Multiple Sclerosis occupies a particularly terrifying niche among chronic, disabling diseases. While all serious threats to health are to one degree or another fearsome, those we understand least, and that leave us feeling most vulnerable and defenseless, are certainly the most feared.
Variable in its course and at times indolent for years, MS can, when extreme, progress rapidly and culminate in total disability and premature death. Characterized by most as an autoimmune disease, MS is still poorly understood. We don't really know exactly why some people get it, we don't know how to prevent it, and there is treatment, but no cure.
This is a situation that screams necessity, and thus invites inventiveness, such as that of Dr. Paolo Zamboni, for whom the need became personal. Dr. Zamboni, an Italian vascular surgeon whose wife has MS, was frustrated with the ineffectiveness of conventional therapies, which mainly involve suppressing immune system function.
Seeking, initially, to account for the common occurrence of iron deposits in the brains of MS patients, Zamboni conducted brain scans. He noted apparent blockages in the veins that drain blood from the brain in MS patients, consistently absent from the brains of healthy control subjects. He also noted that the blocked veins corresponded well with the location of iron deposits, and that the more severe the blockages, in general, the more severe the MS.
Zamboni next converted his insight into an angioplasty procedure -- now known as "liberation therapy" -- in which a balloon-tipped catheter is used to open up the partially blocked veins.
In Dr. Zamboni's published work, responses to liberation therapy have been very encouraging, although even at best the procedure is not a panacea. Zamboni suggests that the longer veins are blocked before liberation, the more potentially irreversible damage to the brain becomes. Some veins re-occlude after angioplasty. And some patients simply don't respond well. But the testimonials of those who do, including Dr. Zamboni's wife, are quite compelling -- telling tales of restored function and quality of life.
But there are, as yet, dark clouds of doubt wrapped around the silver lining, if not silver bullet, liberation therapy might represent. From the start, many mainstream neurologists have found the entire theory implausible. I myself am troubled by the fact that MS occurs almost exclusively in those born and raised above the 40th parallel, and see no obvious means by which Dr. Zamboni's theory can account for this.
Now, two studies published in the Annals of Neurology -- one from Sweden, one from Germany -- compound that doubt. Both studies used imaging techniques to examine the neck veins of MS patients and matched controls, and neither detected any consistent difference at all.
So, Dr. Zamboni himself, and the patients who claim significant responses to his treatment, believe his observations constitute an epiphany. Much of the medical and research community is far less sanguine, and considers the approach a potential boondoggle.
The Premier of Saskatchewan, Brad Wall, confronted this dilemma with a greater sense of urgency than most. Canada has one of the highest rates of MS in the world, and the prairie province has the highest rates in Canada. So as of July, Saskatchewan became the first Canadian province to dedicate research dollars to study the liberation procedure, and actively encourage clinical trials. While the other provinces and territories look on with increasing interest -- knowing they, too, have residents traveling abroad to seek the as-yet inadequately studied procedure -- Premier Wall has clearly staked out a leadership position.
I was privileged to speak with the Premier and discuss the basis for his decision. I found him knowledgeable, informed, thoughtful and measured.
The Premier knows that liberation therapy is not certain to work, and is certainly not devoid of risk. But like most residents of Saskatchewan, he knows the toll of MS within his own circle of friends and family. And so he knows how fervent is the hope, and need, for new therapies.
The Premier has not endorsed liberation therapy, even in the face of compelling anecdotes from citizens of his own province. Rather, he has endorsed the hope engendered by the therapy, and the need to cultivate that hope by determining, responsibly but swiftly, whether the promise of the remedy is one it can truly fulfill. He is calling on the research community to make that assessment.
In theory, the prime directive of medicine is "primum non nocere": first do no harm. Even the statistical underpinnings of all biomedical research are designed to protect us from a rush to folly: studies conventionally permit up to a 20 percent risk of a false negative result (i.e., concluding something doesn't work when in fact it does), but only a 5 percent risk of a false positive (i.e., concluding something works when in fact it doesn't). But without boldly accepting some risk of doing harm, we have no real potential to do good. And harm can be done by inaction; there are sins of omission, just as there are sins of commission. (Fellow Star Trek fans will no doubt recall that all of the best star ship captains often found that the only ethical way to honor Star Fleet's prime directive -- noninterference in alien cultures -- was to defy it!)
