Starting in mid Feb. 2014 I began having a fullness feeling like a ping pong ball in the right side of my neck-right over the carotid artery bulb. It felt as though something was pushing on my windpipe, as well as a pulling sensation in the right supraclavicular area.
I had several more similar episodes plus some short heart palpitations usually 1-2 times per week- but growing more intense.
My PCP Dr. Kathryn Neely ordered a carotid u/s to r/o an aneurysm, also had a CT of the soft tissues of the neck 3/5/14- only showing as read- that I am missing the left side of my thyroid and the right side had a small nodule and was biopsied by an endocrinologist-negative.
3/9/14-ER visit at Kennestone after same neck fullness- more pronounced while singing at church-became very faint, heart racing- unable to get heart rate down for 30min, numbness starting at neck and going up face to top of my head. Felt like a TIA. Cardiology ref. given. Same night-had full sinuses, downward pressure right side of face, ear, jaw, teeth and began progressively painful ache behind right ear with the desire to place pressure under right ear and under jaw bone on right.
Cardio ordered echo and 30 day event monitor- echo showed slight MVP (already known) and monitor showed several episodes of PSVT’s.
More frequent episodes now with great pain in jaw, ear, neck, chest pulling-stabbing pain vs. ache in neck right over my carotid and following the path up near jaw and ear. During full blown episode-face numbness and neck stabbing- Have to recline slightly and keep head facing forward. Severe pain with turning any other direction especially to right and bending over. Only help is to sleep- but can’t sleep on sides- feels like I am impeding blood flow. Usually better in the morning and gradually worsens over the course of the day.
After a particularly bad episode- went to vascular dr- did another carotid u/s to r/o carotid dissection-no other diagnosis or help.
Went back to PCP end of March- she decides to try a beta blocker-Bystolic 2.5mg (can’t go higher due to already low b/p), hydrocodone-doesn’t touch the pain, Immitrex- didn’t help, and ordered an MRI of brain to r/o MS and sent me to Neurologist. Amazingly the beta blocker Bystolic helped tremendously! Gradually over about 2 weeks I noticed way less symptoms and although I was aware when the episodes were happening- it was way less painful. I would have a few bad days here and there, but much better.
At my cardio f/u in April- I was changed to Metoprolol-said it was less likely to affect my already low b/p-pain came back the same night I switched and I only lasted 2 days before having to switch back to Bystolic. Took about a week to level back off with my pain.- Also sent to electrophysiologist who said my heart palpitations were called inappropriate sinus tachy and should clear up on there own within a year and to continue Bystolic . Sent me also to Neuro to r/o cervical dystonia.
Neuro tried me on Baclofen- which didn’t help, so cervical dystonia was ruled out- my neck was never pulled out of place involuntarily either. Dr. Jacqueline Green talked about my case at a drug conference and Dr. Michael Johns at Emory Otolaryngology was recommended to look into whether my styloid process or hyoid bone might be pressing on my carotid and causing my symptoms.
Over the past 2 weeks it seems as though the Bystolic has stopped working. I am having a few short heart palpitations, pain is back- stabbing vs dull ache over my carotid, pulling from ear, jaw, lower teeth, under tongue in the far right back of my mouth, right chest, and intense pain during episodes with head movements (backing up car). Worst was Friday- face numbness and extreme pain with any head turning on either side.
Why was Bystolic helping? My theory is that it is a mild smooth muscle relaxer so it decreased my pulse and relaxed my carotid a bit which lessoned contact with whatever is poking in that area-No idea why it is no longer working.
Read lots of articles on Stylo-hyoid Complex Syndrome (elongated vs. calcified), Vascular Eagles Syndrome, carotidynia, Ernest Syndrome- unsure of the validity of these, but symptoms are spot on for several of them.
CT was done in March- 8 mos ago- could there be changes? Also my head was straight- could it be different if my head were turned to the right?
Very worried about the feeling of impeding blood flow and poking feeling- quite scared of a stroke or dissection.
I am seeing Dr. Michael Johns at Emory this coming Monday- he is in the same group as Dr. Del Gaudio.