2 Week Update / Left Side Styloidectomy w Dr. Hackman Nov 6, 2023
Current pain control: 300 mg Gabapentin 3 times a day as well as ibuprofen, lidocaine patch as needed at night. I did have Botox for migraine 3 weeks prior to surgery. So its affects are included in providing relief but all areas it touched are better than pre-surgery.
• I still have some incision pain. Incision by the ear (Dr. Hackman’s route to skull base) has calmed.
• Much of my stylohyoid ligament was removed and that pain on my neck has lessened w/o meds to 40-50% and with meds, negligible.
• Pain in ear is a slight to non-existent stabbing.
• Cannot open jaw fully. Regarding jaw pain, I cut a square of a lidocaine patch and put on my jaw (keeping away from ear incision… very beneficial). Have been able to chew the entire time, very slight chewing after surgery and now can eat fully, but I make sure everything is cut small and not tough. Chewing and talking too much does exacerbate symptoms.
TMJ/jaw was very painful after surgery and ice for me made it worse … suspect the ice was not
good for what I think was trigeminal irritation.
• Throat pain from breathing tube lasted 1 week and was minor.
• I had pain inside and outside throat at styloid; that pain seems gone (trying to parse out what is remaining surgery vs. prior).
• Top of neck/skull base pain and headaches are still a problem if I take a med gap, which I do to check for symptoms…but has lessened. What I’ve called for years, the ‘fork in my neck’ is significantly diminished … at styloid area.
• The ‘guitar wire’ tightness I felt from under ear to under chin (stylohyoid ligament) is gone, Dr. said ligament was ‘under significantly unusual tension’… still some surgery pain/swelling so I expect that to continue to decrease. The ligament to jaw was also significantly tight and he felt all moved much better after released. Crossing fingers TMJ will be very positively impacted.
• I was in constant and somewhat well controlled pain. I would take all the meds as needed but some combo around the clock, plus lidocaine on neck every night. Even with surgery …… reduced all but gaba, ibuprofen.
Pre-surgery neurological symptoms:
I had significant (what I think) was trigeminal pain, jaw, temporalis tightness, forehead, eye, facial pain, back of head, top of neck (TBD on neck as have rotated C1), occipital pain (not stabbing but constant), accessory nerve/shoulder pain and tightness. All are still benefitting from Botox for migraine, but is much better than pre-surgery. Facial flushing (trigeminal?) would happen upon certain movements … this has lessened, but far from full range of motion yet, TBD.
I was not diagnosed with vascular compression, however tests were not done dynamically. I had symptoms of it, but my right side IJV is wide open. It is possible/probable the scalenes are compressing. I chose to address the styloid first in hopes that the thoracic outlet symptoms would improve. A little early to tell, but whole neck and shoulder are looser. So my hope, is once I can start rehabbing all the sad musculature, things will get better and not need intervention.
Most obvious benefits so far:
Brain fog is 90% diminished, as well as memory issues. It feels like my brain is working without the thunderstorm of disruption. Energy has increased surprisingly. While I’m careful and taking it slow, I have the energy and drive to do things I couldn’t before… lots of cooking, organizing… general tasks that seemed monumental prior. I went to three stores yesterday and cooked. That would not have happened prior. )))
Like many of you, I have had pain/dysfunction for years and nothing helped, including C6/C7 fusion, so I have chosen to remain cautiously optimistic, but having my brain back is so encouraging.
I have more to add regarding tips both before and after surgery and will do so when get a moment. For those suffering and looking for answers, hold on ))). Winter surely might make things look literally and figuratively dimmer. I have been on Amitriptyline 25mg/night for years for sleep. There is no doubt I needed the help for my brain and my pain. Please seek help if you feel despondent. All the best.