Hi Kathy,
Personallly, I don't see how upper cervical can't help but improve your brain circulation and symptoms. The thermograms are part of the typical UC protocols for adjusting. They are very valid. Blood flow, muscle activity, irritation and inflammation all produce heat. An imbalance between the left and right sides suggests problems. I was taught to use the original hand held neurocalometer or NCM which was a terrific invention for the time but a pain in the neck to use. Today's fancy dandy devices are far cooler and you can digitize and computerize them. Beyond chiropractic you need to eat a diet that is good for blood and circulatory health and you need to find and enjoyable exercise to pump you up, not in the muscles but in circulation. You have got a small furnace and the temperature and fan speed are set on low. Get it cranked up from time to time.
CCSVI and CCVBP
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uprightdoc
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Thank you Dr. Flanagan,
Tension in the lower spine and cord is really interesting.To my knowledge she does not have low blood pressure or curvature problems although I am not entirely sure. What is considered low blood pressure? How would she find out about pelvic misalignment? I have noticed that she sometimes leans back when standing which is a newish habit.
I wonder if you can help me on another matter. She is due to have a spinal tap this month to check for the JC virus as she is on Tysabri (a monthly infusion for MS). Could taking fluid from the spinal cord cause further problems?
Lastly, why does she need to have her neck corrected so often? Is it safe to have it done regularly and are there any exercises that she could do to strengthen her neck? She is tall and slender.
I so appreciate your help,
Drury
Tension in the lower spine and cord is really interesting.To my knowledge she does not have low blood pressure or curvature problems although I am not entirely sure. What is considered low blood pressure? How would she find out about pelvic misalignment? I have noticed that she sometimes leans back when standing which is a newish habit.
I wonder if you can help me on another matter. She is due to have a spinal tap this month to check for the JC virus as she is on Tysabri (a monthly infusion for MS). Could taking fluid from the spinal cord cause further problems?
Lastly, why does she need to have her neck corrected so often? Is it safe to have it done regularly and are there any exercises that she could do to strengthen her neck? She is tall and slender.
I so appreciate your help,
Drury
Hi Dr., finished your book earlier. You have allot to talk about with Dr. Haacke. Where does one start? There are a few thoughts that have come to mind, which is a challenge to remember, the balloon analogy hanging from the ceiling, I would imagine that if there is a breach of the BBB it is possible that it would have a bellows effect.
I had a lumber punch, what a performance, two Dr.s tried multiple attempts, I was left with the headaches for 6-8 weeks and they wouldn't do a blood patch. Anyway the time it took to heal had me thinking, the only way I could get relief was to lie down, if there was a small area damaged in the cervical spine that leaked a little due to injury the CSF could be in a situation of low pressure and open BBB, the time to heal a moving injury is generally long, the BBB would be open for some time, inflammation for some time, maybe that is how RRMS symptoms remit. The balance of leakage to top up as the day passes would create waxing and waning. The air pressure difference (summer/winter seasonally) would also have a effect on CSF pressure and if there was leakage the balance pressure would be hard to maintain if the pressure changed during the day.
If Dr. Haacke was able to visualize the axons in MS that are damaged /disconnected it would enable you to see the areas in the cervical cord for instance that cause the problems. I guess that they haven't had an area to target before to concentrate on, mile of axons, where do you look around the CNS at such a minute frame size, if you didn't have clues where? Would have to have a loaded cohort to work with!
I agree with the cervicoencephalic connection, I do wonder if reflux happens, how far the back flow travels. With the idea that the cord is the BBB breach, then the flow of CSF will spread the contents within the brain.
With the refluxing blood I would assume would travel to areas that lesions appear. In a sense there would be issues happening inside and outside the CNS and also contained all within the skull? (CSF system and Blood system)?
Lots of things have begun to make more sense as my slow brain processes, I need to write them down as I think of them. Mostly about areas effected and the links to symptoms. The tide level concept of CSF is something that has stuck for some reason. If for reasons yet proven the cisterns are fluctuating in content e.g due to intermittent leakage of CSF and the awake/sleep intervals due to fatigue of PwMS would create a state of false balance because the system is slow to recover.
