Dr. Hackman Surgery 2/28/22 + Full Story

The Beginning:
In the June of 2021, I started to suffer from GI issues along with dermatology problems and went through a barrage of medical testing & treatment without much avail. This included my PCP, functional medicine, GI specialist, and chiropractor. Towards the end of summer, after a lot of dietary & lifestyle changes, my dermatological symptoms started to subside, but the GI issues remained. I was hopeful that I was moving in the right direction.

In October 2021 (after a bout with COVID-19 in September), I developed insomnia, visual snow, light sensitivity, and intense anxiety, literally overnight. My initial thought was that it was from COVID & would be temporary, but as the weeks went by and the symptoms remained, I started to look into other possibilities. As November rolled around, unilateral tinnitus was the next symptom to arise, shortly followed by ear pressure & Eustachian Tube issues. In December, blurry vision, migraines, and head pressure began. After multiple visits to the optometrist, my PCP, a colonoscopy, a ton of lab work, and multiple visits to local ENT’s, I was told there were no definitive explanations for my symptoms other than I might have TMJ Disorder.

Diagnosis:
I finally went to Caring Medical Florida to see Dr. Hauser in December 2021 because I suspected cervical instability as a factor after a slew of internet research (I was a multi-sport athlete, have a history of high-velocity chiropractic work, and I work in a fast-paced job that required a lot of “hunch over” time on a laptop & cell phone phone). After my testing in his office, he discovered that I had a completely occluded jugular vein when sitting upright & that it was still compressed while lying down. He ordered & CT with 3D reconstruction & venogram, which confirmed his suspicion of elongated styloids (4.1 and 3.7), and jugular vein compression (we also suspected nerve compression because my vagus nerve tone was significantly low). The right side was completely calcified & left was not (though that was the side that had way more compression). I also have been diagnosed with craniocervical instability in several cervical spine ligaments, which may or may not also play a role in my symptoms, so only time will tell. Dr. Hauser seemed to believe the cervical instability & eagles syndrome onset are related (one often exacerbates the other). Further, as I lost muscle mass in 2021 (over 25 lbs of muscle due to being sidelined from the gym for over 6 months), my neck and shoulder muscles weakening, along with ES & instability may have also led to my onset of symptoms.

Finding a Surgeon:
I was referred to Dr. Osborne in LA and he agreed to do my surgery, but due to not accepting insurance, and it being such a long way to travel (I live in Ohio) with a myriad of medical issues, including Eustachian tube dysfunction which made flying undesirable, I consulted Dr. Hackman at UNC in January 2022 after coming across this site (Dr. Cognetti could not get me in for consultation until late spring/early summer). In the consult, he seemed supremely confident in his ability to perform the procedure, and his track record is quite good. I opted to schedule my surgery with him. My bilateral styloidectomy surgery was performed on Monday 2/28.

Post-Op:
The first 2 nights were quite rough. I was scheduled to stay one night in the hospital, but ended up staying two. My post op issues include: lots of swelling & pain which was expected, both ear canals were numb, including my left ear lobe, lots of facial numbness, my jaw could hardly open, issues opening and closing my right eyelid, and new onset tinnitus in my left ear (previously unilateral in right ear). I also had some reactions to the anesthesia (known as SUCK), which included burning eyes, nausea, and anxiety/panic.

After the first 5 days, the nausea & burning eyes subsided & the jaw is getting better slowly. I also started to notice my tongue seemed a bit “loose” on the floor of my mouth and feels uncoordinated. I initially attributed this to the removal of the styloid process & peeling of styloglossus muscle during the surgery, but wasn’t sure. If anyone has any insight into what happens to the styloglossus muscle (does it still function or not), I would greatly appreciate a comment!

On day 7, I started to have a clicking/popping and pain with swallowing (saliva, liquids, food) in my jaw & some pain/tension in my neck.

My 1-week surgery follow-up was on 2/8 (8 days post-op) and Dr. Hackman seemed confident that the ear lobe & ear canal numbness would subside in time, as well as the newly onset tinnitus (I still have a lot of inflammation & some fluid), other facial numbness, pain & clicking in throat, jaw mobility, as well as my issues with my tongue (which he believes is due to post op inflammation & muscle irritation, but still unclear as to styloglossus after follow up) would all resolve in time.

Today is day 9 post-op and my post-op symptoms are still pretty intense, I also MAY be experiencing the beginning of “first bite” but I am not 100% sure. Definitely having pain in the jaw when I begin to chew (hoping it’s just post-op soreness). But I am hopeful for a full recovery from the surgery, as it sounds like most of Dr. Hackman’s patients do!

As far as my initial ES symptoms go (GI issues, insomnia, visual snow, anxiety/restlessness, ear pressure, tinnitus, light sensitivity) I have not had any resolution yet (admittedly was hoping for a magical “YES!” moment when I awoke from surgery), though I have had a few decent nights of sleep (5-6 hours which is a lot compared to what I’ve been getting lately, though a far cry from my normal 8-9) post-op, which gives me some hope! I also plan to start treatment for my cervical instability this year, so I am trying to keep that in mind as well.

