Neuroveda Podcast for Complex Health

Today we discuss: Cerebrospinal Fluid (CSF) leaks

Agenda: 

 1. Dr. Cardenas: Tell us your story! 

 2.     So, what is a CSF leak? 

a.     What is leaking? From where? Why do leaks happen? 

b.     Common symptoms? Uncommon symptoms? 

c.     Why don’t more people know about this? 

3.     Okay, so let’s go back to basic anatomy & let’s go from general to specific- talk to us about: 

a.     connective tissue

b.     vasculature

c.     central nervous system flow: CSF, lymph, blood

d.     Relationship with bones like CCI, Eagle’s, others?

e.     Relationship with the vasculature/ flow in the rest of the body like pelvic venous congestion

4.     How do we evaluate for this?

b.     Imaging

c.     Blood patches 

d.     Embolization 

5.     How do we TREAT this? 

a.     Immediate: Blood patches/ embolization/ pressure adjustments (meds, etc) 

b.     Counter facial strain. What is it & how does it help? Role for other physical tx like PT/ chiro?

Bio: Dr Brianna Cardenas is a Physician Assistant, a certified athletic trainer and the founder of Healed and Empowered, an organization that specializes in optimizing health among those living with chronic illness. She has recently joined the team at NeuroVeda Health where she brings 13 years of healthcare experience. She is also a patient living with Ehlers-Danlos Syndrome, an “invisible” condition that can be hard to diagnose and often discounted by healthcare providers as a result. Brianna’s lived experience as a patient informs her work as a healthcare provider to others.Bio: Dr. Maxwell is a Board Certified Pediatric Cardiologist and Pediatrician. He received his medical degree from Johns Hopkins Medical School and a Residency in Pediatrics at The University of California at San Francisco followed by clinical and research fellowships in Pediatric Cardiology at Lucile Salter Packard and Stanford Hospitals and Children’s Hospital of Philadelphia. His research interests include study of endothelial control of vasomotor tone, nitric oxide, sports cardiology, dysautonomia, hypermobility syndromes, & mast cell activation syndrome and their relationships to environmental toxins. For his research he received an American Heart Association Award for Research in Molecular Biology and was an American College of Cardiology Young Investigator Award finalist. He has published many articles and book chapters on these subjects. For his clinical work, he has been voted by his peers as a Top Doctor in Northern California annually since 2017.

Resources/ Links/ Articles: 

Professor Prita Lal Bio:

Bio: Raised as a child of South Asian immigrants in theAmerican South, Professor Prita Lal became interested in social justice issues at a young age and now teaches at Evergreen State College at the intersectionsof food and environmental justice, social movements, Black studies, solidarity economics, cooperative education, healing justice and community-based learning.Dr Lal completed her BA in French & anthropology at Tulane, her Master’s & Doctorates in Sociology at Stony Brook University. Her teaching style focuses on education for transformation and liberation. She also has completedextensive training in yoga and Ayurveda (an ancient system of healing from South Asia), which she integrates through somatic and trauma-informed teaching practices. Her work analyzes the root causes of social problems, not intending to paralyze, but rather inform just alternatives to transform (rather than recreate) systemic injustices.

Path Affiliation

Dr. Shouhed is a nationally renowned, board-certifiedminimally invasive weight loss surgeon with expertise in Robotic Bariatric, Gastrointestinal, and Complex General Surgery. He was born and raised in Los Angeles, California, and graduated summa cum laude from UCLA with adegree in Human Physiology.  Dr. Shouhed earned early recognition, a Phi Beta Kappa induction, and a near-perfect MCAT score, which secured him a placeat UCSD School of Medicine with the highest merit-based scholarship. Dr. Shouhed completed his general surgery residency training at Cedars Sinai (#2Hospital in the country), where he graduated as Administrative Chief Resident.  He completed his fellowship at Mount Sinai Hospital in New York, the first fellowship in the country, where he focused on minimally invasive bariatric, foregut and complex general surgery.

Dr. Shouhed is also Medical Director of the Bariatric Surgery and Metabolic Weight Loss Center, Providence Saint John’s Hospital.

 Our focus today is really about the vascularabdominal syndromes that we can see so prevalent in connective tissue disorders & complex conditions. Please get us started with a description of the anatomy of the abdomen, including the GI organs, but also the ligaments &connective tissue that holds these organs in place and the vasculature that feeds them oxygen & carries away metabolic wastes.

    Now, let’s get into the syndromes that we wantto focus on today & we’re going from the top down because that’s how they might be unlocked, meaning closest to the heart to the most distant to the heart and in the pelvis, that’s from chest to pelvis direction.

    a. MALS: median arcuate ligament syndrome

b. SMAS: superior mesenteric artery syndrome(duodenal comp) (meat?)

c. Nutcracker: renal vein compression

d. May Thurner: iliac vein compression

e. Pelvic congestion syndromes including pelvicvenous insufficiency, vaginal/ labial varices

For each we talk about:

a. Symptoms

b. Evaluation

c. Treatment: ancillary tx? Visceral manipulation?

What would a patient look for in a provider? Whois doing this care? How easy/ common are folks doing these treatments? Howoften can or do treatments go wrong?

We end with discussing: where is research going with this?