Some of the results from Angio work on CCSVI could be effected by the balancing of CSF fluids and symptom changes and reversals of positive effects.
My light headedness when standing after periods of bending, is I believe not to do with breathing and oxygenated blood, because it happens so rapidly and I get improvement from bending over again. I am guessing the in fluid dynamics involved some how, maybe vestibular system/vertigo association?
Enjoy chatting with Dr. Haacke, sure it will be ongoing and productive, remember he likes to talk allot as well.
I had a lumber punch, what a performance, two Dr.s tried multiple attempts, I was left with the headaches for 6-8 weeks and they wouldn't do a blood patch. Anyway the time it took to heal had me thinking, the only way I could get relief was to lie down, if there was a small area damaged in the cervical spine that leaked a little due to injury the CSF could be in a situation of low pressure and open BBB, the time to heal a moving injury is generally long, the BBB would be open for some time, inflammation for some time, maybe that is how RRMS symptoms remit. The balance of leakage to top up as the day passes would create waxing and waning. The air pressure difference (summer/winter seasonally) would also have a effect on CSF pressure and if there was leakage the balance pressure would be hard to maintain if the pressure changed during the day.
If Dr. Haacke was able to visualize the axons in MS that are damaged /disconnected it would enable you to see the areas in the cervical cord for instance that cause the problems. I guess that they haven't had an area to target before to concentrate on, mile of axons, where do you look around the CNS at such a minute frame size, if you didn't have clues where? Would have to have a loaded cohort to work with!
I agree with the cervicoencephalic connection, I do wonder if reflux happens, how far the back flow travels. With the idea that the cord is the BBB breach, then the flow of CSF will spread the contents within the brain.
With the refluxing blood I would assume would travel to areas that lesions appear. In a sense there would be issues happening inside and outside the CNS and also contained all within the skull? (CSF system and Blood system)?
Lots of things have begun to make more sense as my slow brain processes, I need to write them down as I think of them. Mostly about areas effected and the links to symptoms. The tide level concept of CSF is something that has stuck for some reason. If for reasons yet proven the cisterns are fluctuating in content e.g due to intermittent leakage of CSF and the awake/sleep intervals due to fatigue of PwMS would create a state of false balance because the system is slow to recover.
Some of the results from Angio work on CCSVI could be effected by the balancing of CSF fluids and symptom changes and reversals of positive effects.
My light headedness when standing after periods of bending, is I believe not to do with breathing and oxygenated blood, because it happens so rapidly and I get improvement from bending over again. I am guessing the in fluid dynamics involved some how, maybe vestibular system/vertigo association?
Enjoy chatting with Dr. Haacke, sure it will be ongoing and productive, remember he likes to talk allot as well.
Dr I have had another thought about the difficulty people are having defining what MS is or isn't. After reading your book I have had the thought that the disease has effect on two areas at once in essence. The CSF and the blood service. The combination of variables is huge, in some forms there is inflammation leading the disease in other it is reflux and others a combination it is little wonder they haven't been able to nail the disease down and understand it. As soon as they find something tangible someone comes along and reminds us that there are other factors involved. It is the combination, that mix at gives the diseases you mention in your book their colors, the differences in symptoms and yet the similarities in cause.
What can happen in the CSF may not be possible in the vascular system and vice versa, hence the spread of disease possibilities.
What can happen in the CSF may not be possible in the vascular system and vice versa, hence the spread of disease possibilities.
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uprightdoc
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NZer1
You are definitely starting to catch on. Your problems with bending over have more to do with Valsalva-like affects, that is, increased abdominal and thoracic pressure on the VVP. You are correct, although the signs and symptoms in the patient may be the same, arterial, venous and CSF problems all affect the brain in slightly different locations in slightly different ways. Moreover, the location of the lesions do no always correlate with the symptoms. The symptoms often come from structures in the posterior fossa while the lesions are often found in the middle or upper fossa and sometimes the cord. MS is truly mysterious in many ways but modern brain scans, MRA, MRV and cine MR are quickly unraveling the mystery. My next blog will be on line analysis. After that I will start to go more into the contents of the posterior fossa and MS signs and symptoms.
