DrSclafani answers some questions

[drsclafani]

I would just like to express my thanks to you Dr Sclafani. Although I post rarely I have read this whole thread over the last few years and it has helped me greatly. I would like to add that I have a dear friend that was treated by you twice and is extremely happy with her outcomes.

I too believe that there are other avenues people with MS may need to travel and that various complimentary therapies are going to be needed for most patients.

However, much as we would like it, I do not feel that it is not possible for one doctor - in this case Dr Sclafani - to be able to converse on all these different subjects. He has expertise in vascular surgery and I respect the knowledge that he has acquired over a long and distinguished career.

Thanks, i needed that

[SaintLouis]

Ditto what Hooch said.

[ada]

I would just like to express my thanks to you Dr Sclafani. Although I post rarely I have read this whole thread over the last few years and it has helped me greatly. I would like to add that I have a dear friend that was treated by you twice and is extremely happy with her outcomes.

I too believe that there are other avenues people with MS may need to travel and that various complimentary therapies are going to be needed for most patients.

However, much as we would like it, I do not feel that it is not possible for one doctor - in this case Dr Sclafani - to be able to converse on all these different subjects. He has expertise in vascular surgery and I respect the knowledge that he has acquired over a long and distinguished career.

Thanks, i needed that

we me and my wife would like to express our thanks to a great person and an expert dr ,to our dr ,DR Sclafani ,a real friend that we can trust on blinded eyes ,a man taht is allways close to us whenever we need them.
we have travelled half the planet to meet him just about two years ago,we did not solve the whole situation with our ms still ,but we are more than sure that we made the best choise for us .
trust and confidence to dr S opinion.he is hearing everything ,open minded to new ideas and approaches
basic principle for him ,if we can not fix then do not harm .
and of course a great teacher to many people to this planet ,from patients to doctors.
as about his dr skills he as an artist
we need you to be with us our dear dr and we just wanted to express our THANKS also
agni and mixalis

[Robnl]

Dr Sclafani addresses a piece of the puzzle, and his help does not stop when you walk out his door!

I still have contact and ask for advise for my next steps!!

BTW..July 1st i have an upright MRI scan to identify possible problems with the upper spine and CSF.....

Regards,

Robert

[drsclafani]

Dr Sclafani addresses a piece of the puzzle, and his help does not stop when you walk out his door!

I still have contact and ask for advise for my next steps!!

BTW..July 1st i have an upright MRI scan to identify possible problems with the upper spine and CSF.....

Regards,

Robert

Thanks Robert
Please let me know what your Upright MRI shows. I would like to correlate it with what your venogram looks like. It would be a great opportunity to compare the two modalities.

DrS

[dania]

Dr Sclafani addresses a piece of the puzzle, and his help does not stop when you walk out his door!

I still have contact and ask for advise for my next steps!!

BTW..July 1st i have an upright MRI scan to identify possible problems with the upper spine and CSF.....

Regards,

Robert

Thanks Robert
Please let me know what your Upright MRI shows. I would like to correlate it with what your venogram looks like. It would be a great opportunity to compare the two modalities.

DrS

This is what I meant. Have as much info as possible.

[drsclafani]

Dr Sclafani addresses a piece of the puzzle, and his help does not stop when you walk out his door!

I still have contact and ask for advise for my next steps!!

BTW..July 1st i have an upright MRI scan to identify possible problems with the upper spine and CSF.....

Regards,

Robert

Thanks Robert
Please let me know what your Upright MRI shows. I would like to correlate it with what your venogram looks like. It would be a great opportunity to compare the two modalities.

DrS

This is what I meant. Have as much info as possible.

thanks dana, glad to see that we have some common ground. I was debating against the point of view that patients should be evaluated for malalignment prior to venography. If i were sold on it I might do that, but at this point i havent bought in that it is a general common association

DrS

[dania]

Dr S there could be more than misalignment. Eagle's syndrome, bone spurs in the neck stopping blood flow. Those patients need surgery to correct their problem. Angio does not help. Being a Canadian, we must pay out of pocket for any procedure. X rays and scans are not as expensive as angio. Or an upright MRI to see if it is a CSF flow problem. Again angio is not the best solution. I do encourage you to talk with Dr Flanagan. Maybe the best solution is correcting CSF flow plus angio to correct blood flow. Do both.

[Robnl]

BTW..July 1st i have an upright MRI scan to identify possible problems with the upper spine and CSF.....

Regards,

Robert

Thanks Robert
Please let me know what your Upright MRI shows. I would like to correlate it with what your venogram looks like. It would be a great opportunity to compare the two modalities.

DrS

Ofcourse, hope to send you some images if csf problems exits...