I plan to continue to update my recovery, and look forward to hearing from members! Hope this helps!

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Pleaseeee keep me updated. I’m going to Hackman on the 31st. This will be my 3rd surgery. I also have had tinnitus and visual snow.

It seems Hackman is willing to dig in deep where a lot of doctors aren’t which obviously comes at the expense of the nerve, but sounds like that always heals.

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Hi Dobbs,

Thank you for sharing your whole story! I’m sorry for the early troubles you had from the anesthesia but glad you’ve recovered from those.

You are still VERY EARLY in your post op recovery. It can take several weeks to some months for symptoms to really begin disappearing. I agree w/ Dr. Hackman that your new post op symptoms are likely due to nerve irritation from the post op swelling. I actually had half my tongue paralyzed after my first ES surgery because my glossopharyngeal nerve was irritated during surgery. It took about 9 months to fully recover, but by 6 mos it had improved significantly. I would suspect your glossopharyngeal or hypoglossal nerve is the culprit for your tongue issues rather than your styloglossus muscle. A post op sore jaw & pain w/ chewing (& swallowing) are very common & can also last from several days to several weeks.

The post op swelling serves a purpose: it puts a fluid “cushion” around the injured area to help protect it while it heals. Unfortunately, that fluid cushion also applies pressure to the healing tissues which can be irritating & can cause new symptoms for a bit. Sounds like that may be what you’re experiencing.

I hope you don’t have First Bite Syndrome, but if you do, it usually goes away w/in a month or two. I had that but sadly mine stuck w/ me. Just got much less intense as the years have passed. Now that I’m writing this, I just realized I haven’t had it at all for awhile. I’m 7 years post op from my first surgery. That tells me that nerves do keep healing well beyond the predicted 1 yr mark.

Though Dr. Hauser helped you with your ES diagnosis, I recommend you do a Google search of reviews about him & his medical approach. Though he may have helped some people, others have not fared so well. I would hate for you to recover from one thing & end up the worst for wear from another. There are other approaches to helping CCI than prolotherapy. This is to say, do your homework before jumping into an approach that is considered alternative therapy.

Here’s a link to a current thread w/ a discussion about prolotherapy/Dr. Hauser:

I really hope the all of the new symptoms are temporary, and that the ES will subside in time. I started to have left upper and lower eyelid twitches & spasms in the last 12-15 hours (hopefully that’s part of the same temporary group).

For the CCI, I am actually working with an Upper Cervical Specialist & consulting another Physician in Boulder, CO who has a much different approach than the Prolotherapy, if still needed later in the year. I have had many upper cervical specialists recommend Regenexx, as they have a much different approach tk regenerative treatment.

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Will do! So far, it sounds like all of my new surgical symptoms are to be somewhat expected and should subside in time. Still hoping for a full recovery!

Glad that you’ve been able to get surgery, and hope that things do settle down for you soon. Dr Hackman is very unusual in that he does both sides at once, which many doctors don’t like to do- so bear in mind that you will be experiencing more pain and swelling than members who’ve just had the one side done, it’s likely to be tougher. (This isn’t a criticism of his approach, we’ve seen quite a few members who’ve had bilateral surgery with him & have had really good results, just want you to be aware that your recovery might be a bit rougher!)
Thinking of you :pray: for a good recovery!

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Thank you! Definitely a lot to go through all at once, but hoping it eventually allows for a more expedited and full recovery!

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Day 10 Post-Op Updates:

My jaw is continuing to improve in its mobility, and I’m finding it a bit easier to eat (though still almost all soft foods), as well as get around today. My pain level is much better today, just working ice and anti-inflammatories for swelling. I am continuing to sleep upright, and will continue to do so until the noticeable swelling is gone.

I have had some new issues arise: I am experiencing some tingling and tension in the area between my ear and temple, and some of that is radiating to my left eye, which is quite the bizarre sensation. I’m having some shooters into the left upper and lower eyelid as well, accompanied with some conjunctiva issues (no present infection but a discharge is present), tearing, and additional light sensitivity.

I’m considering that it may be trigeminal nerve irritation from the swelling (root of the nerve sits just above the upper third of the ear and innervates much of the face, eyelids, and even plays some role with eye function). I’m hoping that it’s short-lived since it didn’t start until the end of day 9 after surgery and only begun once my jaw mobility started to get better. Has anyone else had any experience with this?? Would love to hear someone who has fully recovered from eyelid/eye-related issues post-op.

I did have my first bit of surgical glue come off today, and the scar looks surprisingly well for only 10 days post-op. I have attached a photo for reference.

I will keep everyone posted on updates & process!

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WOW! Your incision is barely visible! No neck incision? I completely agree that the symptoms you described are trigeminal nerve. It gets irritated by ES & can also be annoyed by surgery or post op swelling. I expect you’ll notice those symptoms come & go for several weeks but they will ultimately go.

