Seems critical to me!! I think the CA medical system needs to redefine critical in JC’s case!! 
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This is when you have to look into self pay cheaper sites . However, when I looked around at the ones in my location they could not do 3dciss program.
You still need a doctor’s order in US. Other countries I have seen it done with no order.. in India this test is really cheap.
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I’m glad that you can be strong & confident in JC’s recovery, a long slow road, but keep that positive attitude as much as you can 
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Yes my gastric problems are 100% resolved. It’s nice to eat whatever you want! Actually post surgery it wasn’t gastroparesis at all but just gastritis, mainly from NSAID use I think. I experienced gastroparesis only before surgery, from which I experienced immediate relief after vagus nerve decompression.
My left IJV is closed, not open. It’s very obvious on my MRV.
Have you guys investigated JC’s possible TOS diagnosis? If JC still has head pressure then TOS-CVH is the only major cause I can think of. For me both TOS and ES surgeries were absolutely essential to relieve the head pressure. And I can say with confidence that my head pressure is gone. And Dr. Kamran is THE expert on TOS surgery as he invented a unique technique for it: PURE technique.
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I’m so so so happy to hear you can eat again!! That’s the best news I’ve heard all day/week.
TOS has been queried but he has no signs/symptoms of it. His original CTV in Antalya went down to the clavicle and there’s no sign of additional compressions. Dr. K’s looked at all those scans and never brought it up, and given his expertise in that area it’s something I was half expecting. So the fact we’ve never gone there in discussion is a good sign.
I have a copy of the CTV done in March and emailed it to Bassam, we’re hoping to book a follow up call in the next couple of weeks. Ideally the IJV ultrasound would be done before then but it looks like it has to be arranged by a specialist.
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Unlike ES, TOS is very hard to recognize on a scan. You can have TOS even if scans look normal. Indeed in my case they looked almost normal. So TOS is best diagnosed through provocative tests in addition to scans.
One of these tests is the Roos test. You raise your arms and open and close your hands rapidly, and see how quickly you get pain. For me it was very obviously positive.
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What great news @Bowser! I was really concerned about you when things were so bad with your intestinal tract. Very fantastic to hear you’re doing so well now that you’re mostly healed.
Are you considering surgery to open your left IJV or are you asymptomatic enough you’ll just leave it alone?
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I’m completely asymptomatic in terms of head pressure. So no more surgery needed. I believe all structural issues have been solved, and I’m considering a stellate ganglion block for three remaining symptoms: neck pain, facial pain and chronic fatigue.
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I highly recommend consulting with Kjetil Larsen if you want to investigate TOS; https://mskneurology.com/
He is the one who wrote this paper on TOS causing head pressure: View of Does thoracic outlet syndrome cause cerebrovascular hyperperfusion? Diagnostic markers for occult craniovascular congestion | Anaesthesia, Pain & Intensive Care It’s called TOS CVH
He and Dr Kamran have a good relationship too. So if you get a diagnosis from Kjetil, it can be useful.
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@Bowser , so pleased that your head pressure and stomach issues have all resolved, that’s great news!
I’m glad that Kjetil Larsen helped you with your TOS diagnosis, we do often suggest getting his opinion on scans to members who are struggling.
I hope that you’re able to find a treatment which helps your pain, let us know the nerve block helps if you do pursue that!
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I’m optimistic about SGB not just for the pain but for the chronic fatigue:
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Thank you for that link, @Bowser. A couple of years ago, I’d read about stellate ganglion blocks being helpful for people w/ long COVID, but then never saw any follow-up information (didn’t go looking so probably my fault). You’ll be our “guinea pig” & can let us know the good results (I’m optimistic alongside you!) you get with it.
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This is really interesting @Bowser. I’ve just read that damaged nerves may heal better with a stellate ganglion block administered. Please keep us updated on how you go. I’m having a lot of pain at 5 months post op. Especially around the surgical site and down the neck/shoulder. I do feel like the nerves aren’t getting enough healing time because of the inflammation both from the surgery but also from the muscles which I’m feel are tensing every time I turn my neck to the left (because the nerve is being compressed still). I could be wrong but it feels like it’s caught in a loop of compression then inflammation then compression again, if that makes sense.
All the best with the block. 
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@BraveKat - I’m very sorry that you’re still struggling so much. You may be on to something about your pain cycle i.e. the accessory nerve is compressed (possibly by scar tissue or muscle or ?) which causes inflammation which causes pain which causes tension, nerve compression, swelling, & more pain…
I’ve forgotten - have you tried a muscle relaxer? You’d need to take it at night because those meds relax all muscles, but something like that might allow your tensing muscles to take a much needed break & give the nerve a rest & allow you to heal.
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My pet theory is that there is no longer any structural compression after surgery, but it may feel like it is still being compressed because of an overactive sympathetic nervous system preventing the nerves from fully healing. Such dysautonomia may have been triggered by compression of the vagus nerve (which controls the parasympathetic nervous system) but even after decompression has been achieved, the nervous system is still unable to dial back its sympathetic overactivation. That’s what the SGB is for.
Basically the SGB will restore the sympathetic/parasymathetic nervous system balance and allow the autonomic nervous system to “reboot”
When you first hear the term “reboot” it almost sounds like pseudoscience. The human body is not a computer. How can it reboot? But this is the exact term they use in the literature:
“Cervical sympathetic chain activity can be blocked with local anesthetic, allowing the regional
autonomic nervous system to “reboot””
Stellate ganglion block reduces symptoms of Long COVID: A case series - ScienceDirect
The ability of SGB to reboot the nervous system is well described in the literature in many papers like this one. It’s even used for stuff like PTSD.
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It sounds like a ‘wonder’ procedure - too good to be true! I’ve definitely got an overactive sympathetic nervous system. That’s one of my main day to day symptom groups (my vagus nerve hasn’t healed) along with pain when moving my head to the left and a feeling like I might pass out if I do it quickly in small increments (like navigating a path to walk at the mall etc).
I have days where the vagus nerve symptoms feel more quietened down (definitely not back at a base level) but will ramp back up the minute I have pain or move my body out of alignment for more than a few minutes. For example twisting to one side or bending down. It seems to be generally happy if I look straight and keep my spine in line with my head.
I feel apprehensive though to try the block for some reason. It could be that I feel alone in this journey again and under qualified to make the best decisions for myself. What if im reading it all wrong and that’s not what I need at all. I know we are all in the same type of boat but it’s hard navigating this all again post op. I really commend you @Bowser and everyone else who keeps the fight alive post op.
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