Dr. Hepworth Surgery Yesterday - Post op Report Today

General
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First I want to thank all of you for your prayers, healing wishes, & for thinking of me during my surgery yesterday.

I know many of you have been following my IJV compression story. My surgery with Dr. Hepworth yesterday (10/30/24) went extremely well. I’m feeling much better than I expected this morning probably due to Percocet, ice, & a course of dexamethasone (steroid).

Dr. Hepworth gives the time he needs to do the best possible surgery for each patient he sees so he often runs behind which means a bit of a wait if you aren’t first on his surgical schedule for the day. My surgery was scheduled at 1 pm, & I think it didn’t start till closer to 4:15 pm. I didn’t mind the wait because I knew when it was my turn he’d give me the time I needed.

Prior to surgery, Dr. Hepworth came in to have me sign a couple of documents giving him permission to resect part of my thyroid if necessary & to apply sheep intestinal tissue to my IJV to protect it from further risk of compression. He didn’t need to touch my thyroid, & I don’t know if I’ll bleat occasionally now because I’m part sheep :sheep: :joy:, but will find out at my post-op appt.

My surgery must have been very straight forward as it only took an hour. Dr. Hepworth told my husband that he further shortened my styloid, moved my IJV away from C1 & removed some lymph nodes that were contributing to the IJV compression & my IJV opened right up. I am thankful that I didn’t need a C1 shave & my thyroid wasn’t part of the problem.

I awoke feeling like I had a humongous earplug in my left ear, the same level of tinnitus I went into surgery with, a horrifically sore throat on the left side (from the breathing tube), a slightly stiff jaw & the usual neck pain one gets after having the neck sliced open, plus some facial numbness on the left. The earplug sensation is gone this morning, no change in hearing yet, & the “fun” is just beginning w/ post op swelling. Gotta love ice!!

Having been through styloid resection surgery twice before, I know that healing is a game of patience. In 4-6 mos if I experience no hearing restoration, I will assume that the damage to my ear nerves was substantial enough they can’t recover, but I will have no regrets for having the surgery. Nothing ventured nothing gained.

For those who don’t know my story, I had this surgery due to hearing loss in my left ear which began after a cycling accident w/ head injury 9.5 years ago between my two styloidectomy surgeries for bilateral ES (not done by Dr. Hepworth). Three years ago I learned that what had been diagnosed as Meniere’s Disease, which is idiopathic, could actually be caused by IJV compression. After several scans & some help from our forum members, I learned I had bilateral IJV compression, but only the left side was seriously symptomatic. I chose Dr. Hepworth to do the surgery because of the reputation he’s developed among our members since 2015 when his name first appeared here. Though it can be frustrating to get through to his office, I believe it’s worth the perseverance it takes to do so if you want a consult/surgery with him.

I will update periodically as healing begins.

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So happy to read your detailed update @Isaiah_40_31! Prayers for improvements in your symptoms and a smooth as possible recovery! :pray: :hugs:

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Hi Isaiah,

I was so happy to hear that your surgery went well! I’ve been thinking about you and am really glad to know everything went smoothly. Wishing you a smooth and restful recovery – take all the time you need to heal, and know I’m cheering you on. Looking forward to hearing that you’re back to full strength soon.

Take good care, and get well soon! :hugs::orange_heart:

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Glad to hear things went smoothly. You had just been telling someone about that sheep’s wrap and then you end up getting it as well.

Hopefully you will be up and running soon and educating the rest of us about this awful syndrome!

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Thank you for taking the time to detail your surgery and recovery thus far. Wishing you all the best for a speedy and full recovery! :heart:

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Thank you all for your kind words. I truly am feeling remarkably well today. A little loopy from the Percocet which I knew would be the case. Dying to go outside for a long walk, but I preach don’t overdo it on here so feel obligated to practice what I preach! :joy:

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So pleased it’s done, good you didn’t need a C1 or thyroid shave! If the sheep thing works to stop scar tissue or adhesions then that’s helpful… definitely take it easy & don’t overdo it! :hugs::pray::bouquet:

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Great to hear everything went well! Hopefully you find that it resolves many of your symptoms.

I’m having surgery with Dr Hepworth in a week and a half and I concur that he’s worth the wait. Not only for his experience with performing this surgery, but his knowledge of comorbidities and the fact that I know he’ll stick with me if I continue to have problems after surgery.

Looking forward to hearing updates on your progress over the coming weeks and months.

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Oh man! I had no idea you were gearing up for a procedure, & yet you still took time to help me out! That really speaks volumes so thanks a ton. Best of wishes to you in the coming days & weeks, glad to hear Dr. Hepworth thought he addressed things adequately for you!

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Jrodefeld is excited for the surgery. It leaves me wondering if he is a glass half full type of person. Optimistic. I am glass half empty outlook and i am dreading it and terrified. Pessimistic.

Although, dealing with Eagle Syndrome could turn an optimist into a pessimist pretty quickly with all of the incompetence.

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@Isaiah_40_31 Such great news! I’m so happy for you. Take it easy!!

