Had my first consult with Dr. Ramirez in Warren, MI late last week. For the first time since I started this crazy ride in 2014 with a carotid artery dissection, I felt like I was speaking to an experienced expert in my area. While Dr. Fessler is clearly super sharp, he’s an endovascular neurosurgeon. Different skill set. I’m happy to have them both in my court now.
Dr. Ramirez clearly knows this syndrome, its symptoms, and its treatment. His experience and confidence was really comforting. And I have this group to thank for finding him!
My appointment yielded more questions than answers, but we at least have a path to explore. Dr. Ramirez seemed suspect that my styloids actually caused the dissections. I got fresh CT images, but they didn’t do the requested 3D models, so he and his team were going to tackle those. He also planned to confer with Dr. Fessler about his rationale for placing stents to better understand his goals.
Dr. Ramirez felt my styloids were longer than normal, but that they weren’t excessive. But, he felt that many of my symptoms were indicative. He is concerned that due to the dissections, I may have a lot of scarring in the area, which could complicate surgery. However he pointed out that I’m the youngest I’ll ever be, so if it needs to be taken care of, better to do it now than in a decade.
So, one step in a journey. But it felt like positive progress. If you’re in Michigan, I highly recommend a consultation with Dr. Ramirez. Also, his office staff are first-rate!
Thanks for the update Chromechaser! Very pleased that you’ve found a doctor who’s willing to help & who you feel confident with, & hope that it doesn’t take too long until you can get surgery if you feel that’s the right path…
I’m so glad you had a good & productive appointment, Chromechaser! Stents should be a last resort after ES surgery & only if having the styloids removed doesn’t allow the compressed vascular tissues to re-open. Stents are irreversible & some people have regretted getting them as they didn’t end up helping & ultimately may have caused worse problems. They do sound good in theory though.
I like how Dr. Ramirez thinks regarding you being the youngest you’ll ever be, etc. I recently made an I’m healthy & fit argument (didn’t think about the age argument ) to an orthopedic surgeon I’m seeing for bilateral hip surgery. He agreed to do the surgery, at least partially based on my comment. Getting your ES taken care of sooner than later will most likely allow you to enjoy the years ahead of you at a significantly greater level.
I recently made an I’m healthy & fit argument (didn’t think about the age argument 
) to an orthopedic surgeon I’m seeing for bilateral hip surgery. He agreed to do the surgery, at least partially based on my comment. Getting your ES taken care of sooner than later will most likely allow you to enjoy the years ahead of you at a significantly greater level. 
