CCSVI and CCVBP

[NZer1]

For some of us there is suspicion that injury was a factor in the timing of MS onslaught.
For others the similarity of our injury symptoms and the MS disease (dx) is apparently difficult to separate.
The physical likely hood of injury, stretching, damage causing inflammation, nerve damage, CSF containment system damage, damage to vascularture, damage to tissue and muscle are factors that cannot be ruled out of the study of MS incident.
The timing, severity, and ability to hasten the onset of MS from injury is a yet to be studied causical factor in MS progression.
Until the mechanisms of MS are known the involvement of injury has more logical and statistical likely hood than the other theories such as auto-immune system.
The degree that injury speeds the MS process is yet to be qualified and to do so is going to be a challenge. Dismissing it at this point of CCSVI awareness would be foolish.
The factors that manipulate MS are likely to be Vascular. The actual cause and mechanism of MS is likely to be influenced by many factors which are now being seen to modify the disease. The changes made to the symptoms of MS from angio treatment of veins indicates that 'we' are searching in the 'right' areas. Whether the changes to the vascular system achieved by angio are the sole issue in MS seems unlikely from the outcomes so far.
With broader understanding of the whole Arterial and Venous systems of the brain and upper skeleton and their interaction with the CSF system we will have a new understanding of many diseases, and especially degenerative diseases of the CNS.
Too rule out injury at this point is missing too much detail in the mechanism of MS, there is likely to be insights from the way injury accelerates the progression of degenerative diseases, we need to learn from this.
The belief that MS has a causical structure development related to time has been unproven. By this I mean that saying MS does not speed up from example injury is not based in fact. Examples where mental stress brings on exacerbations is a case in point. We cannot say that an event will NOT accelerate the disease. Many examples of general ill health have caused an increase in progression and speed of progression. On that basis we have to look seriously at physical injury and its effect to understand more about the disease mechanism. Physical injury activates an inflammatory clean up action which we see in RRMS as well. The likely effect on a person with PPMS is yet to be verified, although my personal experience is that disease progression increases during and after injury.
There is a poorly understood interplay within the Blood flow in and out of the upper body, its effects on CSF are a case in point. The balancing of this system also needs to be understood to better understand the dynamics that effect degenerative diseases, especially MS.(Many Scars)
Thank you Dr. Flanagan for your commitment to this learning.
Regards Nigel

[Drury]

Dr. Flanagan,

Thank you very much for your kind offer. I will certainly mention it to my daughter's lawyer. I am ashamed to say I have not yet read your book but look forward to doing so.

Just for the record my daughter's case was based upon her getting hit by a cab that ran the red lights NOT for getting MS after her accident. The problem is that she now has MS and it has muddied the waters as you understand so well.

Prairiegirl,

There seem to be many cases of people having accidents and then getting MS. I am not suggesting that everyone who has an accident will then get MS but there are cases like my daughter's that do seem to point in that direction. The question is "If she had not had the accident would she have still got MS?" I believe she would not have. The other question might be "If she did have MS did the accident cause it to progress?"

Prior to her accident she did not experience a single symptom of MS. She rarely went to the doctors and there is no MS on any side of our family.I clearly remember the neurologist that she saw about 5 days after her accident telling me that the type of brain trauma she sustained could cause problems down the road like Parkinsons, etc. and when I looked at him in horror he said he meant much later in life. He was stating facts, not trying to scare me but now that she has MS I cannot help wondering.........

There is also the issue of trauma causing CCSVI which in turn could cause MS. I do not know if she has CCSVI as she is waiting to be tested for it but
if she does what came first?

There is not a day goes by that I wish that my daughter and I had used another crosswalk!

Drury

[DrKoontzDC]

First off I'd like to apologize for being away from the forum for the last couple of weeks. I've been getting things organised to open my new office. My schedule was a bit crazy there for a while but has calmed down a bit. I still have some more work to do but not near as much as I did.

I'm extremely happy to report that my upper cervical (Atlas Orthogonal) chiropractic treatment is going extremely well. I can now walk without a cane and can use stairs again because my feet are not numb anymore.

My left foot numbness has now remitted 100% after three Atlas adjustments. My right foot numbness remitted 100% after my first Atlas adjustment (as I previously reported). Never before in ten years of having foot numbness during relapses has my numbness remitted this quickly, this completely.