You are definitely starting to catch on. Your problems with bending over have more to do with Valsalva-like affects, that is, increased abdominal and thoracic pressure on the VVP. You are correct, although the signs and symptoms in the patient may be the same, arterial, venous and CSF problems all affect the brain in slightly different locations in slightly different ways. Moreover, the location of the lesions do no always correlate with the symptoms. The symptoms often come from structures in the posterior fossa while the lesions are often found in the middle or upper fossa and sometimes the cord. MS is truly mysterious in many ways but modern brain scans, MRA, MRV and cine MR are quickly unraveling the mystery. My next blog will be on line analysis. After that I will start to go more into the contents of the posterior fossa and MS signs and symptoms.
Thanks Dr.. When I was first trying to understand my symptom cause I keep coming back to the thalamus. Its involvement in the processes that involved all my early symptoms.
Have you made contact with Dr. Hubbard? I have mentioned to Arelene his wife that you are onto something with the puzzle we are looking at.
I understand the frustration that exists because of the view the medical profession has on Chiropractors. If only they could get past that and understand the work and effort you have put into your studies. Teaming up with someone 'accepted' would help to 'spread' your knowledge to those who need to hear it. Dr. Shelling had similar frustrations plus the financial challenges, which I gather were also the reason he was not accepted at first.
I commend you for making contact with Dr. Haacke, his skill and intellect will be priceless. The challenge will be to convey so much detail in such limited time.
The MR involvement in 'showing' the finer points of your skull and spine flow challenges, and also 'showing' the challenges in the cord stretch will enable people to grasp your work better. The reflux in the blood return system and the BBB breach in the cord will open some minds to the interplay of the CSF pump. There is so few that have the full picture, many will have the pieces but are not talking and corroborating the knowledge in context of the diseases you have spoken about in your book.
One thought I have had overnite, could lesions that form on the vein surface of the middle or upper fossa for instance grow through the walls of the vein and enter the CSF and cause the breach of the BBB? Trying to think about other ways the reflux and BBB breach could be linked or interplay. The thought being that the lesions could continue the progression and BBB leakage after the initial cord breach, this is on the assumption that the cord repairs eventually.
Have you made contact with Dr. Hubbard? I have mentioned to Arelene his wife that you are onto something with the puzzle we are looking at.
I understand the frustration that exists because of the view the medical profession has on Chiropractors. If only they could get past that and understand the work and effort you have put into your studies. Teaming up with someone 'accepted' would help to 'spread' your knowledge to those who need to hear it. Dr. Shelling had similar frustrations plus the financial challenges, which I gather were also the reason he was not accepted at first.
I commend you for making contact with Dr. Haacke, his skill and intellect will be priceless. The challenge will be to convey so much detail in such limited time.
The MR involvement in 'showing' the finer points of your skull and spine flow challenges, and also 'showing' the challenges in the cord stretch will enable people to grasp your work better. The reflux in the blood return system and the BBB breach in the cord will open some minds to the interplay of the CSF pump. There is so few that have the full picture, many will have the pieces but are not talking and corroborating the knowledge in context of the diseases you have spoken about in your book.
One thought I have had overnite, could lesions that form on the vein surface of the middle or upper fossa for instance grow through the walls of the vein and enter the CSF and cause the breach of the BBB? Trying to think about other ways the reflux and BBB breach could be linked or interplay. The thought being that the lesions could continue the progression and BBB leakage after the initial cord breach, this is on the assumption that the cord repairs eventually.
Dr. another thought, I like and understand better the evolution context in your book more now. It has me thinking that the multiple return systems of the brain and regions is likely to have occurred over time to accommodate the upright posture. It also makes diagnosis and testing very complex. Understanding that the multiple outlets of the Cranial vault developed to manage the mixed postures and rest versus vertical posture helps to understand the need for intricate systems to maintain the various systems in the neck and skull.
