Definitely a good warning for some and this doctor seems fairly cautious. I’ve had 3-4 Botox treatments previously and didn’t have any issues.
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@stuuke, I guess it’s a good news/bad news situation i.e. there’s nothing blatantly wrong, BUT you still don’t have an answer to the cause of your current symptoms.
Do you mind sharing again what your symptoms are at the moment & if you had any improvement after your ES/IJV decompression surgery?
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Frustrating finding nothing you can work with… 
On the bright side I wasn’t really looking forward to an additional surgery with Dr. Hep looking at another styloidectomy and C1 shave. 
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Symptoms are pretty much the same for the past several years. I haven’t had any improvement.
- Heavy fatigue, I think I’ve had energy maybe 3 days out of the last decade. I’m able to exercise and do things but I never feel energetic doing it and things take much more effort than they should.
- Pressure in my head, left ear area. Crushing pressure some days and lighter constant pressure other days.
- Tightness on left side of the neck, ear area, back of the skull and down my shoulder to the bicep.
- Tinnitus in the left ear. It’s more of a constant ringing and not pulsing.
- Autoimmune issues. I have digestive issues, skin sensitivity and alopecia. I’d say my immune system is weaker.
- Heart rate is low and blood pressure is high.
Is the left side the one you had decompressed, @stuuke? I’m sorry I don’t remember. It seems w/ the head pressure that there must be vascular or CSF congestion of some sort. It’s curious that’s not showing up on any of the scans. It would be good to get a second opinion on the scans rather than fully trusting the radiologist who wrote the report. I’ve had scans misread by highly respected radiologists. I think they look at so many scans in a day that unless something glaringly obvious jumps out, a “nuanced” problem, which could be causing symptoms, might be overlooked.
Your neck to shoulder/bicep tightness might benefit from some of the postural strengthening exercises @vdm has posted in this thread: List of my favourite resources on YouTube to learn anatomy
Tinnitus, especially constant, is a tough one. I’ve had tinnitus all my life but definitely have it worse in one ear now. I know it’s sometimes related to vascular compression but not always. Your autoimmune issues sound like no fun. Digestive could be related to vagus nerve as you know. Alopecia is also an oddity. Here are some vagus nerve exercises a friend sent me. I haven’t tried them yet but she said they’ve been tremendously helpful for her.
Everyday Mindfulness and Movement for Stress Management with Jenn Gebhardt.pdf (105.7 KB)
Resources for Everyday Mindfulness_Movement_Jenn Gebhardt.pdf (140.7 KB)
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I’d also say general brain fog and difficulty focusing but that might also be due to the pressure/pain and fatigue.
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GM!
I am newer to this forum & curious how did it go with Dr.Hui?!
I am excited as I just got a virtual appt with him for SMO Feb15th
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It has been a month since my scans and still no word from Dr. Hep. I’ve called, emailed and sent messages through the portal.
I haven’t met with Dr. Hui yet. I might get there at some point but still working with Dr. Hepworth and looking at Botox with Dr. Cha.
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That is just WRONG!! I am so sorry!! Have you actually spoken to anyone on the phone at Dr. Hep’s ofc? If not, when you get through, don’t let the receptionist hang up until you have an answer about your scan results (easier said than done, I know).
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I tried messaging Alison and got all excited when I had an email stating that I had a new message. Unfortunately it was this 
Warning! Your message was not delivered. Please try again. Contact your physician’s office if the problem persists.
Oh no! 
So frustrating…
Isaiah said that Dr. Hepworth has new NPs so I’m guessing that the message just bounced back.
YIKES!! I wonder why your email didn’t go through?!
I left a message on the nurse line and also spoke to the scheduler about my imaging. She said she would look into it. Unfortunately the first available telehealth appointment is in mid-June. Hopefully they’ll give me an update on my imaging before then. Also it doesn’t sound like they could do surgery until fall.
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I hope that they do follow this up & be able to help you! 
Well, I’m glad you got through but am sorry things are booked out so far. I was told no appts till Aug. earlier this week but got a telehealth in June. They better get back to you about your scan results!!
Still no response from Dr. Hepworth’s office.
I just don’t understand it. The office staff seems pretty efficient & helpful when a patient is there in person.
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