by Anniel 7/12/15
For many decades Medical Science has taught about the inviolability of the Blood Brain Barrier, which is said to be a shield prohibiting most substances from crossing over into the Central Nervous System. Now we have proof that Thyroid antibodies DO cross the Blood Brain Barrier. Can this be a cause of Pseudotumor? Nobody knows, but many people with PTC also have thyroid problems.
Now that Cate has gone through her own personal hell with thyroid disease, we have also learned new thinking about the major operation performed on people with Chiari: Cerebellar Decompression. As usual this will take some explaining.
At the base of the brain, where it sits atop the spine, the brain stem ends in what are called the Cerebellar tonsils. There is an opening to the spinal column there is a bony structure called the Odontoid Process, where a small but very important upright bone from the C-1 vertebrae sticks up where a slot in the skull fits down over it. This is where the head rotates from side to side and without it you would not be able to turn your head. There has to be a large enough hole in the Process for CSF to flow between the brain and the spinal column, but the hole must also be small enough to stop the Cerebellar tonsils from slipping down into the cervical vertebrae. When a person has a Chiari malformation the two sections don’t mesh and the brain stem protrudes into the the C-Spine and blocks the free flow of CSF between the brain and spine. It is possible for the Odontoid bone to also be incorrectly seated.
Decompression is an operation where an incision is made from the top of the head down past the Odontoid Process and the muscles, ligaments and skin are retracted enough to allow the neurosurgeon to chip out enough bone to open the CSF flow between brain and spine. The surgeon can only reach so far since the side of the bone facing the throat is inaccessible. It’s a delicate operation. Some people need only one decompression in their lifetime and do fine. Babies with Chiari seem to be the ones who do best with the surgery.
Unfortunately, following surgery scar tissue can build up and refill the space cleared. Infections can also cause severe problems. Cate was blessed that her first decompression lasted for a long time before it finally scarred shut. She had a second Decompression a few years ago, and was recently scheduled for another. It seems that the more you have, the more you need.
A few months ago, about the same time that she had a flow study of her CSF done, her neurosurgeon disappeared from the scene for a several days and when he returned he told her new research shows that Decompression should be used on a very limited basis and that most patients actually do better in the long run without it. He told Cate that they have learned this from patients like her and he’s sorry they had to learn from practicing on her. Now she has scar tissue and worse headaches to contend with, and not much relief in sight.
She also has recurrent Hashimoto’s Encephalitis because of the thyroid antibodies crossing the blood-brain barrier and infecting her whole Central Nervous System. Her neurosurgeon now admits that probably the most important surgery she has had was her thyroidectomy.
Now here we are, we can finally discuss the exciting news of the Lymphatic System and how it may change medicine profoundly. It means a lot for Cate, if the research is allowed to continue. The following is an OLD description of the Lymphatic System:
“The lymphatic system is part of the circulatory system and a vital part of the immune system, comprising a network of lymphatic vessels that carry a clear fluid called lymph (from Latin lympha meaning water) directionally towards the heart.”
This description was good until July 16, 2015 when three Finnish researchers from the University of Helsinki at Turku published a paper of their serendipitous discovery that there is a complete Lymphatic System all of its own that is included WITHIN the Central Nervous System, which was a totally unexpected finding.
This discovery means it is probable that lymphatic clearance of the brain will help researchers working on Central Nervous System diseases thought to be caused by misfolded proteins or fluid in the brain, as well as other neuro-immunological diseases, such as Multiple Sclerosis, Alzheimer’s Disease and, I hope, Parkinson’s and Pseudotumor.
The researchers were curious as to how and why what they called “brain fluid” (which has to mean CSF) could drain into the lymph system when there didn’t seem to be a link between the brain and the Lymphatic System.
“We have recently discovered that in the eye, which is another immune-privileged organ previously considered to lack lymphatic circulation, there exists a lymphatic-like vessel,” Aleksanteri Aspelund,a researcher at the University of Helsinki, said in a press release. “This led us to investigate the lymphatic nature of the brain in more detail.”
