Lack of MS treatment followup frustrates patient
Last Updated: Wednesday, November 17, 2010 | 3:00 PM ET
CBC News
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Canadians with multiple sclerosis who've had their neck veins opened outside the country in an experimental procedure not approved in Canada are now trying to get followup treatment at home. (CBC)An Ottawa woman with multiple sclerosis who received an experimental vein treatment in the U.S. said she has had trouble getting doctors in Canada to provide follow-up treatment after complications developed.
Rebecca Cooney is one of several Canadians who went abroad to undergo the controversial "liberation" therapy, where MS patients receive an angioplasty, or ballooning, to open up veins.
Cooney said immediately after the procedure the ringing in her ears disappeared and some of the strength in her legs returned.
"It was like I had a vacation from MS for 4 weeks," she said.
But her symptoms returned, and she said since the treatment is not sanctioned by Health Canada, she met resistance from her own specialist.
After failing to get help in Canada, she was able to get an appointment with the U.S. surgeon who performed her original procedure, and he inserted a stent in a vein, which relieved the pain for a short time. By the time she saw another doctor she had developed a blood clot.
"If I could have got the follow-up care I needed, if people had been educated here in Canada about this, this would not have happended to me," she said.
The vein-opening therapy is based on an unproven theory that blocked veins in the neck or spine are to blame for MS. The theory, known as chronic cerebrospinal venous insufficiency (CCSVI), was put forward by Italian doctor Paolo Zamboni, who proposed treating multiple sclerosis by resolving the venous insufficiency by inflating small balloons to open up veins.
Procedure not recognized in Canada
The procedure is not a recognized MS treatment in Canada.
The Canadian federal government said in September it would not fund a clinical trial of the procedure after consulting with a panel of North American experts. Canadian Institutes of Health Research head Dr. Alain Beaudet said experts weren't convinced Zamboni's procedure works and is safe.
There are also no standards on how it is to be administered, and it is not covered by provincial health insurance plans.
Thomas Foreman, a medical ethicist with the Ottawa Hospital, says doctors are required to care for patients no matter where they received treatment first, but when dealing with unknown procedures they need to tread carefully.
"Doctors are aware of their skill and it's one of their ethical obligations to work within the skill set they possess," said Foreman.
Cooney said despite the setbacks, she would still go through the procedure, because for a brief time, she claims it worked.
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