This is part one in a two-part series looking at the controversial Liberation Treatment for multiple sclerosis and the experiences of two Chilliwack residents. Part one tells the story of Monica Braun, who received the treatment this summer. Part two will tell the story of Jeff Donegan, who is currently fundraising to pay for the treatment.
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Monica Braun walks down the street with a smooth and steady gait that looks as normal as anyone.
But not for long; the fatigue and numbness brought on by Braun's multiple sclerosis (MS) quickly takes over and robs her of that freedom of movement. After a while her left leg will be overcome with a condition known as "foot drop" and her right leg will start to drag.
"I used to be able to run five kilometres and do it on a daily basis," she said. "Just this past year, I'm lucky if I can walk 500 metres. . . . If I don't watch where I'm going I start wandering and look like I'm drunk."
Braun was diagnosed with relapsing-remitting MS seven years ago, which means her symptoms come and go. Those symptoms include chronic fatigue, bladder issues, spasticity in her legs and varying degrees of numbness over three-quarters of her body, particularly her hands and feet.
In November 2009, Braun first heard about the controversial treatment designed by Italian surgeon Dr. Paolo Zamboni known as chronic cerebrospinal venous insufficiency (CCSVI) or Liberation Treatment.
She closely watched the media coverage and online discussion about the treatment, always with a desperate hope that the Canadian health care system would make it available.
Braun would have happily paid thousands of dollars out of her own pocket to a local doctor or a clinic for treatment she had decided she wanted. But the government and the medical community has firmly said "No."
"This is the thing that peeves me right now," she said. "The Canadian government won't let me spend my money in Canada to have it done."
While the Canadian Institutes of Health Research and the MS Society have taken what she calls a "wait-and-see approach" to the treatment, Braun didn't want to wait for a treatment that she hoped could halt the progression of her symptoms.
She first tried a Polish clinic and was put on a two-year waiting list. Then she found a location in Germany, where she was planning a trip anyway. So Braun contacted a doctor in June and was offered a date for the CCSVI surgery that same month.
The idea behind the treatment is that some MS patients have narrow blood vessels or stenosis. The theory is that routine balloon angioplasty can help open up the blood vessels, increase blood flow and relieve the symptoms of MS, long believed to be only a neurological condition.
The topic is an emotional and controversial one for those on the front lines of MS. Many neurologists have dismissed the treatment outright and few studies are under way. When contacted by the Times to discuss the topic, a representative for the MS Society became defensive before any questions were asked.
"The stories that have been published have been pretty unbalanced," said Suzanne Jay, a spokesperson for the BC/Yukon division of the MS Society. "You don't have all the different sides. . . . It's great that people know more about MS and it's more in the public eye but I'd like to be able to direct some more attention to the other work that the society is doing and other issue that people are facing."
On Aug. 26, the Canadian Institutes of Health Research (CIHR) convened a meeting of leading MS experts in collaboration with the MS Society. Instead of pushing for studies, the CIHR showed its skepticism of the connection between blood flow and MS and recommended baby steps forward, which frustrates patients whose daily lives depend on the hope of relief.
The federal government, following CIHR's lead, seems to have taken a similar position.
In a press release issued after the Aug. 26 meeting, CIHR president Dr. Alain Beaudet recommended a "scientific expert working group" be created to look at studies and, depending on the conclusions, recommend further studies.
"There was unanimous agreement from the scientific experts that it is premature to support pan-Canadian clinical trials on the proposed 'Liberation Procedure,'" said Beaudet in the release. "There is an overwhelming lack of scientific evidence on the safety and efficacy of the procedure, or even that there is any link between blocked veins and MS."
In other words, later this year they will get some experts together to look at studies that have been done to see if any more studying should be done.
This isn't good enough for Braun and hundreds of other MS sufferers hearing positive things from patients who have received CCSVI.
"I became very disillusioned with the medical profession and the neurologists and the MS clinic in general," she said. "They just push drugs.
"My MS doctor is giving me options with really serious health risks and on the other hand not allowing me to have really simple balloon angioplasty with very little risk."
The MS Society of Canada and the National MS Society (U.S.) has committed $2.4 million to support seven research projects focused on the relationship between CCSVI and MS. And on Sept. 16, the MS Society announced a further $1 million to be set aside for a "pan-Canadian therapeutic clinical trial" if and when such a trial is approved.
In August, Braun finally got the procedure done in Germany and spent about $7,000 of her own money doing so. The surgery is simple enough that it was done without anasthetic. She said while it wasn't painful, it was extremely uncomfortable.
Her improvements haven't been as dramatic as some others have reported, but neither has her condition worsened.
And when you live with MS, small improvements can mean a lot.
"[My husband] told me now when he holds my hand it feels real," she said. "'Because sometimes when I held your hands it was like holding a mannequin's hand.' And I do have more energy; I don't get as tired as quickly."
In September, Braun and her husband went to a Chilliwack Bruins game one Saturday night. Usually the one-kilometre walk from her house would be too far and her husband would drop her off and come park at home. They were late this day so she said "I can walk."
"We actually walked the kilometre and because we were late I was hoofing it and he was telling me to slow down," she said. "Halfway we got to the curling rink and he said, 'Aren't you tired yet?'
"I actually stopped and said, 'no, I'm not.'"
Braun is not on a mission to promote this procedure. She is well aware of the placebo effect and said she is quite skeptical. But she is certain she can do things now that she couldn't before and her circulation seems to have improved.
For Braun, the issue is less about her results and her MS than it is about gatekeepers and specialists that seem to refuse to look outside their narrow professions at other potential causes.
"It took a vascular surgeon to come up with this because he happened to have a wife with MS," she said.
The MS Society said that the schedule of planned research has been implemented incredibly quickly in the case of CCSVI and MS, much more so than would have normally taken place.
But for Braun and others, the issue is also about the comparison of risks the medical industry tolerates in other procedures and drug use.
"A woman can go in and have breast implants if she wants, which I consider a fairly invasive procedure and comes with a whole bunch of health risk," she said. "Yet I can't even go to [a clinic] and say 'My veins are narrowed, can you please open them up,' even though I'm willing to pay for it."
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