Another thought came from the pulsing of blood pumping and the refluxing process. It would be able to draw and dislodge thrombosis materials in the veins that are malformed or restricted for other reasons such as twists or crimping. This in turn could be deposited in other regions and if it is 'sticky' blood could attach in places upstream because of the reflux. The way that lesions come and go over time could be explained by the migratory waste products of reflux and the pulsing of blood through the low pressure/flow vascular system, waste being pumped upstream due to its mass and weight. The fluid dynamics and hydraulic implications are quite mind boggling.
The MRI time sequence shots that I found must have some part to play in the pumping of blood and its contents;
http://healthworldnet.com/TheCuttingEdg ... re/?C=7561
Scroll down to the films of the progression.
I think that the understanding of this whole MS and other diseases picture will become clearer when attention is focussed on MRI searches for the vascular causes of flow problem throughout the upper body. The cost is the stumbling block as always.
The focus on the malformations and blockages has really only hinted that there is vascular involvement and the people on the leading edge need to stand back and look at the big picture from time to time to keep their eyes and minds open to the complex system they are working on, one fix will not cure all ails.
Another thought came from the pulsing of blood pumping and the refluxing process. It would be able to draw and dislodge thrombosis materials in the veins that are malformed or restricted for other reasons such as twists or crimping. This in turn could be deposited in other regions and if it is 'sticky' blood could attach in places upstream because of the reflux. The way that lesions come and go over time could be explained by the migratory waste products of reflux and the pulsing of blood through the low pressure/flow vascular system, waste being pumped upstream due to its mass and weight. The fluid dynamics and hydraulic implications are quite mind boggling.
The MRI time sequence shots that I found must have some part to play in the pumping of blood and its contents;
http://healthworldnet.com/TheCuttingEdg ... re/?C=7561
Scroll down to the films of the progression.
I think that the understanding of this whole MS and other diseases picture will become clearer when attention is focussed on MRI searches for the vascular causes of flow problem throughout the upper body. The cost is the stumbling block as always.
The focus on the malformations and blockages has really only hinted that there is vascular involvement and the people on the leading edge need to stand back and look at the big picture from time to time to keep their eyes and minds open to the complex system they are working on, one fix will not cure all ails.
More thoughts, the MS disease would in my mind appear to be of evolution origin, rather than a chemical origin.
The clues of European decent, female versus male skeletal design/size, female versus male blood flows and cycles, climate/latitude, age are all physical related.
The search for cause in MS has moved forward from pathology studies and understanding rather than from chemical interplay.
The length of time MS has been known in historic terms, has been quite short and involves several generations in its development.
The evolving science methodology to understand the processes of MS have not uncovered a cause or better understanding. The chemical analysis has not given clues to disease cause or mechanisms.
The evolution from a malformation trait that has been handed down through blood lines has more 'truth' in its theory than other theories such as auto immune system or other man made models such as the EAE model of MS.
The understanding of Vascular systems has until now not been researched as technology has not been able to verify the learning outcomes.
There are many, many diseases that have been in the too hard basket, the immune system basket and other misbeleifs because money has not been available to search for causes of disease, only for the management and income that can be made from disease.
Enjoy your day,
Regards Nigel.
The clues of European decent, female versus male skeletal design/size, female versus male blood flows and cycles, climate/latitude, age are all physical related.
The search for cause in MS has moved forward from pathology studies and understanding rather than from chemical interplay.
The length of time MS has been known in historic terms, has been quite short and involves several generations in its development.
The evolving science methodology to understand the processes of MS have not uncovered a cause or better understanding. The chemical analysis has not given clues to disease cause or mechanisms.
The evolution from a malformation trait that has been handed down through blood lines has more 'truth' in its theory than other theories such as auto immune system or other man made models such as the EAE model of MS.
The understanding of Vascular systems has until now not been researched as technology has not been able to verify the learning outcomes.
There are many, many diseases that have been in the too hard basket, the immune system basket and other misbeleifs because money has not been available to search for causes of disease, only for the management and income that can be made from disease.
Enjoy your day,
Regards Nigel.