Here’s a link to a thread w/ eyelid paralysis discussion in it. You can find more by clicking on the magnifying glass icon search tool & typing eyelid paralysis into the search window.

I did have neck incisions as well, those just still have the glue so I can’t see how well they’re coming along yet! I’ll post some more photos when it does.

Sounds like the jaw may take some time as well, definitely a test of patience for sure!

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Tingling, itching & other weird sensations in the nerves can be a part of healing, so hopefully that’s what’s happening with you. I had (& still occasionally get) a sort of whoosh around my ear if anything made me jump!
it is a test of patience as you say, but at least you won’t have to go through it again!

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Day 11 Update:

Best day yet as far as eating goes, still mostly soft foods, but becoming more tolerable. Tingling in the eyelid & surrounding areas is a bit better today, which is positive.

I am quite pleased with the scar progress on the right ear & neck; Dr. Hackman said I could remove the glue after a week but I waited until day 11 to make sure since I was traveling such a long way.

On the left side, I unfortunately have a few issues: my left ear was closed crooked (left and right matched well, but front to back is off) and it’s tugging at my skin which is quite uncomfortable, and the incision on my left neck seems to have a bit of a separation. I am going to reach out to the office to see if there is anything that can be done.


At the end of the day, if my ES symptoms resolve, it will be more than worth it, I can always have a cosmetic revision done, or see if they would be willing to correct the surgery. Trying to keep focusing on the positive!

Missed one of the photos! Left side neck incision:

Hi Dobbs,

I see what you’re saying about your ears, but it’s barely noticeable to me, & because they’re on the opposite side of your head & not side by side, I bet no one other than you will ever notice the difference. I do concede the tugging feeling would be annoying, but even that might resolve w/ time & gentle massage using a little vitamin E or BioOil.

I had nerve damage to my mastoid muscle during my first surgery which has caused it to lose muscle mass. My face is no longer symmetrical i.e. the mastoid on the left is larger than on the right. I was sensitive to my appearance for awhile, but realized other people don’t notice it. Since my ES symptoms are gone, I count that little inconvenience a good reminder of how far I’ve come. You may get to a point where you’re able to let it go & just get back to living your life.

I’m so glad your jaw & eye are better today. Noting positive changes certainly helps w/ optimism about healing!!

:blush:

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Hi Dobbs,

Can I ask you who the specialists you are seeing in Colorado? I believe I am headed in the same direction as you and would love to know if anything has helped so far. Please feel free to PM me if you would rather. Thank you so much for your help! :slight_smile:

Eagle,

I see an Upper Cervical specialist in Ohio, and he is referring me to Centeno/Schultz in CO once I heal from ES. My plan is to give the ES surgery at least 3-6 months to heal after my surgery and then start to dig into the CCI issues after depending on symptoms, etc. I definitely don’t want to be adding any new inflammation to my neck anytime soon :joy:. I have included their link below. Centeno is known for creating Regenexx, which is a specific way of delivering Prolo, PRP, or Stem Cells in a way that maximizes each session. I would encourage you to look into YouTube, Regenexx & Centeno have a lot of content that’s CCI specific, as it’s one of the core issues they treat. I really like that EVERY injection is image guided and it seems like a much more precision approach.

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Thank you so much for the info! I will definitely be looking into it!! Please keep me posted on how you do with it once you get started! :slightly_smiling_face:

Have you had any testing done yet to determine if you have CCI?

Hi Dobbs - I am also a patient of Dr. Hackman’s (surgery July 2021) and had numb ears, eyelid nerve palsy, and uneven ear issues. He did not do neck incisions, but I did have a hole in the incision by one ear that caused me to freak a bit and send a photo in to Dr. Hackman’s assistant. It all healed up pretty well. Got crazy zaps as nerves started coming back and I am still having issues with vision changes and Eustachian tubes not clearing completely. About 40 days post op, I had lymphatic drainage facial massage around my ears and jawline, which helped significantly with incision tightnesses and lumpiness. This has given me a good excuse to have a monthly facial and massage😊. I have noticed a return of mild tinnitus - I had it about 20 years ago and it went away when I stopped taking aspirin, but returned with surgery. I have to remind myself daily that my long styloids wreaked havoc for 16 years before they were removed, and it will take time for everything to start working again. Patience is the key. Your incisions look fantastic!

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Forgot about the clogging of the lacrymal drains - I have that - seems like conjunctivitis but I think it relates to nerve damage affecting the drain function. I had discharge from both for several months, now just the left intermittently.

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Catmd,

I am also experiencing issues with my Eustachian tubes not clearing. They were actually fine for the most part until the surgical glue came off, and now they don’t want to clear well, even if I yawn, swallow, etc. It’s quite maddening, and I travel quite a bit for work via air travel, so I am hoping that it’s temporary. Are you able to fly with your ears not clearing well? I fear my ear being uneven is why the Eustachian Tube problems are existing, as the body is such a precise instrument. Did you have these issue since the first day after surgery or did it seem to start later? My eye issues started 8-9 days post-op and my ear issues started on day 10-11 post op.

Thanks!

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