Hi BG ~
I definitely had many steps backward during recovery. There were days I felt just like you do now. I jumped back into exercising 2 weeks post op which definitely caused more inflammation & slowed recovery. It was a solid 2 months post op before I started feeling sort of normal again, & it was at 2 months post op I noticed my normal energy level return.
I had bilateral ES & the second side was definitely the one that caused the bulk of my pain & symptoms. The first side removed was doctor’s choice because of its angle. I begged for the longer more painful side to come out first but in the end, his decision was best. I have no doubt that your current struggles may be largely coming from your remaining styloid. It’s uncanny how symptoms from the remaining side can flare & take over once one styloid is removed. Symptoms can even cross-over to the “fixed” side.
Your pain & other issues are likely worse at night because you’ve been up & active (even if just moderately) during the day. Your body reacts w/ inflammation both to gravity & activity. Your brain is still trying to protect your surgical site so it can heal thus it creates that little protective cushion of swelling in that area. Our bodies suffer inflammation on a regular basis as there is nothing we do in a day that doesn’t require some sort of repair, BUT our bodies are made to take care of themselves that way. Unfortunately, w/ any type of inflammation often comes pain, numbness, tingling, etc. These are the warning signs that we need to back off a bit & rest & take care of ourselves. Don’t face your symptoms fearfully but as signs of your body at work repairing on the surgical side & as an alert that something needs to still be dealt w/ on the side w/ the remaining styloid.
No doctor will guarantee results w/ any surgery, but most will offer hope of a cure or at least reduction in symptoms. Dr. Cognetti, from what I’ve heard, is not the most encouraging post op. Instead of counseling patients to be patient & allow some months for healing, he is dismissive of continuing post op issues & proffers that they either aren’t related to ES or that you’re stuck w/ them. I don’t feel this is good professional advice & comes from a place of his lack of understanding of the magnitude of pain & diversity symptoms ES can cause. There is a HUGE body of experience on this forum that shows we each heal at a different pace; that patience w/ the healing process & time must become our best friends post op; and that over the course of 6-12+ months, you will notice your symptoms gradually disappearing. That said, as long as you still have a symptomatic, elongated styloid in place, your symptoms reduction from operation #1 may be minimal.
Dr. C actually told one patient w/ bilateral ES that since her symptoms didn’t resolve after the first surgery, he was reluctant to do a second one. I told her to insist that she wanted the second surgery anyway. She did so & is now about a year post op from both & doing great. As you’ve read here, we often have to be our own advocates, sometimes even w/ experienced ES surgeons. Remember, they’ve never experienced the pain, etc, of ES. They only know the way to produce a “cure”.
The end of my story is this: I had my first ES surgery in 11/14 & the second in 8/15. My major ES symptoms are gone. I did suffer a little permanent nerve damage to my glossopharyngeal nerve (tongue isn’t perfect) & trigeminal nerve (permanent first bite syndrome); I have a little facial numbness along my jawline on the left side. These are problems I willingly & happily live with because they don’t affect my overall ability to function & enjoy my life. I’m very physically active & am so thankful that I’m able to do what I love w/o the debilitating symptoms ES caused. It took me a little over a year after each surgery to feel like my nerves & pain were as completely healed as they would be but by 6-9 months post op, most everything was pretty settled down & feeling better.
I hope this info encourages you, BG. You will get better. The steps backwards always feel 
, but they are usually followed by improvements. Look for the little positive changes each day. There is always something, however small, that is likely to be even a tiny bit better as time progresses.
I am still praying for your healing progress & a good frame of mind.