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uprightdoc
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Drury,
I apologize for not getting back to you sooner. Low blood pressure could be anything below 110/70 or so. The spine sits on top of the sacrum in between the pelvic bones. The pelvis is as complicated as the head when it comes to misalignments. Pelvic misalignments can keep a constant strain on the rest of the spine. It can also cause irritation to the shoulder muscles as the shoulder and pelvic modules are linked together anatomically and physiologically. Pelvic misalignments can also strain the cervical spine, and like scoliosis, they can cause the head to tilt. Take a look at Fernando's x-ray back in the first few pages. It is highly likely, due to the mechanism of injury, that your daughter injured her pelvis. Shoulder and lap belts complicate the strains on the spine. Your daughter needs a proper orthopedic and neurological evaluation of her low back and pelvis, which should include the hips and knees as well. In addition to standard orthopedic and neurolgical exams I always did complete range of motion, station and gait, muscles tests and palpation of everything connected to the spine and pelvis. I will be covering the human pelvis on my new website. Like the skull, it is unique due to upright posture and can cause as many problems in humans as upper cervical misalignments.
I apologize for not getting back to you sooner. Low blood pressure could be anything below 110/70 or so. The spine sits on top of the sacrum in between the pelvic bones. The pelvis is as complicated as the head when it comes to misalignments. Pelvic misalignments can keep a constant strain on the rest of the spine. It can also cause irritation to the shoulder muscles as the shoulder and pelvic modules are linked together anatomically and physiologically. Pelvic misalignments can also strain the cervical spine, and like scoliosis, they can cause the head to tilt. Take a look at Fernando's x-ray back in the first few pages. It is highly likely, due to the mechanism of injury, that your daughter injured her pelvis. Shoulder and lap belts complicate the strains on the spine. Your daughter needs a proper orthopedic and neurological evaluation of her low back and pelvis, which should include the hips and knees as well. In addition to standard orthopedic and neurolgical exams I always did complete range of motion, station and gait, muscles tests and palpation of everything connected to the spine and pelvis. I will be covering the human pelvis on my new website. Like the skull, it is unique due to upright posture and can cause as many problems in humans as upper cervical misalignments.
Dr. Flanagan,
Please do not apologize. Any time you give to us is a gift.
My daughter was a pedestrian when she was hit by the speeding cab. She was clipped by the passenger wing mirror and thrown onto the windshield which she smashed with the left side of her head, hit the hood and then the ground (I was with her when it happened). No seat belts involved.
She is having an MRI of the shoulder and left knee on Monday and we will see about getting an evaluation of her lower back and pelvis. Is there anyone in NYC that you could recommend?
Any thoughts on her having a spinal tap with current issues?
Drury
Please do not apologize. Any time you give to us is a gift.
My daughter was a pedestrian when she was hit by the speeding cab. She was clipped by the passenger wing mirror and thrown onto the windshield which she smashed with the left side of her head, hit the hood and then the ground (I was with her when it happened). No seat belts involved.
She is having an MRI of the shoulder and left knee on Monday and we will see about getting an evaluation of her lower back and pelvis. Is there anyone in NYC that you could recommend?
Any thoughts on her having a spinal tap with current issues?
Drury
Hi Dr, having a bit of memory foggyness today. Found this piece about CSF and I was looking to find where the CSF is drained and how.
Circulation
MRI showing pulsation of CSF
CSF is produced in the brain by modified ependymal cells in the choroid plexus (approx. 50-70%), and the remainder is formed around blood vessels and along ventricular walls. It circulates from the lateral ventricles to the foramen of Monro (Interventricular foramen), third ventricle, aqueduct of Sylvius (Cerebral aqueduct), fourth ventricle, foramina of Magendie (Median aperture) and foramina of Luschka (Lateral apertures); subarachnoid space over brain and spinal cord; reabsorption into venous sinus blood via arachnoid granulations.
It had been thought that CSF returns to the vascular system by entering the dural venous sinuses via the arachnoid granulations (or villi). However, some[1] have suggested that CSF flow along the cranial nerves and spinal nerve roots allow it into the lymphatic channels; this flow may play a substantial role in CSF reabsorbtion, in particular in the neonate, in which arachnoid granulations are sparsely distributed. The flow of CSF to the nasal submucosal lymphatic channels through the cribriform plate seems to be specially important.[2]
http://en.wikipedia.org/wiki/Cerebrospinal_fluid
The reason I am interested in this is because I had the thought that vascular reflux/back flow could cause back flow into the CSF drain system, if it is in the venous system. Could it be the equivalent of a BBB breach?
