy findings about the relationship between veins blood flux interruption and vein spams. I have always think that stress is one on the main factors in the sunset of MS crisis, so it was the first think that I told to my MD 15 years ago that he mispreciated. Linked to early virus infection style of life latutude (and I would added altitude- see Rocket Mountains high MS rate not according with latitude) I also think that psychological issues are in the top of the problem, so in order to solve it there is also to consider them in an integrative model. To finish I would like to share with you all that I am feeling better and day by day (if it wasn't for a hard flu) that hasn't stop my improvements. Biomagnetism and neuroelectrical stimulation are improving some lost body functions inmy right arm and leg after many years. I do really think now that I am in the way of healing. As I told you and it is posted in this forum, I have developed my T.R.A.N.QUI.L.N.E.S.S. (that must be updated) strategy, which shares as you now a lot of points with you, and that I have posted in this forum and in my web page in 9+1 steps (http://www.secretosdelaesclerosismultip ... pot.com.es, written in spanish but there is a translator to any language).
My best wishes and congratulations again for your ver interesting post.
Hugo

[vesta]

HI Vesta

Congratulations for your excellent resume and reflexion about MS nerves and virus. It has also been very interesting Dr Owiesy findings about the relationship between veins blood flux interruption and vein spams. I have always think that stress is one on the main factors in the sunset of MS crisis, so it was the first think that I told to my MD 15 years ago that he mispreciated. Linked to early virus infection style of life latutude (and I would added altitude- see Rocket Mountains high MS rate not according with latitude) I also think that psychological issues are in the top of the problem, so in order to solve it there is also to consider them in an integrative model. To finish I would like to share with you all that I am feeling better and day by day (if it wasn't for a hard flu) that hasn't stop my improvements. Biomagnetism and neuroelectrical stimulation are improving some lost body functions inmy right arm and leg after many years. I do really think now that I am in the way of healing. As I told you and it is posted in this forum, I have developed my T.R.A.N.QUI.L.N.E.S.S. (that must be updated) strategy, which shares as you now a lot of points with you, and that I have posted in this forum and in my web page in 9+1 steps (http://www.secretosdelaesclerosismultip ... pot.com.es, written in spanish but there is a translator to any language).
My best wishes and congratulations again for your ver interesting post.
Hugo

Thank you Hugo for your kind words. I appreciate that you managed to read my long paper even if it is not in your native language, also that you write in English. I am delighted to learn that you are Healing through bio magnetism and neuroelectrical stmulation.
My best wishes and thanks again,
Vesta