NGL slightly triggered by all the posts about people getting diagnosed 2-3 years in… I’m at a decade and a half

[Glitterbats]

I’ve been pretty disabled for the last decade and a half and just got formally diagnosed with ES( + was diagnosed with CCI about 5 years ago).

I’m seeing allot of posts about people talking about suffering severely for a few years and remarking on how long it’s taken them to get answers and how many drs they’ve seen, etc. I realize it’s brutal for even 24hrs.. However, I’m wondering how the people who are in the decade+ category have responded to surgery?

I have made some progress by working on my CCI but I’ve also become so disabled in the last few years that I now have full blown ME CFS.

I am house bound, cant drive and get severe PEM for days 24hrs after even a short trip down the road. My HRV is very low and I was recently formally diagnosed with dysautonomia( which I’ve technically had for years). I cant work( haven’t been able to for many years), function as a human, fill in the blank.

I also have had all the classic eagles symptoms on the left side as well as body pain for well over the last decade and a half+.

My calcified styloids were identified recently along with May Thurner syndrome, all on the left side.

So, it’s quite possible that I’ve had a chronically smashed vagus nerve( along with jugulars of-course) this entire time.

Length of suffering is no competition, but I’m wondering if styloid surgery has helped anyone here fully recover from a similar number of years of this level of compression/ autonomic nervous system dysfunction?

The fact that it’s so hard to get surgery scheduled with a surgeon knowledgable about complex cases asap even though I’m at a point where my nervous system has given out/seems to be showing no signs of resilience, while many others who have been symptomatic for a few years are booking out the schedule for the next year plus is frankly, bringing up feelings for me. I know it’s first come first serve, but I’m quite literally afraid of what another year of waiting will do in my particular case.

Things really can get worse, the longer something like this goes untreated and waiting is very hard to fathom right now as I am not joking when I say that I can barely function. I know what living severe chronic pain and many others issues is like, but it’s different when your nervous system basically stops working( not sure how else to explain it but you know if it happens to you).

Anyway, there are some concerns about ES surgery destabilizing my neck but at this point, I can’t justify not having this surgery and I would do it tomorrow if I could.

Not sure how many fully or partially recovered ES patients hang out on here(?), but would love to hear from anyone who has dealt with severe ME CFS( or any of the other things mentioned) for many years who have already had or are planning a styloidectomy? Hearing from anyone with a history of disabling CCI who has had ES surgery would also be great in general.

Thanks for any constructive feedback!

[TML]

@Glitterbats welcome to the forum.

There has been many members who have had to suffer for many years, and some members who have only suffered for months. Sometimes some people experience pain only, while others like myself, are bedridden due to dizziness, vertigo, and dysautonomia-like symptoms.

To be honest, most members we see on this forum have a hunch that they have eagle syndrome but aren’t totally sure. They come across the symptoms on google, and then they come to our forum and post their “mystery” story and then we look at the imaging (none of us are radiologists or doctors - but to be fair, we’ve probably seen a styloid more than the average radiologist). Then they take the images that we have annotated to their doctors and then end up seeing the right specialist and getting their much needed surgery. So basically, what I’m trying to say is, it’s often how early on in suffering that members stumble across this forum that dictate how long they will be suffering for. It is very rare for a new member on the forum to post about having had eagle syndrome diagnosis and surgery, it’s almost always that they think they have the syndrome and want guidance on how to better understand if they may have it.

I started experiencing symptoms a year ago and have been in bed ever since. I’m only 27. My wife has to walk me to the bathroom. Down 45 pounds (135lbs at 5’11” male). Sometimes I wonder if I’ll make it to surgery too, but there are a lot of members who are worried about that (particularly us who have the vascular subtype of eagles). In reality, there have been very few reported deaths by eagles (actually only one that I can think of research-wise), so as scary as the symptoms are, I am confident you will make it. You will continue to have scary moments until then, but you will cross the finish line.

Do you happen to have access to your CT? We can take a look and then help you get an idea of what eagles specialists are closest to you.