I do not yet know if liberation therapy works. I agree with Premier Wall that we need to find out. I commend the Premier for exercising bold leadership betwixt the perils of commission, and omission. Saskatchewan's policy -- which I hope others will adopt -- will help us determine sooner than later what happens when the hope kindled by liberation therapy is fed the fuel of science.
Between now and then, I urge patience. Hope is a powerful impulse that readily invites a leap of faith; good science, however, offers much much more reliable footing. There is apparent promise in liberation therapy, but we need well-done research to tell us if it is promise the procedure can keep.
Dr. David L. Katz; www.davidkatzmd.com
Follow David Katz, M.D. on Twitter: www.twitter.com/DrDavidKatz
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The Liberation Treatment needs to be done and documented. There are literally in the hundreds to possibly thousands now of people that have had or are going to have this procedure and the results are
needing to be coordinated so that the medical community can come together FOR this issue...not be separated by different opinions within the various areas of medicine. This is not necessarily for everyone with MS but if positive results are evident for many it must be pursued.
Remember Lorenzo's Oil......
"owned and cared for" the MS community the past 5 decades, seems to be
the opinion that the media is favouring. Rather than force suffering people to jump on the medical tourism bandwagon and subject themselves to atrocious costs and lengthy travel, pursue this treatment now in consultation with the interventional radiologists and vascular surgeons that
actually do the procedure. Do not leave the decision making processes to the neurologists that would not even be conducting the treatment. Post liberation procedure aftercare needs to be addressed also.
Canada Premier Brad Wall should be commended for stepping up to the plate with the courage to challenge the status quo. The MS community of Saskatchewan
encourages Brad Wall to again use good judgement when approving the trials, ensure that those truly genuine to the cause are those being consulted in the decision making regarding the Liberation Treatment.
Consult with Dr. Zamboni, Dr. Franz Schelling, Dr. Simka, Dr. Haacke, Dr. Dake, and of course Canada's own, Dr. Sandy McDonald of Barrie, Ontario.
These men should be commended for their pioneer efforts......something that Saskatchewan was built on.....pioneers.
When a blockage occurs in one or more of the arteries to the brain, a person can suffer from isolated weakness in one side of the body or face when plaque builds up within this arterial system. This symptom also may manifest as numbness within an arm or a leg or in half of the face. Other times, it can present itself as paralysis within these same areas of the body. Sounds like MS to me. This where our battle begins. Most Doctors have a wait and see attitude while patients are getting worse. By seeing other MS people getting the liberation treatment and showing definite improvements in there MS symptoms we are getting upset. Dangerous operation? They do 1.4 million angioplasty's a year in the US alone. The price compared to other MS treatments is very cost effective. About $12000. for treatments outside of US and Canada. Another Doctors thought is long term effects of this treatment. Even if it helps in the short term, it's another tool that should be used.
The MS society has no credibility. During WWII the Nazis stole the fatty foods in the countries they invaded, leaving only the low fat foods that could be grown in gardens. After the war it was noted that people with MS in these countries had a 50% decrease in relapses during occupation. Based on this observation, Swank started a study in 1950 in which MS patients were told to follow a low fat diet. Those that did had a 90% reduction in relapses and a markedly lower rate of disability and death. The MS society has done its best to keep MS patients from following this diet. The Nazis did more for MS treatment than the MS society ever did. Who would have thought that it was possible to be more evil than the Nazis?
It is called low dose naltrexone (LDN). Naltrexone, in high doses (50mg) is an FDA approved medication to aid in withdrawal from opiate drug addiction. In very low doses (4.5 mg), it has remarkable properties to boost immune system response and to normalize autoimmune disorders.
In addition to MS, beneficial effects have been reported for a variety of other conditions.
For additional information, see:
General info: http://www.lowdosenaltrexone.org/
Video: http://www.youtube.com/watch?v=CVpjsDK0LPA
Book: "The Promise of Low Dose Naltrexone", by Elaine Moore & Samantha Wilkinson
Ebook (free): http://www.keephopealive.org/naltrexonecasereports.pdf
Patient website: http://www.ldners.org/index.htm
Database: http://www.ldndatabase.com/
Research: http://www.ldnscience.org/
Roy Mankovitz, Director
http://www.MontecitoWellness.com