A big thank you

First, I want to thank everyone on this forum especially Isaiah and Jules who answered every single post. This forum gave me the strength to finally advocate for myself after years of doctors telling me I was “crazy.” Truly, I don’t know where I would be without this community.

For those who haven’t read my earlier posts, I suffer from a 3.8 cm styloid on the right and a 3.6 cm on the left. I experience many of the classic Eagle symptoms, but the worst for me have been the headaches and the nonstop feeling that something is stuck in my throat/choking.

In addition to that, I also suffer from hemifacial spasms, facial pain, pressure behind my ears, jaw pain, ear fullness, and numbness in my hand. The typical “lighting strike” when I turn my head. After trying many different medications and therapies, nothing truly helped. The only partial relief I ever got was from Botox and muscle relaxers, but once they wore off, everything came right back. None of which ever helped the choking though.

Over the course of a year, I lost over 50 pounds simply because I couldn’t eat. My diet was basically protein shakes, eggs, and oatmeal. I saw countless doctors who kept telling me nothing was wrong, that this was multifactorial and psychological. Most of them had never even heard of Eagle syndrome. Shockingly, not even the hospitalist in the emergency room hadn’t heard or it. Despite it being clearly visible on the CT scan and explicitly documented in the radiology report.

This forum became my lifeline and my resource for finding knowledgeable doctors. Living in New Jersey with BCBS, my options were very limited. I did see Dr. Osborne, but unfortunately with my insurance I would have owed a significant amount out of pocket, which wasn’t feasible. I also saw Dr. Shohet in NYC, who while kind, didn’t seem fully knowledgeable about what was actually happening to me although he did refer me to a throat specialist, which I appreciated. The barium swallow ordered determined that when I said I was choking, the food was not even in my throat yet just on the very back of my tounge

Through this group, I found Dr. Paskhover—not initially for surgery, but because he actually knew what Eagle syndrome was. Because he was very apprehensive about surgery, he referred me to Dr. Agrawalla, who did agree surgery was an option. However, his hesitation and recommendation to try Botox one more time, which would have set me back another 4–5 months didn’t sit right with me.

Through this group, I also learned about Dr. Liu (whose actual main focus in aneurysms but fell into this by accident becuase head and neck surgeons would call him in to be the secondary Dr) whose office is right next to Dr. Paskhover’s. He took me seriously and immediately and connected me with Dr. Mir( head and neck surgeon who is a oncologists and vascular specialist. He mainly removes tumors from the skull base ) who is actually in Dr. Paskhover’s office. From the very beginning, they were honest: this surgery may or may not resolve everything but they were willing to try. (They have reported that they are doing 3 per month and nerve monitor) That alone meant everything to me and why Im perusing them.

Dr. Liu and Dr. Mir are the only doctors who truly listened and took me seriously. Dr. Liu, being a neurosurgeon, also believes he can explain the facial spasms and hand numbness and plans to confirm his findings during surgery, which is scheduled for January 30.

Finally, after 7 months of an official diagnosis, 5 years of unexplained symptoms, endless medical bills, missed work, sleepless nights, and overwhelming stress I feel like I can finally see the end of this road.

To anyone still searching for answers: don’t give up. Advocate for yourself. Use this forum. You are not alone and you are not crazy!!

IM very nervous for surgery but will update after its done. Thank you again everyone. .

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@Gaby - Thank you for your passionate post & sincere encouragement to never give up until a plausible answer/diagnosis are received. I’m beyond excited that you FINALLY have a path forward with two doctors who sound like a fantastic team. I will add Dr. Mir’s name to our Doctors List in tandem w/ Dr. Liu since they operate together.

I’ve put your surgery date on my calendar so I can pray for you then especially. I truly look forward to hearing what Dr. Liu says about your facial spasms & hand numbness once he gets an “inside look” at things.

:hugs:

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Well done you for not giving up, for advocating for yourself and for pushing to get treatment! And I’m glad that you’ve found the site helpful :smiley:
I’ll pray for a successful surgery for you, and that this turns your life around! :hugs: :folded_hands:

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Thank you for posting this! I’m in the diagnostic process now; it’s been about a year since symptom onset, 10 months since it’s been moderate/severe. I too, have been shoved in the “it’s just anxiety” box. I know so many of us have similar stories but it’s so validating to hear while I’m still trying to get proper diagnosis and treatment. I’m so glad you found some doctors who listened and I hope you get significant symptom relief from your surgery!