I believe patients with spinal lesions and/or symptoms should make an appointment for a consultation with an upper cervical chiropractic doctor. Patients deserve no less than a complete picture of their spinal column consisting of both X-ray and MRI.

For anyone in the Albany, NY area looking for an excellent upper cervical doctor who uses the very gentle and completely painless Atlas Orthogonal technique, I highly recommend Dr. Craig Wehrenberg in Clifton Park, NY (518-383-9000).

Happy Poet I am very glad to hear that you are experiencing such great results from the Upper Cervical Care you are receiving! Be sure to keep us posted as your care continues.

[DrKoontzDC]

Happypoet this has been a lovely posting to read - as Im attending a NUCCA Dr Heidi here in London(contact given by Dr F) this Thursday I go for the results of my three x-rays along with my first adjustment ?

Although I am a little confused the x rays taken were of the neck I never had an open mouth x ray ! Is this done for certain cases or would it be that I did not meet the criteria ? maybe the good DR'S could shead somelight on this ??

If possible, can you please describe the 3 x-rays that Dr. Heidi took so we can have a better idea about the x-rays taken.

[DrKoontzDC]

I HAVE A QUESTION THAT I'M SURE APPLIES TO OTHERS HERE. for those of us that need more than a upper cervical chiro. and we can only stand a very short time and that's holding onto something and we're probably a little shakey and not standing very tall at best----how can we get x-rayed? at least a full spine. even if i try to stand straight "holding on" wouldn't that interfer with a true picture of what is going on?

As Dr. Flanagan mentioned there are table buckys that allow you to lay down which will give you an idea of what is going on. However, from a chiropractic point of view, whether it is full spine or upper cervical, to have a truly accurate picture of how your body is balancing its self it is better to have lumbar and thoracic x-rays taken while standing. Some of the table buckys for the standing position have small handle bars to help you stabilize yourself in an upright position which shouldn't compromise your posture to much.

As far as Upper Cervical x-rays go, there is specialized x-ray equipment for Upper Cervical x-rays that utilizes a chair which allows the chiropractor to swivel and slide you in to the correct position. This also allows for a greater degree of accuracy when taking the x-rays. These chairs usually have arm rests so it would help you to maintain an upright position. If you are in such bad shape that you are unable to sit upright long enough for the x-rays to be taken you could always be assisted by someone wearing lead lined protective gear so as to keep their exposure to the x-rays down to a minimum. You would need to contact the Upper Cervical Chiropractors available in your area to find out if they utilize this kind of x-ray equipment.

[uprightdoc]

Cece,
You made a good point about preexisting conditions. If you read the UK case I posted they mention preexisting conditions. Preexisting conditions make you more susceptible to injuries. A 90 year old lady with osteoporosis has preexisting conditions of age and weak bones. If she slips and falls she is much more likely to break a bone. Likewise if you have venous anomolies assoicated with poor drainage of the brain and you sustain a serious neck injury you will be much more suceptible to getting MS.

[uprightdoc]

Drury,
The cab running the light and hitting your daughter is the mechanism of injury. The suit is about the injuries your daughter sustained. We know she sustained a brain injury and one of the doctors warned you that your daughter could get PD later in life as a result of the injury (that's important evidence). That doctor obviously knows about the growing body of evidence showing a connection between head trauma and neurodegenerative diseases.

In other words. in your daughter's case you have ample evidence of traumatic brain injury as noted by treating doctors which your lawyer should be able to use for settlement. However, because she was subsequently found to have MS lesions he can no longer sue for the brain injury your daughter clearly sustained at the time of the accident. What's more, the defense will use MS to try and mitigate every sign and symptom your daughter has.

Typically the defense hires hack neurologists who know very little about the subject and could care less about how they are harming your daughter. They don't even have to show up to court and defend their ludicrous position. They simply cite the epidemiological study Cece presented earlier and two other similar studies that are extremely weak, difficult to defend and easy to tear apart. More than that, they are old epidemiological studies not physiological studies. The neuros use the AMA's position to cover their hides. Epidemiological studies are weak compared to rapidly developing MR physiological studies. Have the lawyer read the UK case I posted previously for Cece and get the whole case if he can find it. If not I have it somewhere in my files. He can use the UK case for leverage. He can also read my book and tell him to feel free to contact me. I relish the challenge. Defense lawyers do not want these cases to go to court and be heard by a sympathetic jury.

