May-Thurner and MS/check it out

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.
AlmostClever
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Post by AlmostClever »

Now that I have been diagnosed with M-T, am wondering why or how the right leg can be more affected (i.e weaker) than the left?


Thanks for any ideas.

A/C
If you can't explain it simply, you don't understand it well enough. - Al Einstein
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Post by Rokkit »

AlmostClever, the only 2 explanations I can think of:

1) The MT is incidental and has nothing to do with your right leg issues.

2) The MT in combination with another lumbar or azygous issue is resulting in redirected flow that's causing the right leg issues instead of a situation where the MT directly affects the left leg. I have no idea if this is even physiologically plausible.
AlmostClever
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Post by AlmostClever »

Thanks Rokkit

Do you think that it is possible for the right iliac artery and the left iliac vein to compress each other resulting in reduced flow of each leg?

I have read that the artery will be much stronger because it is under greater pressure but I was wondering if this was possible...
If you can't explain it simply, you don't understand it well enough. - Al Einstein
Cece
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Post by Cece »

I know MT is far more common on the left but it can happen on the right too. I'd assume that on the right it'd be the right iliac artery compressing the right iliac vein?
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KDGO
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Post by KDGO »

AlmostClever wrote:Now that I have been diagnosed with M-T, am wondering why or how the right leg can be more affected (i.e weaker) than the left?


Thanks for any ideas.

A/C
I too have M-T which is an asymptomatic syndrome until it presents itself. I did read that it usually is the left but not always....my right is worse than my left. My concern is that under "normal" circumstances why would one even be tested for M-T unless they present with a clot...therefore what should a dr do if it does present...wait for the problem?
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Post by newlywed4ever »

As of 8/5, Dr S told me "thought I'd seen the worse case of May-Thurner, until you...but your body has dealt with it efficiently." (??) And I present with right foot disability.
AlmostClever
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Post by AlmostClever »

Throwing this out there for you guys to chew on:

Looking at the x-ray sequence of the dye injection into my left iliac vein, it is very obvious that a portion of the blood flow refluxes back down into the right iliac vein.

To me, this seems to be the same as blood refluxing back up into the brain from occluded jugulars. This might also explain why some people here present with worse right leg symptoms due to May-Thurner's.

Although the doc said the body had sufficiently accomadated for the M-T, isn't this the parallel of jugulars forming collaterals? There is still a flow problem that needs to be corrected in my opinion.

Maybe there is excess iron deposition in the right leg or the flow of oxygen and nutrients is slower and insufficient?

I'll try to post my video sequence of this when I get home next week but thought it to be an interesting theory.

Check your videos if you got them to see if this is the case for you as well!
If you can't explain it simply, you don't understand it well enough. - Al Einstein
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Post by Katie41 »

6 week update: Just returned from a 4 day camping trip in the High Sierras. What a glorious time I had with my 5 and 7 year old granddaughters! I was able to climb a mountain trail in 20 min! I wasn't even huffing and puffing in the more than 1 mile altitude! Last year, it took me 1 1/2 hours and I was exhausted! This year, I wasn't even tired! One of my goals was to walk across a large fallen log that crosses a mountain river. My great, new and improved, balance made it possible for me to cross the log and I have the pictures to prove it!!! My left leg, which was always the much weaker one, was so strong that I was able to climb up a 3 to 4 foot boulder, putting most of my weight on my left leg! Last year, prior to my liberation in Poland and my MT stent in Costa Mesa, I never could have remotely done that. I'm still working on becoming stong enough to get across the second log required to completely cross the river. Next year! Not bad for a 69 year-old!

I always resented how old MS made me look, since I didn't ever feel that old. Now, I'm able to do things that I haven't been able to do for years, and I'm looking younger! Yeah!!! :D One of my student's parents asked when I was thinking of retiring since, "You must be getting close to 60". Little did she know, I'm getting close to 70! I'll never tell :lol: Ready for my very challenging 4th/5th/6th grade class of 32 kids! Bring it on :D :D :D
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CCSVIhusband
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Post by CCSVIhusband »

Love it ...

Good luck with the kids Katie ... fantastic! So happy for you.
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Post by 1eye »

I've had swelling in my left leg only a few months: in fact I was thinking being on this forum all the time was doing it! :wink:

But Dr. Siskin, even though he went in on the left, didn't find that.

So what else might it be? It has been better occasionally since liberation. Mostly not.

It has not been swollen, but has been paralyzed (no toe movement or dorsiflection, and walking (leg use) affected but probably by the compensations for the primaries (foot paralyses).

As far as I can see (I know, Lyon, that ain't very far) only the foot is swollen, not rest of leg, so far.
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Katie41
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Post by Katie41 »

Our bodies sure are a puzzlement :? It can be very frustrating in many instances medically (for many conditions, not just this). At least, we have some answers now. Just keep searching, something will probably come to you that will answer your questions and send you in the direction that will work for you. Always trust your own instincts and follow them. They generally will lead you to what is best for you.
AlmostClever
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Post by AlmostClever »

Can someone refresh my memory on why some doctors have begun to check the iliac veins?

Thx
If you can't explain it simply, you don't understand it well enough. - Al Einstein
Rokkit
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Post by Rokkit »

I think just because Zamboni's "liberation 100" paper talks about it, especially with respect to PPMS.
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Post by Lyon »

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Last edited by Lyon on Sun Nov 20, 2011 5:24 pm, edited 1 time in total.
Cece
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Post by Cece »

AlmostClever wrote:Can someone refresh my memory on why some doctors have begun to check the iliac veins?

Thx
Dr. Sclafani came back from Italy with the information, which was put into practice quickly by Dr. Siskin, that Dr. Zamboni entered from the left to check for hypoplasic lumbar veins and MT syndrome. The explanation for why he entered from the left was left out of Zamboni's original paper by the editors for space reasons, which is why we weren't talking about it back in 2009 but are now. Problems with the lumbar veins means that blood flow may be redirected to the azygous. If you also have azygous stenosis, it cannot handle its own load let alone the redirected flow from messed-up lumbar veins.
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