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Hope your surgery goes super smooth and that you find relief from your symptoms quickly!

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can i ask which dr. liu youre seeing specifically?

Here are the doctors who did @Gaby’s surgery yesterday:

•Dr. James K. Liu, 200 S. Orange Ave, Ste. 265, Livingston NJ, https://www.neurosurgeonsofnewjersey.com/james-k-liu/ - Dr. Liu reportedly does styloidectomies w/ IJV decompression/C1 shaving if necessary. He’s done 11 of these procedures. None of our members have seen him yet (as of 10/20/25) so we don’t know how the outcomes have been.
•Dr. Raema Mir - operated together w/ Dr. Liu - https://doctors.virtua.org/provider/raema-mir/2136751

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How are you doing Gaby, let us know how you are when you’re up to it, thinking of you :hugs: :folded_hands:

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Hello Everyone.

so sorry in the delays in response. I’m moving at half speed.

to clarify my surgery was preformed by Dr James Liu of neurosurgeons of NJ. (Livingston office) alongside Dr. Ghayoour Mir Ghayoour Sattar Mir DO | Otolaryngology/Ear-Nose-Throat | Newark NJ (Rutgers school of Otolaryngology) office Livingston or Newark at University Hospital.

Aside from the 2 surgeons there was a vascular neurologists monitoring me the whole time and a specific vascular anesthesiologist. They handled me very carefully as I explained laying in certain positioned will make me feel choked and they weren’t sure if it was a sensation or if I truly couldn’t breathe they also expressed since I’m so petite they have to be very careful with the medicine they give me for reference I’m 5’1 118lbs
I had 5 IVs during the whole surgery 1 in each elbow crevice, 1 in each forearm and one in my SHIN! Apparently my feet swelled so bad they couldn’t put it there as planned

Some background- after seeing many ENT and Dr Pashkover who is even in the same office as Dr Mir. No Dr was really interested in picking up my case until I spoke with Dr Liu. He was the only neurosurgeon that made the connection of what was happening with my eye ticks and spasms. I’m glad I went with his route, instead of going with the ENT as a primary in my case specifically. Dr Liu used to work in conjunction with the public practice of Rutgers who Dr Mir is affiliated with, but switched to private practice yet still works with Dr Mir

Instantly upon waking up my eye felt “free” and there was nothing in my throat. Day 3 I can swallow again much easier but in swell hell and lots of pain. Clearly the surgery was a major success.

I will update on a major post within the next few days when I’m feeling up to it. Thank you again everyone. This group has been my rock- and without you and the admins I’d still be suffering and depressed. I’ve documented my whole journey via Instagram. Not sure if it’s allowed but if anyone’s interested let me know.

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Thank you for this post op update, @Gaby. It’s great news that you’re already feeling some better (in spite of the swelling at the moment). By week 2 the swelling will start subsiding though it can take a month or more for it to go completely away. Healing occurs by baby steps but those add up to leaps & bounds eventually!

I look forward to reading future updates. I’m so glad you found this amazing team to do your surgery. They are now on our Doctors List.

:hugs:

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Good that they took good care of you, that you’ve seen some improvements already! I hope you have more symptoms resolve soon, take care & best wishes :hugs: :folded_hands:

My final recovery update:

Sorry guys for the long time to write an update. My fatigue is on a whole other level. Today marks 3 weeks post op. Let’s start with this surgery has CHANGED MY LIFE.

I was very depressed prior to this surgery. So weak, weighing just a mere 118 pounds after losing more than 100 pounds from severe dysphagia. During the end I couldn’t even swallow a pill. I had a constant lump in my throat. My eyes were gaunt, permanent headaches migraines, tinnitus and an eye tic. I also had vertigo, dizziness, synapse when you get a sudden faint, and other things I did not know were related such as low blood pressure. It was in the low 80s.

After many doctors and rejections from no one believing me or knowing what Eagle syndrome was or not believing I could have it with only 3.8 cm, I found the most incredible Dr. James Liu. Him and his counterpart Dr. Ghayoour Mir stated that we are going for this because I had exhausted all other options.

I was very very nervous and maybe it was just my own personal demons from previous doctors gaslighting me. But I felt if I kept going that way very soon I would end up with a feeding tube and already way more malnourished than I was. Not to mention my days consisted of being in agony.