[DrKoontzDC]

I was in an accident after which I experienced my first definite neurological symptoms of MS. I do not believe my accident caused my MS. In light of CCSVI theory, I believe my MS was caused by a cascade of effects as a result of bilateral jugular outflow obstructions, recently identified by my doctor using doppler ultrasound. My accident was a secondary factor as the anatomical abnormality preceded it.

Cece,
I respect your healthy skepticism with how you question everything as it really keeps us on our toes. However I have to wonder how you can not consider the fact that your accident may have been the trigger that started your neurological problems especially since they occurred after your accident.

Think about this, there is a relatively common anatomical variant known as a Cervical Rib which is where the transverse process of the 7th cervical vertebra is elongated (longer than normal) sometimes resembling the 1st rib.
http://en.wikipedia.org/wiki/Cervical_rib
Sometimes the cervical rib can cause what is known as Cervical Rib Syndrome. This is the result of the cervical rib or elongated transverse process compressing the nerve bundle exiting the neck at that level.

The thing to keep in mind is that people can go their whole life with a cervical rib or any other anatomical variant and not even know it because they never had any kind of problem that would cause the doctor to look for it meaning it was asymptomatic. Most of the time these anatomical variants are discovered incidentally during exams.

I previously cared for a patient that was career military. He reached a point where he was doing more desk work than field work. Previously his only complaint was mild neck and back pain. When he came to see me he was experiencing numbness and tingling down both arms which is something he had never experienced before. The desk he was stationed at had extremely poor ergonomics forcing him to bring his elbows almost up to the height of his shoulders just so he could type on the keyboard. This particular posture forced his cervical ribs (he had bilateral cervical ribs) in to compressing the cervical nerve bundles on each side of his neck. While under my care his symptoms began to remit. However it wasn't until he was able to change the ergonomics of his desk at work that the numbness and tingling in his arms went away completely.

What does this have to do with you, your accident and your MS you ask? Your case is similar to my old patients. He too has a preexisting condition only his makes him prone to developing cervical rib syndrome. At the time he came in to see me he was 50 years old and had lived his whole life up to that point with the bilateral cervical ribs never being aware he even had cervical ribs until he was put on desk duty forced to sit at a desk with poor ergonomics causing the compression of his cervical nerve bundles.

I would like you to consider the fact that, while you have a preexisting condition that made you more prone to developing symptoms of MS, isn't it possible that had you not had your accident you could have lived out your life without ever developing MS?

The point to take from this is that people can have anatomical variants and be completely asymptomatic their whole life. While others can have these same anatomical variants and have a whole host of problems. The majority of people out walking around today have some sort of preexisting condition that is asymptomatic. Some of these same people may live their whole lives without ever experiencing a problem associated with their preexisting condition while others will. What we have to look at is the precipitating event or factor that aggravated and/or added to the preexisting condition causing the individual to develop the syndrome, condition or disease that they were prone to developing due to their preexisting condition.

In my humble opinion, the answer as to "why" this happens is due to the dynamics of the spine and what happens when a person sustains an injury to that which the spine protects, The Nervous System. I believe we can say, with a reasonable amount of certainty, that when the spine is injured it can also cause an injury to the spinal cord, a.k.a. the nervous system, and we are only beginning to understand the full extent that an injury to the nervous system can cause on a systemic, whole body view. For medical doctors to continually insist that trauma to the nervous system could never be a precipitating factor in things such as MS is not only careless it is paramount to malpractice because they can not prove that it does not nor can chiropractors prove, beyond a shadow of doubt, that it does.

What we as Chiropractors do know is that we see people all the time who developed problems after being involved in some kind of accident, big or small, that ended up resolving while under chiropractic care. Does one equal the other, not necessarily, but when someone has undergone every other type of medical procedure out there and taken every pill possible for their problem and not received help until they began chiropractic care, I think the results speak for itself.

One last thing before I go
I'd like to add a brief case summary of another of my previous patients. A lady in her late 40's came in for care because she couldn't move her hand or even squeeze her fingers. It was as limp as a noodle! She had been involved in 3 car accidents in her life the most recent being where she was rear ended which was 3 years prior to the onset of her problem. After the most recent accident 3 years prior she developed a mild disc bulge between C6/7. The disc bulge was asymptomatic in that it wasn't causing any problems one might associate with a disc bulge during the 3 years leading up to the paralysis of her hand.

