If it's not eagles, what could it be?

Hi everyone,

How amazing that this forum exists! I’m new here and I’m just figuring out how all of it works, perusing the different topics etc. Thought I’d introduce myself to start with.

My name is Jane, I’m 31, I have the sweetest husband and a 4 yo son who is the joy of my life. I’m really into everything creative, from singing, to drawing, to crocheting, you name it. I used to be really active and do yoga and surf, play in musicals and sing in a band, start all kinds of crazy projects, but not so much anymore, since for the past 10 years my health has slowly been declining.

And that’s how I ended up here! I’d love it if you’d read my story and let me know what you think!

After going back to my GP countless times and doing all different kinds of physio, I was finally diagnosed with POTS (and ME, but I’m not sure about that, since I don’t really experience PEM or muscle weakness/acidosis) at the beginning of this year. A Dr. here in the Netherlands does tilttable tests using ultrasound on the carotid and vertebral arteries, measuring the bloodflow and it turned out that, when upright, the bloodflow in those arteries was cut in half, despite my heartrate rising with 30 to 40 bpm.

POTS is my most debilitating symptom, it makes me wired-but-tired all the time and unable to fall asleep at night when I overdid it, resulting in a vicious cycle. I can’t work, do anything in the household or play sports anymore because of it and I am so sensitive to any kind of stress, it even affects my relationships.

But I’ve also been dealing with brain fog, concentration issues and cognitive decline, tinnitus, headaches, headpressure when lying down and painful globus/choking sensations preventing me from having good posture.

And also some other really weird things: excessive saliva, eye twitching when rotating my head, trouble eating thicker foods and drinking, like it just stays in my esophagus for longer, trouble with voice control when speaking or singing loud, not able to speak and sing for as long as before, toothaches from chewing too much or too hard, like a carrot, and sensitive teeth in general.

I’ve had physical therapy for the headaches and the globus, but it never got better and I just assumed it was psychosomatic, since that’s what I was told. I’ve adjusted everything in my life according to these symptoms, I’ve gotten pretty good at accepting my body for what it is, without knowing why, a skill I am grateful for, but ever since my diagnosis I’ve been digging deeper into possible mechanical causes.

The Dr. who diagnosed me said that to have a chance at stabilising and not getting worse I’d have to be horizontal as much as I could, preventing my heartrate from rising. So I did that… And my headaches suddenly became much worse. I figured out that they’d happen most when lying on my back, because I’d be trying to look down and that movement causes a stinging in my throat, like someone is pinching it from the inside, that shoots up around the back of my ears, along the side of my nose and around my eye. I started looking into neck issues as an explanation for my POTS, remembered a head injury in 2016 and had xrays taken to check for any missed damage. Nothing worth noting according to the doctors, but I did notice I have a reversed cervical curve, which I think in my case is a pretty significant finding. I’ve started doing exercises to bring some lordosis back to it, which is quite hard, because of the choking, stinging sensations/headaches.

The orthopedic Dr. I’m going to now wants to do an mri, to make sure it’s nothing orthopedic, before referring me anywhere else, so I’m doing that at the end of the month, but I have a well-meaning GP who has already said she’d give me a referal to an ENT after this, so I’m hoping for that to be a quick straightforward process giving me the answers I need about whether this is caused by my styloid processes…

I’m so overwhelmed by all this, my diagosis only gave me more questions. My biggest question right now is, if it’s not eagles, what else could it be?

.

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@chaoticmindhappysoul - The image you posted shows the situation w/ your lordotic spine nicely but is too low to show your styloids. If you have any imaging that shows your skull base higher up, & cervical spine, it would be more helpful.

Your symptoms (POTS, brain fog, concentration issues and cognitive decline, tinnitus, headaches, headpressure when lying down) are textbook for internal jugular vein compression including POTS & ME/CSF even if you don’t have the exact symptoms for that. Increased head pressure/headache when lying flat is also very telling of IJV compression. The reduction in blood flow through your carotid & vertebral arteries could somehow be related to IJV compression or could be an “added bonus” to the potential IJV compression you most likely have.

These symptoms are caused by other cranial nerves which have likely become irritated if your styloids do end up being elongated or stylohyoid ligaments are calcified: The glossopharyngeal (GPN)& facial nerves affect saliva production; facial nerve most likely is causing the eye twitch, trouble swallowing & drinking, vocalization/singing, plus sensation of something stuck in your throat is from your GPN & possibly vagus nerves. Food feeling like it’s stuck in your esophagus could be from actual compression of your esophagus by your styloid(s) though this is very rare. Toothaches are from the trigeminal nerve being irritated. These are among the nerves most commonly affected by ES. You can use the magnifying glass search tool to look for images of where these nerves exist in the body as there are a number of posts which include images of these nerves. You can also search for images on Google.