[drsclafani]

Dr S there could be more than misalignment. Eagle's syndrome, bone spurs in the neck stopping blood flow. Those patients need surgery to correct their problem. Angio does not help. Being a Canadian, we must pay out of pocket for any procedure. X rays and scans are not as expensive as angio. Or an upright MRI to see if it is a CSF flow problem. Again angio is not the best solution. I do encourage you to talk with Dr Flanagan. Maybe the best solution is correcting CSF flow plus angio to correct blood flow. Do both.

dania
i think you are missing my point. Angio and IVUS are quite good at showing stenoses, regardless of where they are located. Significant stenoses of all causes, including those caused by bone spurs, misalignments and so forth are best seen by angio and ivus, not xrays which can only show the bones. In addition, my experience indicates to me that these upper lesions are just not that common. The overwhelming percentage of patients have no problems with the jugular vein except where it enters the chest. I am not arguing that these other things do not occur, it is just that they are not common. and even if present, they are almost always going to be accompanied by valvular stenosis of inferior jugular bulb. No point in treating upper lesions without also addressing the lower lesions. In addition, xrays and scans are not going to help find the azygos vein stenosis present in about half of patients nor in showing the compression of the left renal vein that is present in 25%.

So my clinical judgment is that angiography and IVUS are the key and the starting point. If they fix the problems then great, end of story. if they don't then i would consider these other options but would prefer more and better data than i have seen so far.

Thanks for the discussion, Dana.

[dania]

I agree that angio and IVUS are excellent at showing stenoses. All I am trying to convey is that for some stenosis might be caused by a problem with CSF flow. I also think that, perhaps, if angio is performed when the patient's disabilities are minor and they keep themselves healthy and exercise regularly they are more likely to keep their improvements. For me I did very well for 18 years. No meds. But I use to go to the gym 5 times a week and weight train. Heavy weights. I could leg press 400 pounds. I was 5'6" weighed 120 lbs. It was when I stopped going to the gym that my condition declined.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2117722/

http://link.springer.com/article/10.100 ... rue#page-1

[vesta]

Dr S there could be more than misalignment. Eagle's syndrome, bone spurs in the neck stopping blood flow. Those patients need surgery to correct their problem. Angio does not help. Being a Canadian, we must pay out of pocket for any procedure. X rays and scans are not as expensive as angio. Or an upright MRI to see if it is a CSF flow problem. Again angio is not the best solution. I do encourage you to talk with Dr Flanagan. Maybe the best solution is correcting CSF flow plus angio to correct blood flow. Do both.

dania
i think you are missing my point. Angio and IVUS are quite good at showing stenoses, regardless of where they are located. Significant stenoses of all causes, including those caused by bone spurs, misalignments and so forth are best seen by angio and ivus, not xrays which can only show the bones. In addition, my experience indicates to me that these upper lesions are just not that common. The overwhelming percentage of patients have no problems with the jugular vein except where it enters the chest. I am not arguing that these other things do not occur, it is just that they are not common. and even if present, they are almost always going to be accompanied by valvular stenosis of inferior jugular bulb. No point in treating upper lesions without also addressing the lower lesions. In addition, xrays and scans are not going to help find the azygos vein stenosis present in about half of patients nor in showing the compression of the left renal vein that is present in 25%.

So my clinical judgment is that angiography and IVUS are the key and the starting point. If they fix the problems then great, end of story. if they don't then i would consider these other options but would prefer more and better data than i have seen so far.

Thanks for the discussion, Dana.

Dr Sclafani:
I think you are missing our point. I believe it may be easier and less expensive to check out and treat CSF problems BEFORE angioplasty. See if such treatment works. A practical and financial question which may be medically advantageous as well. We have to live with and pay for the conséquences. This is not to doubt your dedication, expertise or competence. It's just survival.

MS Cure Enigmas.net

[dania]

Thanks Vesta. That is my point of view, exactly. I guess I was not articulating it very well. It is not being argumentative. Just an opinion and my experiences. If my experiences helps anyone, so much the better. I completely drained my retirement funds. If I had known what is my particular problem I would have done everything differently.

[DrDiana]

Hi Dr. Sal, Can I trouble you with two quick questions? I'd be so grateful for your input.
1) Did anyone ever determine why the collagen in the veins seemed to turn from collagen 1 to collagen 3? Do you know if there is a similar change in something like pelvic congestion syndrome?

2) Has anyone ever compared the CCSVI study results, separating them for the patients who received blood thinners post-op and those who did not? (Upon casual observation, it seems that the 'received blood thinners group' tended to do better, but I could be wrong.)

Thank you so, so much for your continued dedication!
;) Diana

[EJC]

Diana,

Seeing in your sig that you are a therapeutic optometrist may I ask you a question?

What do you think the mechanism is with a CCSVI procedure such as that carried out by Dr S that leads to noticeably improved eyesight and relief from some eye "syndromes"?

My partner had a procedure in Scotland in 2010 but her eyes have now returned to pre procedure state. We are considering a procedure purely for eyesight improvement at present as many of her physical issues have been addresses with Jaw/Atlas misalignment treatment.