The night before waking up with the problem she had fallen asleep for a few hours on the couch with her head tilted backwards. While moving from the couch to the bed she remembered her left hand feeling a little numb. Upon waking in the morning she was unable to move it at all. This patient had a primary cause, the car accidents, which caused the disc bulge to form. Later, her precipitating event aggravating the now "preexisting condition", was the fact that she fell asleep with her head tilted backwards most likely causing the disc bulge to put undue pressure on the nerves at the level of C6/7 which directly corresponds to the muscles in her hand that she was unable to move.

As I mentioned before she didn't have any symptoms before the hand paralysis that one might directly relate to a disc bulge. However she did experience the feeling of her neck muscles being tired and unable to hold the weight of her head without her supporting it with her own hand while sitting at a desk. As her head felt more and more heavy and her neck muscles became more and more tired she developed a headache every day around the same time as the heaviness and weakness set in and the headaches only got worse as the day went on as her head felt heavier and her neck muscles felt weaker.

The MD's wrote her off saying there was nothing they could do but a little bit of physical therapy and that she might regain a small percentage of use back but she would never be 100%. They also said the disc bulge at the C6/7 level had nothing to do with her symptoms even though that nerve level directly corresponds to the nerve innervation of the muscles involved. After the very first adjustment following the onset of her symptoms she was able to bend her fingers slightly which was more than she could do before. After 6 months of care she had regained nearly 100% use of her hand.

In this last case the major symptom that developed, the hand paralysis, didn't occur until years after the last car accident. In most doctors minds the 2 would not be related or even relevant. I bring this up because even though the car accident was years prior it still set in to motion a series of events which lead up to her first having the headaches then the hand paralysis. There are many other cases like this which show that trauma, even occurring years prior to the onset of symptoms, to the spine and as a result, to the nervous system, should not be dismissed so casually as it could be directly linked to the current condition that a person is experiencing.

[NZer1]

Excellent discussion material, thanks Dr.'s
I have always felt that as the MS disease progresses and the body for either disease related reasons directly or indirectly losses posture that the disease will also advance. Irritating or exacerbating the area concerned with the 'injury' that started the cascade. So the disease worsens because the posture weakens. My Uncle is a case in point he at age 6 was g rotted by a low clothes line and whiplashed, no great injury symptoms at the time, and at age 35ish developed slow progression MS. He has been in a chair for 30ish years and has the most amazing forward curvature in his neck. He can rest and sleep with his chin on his breast bone, I cannot touch my breast bone with my chin! He totally believes he has a neck issue not MS yet his eventual DX was MS!
I have a question that for some time I have not been able to get my mashed potato brain to understand. Are the 'lesions' in MS on the inside or outside of the CSF space or both in and out. That is to say inside the veins and or inside the CSF spaces? Is it possible that the actual lesion itself crosses the BBB and in the reason for the breach?
Interesting comment on Dr. S's thread from a patient who has been Angio treated and the flight home and two other flights where the times that her symptoms from re-stenosis were undoubtedly noticed as 'returned'.
Cece can I politely ask about your injury/accident prior to your MS dx?

[Cece]

Cece can I politely ask about your injury/accident prior to your MS dx?

I'll pm you, Nigel, remind me if you don't hear from me, it's a busy day.

[coach]

Dear Dr. Flannagan,
Will keep this short and try to answer the questions you asked since we are at Stanford for my one year checkup and I'm trying to use my husband's laptop. I do better with a desk top and mouse. I am 5'1". My daughter is 5'8". I played basketball, softball, and cycled. Somewhat of a jill of all sports, master of none. I had a cycling accident when I was about 18 where I hit an erosion in the pavement and went over the handle bars. I didn't break anything. Just wound up with a sore right shoulder. My daughter played softball and soccer. She was the catcher and met contact at home plate at times. She would use her head on the soccer ball at various times. She was in an auto accident about 3 years ago where she was going too fast and did not negogiate the curve and spun off the road. She was fortunate as she walked away from that with no apparent injuries. Her car did not fare as well. Well I hope I answered most of the questions. Based on my recurrence of some of my symptoms that had improved post procedure I think they are thinking there nay be somw tissue growth either in the stents or over the ends of them. When my azygous was checked last year I don't think there was any flow through it since the dye used during the procedure "blew back" toward the camera.
Tests tomorrow (mri,mrv) and consult on Thursday.

[prairiegirl]

@Drury: sent you a PM

[silverbirch]

As far as Upper Cervical x-rays go, there is specialized x-ray equipment for Upper Cervical x-rays that utilizes a chair which allows the chiropractor to swivel and slide you in to the correct position. This also allows for a greater degree of accuracy when taking the x-rays. These chairs usually have arm rests so it would help you to maintain an upright position. .

