Is Supine (laying down) treatment enough?

[CureOrBust]

One thing that has always bothered me a little, is that Dr Z used both the Supine (laying flat) and upright positions when testing for CCSVI using ultra sound. However, when we get treatment, we are only viewed while lying down.

Are we possibly missing something by not having the treatment while also in an upright position? the veins open differently in the two positions.

[Cece]

The difference though is that the vein is more collapsed when we are upright. Since the vein is most open when we are lying down, that would accentuate the stenosis if a stenosis is there.

[PointsNorth]

Good Question. Good Answer. Thank You.
PN

[Cece]

It's interesting to think that, if we were able to have venogram/ivus/treatment done while upright, then that would show the alternative flow routes. If there is valvular stenosis of the vertebral veins present, this would be more easily seen when upright, if flow is increased in the vertebral veins when upright. Verts are not currently treated in CCSVI but it makes sense that they would be of importance and, since valves are present in the verts, the valves can be malformed there as well. We often have more than one thing wrong inside our veins: bilateral jugular stenosis, jugular and azygous stenosis, jugular and azygous stenosis and nutcracker sydrome. Why not jugular and azygous and vertebral vein stenosis?

[milesap]

I think over time the MS data coming from the Upright MRI which can measure blood and CSF flow is going to become more important. There is already a trial in place looking at C1 vertebrae (atlas) in conjunction with the Upright MRI to see how that may restrict blood and csf flow in MS patients with some anecdotal positive results from some patients .

[daniel]

Does anyone know if this means that technically some people will get sicker the more time the spend standing while others will deteriorate more while sleeping?

[1eye]

I always get worse when I lie down. I dread going to bed. I feel worse after a night's sleep, especially after over-sleeping, than I did when I went to bed. That got appreciably better after my procedure, and still is not as bad as it was before it.