Unfortunately, many of the early comments on the matter are now being “sanitized” so that everything looks more deliberately thought out than the first news indicated.
The early accounts were that Dr. Aspelund and a colleague directed a graduate medical student named Salli Antila to remove some spinal material from mice meninges and spread it out on a plate for imaging.
Apparently that was the customary procedure, but Antila said something like: “Why don’t I take the plate to the sample and tip it out, that way we won’t have to spread it?” That was fine and no one was paying much attention.
Salli Antila has been described as an unflappable man of few words, so when he calmly said, “I think we’ve got something here. You need to come and look,” Aspelund and his colleague were nonchalant until they did look, and then they were so excited they could hardly speak. It seems that the lymph vessels are sandwiched underneath the meninges and they collapse easily when the meninges are handled, which makes them invisible, so they had never been noticed before.
Not only is the Lymphatic System NOT part of any other system, it exists WITHIN the vaunted Blood Brain Barrier and carries out other functions, such as helping drain CSF and controlling eye pressure. There is some indication that the Lymphatic System has drainage systems right along side arteries, veins and cranial nerves. These lymphatic vessels are clearance routes for the brain and CSF out of the skull and into the deep cervical lymph nodes. One large lymphatic vessel has been imaged and goes into the eye and drains excess fluid there, right where my daughter faces eye damage from high pressure. You can see why this new information is so exciting for us.
Quoting Dr. Aspelund again: “We were stunned to find such an extensive network in connection to the brain. This incredible finding completely changes our understanding of brain anatomy and gives a chance to look at brain diseases from a completely new angle.”
The big question is: How did the lymphatic vessels manage to escape notice until now? The real answer seems to be that no one was looking. The politic answer is that special imaging techniques were needed, and now funds have been received for the necessary imaging machines.
I was explaining this to a friend and said, “Sometimes things are discovered by fluke.”
He smiled and said, “No, not by fluke, but they come when the Lord wants them known.” He is absolutely right. It’s up to men what they do with what God sends.
Unfortunately, this news, that would bless so many, is subject to many other forces. What follows is a sad but cautionary tale. It shows what can happen in medicine, and starts with two words I detest even hearing: BIG PHARMA, which should always be followed by lots of dollar signs. I hate the conspiracy theory idea of BIG PHARMA, but I have to admit, their skirts do look dirty.
Around 25 years ago a lengthy front page, below-the-fold article appeared in our local paper. It concerned insulin, especially the type known to be human derived. The article said that in the manufacturing process of creating human insulin another watery substance is produced which has to be removed from the purified insulin and thrown away. Along with insulin, the pancreas in the body also produces the same substance, which, if I remember correctly, was called P-1, so we’ll use that name. No one paid any attention to the stuff, they just kept throwing it out.
Finally a curious researcher decided to find out what the substance is. He said he discovered that P-1 is what the pancreas produces to prevent the damage caused by Diabetes. Think of that, no more diabetic retinopathy, amputations, neuropathy, pain, all the things that go along with the disease.
The next day there was a one paragraph, 2nd page article that quoted one FDA official who said: “This is the research Nobel Prizes are awarded for.” And, he said, “Since it is a naturally occurring substance the agency is putting it on the fast track.” Pffft, the story disappeared into the ether and that was the end of that.
Not another word has been heard about it. Did it not prove out? Did the FDA stop it? BIG PHARMA? No money to be made? Who knows, but I read it aloud to my family at breakfast one morning. I wasn’t imagining it. I did call the FDA at one point and they claimed not to know what I was talking about.
I hate to be on a downer, but I need to put a few more things out there, even though some of them are about our society as much as about medicine.
