Hi . I know that every one has different criteria as on how to decide for a dr to perform surgery but was just curious to know if anyone on the forum that has seen both Dr Costantino and Dr Hepworth decided to proceed w Costantino for a different reason than waiting times or insurance ?
Thank you very much
We have had some discussions about members’ experiences of both doctors before, here’s a link to one discussion:
Inquiring patients of Dr. Hepworth and Dr. Costantino for their surgical and patient experiences - General - Living with Eagle
Hopefully others with experience of the doctors will comment too!
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For me personally, I chose Dr. Nakaji over Dr. Costantino for a couple of reasons. 1. He is part of the group of doctors who are really trying to understand venous hypertension/venous outflow congestion. They are trying to sort out what the mechanisms that underlie the symptomology are and how to best treat. They are collectively working to develop ‘best practices’ for treating us and they are sharing information about what they are finding and continually updating their surgical approaches based on that data. He is really trying to understand the problem. 2. Dr. Costantino, who seems to be an amazing surgeon, is not part of this group. He has developed his own surgical plan that he applies versus making decisions about what to remove once he’s in the field. There is no outcome data so it is impossible to compare. I just felt more comfortable with Dr. Nakaji’s approach who left behind several things Dr. Costantino would have taken out because, while in the surgical field, didn’t find those things to be problematic. I was considering Dr. Hepworth as well, he is also part of the group of doctors trying to understand the problem, but the wait was just too long.
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I saw both. I have not had surgery yet. I have been getting other imaging and consultations done prior to surgery to rule everything out. If you can wait for Hepworth, I would. He is worth the wait. He is much more analytical in his thinking and found things Costantino did not. I, personally, did not think Costantino was very thorough.
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How did your surgery go? Was there anything Nakaji took out or did unplanned once he was inside
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The surgical plan based on imaging and IR angiogram was to remove the left styloid and resect C1. He tested movement of my neck in relation to IJV and found it was completely free without having to resect anything else. He is aware of all of the other potential culprits that could restrict IJV from his own experience plus the experience of all the doctors in the venous congestion group who have shared what they have encountered. Once in the surgical field he was able to see the the original surgical plan was enough. Hope that helps.
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Thank you for answering!
I have consulted with Constantino, Cognetti and am waiting for Nakaji!
I am in Canada…
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I made the same rounds. Good luck!
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@Carrie68
Hi!
Do you mind me asking how much was your consult with constantino and cognitti and how much did they quote you for surgery?
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I think the consults were about $350. No quote for the surgery as the plan would have been to get insurance authorization.
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Hi! Cognetti didn’t charge! I believe I only paid $100 US for Constantino!
Waiting for quotes as hoping for OOC assistance
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@Chrickychricky was the testing of your IJV done intra-op or pre-op?
He took my neck through a range of motion while I was on the table to make sure the IJV was free. He plans to do follow-up imaging if needed.
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