Circulation
MRI showing pulsation of CSF
CSF is produced in the brain by modified ependymal cells in the choroid plexus (approx. 50-70%), and the remainder is formed around blood vessels and along ventricular walls. It circulates from the lateral ventricles to the foramen of Monro (Interventricular foramen), third ventricle, aqueduct of Sylvius (Cerebral aqueduct), fourth ventricle, foramina of Magendie (Median aperture) and foramina of Luschka (Lateral apertures); subarachnoid space over brain and spinal cord; reabsorption into venous sinus blood via arachnoid granulations.
It had been thought that CSF returns to the vascular system by entering the dural venous sinuses via the arachnoid granulations (or villi). However, some[1] have suggested that CSF flow along the cranial nerves and spinal nerve roots allow it into the lymphatic channels; this flow may play a substantial role in CSF reabsorbtion, in particular in the neonate, in which arachnoid granulations are sparsely distributed. The flow of CSF to the nasal submucosal lymphatic channels through the cribriform plate seems to be specially important.[2]
http://en.wikipedia.org/wiki/Cerebrospinal_fluid
The reason I am interested in this is because I had the thought that vascular reflux/back flow could cause back flow into the CSF drain system, if it is in the venous system. Could it be the equivalent of a BBB breach?
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uprightdoc
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Hi NZer1, you are really starting to catch on. It is unlikey however that venous reflux can cause back flow into the CSF system. Most CSF leaves the subarachnoid space and enters the superior sagittal sinus through what are called the arachnoid granualtions. The process by which it is expressed through the arachnoid granulations and into the superior sagittal sinus isn't fully understood. It's pulsatile nature, however, is strong enough to leave impressions in the roof of the skull. The process appears to be both an active and a passive. For venous blood to reflux back into the subarachnoid space it would have to first breach the arachnoid granulations. The arachnoid granulations are not considered to be part of the blood brain barrier.
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uprightdoc
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Drury,
With everything your daughter is going through right now I don't see the point of the spinal tap. Her problems are without question due to the car accident not an immunological problem. The tap won't change the diagnosis and it won't improve treatment. On the other hand it is highly likely that it will aggravate her already unstable condition and make her unnecessarily uncomfortable.
Orthopedic doctors only do standard tests. At best they may find a strain but they won't know what to do about it if they do. Orthopedic doctors do not look for misalignments. They don't believe they even exist just like they don't believe in upper cervical subluxations. Most upper cervical chiropractors don't examine or work on anything below C2 so they wouldn't know if she had a pelvic problem or not to begin with. SORSI chiropractors, on the other hand, use a unique gentle non-force approach to pelvic analysis and correction that uses counter-strain pelvic blocking techniques. In additon to pelvic correction, the also use non-force correction of the musculoskeletal system of the skull and the upper cervial spine.
Your daughter needs to have her low back and pelvis checked out by a good highly qualified competant chiropractor. I want you to go to the SORSI website and look for a doctor in NYC area. There are quite a few. Then get back to me and tell me which ones are the most convenient for you.
With everything your daughter is going through right now I don't see the point of the spinal tap. Her problems are without question due to the car accident not an immunological problem. The tap won't change the diagnosis and it won't improve treatment. On the other hand it is highly likely that it will aggravate her already unstable condition and make her unnecessarily uncomfortable.
Orthopedic doctors only do standard tests. At best they may find a strain but they won't know what to do about it if they do. Orthopedic doctors do not look for misalignments. They don't believe they even exist just like they don't believe in upper cervical subluxations. Most upper cervical chiropractors don't examine or work on anything below C2 so they wouldn't know if she had a pelvic problem or not to begin with. SORSI chiropractors, on the other hand, use a unique gentle non-force approach to pelvic analysis and correction that uses counter-strain pelvic blocking techniques. In additon to pelvic correction, the also use non-force correction of the musculoskeletal system of the skull and the upper cervial spine.