Seconds from waking up after the surgery I instantly felt that lump was gone. I was in a lot of pain and overall I just felt like I got run over by a bulldozer. I stayed 1 night in the hospital and they wanted me to stay 2 but I really wanted a peaceful night sleep. The first two days I could not walk or even shower by myself. I think this is because I had no strength even before the surgery. I stayed on Tylenol and Oxy rotating for about a whole week but by day 8 or 9 I only needed 1 or 2.

However by day 8 or 9 I was in swell hell. My whole face ballooned up and I had no neck. It was very very very painful and I couldn’t even turn my head! By day 12 to 14 I started feeling normal and that’s when I went to the doctor for a follow up. Unfortunately Dr. Liu was called to emergency surgery but his amazing PA walked me through everything.

They went through the front approach. So my scar is smack dab in the middle of my neck. When they did this apparently the whole chain of lymph nodes was severely abnormal so they had to remove them. They said it was so badly inflamed they sent it in because at first glance it looked like lymphoma. They removed the styloid and the ligament and shaved it down to my skull. In the biopsy they found a separate tissue( they kept saying the ligament was “so wide”) turns out that attached to the ligament there was just extra tissue that they’re identifying as a growth /tumor but it’s benign anyway. So they said since there was more in my neck than they thought from imaging this is potentially contributing to my long heal time.

But the main take away is I am swallowing so well my dysphagia is like a figment of my imagination. It’s like a dream. It’s like it almost never happened.

I can swallow anything. I ate a lamb chop the other day. I was floating to heaven with every bite.

My eye tic is still there if I lift something heavy but it doesn’t fully spazz out like before.

Instantly my BP was fixed.

So it turns out there was no true compression. However the styloid was just pressing on nerves 7 to 12 and the hypoglossal and vagus nerve were the ones mainly affected which makes total sense why I was choking so bad. But they feel this odd growth and the lymph nodes were additionally contributing.

I have now amassed a medium sized group that has found me through IG/FB has reached out to him. ( I always give credit to this group and refer them to here as well) His Pa was laughing because I was saying Eagle syndrome is not as rare as the textbook seemed. And she laughed and said no it definitely is you have just enmeshed yourself so deeply in it and found your community!

I’m so so so beyond grateful for the knowledge and support this group provides. Because of your wonderful resources my eagle is free :eagle:

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:heart_eyes: @Gaby - Thank you so much for this incredible update! It made me tear up! I love your last sentence especially!! I’m so glad you’ve been able to let others know about Drs. Liu & Mir. I added them to our Doctors List & have referred a couple of our members to them as well.

It’s wonderful to hear how well your recovery is progressing. I’m sorry for the BIG set back at days 8-9 but am so glad that only lasted a few days, & you were soon back to healing more normally. I’m also glad for how thorough it sounds like Dr. Liu & Dr. Mir were in cleaning up the mess inside your neck & getting rid of your styloid & calcified s-h ligament. I’m sorry I’ve forgotten if your surgery was on one side or both. It sounds like it was just one.

I noticed recovery milestones after my first ES surgery i.e. I noticed significant symptoms disappear at ~2 months, ~4 months, ~6 months, ~9 months & ~12+ months. Some symptoms slipped away so silently, I didn’t notice they were gone till they’d been gone for a while. I hope now that you can swallow again, you’ll be able to put some weight back on. I’m sure your body is happy now that it’s receiving the calories you need which will also help with your recovery. Your eye tic will likely heal further as time passes & will hopefully go away completely.

Please check in with us again as often as you feel like giving us an update. We’d love to hear from you!

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Brilliant news! I’m so pleased that you can eat better now & hopefully can eat more & get stronger… Maybe the fatigue is a reaction to having been so malnourished before? We have heard quite a few members who’ve had enlarged lymph nodes, we’ve presumed it’s from the inflammation the styloids cause but don’t know for sure… And agree with you that ES isn’t as rare as is thought, just misdiagnosed!
Sending you hugs and hoping that you keep seeing improvements with your fatigue especially :hugs: :folded_hands: :bouquet:

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Well done you! Thanks for the update and sending you good thoughts for continued healing.

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Thank you so much for sharing this Gaby. I cried reading this because it has given me so much hope. My worst symptom is my swallowing issues as well and your symptom list is nearly identical to mine. Hope your whole recovery continues to just get better and better, :pink_heart:

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