My xrays were taken in the same way as the above - the first two xrays determined the greater degree of accuracy and how the third xray was taken.

Third Xray -After Xray was taken Dr Heidi said I was a twisted sister and told me to look at the chair when I looked down to the left the chair was all twisted to the side and out by 2inch or more thats what it took to get my neck straight for the final the Xray.
Does that make sence DR Koontz ? I will ask Dr Heidi about the throat Xray this friday .

I did leave a copy of my CCSVI scan and CCSVI procedure along with 3 MRI taken over the last 14 or so months

[NZer1]

Hi Dr.'s I picked up my folder of xrays and MRIs to see if any of the past films gave indication of misalignment and prompt me to find help.
I have 3 MRI's from the last 4 years and all of the neck side on shots show that my top 6 vertebra are in a straight line when I am lying on my back. There is a curve at C6 and the next few are straight again. There is not a curve in the cord as it travels through the two areas and the disc bulge is at C5/C6 on the right side.
When viewed from the front again lying down there is a curve that goes out to the right side at C5 region.
The curve in the neck looks like it happens at one joint and the curve in the thoracic does not cover or spread across many vertebrae and is quite a tight curve in a short space.
I have a dvd of this but have no idea at this stage how it could be uploaded.
My thoughts are that I am best to find help, soon and see if anything more is visible to the trained eye on some new films.
I am very aware that I have problems with my neck and upper shoulders and have done for some years, in the past I have had relief, but not lasting benefit. The Muscular Skeletal specialist I was seeing for rotator cuff tears both sides, gave the impression that "people live with worse visible problems and have no pain", how that is supposed to relate to my case I am not sure. I thought it meant that I must have feeling below the skull, some don't. The original reason for me being there was shoulder pain and transient arm/shoulder pain which during the time I was seeing him developed into leg and foot numbness RH, hand and finger numbness RH, L'Hermittes, mild balance instability issues, fatigue. So he felt under pressure that he had been 'blamed' for my newer symptoms, which was not the case and was one of his issues (sadly too responsible).
Could the MS have begun/progressed because of the heavy lifting of house flooring steel beams that I did with my shoulders and head whilst stretching out to prop them? I think yes even though I don't remember anything more than stiffness for a few days afterwards. Plus I have the sports injurys and fall from a horse at speed when younger.

[costumenastional]

I was in an accident after which I experienced my first definite neurological symptoms of MS. I do not believe my accident caused my MS. In light of CCSVI theory, I believe my MS was caused by a cascade of effects as a result of bilateral jugular outflow obstructions, recently identified by my doctor using doppler ultrasound. My accident was a secondary factor as the anatomical abnormality preceded it.

When I was told that both my jugulars showed complete absence of blood flow I was certain that I had found the cause of my slow death.
Unfortunately, after the angioplasty the benefits even though present, were far from life changing. I do not think that I would suffer from what I am suffering if my neck was not nearly broken, even with those vein problems I had.
Under what circumstances CCSVI should be interpreted as the only reason for whomever has it along with MS? When one should stop searching for coexisting conditions?
Given the testimonies of hundreds of patients that weren’t helped by “liberation” and my experience so far, I believe that for those who don't feel MAJOR AND INSTANT relief after "liberation" (especially in brain issues) CCSVI is only a secondary factor and nothing more and repeated angioplsties won't change a thing. The veins Zamboni based his theory play a major role in CNS drainage. Improving their blood flow should and does have a dramatic effect in SOME symptoms right from the start but I suspect this happens only to those with serious vascular problems which really needed to be resolved.

When this doesn't happen, it is viable to hypothesize that the real problem is elsewhere. Maybe in a more secret place, sneaking and working very slowly but effectively for years. And when this is the case, I really don’t see how even chiropractic adjustments, surgery or whatever could result in instant improvements. We all got to start from somewhere though. And continue searching for answers if we are not satisfied from the result.
All I want to say here is that you don’t have to feel liberated if you don't feel liberated, or something among these lines.
I had CCSVI but that didn’t stop me from having an almost broken neck.
IF YOU DON’T FEEL BETTER AFTER LIBERATION CHECK YOUR UPPER CERVICAL SPINE.
After all, a couple of x rays by an experienced chiro is not such a big deal.