Ok, fellow warriors, I have post surgery imaging. I was told flattening of the jugulars is not abnormal based on their shape? Any thoughts? Am I being misinformed??? Thx all!
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Technically as far as Iām aware, the jugular veins do collapse when laying flat & are open more when upright, but if theyāre flattened because of compression then thatās different! And should be easy to compare with your pre-surgery CT report, and with what the āaverageā is? The report also mentions the narrowing of both compared to a normal lumenā¦ It sounds (obviously not a medical professional!) as if either thereās still some compression by C1, or that the IJVs havenāt opened up fully after surgery, which does seem to happen for some people. I guess the next step would be possibly trying angioplasty & then stenting, although thatās a big step! It does seem from what weāve read on here, & some doctors are coming round to this too, that for some people even middle compression of IJVs can cause quite severe symptoms, whereas others with quite significant compression seem to be compensatingā¦
Have you asked about the comment where it says the thyroid & isthmus are not consistent with pre-surgery?
Iām sorry that thereās not been an improvement in your vascular symptoms, youāre still struggling to be taken seriously post op I guess? 
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@Brandy if you have access to the CT I can help you assess whatās causing the flattening
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I see Costantino and Tobias next week. I have about had it with Hepworth. I do not think he even read the report done by Patsalides on my cerebral angiogram/venogram. He basically told me he cannot find it. He has been all over the map. My initial consult with him stated my right jugular is compressed profoundly between C1process. That is my dominant vein. Surgery was on the left which was compressed worse. He also wrote in my initial summary that I had compression at my digastric muscle. It does not state which side. He is back to saying my vein are being hijacked in my head even though Patsalides had ruled stenting out. Honestly, I do not feel confident in him anymore. Its like he is way too busy and he doesnāt even have a handle on me. Everything that he said would happen with surgery has not. It doesnāt even look like I had any nasal surgery. I didnāt even go into the fact that insurance approved him to fix my ācomuellaā on my nose and that never happened. I do believe I have an isthmus and right thyroid lobe. They are so small imaging cannot pick up on it. Extremely disappointed.
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I do have the CD. Im not very good with computers!!!
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Itās so frustrating the doctors who do such a good job at times then totally drop the ball with other patients, well- frustrating is putting it mildly if youāre the patient! Sending you hugs and prayers and definitely praying you get some answers from the other doctors 
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Are you able to open the CT imaging at the least? If so I can navigate you to the correct series of images!
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Thank you.
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@Brandy - I second what @Jules said. The surgeon who did my first two styloidectomies subsequently did surgeries for other members here who came back w/ follow-up CT scans that showed styloids & ligaments still looking to be in their pre-surgical states. It was alarming. Post op reports were also minimal.
I know you spent a lot of time doing consults & thinking through which doctor would do a surgery that would provide you the best results. I am so sorry he didnāt come through for you. I also hope your consult with Drs. Constantino/Tobias provide you with answers as to why youāre still feeling awful & will be interested in taking care of fixing your columella as well.
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The report states normal, which is odd. Hepworth states the flow is what matters on ultrasound. Itās still over 91 cm/s on right jugular at C1, but the ultrasound came back as normal and said no need to do the right side. I asked about a stent, he said possibly. Heās all over the transverse sinuses again. I, honestly, donāt think he can keep up with what he says. He then made a crack about me āhaving 1800 pages to my record recordsā. He should know better than to say that to complex patients who have been gaslit.
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@Brandy if you can open up your CD and go to this axial slice I can help you:
Itās the view of C1, styloids, and IJVs. Above is my own imaging to help you know what to look for. Look for the top vertebrae that has a white circle in the top middle!
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Thatās awesome! Can I reach out to you in a few days? Maybe even this weekend?
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Of course!!
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@Brandy - Thatās a lot of gaslighting youāve experienced! I am SO SORRY! Itās a shame your past information has overwhelmed Dr. Hepworth to the point he has stopped being able or willing to help you. 
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I donāt want to say, heās not willing to help, per se. Itās just heās all over the map with me and not consistent.
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Inconsistency is just as bad in my book. Very confusing for patients.
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Agree. That creates more stress.
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