Your daughter needs to have her low back and pelvis checked out by a good highly qualified competant chiropractor. I want you to go to the SORSI website and look for a doctor in NYC area. There are quite a few. Then get back to me and tell me which ones are the most convenient for you.
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silverbirch
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Morning all. Dr I have been watching the two threads, yours and Dr S's for what seems like forever. As a person with progression non episodic MS I have difficulty understanding the connection of RRMS to MS disease in general.
If the diseases were looked at and named independently (maybe MS type 1 and MS type 2) because of the rapid disability of RRMS, I believe there would be deeper understanding of each type.
I cannot see a connection between the two. I can see that there is underlying progression in RRMS that is much the same as PPMS. The key thing is that is it slow in general in RRMS. The rapid onset and disability of RRMS flairs does not fit the picture or story of MS. The involvement of inflammation in one form but not the other is another key point I cannot understand.
The processes seem to me to be too different. If one was to look at the RR flairs as an extreme breach of the BBB, I could make theoretical connections and link the example that you gave with the glutamate cascade happening in Strokes does give 'possible' possibilities of thought to the sudden nature of RRMS after an injury such as the example in your book and the court case. I think of my own experience with prior throughout life injuries and the onset of MS afterwards, at a mild progression rate without inflammation evidence, and no relapse and remission form.
If my disease had started after any of the bigger injuries, falling from a horse and landing at speed on my elbow aged about 8, rugby injuries to my neck aged about 17 to 19, lower back disc issues aged mid twenties, and the evidence of more wear and tear from MRI's, bulges, disc degenerations, unknown vascular system.
Why would the disease have a mild progression for me and rapid onset and remissions and with relapses disabling other/new areas seemingly without physical injury as a cause for other people.
I understand the variety of structures in the spine and skull and can imagine the problems that will create. I can also understand the problems that malformations in the brain drainage system could create. The hereditary connection/evolution is also understandable.
There seems to be an interplay with all these issues, and that is where I am stumped. Each time I try to see RRMS in the picture as a part of MS I find that the whole picture doesn't work any more.
If RRMS was separate from the picture things make more logical sense.
And if I see RRMS as a blowout and separate issue on top of the underlying PPMS disease I can theorize but not quite put logic to that hypothesis.
I probably need to re-read your book!
Guidance please!
Regards Nigel
If the diseases were looked at and named independently (maybe MS type 1 and MS type 2) because of the rapid disability of RRMS, I believe there would be deeper understanding of each type.
I cannot see a connection between the two. I can see that there is underlying progression in RRMS that is much the same as PPMS. The key thing is that is it slow in general in RRMS. The rapid onset and disability of RRMS flairs does not fit the picture or story of MS. The involvement of inflammation in one form but not the other is another key point I cannot understand.
The processes seem to me to be too different. If one was to look at the RR flairs as an extreme breach of the BBB, I could make theoretical connections and link the example that you gave with the glutamate cascade happening in Strokes does give 'possible' possibilities of thought to the sudden nature of RRMS after an injury such as the example in your book and the court case. I think of my own experience with prior throughout life injuries and the onset of MS afterwards, at a mild progression rate without inflammation evidence, and no relapse and remission form.
If my disease had started after any of the bigger injuries, falling from a horse and landing at speed on my elbow aged about 8, rugby injuries to my neck aged about 17 to 19, lower back disc issues aged mid twenties, and the evidence of more wear and tear from MRI's, bulges, disc degenerations, unknown vascular system.
Why would the disease have a mild progression for me and rapid onset and remissions and with relapses disabling other/new areas seemingly without physical injury as a cause for other people.
I understand the variety of structures in the spine and skull and can imagine the problems that will create. I can also understand the problems that malformations in the brain drainage system could create. The hereditary connection/evolution is also understandable.
There seems to be an interplay with all these issues, and that is where I am stumped. Each time I try to see RRMS in the picture as a part of MS I find that the whole picture doesn't work any more.
If RRMS was separate from the picture things make more logical sense.
And if I see RRMS as a blowout and separate issue on top of the underlying PPMS disease I can theorize but not quite put logic to that hypothesis.
I probably need to re-read your book!
Guidance please!
Regards Nigel