Yes I do. I have the head of my bed propped up 6 inches. But I think maybe I need higher. Great suggestion. Thank you. I am very glad I found this site.
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Hi, Iâm curious about the following:
My symptoms get worse when I do mental work or concentration tasks. Especially the tinnitus (non pulsatile) and the neck discomfort. When things get very bad, I get muscle spasms on my head, down my back and legs to my feet, which only slowly subside over the course of days.
Can you also observe this dynamic in yourselves or are the IJVS symptoms actually only changing a little?
Best regards
Hi Henry,
Dr. Cognetti has a history of leaving 1-2 cm of styloid behind which has caused some later problems for other members on this forum. I would try to find a surgeon who will remove your styloids back to your skull base & will also make sure to remove your stylohyoid ligaments if theyâre at all calcified. Dr. Annino in MA, Dr. DeLacure in NYC & Dr. Hackman in NC are all doctors who remove to the skull base if at all possible. If youâre willing to travel, Dr. Samji in CA is the most experienced ES surgeon on our list. He did my surgeries, & I think the world of him.
Colie3387,
Even though Dr. Samji prefers a CT w/o contrast, I would still reach out to him & send him what you have. Worst case, heâll ask for one w/o contrast. Itâs well worth your effort to have an appt w/ him.
Hi The Dude,
Pay attention to your posture & head position when youâre in deep concentration. We often get into a relaxed, slouched position w/ shoulders rolled forward & upper back hunched, chest becomes concave, & head/neck tipped forward when sitting for prolonged periods. Being in this position for extended periods puts strain on the lower & upper back & back of the neck which will irritate a myriad of nerves & muscles over time. Try sitting w/ good upright posture - shoulders back, scapulas down, spine & neck erect but relaxed next time you do your work (this make take effort if youâre not used to it). Put your computer or book, etc. in a more elevated position so you donât need to look down to view it. Just changing your posture may make a HUGE difference in how you feel.
I selected this video at random from YouTube (but did watch it first). It has a good explanation of what Iâm talking about & the problems it can cause along w/ some really basic exercises to help reverse the problem.
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Thank you Isaiah. I just called Dr Samjis office. Will keep after it. Will reach out to another couple.
Hi Henry,
The more doctors you talk to, the more opinions & different views youâll get. This can cause confusion for you. It might be better to send your scans to & make appts w/ (either virtual or in person) 2-3 of the more experienced doctors on our list than to contact a whole bunch of doctors. We have had members who were diagnosed w/ ES by one doctor & told by another they didnât have ES, that surgery wouldnât help, etc. Some of these people have left the forum & chosen not to have surgery believing theyâd been misdiagnosed when in reality they had not been. Iâve wondered how theyâre dealing w/ their symptoms now.
Thank you Isaiah. I am just worried at the moment that I wonât get prompt treatment. Lot of suffering. I see that I am not alone in that.
Hi Collie
Is your mrv with contrast?
Sorry to hear of your struggles.
I also have bilateral internal jugular vein compression from c1 and styloids
Suffering greatly. Having an invasive venogram next to check pressure gradients and measure narrowing
Good luck 
Hello Isaiah,
thank you very much for your quick reply, again.
Of course, Iâve already thought about the body positions and set up my office ergonomically.
The symptoms, in fact, seem to correlate with mental exertion.
This does not occur, for example, when watching a video in the same positions.
Or, if I write in English it will be worse than if I write in my mother tongue. Driving a car for example becomes really exhausting after 2 hours âŚ
Have you ever heard of something like this?
Hi @TheDude
Can you correlate these episodes of exhaustion to times when you using your arms, e.g. typing, driving, or simply holding a book?.. I noticed that my arms give pain to shoulders, which makes the neck stiffen and that increases brainfog too.
Yes it is with contrast! Itâs so obvious to me I do t understand!
Hi vdm,
I really think it correlates with mental activity. It is as if the pressure from the brain / cranial nerves were transferred to the head / neck tension (especially sternocleidomastoid & trapezius muscle) and then over the whole body.
Very similar activities, such as surfing the Internet, also hardly cause me any complaints worseningâŚ
Hi Henry,
Dr. Samji doesnât schedule too far ahead. You may need to wait a few weeks for a consult & once thatâs done, if he feels surgery is warranted, it gets scheduled soon after.
Many thanks.
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Hi TheDude,
If your posture is good when youâre mentally busy but sedentary, then another possibility is the muscle fatigue caused by holding your head, neck, shoulders, & back in one position for an extended period. Itâs like standing at attention if you were in the military. Subconsciously youâre working to maintain good posture so your muscles obey but arenât relaxed. When you watch a video in the same position, your mind is working at a different level & your muscles are much more likely to be relaxed. Iâm not discounting that there may be a âmentalâ connection to whatâs going on as well since your brain signals control your nerve impulses which then control your muscles which control your bones & posture. Itâs all interconnected.
NattyâI also have bilateral jugular compression by styloids. How did you make out with your venogram/pressure measurements? Henry.
Just an update for this group: I saw Dr Hackman this week. My CTV is pretty clear â bilateral compression of jugulars. Severe in flexion. My symptoms are consistent with this. So he scheduled surgery. Not too far out. Dec 4. Will have both styloids removed.
I want to thank several of you for your advice. You know who you are. This site has been very helpful. Henry.
Will be praying that all goes well for you! 
I called Hackmans office and have an appt for Dec 8th to discuss my scans. However, the office wants me to fly in just for the consultation. Does anyone know if this sounds right?