After Cate had transferred to the University of Chicago to be near the doctor who actually treated the conditions known as Chiari I and Pseudotumor Cerebri, I had occasion to approach him about some questionable behavior on the part of a resident in his program. The physician explained many things to me about the new students coming into medical schools. He said they were unused to real work and believed whatever they did had to be right because they had been reared by parents and teachers who told them they were the best and the brightest. Students who had been raised on “self esteem” by those parents and teachers now have unions representing them, so they never have to take responsibility for themselves. He told me that minority students have gone to their union representatives and accused doctors of being racist if they dare chastise them.
At the end of our discussion the physician said to me that we would look back on the 1990′s as the last of the “golden age” of American medicine. His confession stunned me.
The good doctor usually made rounds with only two or three Residents or Fellows accompanying him and they were pretty quiet then. One day he took all of his students on “grand rounds.” That meant that 10 to 15 people were crowded into Cate’s room. I could not believe the student’s rude and insulting behavior, not just to my daughter, but to their teaching physician, too. They talked and whispered to each other incessantly, giggled and laughed at jokes, and even shoved each other. The physician told me later that if he demanded they stop, someone would go to the union about him.
I finally could not stand such rude behavior to the doctor and my daughter and said, “Dr. A, awhile ago you told me that the quality of the new residents you’re getting isn’t very good and they are hard to deal with. Were you telling the truth and do you still feel that way?”
The residents heard a new voice and stopped yukking it up to listen while the doctor answered. “Annie,” he said, “It’s worse than I can tell you. They are so poorly educated that we almost have to start over. They don’t know how to work and don’t even seem to care. It’s a very sad situation.”
He said some other unflattering things while the students listened with slack faces. I would have been crying had I been one of those students because I would not want anyone to think that I was that bad. When the physician the physician turned again to my daughter, to my astonishment, the students went back to their former behavior. Remember, these were fellows and residents, which means they had already graduated from medical school. When they left I told my daughter that I could not believe none of them acted chastened at all. She laughed and said, “Oh Mom, they don’t think he was talking about them.” True? Yes, I think so, and ObamaCare only makes matters worse.
I have now put myself out there on what I think about some medical matters no one expects to hear about, and have written about the new discoveries on Biofilms and the Lymphatic System which would be so critical to so many people. What will happen to that knowledge? Suddenly there are other groups, even some in the United States, who say they discovered the Lymphatic System first and were only a day later than the Finns with the news, and they have images showing how large the lymphatic vessels are so they deserve the credit.
Will political considerations between universities, doctors and countries interfere in what should be mutual research? The man who really discovered what was going on is not a bigwig, so will he get lost in the crunch? Will everything disappear as the diabetes finding did? Or maybe Obama will take credit for funding the research, after all he’s the smartest man alive.
Do the Antihumanists and Zero Population Growth people want to suppress this discovery because it would help too many people? I no longer know what to believe about many of my fellowmen.
I have been considering the plight of doctors under ObamaCare. How many of them are leaving the profession? How many of them will refuse to sit on a “Death Panel,” or ask intrusive questions of their patients? How many experiments will not be done because permission will not be given?
I also want you to know that there are very brave doctors out there who have a right to our support and praise. What can we do to give that support? I wish I knew how to free us all from the prison we are being forced into. Medicine may have to go on the Black Market in order to survive.
As I wrote these articles I did so hoping against hope that my daughter and others like her will be given a new lease on life. Cate has decided to return to her home, Alaska, and live as best she can under her particular circumstances. No one can say how much she can do. I guess we’ll find out.
Just so I can end this series on a high note and to show you how lacking in humor some people in the medical profession can be, I leave you with a picture Cate tried to show a visiting Resident physician during her last hospitalization. He closed his eyes and would not open them, because under HIIPA Regulations he said he cannot look at the records of a patient not his own:
Do any of you recognize this patient? Under ObamaCare to see more of him.
I want to thank Brad for allowing me this forum, and thank you all for going along for the ride, I hope you learned some good things on the journey. I also pray we can do away with what ObamaCare and the Supreme Court are doing to our people and The United States of America. God bless us everyone. • (1453 views)