Cheer:
Yes, I agree venography is where it is at, clearly. I have not been told to prepare for possible venography so do not believe they are thinking along those lines for friday.
Cure: I understood, believe it or not, the wild muscular idea in your post, the interesting thing about this is you kind of have to go that far to find an "explanation" that isn't what Zamboni is offering. Then you are sort of wandering in the weeds: occams razor and all that.
I'm a nervous ball of energy I spend all day re reading the papers I have copies of regarding Zamboni's work, getting ready to talk and ask the "right" questions Friday.
And now more baloney slicing from the peanut gallery;
I've been read in the Zamboni papers again trying to glean more understanding and also reading some of what he used for reference. Sometimes I get a fuller understanding, for example one paper about venous issues mentions that all people with venous ulcers have other changes in their SKIN too, indicating the different veins may be different to begin with in terms of collagen....this suggests that it is not all about pressure and there is some genetic issue to begin with. For me, knowing Z used that reference clarifies a statement he made in email that his proceudre may work in tandem with other approaches--in other words we may need something to address the eventually-clarified systemic issue as well.
But along the lines of reading those references, there are a lot of mental/brain issues that show cerebral venous problems. About the 4th time you hit a paper that talks about venous drainage, you start to go hmmmm..... this is not such a new idea at all.
Read this bit from an abstract found
CLICK HERE
IN approximately 90% of human internal jugular veins (IJVs) there is a valve. 1,2 It is situated directly above the termination of the IJV in the inferior bulb, the position of which may vary slightly from being almost directly posterior to the head of the clavicle to a position 3 cm further inferior and 3 cm further lateral. 3 The valve prevents backward blood flow toward the brain when the intrathoracic pressure acutely increases and can create transvalvular gradients of up to 100 mmHg. 3 The competence of the valve has been found to be crucial for developing a transcranial blood pressure gradient during cardiopulmonary resuscitation with closed-chest compression. 4 In addition, this valve prevents sudden increases in the IJV pressure during coughing or positive pressure ventilation and may thus protect the brain from acute increases in intrathoracic pressure. 3,5
Ok so the valve is there protect the brain.
Another from
CLICK HERE
Background and Purpose. Jugular venous valve insufficiency may play a role in different neurological diseases. ---snip!--
Well, fine then. We all think so.
Another one
HERE
Valvular insufficiency (either left or rightsided, or bilateral) was identified in 85% of patients with TGA,and in 45% of controls (p = 0.008).
That one used valsalva to assess for reflux, not the test Z uses so the 45% controls is not the same. But notice that the difference between so called healthy normal controls and patients with
TGA is small in terms of pressure. This to me suggets the brain can't take a lot of difference here, reflux is hard on it (BTW, these
TGA patients do not have abnormal white spots on MRI, I looked) But note that the
TGA issue is often one of a post valsalva problem. The valsalva is the thing you do if --ahem!--constipated and you hold your breath and push..got it?
If you have
TGA it appears the mechanism may be that your jugular valve is not competant and that "push" results in backflow into the brain briefly--Wham!--you get transient amnesia. It goes away, perhaps not to happen again for months.
But, accepting Z work, MSers have reflux that happens all the time not just with valsalva. Even though the times are smaller it is with every breath all the time. It is not at all hard to understand that this constant whirl and chaotic blood flow might cause an the issue we call MS esp when you realize that it is these specific veins that are attached to those specific lesion area that are affected. I mean why not arteries? If you think it is the immune system coming in and attacking why only veins? Why do lesions grow in the direction of the vein and not into the brain?
Taken together with the idea of the neuro protection of the brain by the jugular valve and apparent acceptance of the idea the brain needs protection from these chaotic pressure changes, is it at all odd that we would think this work done by Zamboni is critically important and not just some new whacky theory?
But as I schlepp along the pubmed path I keep hitting these hints that neuro issues are associated with venous issues, and that in some quarters it is pretty well accepted.
I am pleased to be part of what could be termed a grass roots effort to get this information in front of people who will listen and assess it---NOW, not a year from now, and not 5 years from now. Now.
Thanks to everyone contributing to this thread I read every word with interest............peace everyone