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I think most of us alternate between the two! It’s natural to be anxious about the surgery, & I guess if you are thinking it’s going to be the magic cure then you could get disappointed as it can be just a step along the journey to getting everything sorted…but most of us get to the point where if it resolves at least some of the symptoms then we’re happy with that! If you can see an experienced doctor then that’s a good thing.

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I am optimistic but I wasn’t always that way. It seems like knowledge has progressed in this field so that outcomes are improving so that is reason to be hopeful.

I’m not worried about the surgery itself. I’ve had more complicated surgeries in the past and have done pretty well with them. Especially with someone as good as Dr Hepworth, I think the only question is whether this will resolve most of my symptoms, nearly all of them, or only some of them?

A lot of the pessimism and anxiety used to come from not understanding where my symptoms were coming from and, like you said, dealing with the incompetence of doctors in trying to figure it out. But now that I better understand how the vagus nerve effects the body, as well as the role of CSF leaks in causing symptoms, I have more confidence that these things are fixable.

I don’t mind if there are additional steps beyond this surgery to getting everything resolved so long as I have someone helping me along that path.

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Great to hear!! He wants to do a thyroid removal with me. Not sure if that will happen. He also wants to do sinus surgery and untangle my vagus nerve. I told him only do a C1 shave if absolutely necessary!! Happy healing!!

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@Brandy - I also let Dr. Hepworth know I’d prefer for my IJV to be moved vs having a C1 shave. In my case the move worked. I’m very thankful for that. I’m also glad to have my thyroid intact. I have two large, calcified nodules one on the left & one on the right. In my imaging it looked like the left one may have been contributing to my IJV compression, but once Dr. Hepworth could see the situation visually, he determined it wasn’t a problem. I recently had the nodules fine needle biopsied so know they’re not cancerous at this time.

I hope it works out that your thyroid can stay put as your recovery will be a bit more challenging with a second incision, but easier to get both things done at once than over two surgeries.

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I like the way you think, @jrodefeld! I went into my surgery optimistically, too. I think it helps that we’ve both been through essentially this surgery before so know what to expect. I recall you’ve been on this forum nearly as long as I have. Our journeys have been somewhat similar though also different. It’s interesting that we both have the same landing point w/ Dr. Hepworth at this time as we work to resolve what remains after our first styloidectomies.

I just checked my calendar & am embarrassed to say I forgot to put your surgery date down. It’s 11/11, correct?

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Agree 1,000%!!! The more of my anatomy to stay intact, the better!! However, he did tell me my thyroid shifted to the left impinging on the jugular vein and crowding the omhyoid muscle. Hopefully, he can move the jugular as well but many unknowns until he opens me up…

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Yes, November 11.

I think the problem I had in my journey with this was that I had styloidectomies with an ENT doctor back around 2011 or 2012 who didn’t have a lot of experience with this. In fact, I may have been his first Eagle Syndrome patient. He did perform the surgeries in consult with Dr Burke at UCLA, who also didn’t have a lot of experience. None of them realized my problem was jugular compression. So none of my symptoms improved after surgery.

I followed up with several doctors who had more experience with Eagle Syndrome after these surgeries, including Dr Samji in San Jose, and they also didn’t see a problem. At the time Dr Samji didn’t believe in vascular Eagle Syndrome, not sure if he’s changed his position on this.

I also was told at the time that doctors considered Styloids shorter than 2.5 cm as “normal”. My first styloidectomy surgeries left my styloids a bit over 2 cm on each side. They are also abnormally thick.

I guess doctors just didn’t know enough about this problem back then?

Regarding Dr Hepworth and a C1 shave, doesn’t he always try to avoid it unless absolutely necessary? I have a pre-op telehealth appointment with Sarah on Tuesday so I’ll be sure to ask her about this.

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Can someone explain to me what these Doctors who dont believe in vascular Eagle Syndrome think they are seeing in our imaging. Are they calling it “mystery compression”?

My neuroradiologist flat out says IJV is severely compressed in a neutral position by my styloid that happens to be extra thick.

So if not Vascular Eagle then what is it in their view? I dont care what you call it but you better recognize the issue. Its a question i am going to put to the neurovascular surgeon who contradicted what the radiologist found before he saw the report. I am P.O.'ed that an expert would claim i have no jugular problem when it can clearly be seen.

Now maybe once i am cut open a Doctor will find a different issue but you just cant ignore what that report says.

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I think I encouraged you to see Dr. Samji way back when as I’d had such a good surgical experience w/ him but didn’t know much about IJV compression & the symptoms it causes back then. I believe he still takes the stand that vascular ES doesn’t exist, but I intend to take my imaging in to show him & ask him to justify his position on this topic. I’ve made a couple of appts w/ him to do that in the past but cancelled them as I didn’t want to appear confrontational so have to get myself in the right mindset where I can present my case as educational information & not as “how could you see this & not acknowledge what it is!?!”

Too many still don’t know enough about this problem, but thanks to Dr. Hepworth & a growing community of doctors he’s helping to educate & train surgically, the knowledge is spreading.

I asked him specifically about this prior to my surgery this week. He said his first course of action is to try moving the IJV, away from C1, but if it’s obvious that C1 is aggressively compressing the IJV, then he shaves it as minimally as possible to make the room the IJV needs to open.

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