It’s remarkable that you’ve been able to adapt to the increasing symptoms but very sad you had to convince yourself they are psychosomatic when they are very real symptoms with a tangible cause & which can be successfully treated. I applaud you for continuing to search for answers! :clap:

That’s a ridiculous suggestion. What active mother w/ a young child is able to stay in bed all day every day?! When you lie down, elevate your head & shoulders using a wedge pillow or extra bed pillows. You may need to experiment to see how much head elevation is necessary for the greatest benefit. That will help reduce your head pressure so you feel better for a while after you’re up & around. Icing your neck for 15 min several times/day can also be helpful. If ice doesn’t help, try heat. Gel ice packs are good for either icing or heating your neck just make sure to buy one or two that can be frozen or heated. Lastly, a number of our members have been Rxed a blood thinner such as Brilinta, Plavix or Xarelto & taking that for at least a month & preferably until just before surgery has been helpful for a number of members who had/have IJV compression.

An MRI won’t be as helpful in providing a diagnosis as a CT scan with contrast will be. Hard tissues such as the styloids don’t show up well in MRIs.
•You want to get a CT scan that will show the veins, arteries & styloids.
•The CT scan should cover the area between skull base & hyoid bone or collar bones.
•The radiology report should include information about 1) your styloids & stylohyoid ligaments
2) internal jugular veins & internal carotid arteries.
•Request that 3D images of your styloids, IJVs & ICAs be included among your CT slices.
•A comment about the condition of your hyoid bone & its greater horns would also be good.

Your GP or orthopedic doctor would need to order the CT scan w/ contrast & request the specific information I listed above to be included in the radiology report as that will give a much more clear picture of what’s going on than an MRI. In order to avoid another doctor dismissal, once you know who your GP plans to send you to, call ahead to see if the ENT is experienced w/ ES. If not, don’t waste your time going to see that doctor. We have one doctor on our Doctors List for your country. It would be worth having a consult with him:
•Professor H.A.M. (Henri) Marres, Prof. H.A.M. Marres (Henri) | Radboud University

Should the radiologist who reads your scan & reports on it say that everything looks normal, please post your imaging here so we can take a look at it & give our non-medical but experienced opinions as we often see things doctors & radiologists miss.

I’m sorry that I don’t have an answer for what could be causing your symptoms besides IJV compression & possibly elongated styloids & the C1 vertebra. Perhaps others will have suggestions.

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Hi and welcome!
I think it’s certainly worth looking into ES/ IJV compression as a possible cause of all your symptoms, certainly members have experienced all of those that you mention. The vagus nerve can be compressed so that can cause BP and heart rate issues, & other cranial nerves as @Isaiah_40_31 has mentioned are often irritated. There’s more detailed info in the Newbies Guide Section about common symptoms if you’ve not already read that.
An MRI can be useful to rule out any other neck issues, but certainly a CT with contrast is the best to diagnose ES. If you can push for this that would be your best next step & stress as @Isaiah_40_31 said that it’s timed to show both the arteries and veins, as sometimes radiographers just look at the arteries.
I hope that you can get a scan & some answers, it must be so hard coping with this and a 4year old! :hugs:

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Isn’t pots easily diagnosed in clinic? Don’t they just do a pots test? Lay down and stand while checking heart rate.

This site is a blessing and I hate you’re going through this medical issue. I believe there are things the body can do or go through that drs have no clue at times. I still believe I have a form of eagle/neck issues but can’t seem to get anyone to agree on what to do or how to diagnose.

The people on this site are amazing and seemingly well informed plus willingly able to help.

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@Getmused -

It’s not as simple as a lay down & stand up/measure heart rate test to fully determine if a person’s symptoms are being caused by POTs, but that is one way to begin diagnosing it.

Have you sent your imaging to & had a consult with any of the doctors on our Doctors List who deal w/ IJV compression i.e. Dr. Costantino, Dr. Liu, Dr. Cognetti, Dr. Nakaji or Dr. Hepworth? If not, getting a consult w/ a couple of those doctors would be helpful. Since your C1 vertebra is shifted to the left, it’s likely your left IJV, even though very small, is being compressed, & the right side could be as well. Your styloids are very curved, but the imaging you posted wasn’t super clear so it’s hard to tell if the styloids could be also compressing your ICAs & causing problems.

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