Consult approaching

General
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My consult with Dr Omlie is quickly approaching (10/14). I’m hopeful yet a bit scared that he’ll tell me the styloids aren’t the issue…or some other reply that I’ve probably already heard. My mind is reeling with all the pessimistic “what ifs”

I’ve spent some time playing with the 3D software and was really able to see things clearer. I’ve attempted to get some sort of idea of length and though I’m no radiologist, it seems to me that indeed my left side is longer than the right…opposite of what the radiologist reported.

I’ll attach as a reference for others who find themselves here and I would welcome any personal feedback or observations from those who’ve got a more experienced eye.

I’d also welcome any feedback on my (lengthily) list of questions for Dr Omlie.

Last, I’ve come to notice that over the last couple weeks Ive refrained from holding my neck and/or applying any light pressure to the area. I’ve done this just out of natural tendencies…”it hurts so hold it”. Since doing so, the pain has settled a bit. Therefore, it feels like the inflammation isn’t as angry. Also the nerve pain has calmed a bit and the Gaba is working better this time. Weird to me that holding the area would make it so angry.

Thank you to any feedback you all are able to provide :pray:t3:

Questions for consultation:

Comfort level that this is what is causing all the pain

Process of surgery/incision size/overnight stay

What is done to monitor & protect nerves

How much of Styloid is removed?

Is any left to protect nerves per which Styloid is originally designed to do?

Calcified Ligaments? Can this be seen on imaging? Will it be removed if calcified?

How common is it to remove less than anticipated?

Can I have someone wait during surgery and present during post op review?

Recovery/release?

Percentage of patients with irreversible damage

Typical temporary nerve damage

Burning tongue? What nerve does this come from?

Success rate/how many have been performed

If I were a family member, what advice or guidance would you give me

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I’ve got to say, your questions for Dr. Omlie are very thoughtful. Usually patients go in w/ a laundry list of symptoms which often puts the doctor off. I think you have great questions. The nerve most likely causing your tongue to burn is the glossopharygeal nerve, but it will be interesting to hear what Dr. Omlie says. Having your styloids removed should help that symptom to go away.

Both of your styloids look long to me & curved downward. The curve alone, even w/o elongation could cause them to run into & irritate nerves/vascular tissues. This is an argument you can make should Dr. Omlie not accept that your styloids are involved in your symptoms (which I very much doubt will happen!).

Remember that the measurements you get from a CT scan are usually less than the real story. Since CT scans are done in slices, the small gaps between each slice need to be taken into acct when measuring. Most radiologists don’t do that, & I suspect you didn’t know to do it either. It’s very common for a person to come out of ES surgery & learn that the styloid(s) removed was/were longer than expected. Our scanning technology, though reasonably advanced, is not perfect. Also, it does not look to me like you have any additional stylohyoid ligament calcification, but it’s best to ask a doctor as I am not one.

I’m glad your appointment is coming up soon!

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@Isaiah_40_31 - Thank you kindly for taking a peek and my post and replying. Im sure you find yourself repeating a lot of information from folks like me who sit in this gray area. However, it’s comforting when those with so much experience and involvement share what they know or have learned from others. I hope in the end that my questions/posts/experience can help someone else down the road as well :blush:

I’ll report soon as to how my consult goes!

Have a lovely week!

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I agree with all Isaiah has said! The styloids are pretty angled as well as a little longer than the norm, so could easily be causing symptoms… Very good questions, we might have to pinch some of them when we give out advice, you’ve thought of a couple I wouldn’t have done! I’d just say though that some surgeons remove the whole styloid without leaving a stub, so leaving in to protect nerves isn’t necessary from our experience, so don’t let that sway you. Sometimes regrowth can be more likely if a bit is left in.
If the burning tongue is really annoying, a solution of bicarbonate of soda swilled round & spat out can help.
Hope your appt. goes well!

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@Jules many thanks for the additional feedback and input. It’s all so very valuable to me! :pray:t3::blush:

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My only other suggestions would be to ask her:

  1. What do you prescribe for post-op pain? ie: what drugs, how many, refills if needed?
  2. Do you prescribe prednisone for swelling after surgery?
  3. Do you take the styloid off at the skull base?
  4. Having someone there before and after surgery will depend on the facility COVID rules. Post op review should be fine. I do suggest the doctor speak to your driver/caregiver right after surgery (in person or by phone - you can request this) and get details of how it went while it is fresh in the doctors mind. This is especially helpful when they have several patients they are doing surgeries on that day. Get the info while it is fresh. I have found that the anesthesia just impacts my memory of even speaking to the doctor when in recovery and I miss out on all the details.

hope that helps. Good luck at your consultation.

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Ooh!! YES! Prednisone for swelling is definitely a question I overlooked! And excellent point on having the surgeon speak directly to my husband! Knew I was overlooking some key points. THANK YOU!

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Great, glad it helped. I found that prednisone to be a key and works like majic! Some docs have different opinions about their use after surgery. Personally, I think it is better to be proactive and prevent major swelling rather that take a wait and see approach. Stay ahead of the pain and the swelling. I was down to one painkiller a day after 3 days!

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Hi I’m so glad to here about your story and your upcoming appointment with DR.Omlie. I do also have an upcoming appointment with him In May. I have tried numerus medications and therapy’s with no help. I appreciate you sharing your Questions for your Doctor visit. They are very thorough and good questions to ask. I was just trying to come up with all the questions to ask. How did you get your images? Were they done a CD and you received a copy ? Thanks much for sharing your information and questions. Hope your Appt. goes well and you will get the care you need to get this resolved.

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Hi Daryl, I had this initial consult Oct ‘21. It’s been a painfully long wait due to Covid & staffing issues but I finally have surgery with Dr. Omlie this upcoming Wednesday (I’m getting nervous but very hopeful).

The CT I obtained on disk from my doctors office and was converted to 3D via one of the free download suggestions on this forum (search 3D conversion). It took some playing with it to figure it out but it wasn’t too hard.

I’ve only had the one visit with Dr. Omlie but I felt good about him and having sought out others experience with him on this forum has helped me a great deal.

I’m happy to help answer any questions for you that I can. Until then, best of luck with your upcoming appt with him!

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Thank you for your response and information. I wish you the best on your surgery this coming Wednesday. Please keep us updated about your progress. It is very helpful to be in contact with people that have met Dr.Omlie and have some experience and surgery by him. I will work on getting that CD copy from the office. Thanks again. Daryl

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