[Glitterbats]

That makes allot of sense about most people being here during the “figuring it out period”. To be clear, I wasn’t saying that I was afraid of dying from ES specifically. ME CFS actually does kill people though. My fear is of this level of permanent disability or my nervous system never recovering. I don’t think anyone can be so confident as to say, “you’ll be ok after surgery” in a complex case such as mine. That being said, I truly hope things can improve obviously and will use whatever little energy I have to move forward.

Also thanks for asking about my imaging. I recently had a new head and neck CTV with contrast, just have to figure out how to upload that!

[TML]

I gotcha! That makes sense to me.

If your dysautonomia symptoms are being caused by compression of the vagus nerve(s) and the styloid(s) they typically do bounce back after surgery - but not usually immediately. Six months to a year seem to be the range in which nerves heal. The good thing is that your vagus nerves are working (i.e., they aren’t cut/severed) - otherwise you’d be dead. So I think if the compression is taken off of them via styloidectomy, they should be able to conduct their full power again. But it’s just a matter of how long it will take.

I’m really glad to hear it was a CTV!

The most important image we will want (when discussing IJV compression and vagus nerve) is the axial view of C1. I’ve attached my own imaging to help you know what to look for. Top vertebrae with white circle in top middle:

We may also want to look at your hyoid greater horns as well, as they can brush against the carotid bifurcation or area of carotid sinus nerve and cause vasovagal responses (which would be evident during head movements and potentially swallowing). But I’ll take a look at the level of C1 first.

[TML]

Actually let me reword things. If a nerve is damaged it can take a year to heal (maybe more) but if it’s just compressed or irritated, the recovery can be almost instant (i.e., when you wake up from surgery). Usually it’s somewhere in between.

[Isaiah_40_31]

@Glitterbats - Welcome to our forum. We’ve had a number of members who had symptoms for 10-25 years & who had ES surgeries that did help their symptoms reduce or disappear completely. The usual scenario is that some symptoms fully go away & others reduce to a level that is tolerable but may sometimes require a low dose nerve pain medication. As @TML mentioned, recovery can take up to a year+ for more severe nerve injury.

We have/had members w/ ME/CFS, POTS &/or MCAS (you can search for posts about these using the magnifying glass icon in the upper right), who have had significant reduction in symptoms post ES surgery. Presently we also have some members w/ CCI (often associated w/ hypermobile Ehlers Danlos Syndrome/EDS). There is a debate among doctors as to whether ES surgery can make CCI symptoms worse, and our patient population here has had mixed surgical results in that regard w/ some doing great post op & others continuing to have symptoms or worsening symptoms. As far as the styloid goes, it doesn’t provide any structural support for the cervical spine so styloidectomy alone shouldn’t cause a problem. Unfortunately many people who have CCI also have internal jugular vein compression being caused more by the transverse process(es) of C1 than the styloid(s), & in those cases, the TPs of C1 need to be partially removed (“shaved off”) to make space for the IJV(s) to reopen. Though the entire spine is strongly supported by ligaments & muscles, it is possible that the C1 shave could negatively affect someone w/ CCI while helping to reduce the symptoms of jugular compression.

Dr. Osborne in Los Angeles would be a good doctor to contact, at least for a consult. If you do have IJV compression, Dr. Nakaji in Scottsdale, AZ, Dr. Hepworth in Denver, CO, or Dr. Costantino in White Plains, NY, would be good options for surgery. Of those 3 Dr. Nakaji may be booked out the least far, with Dr. Costantino being next. Neither one is booked a year ahead, but probably 2-3 months for a consult. When making an appointment w/ any doctor, asking to be put on their cancellation list is a good idea as earlier appointments do come up especially in the late fall & winter months.

You can upload your imaging using the underlined up arrow in the menu at the top of the text box where you write your next message or by dropping & dragging your images into the text box from your computer desk top. If you want to create 3D images, you can upload your CTV into either radiantviewer.com (for PCs) or Bee Dicom Viewer App (for Macs). Please make sure to remove any personal information on the images you post on this forum to protect your privacy.

[jyoti]

@Glitterbats –you could be describing my situation. POTS, other forms of dysautonomia, ME/CFS leaving me bed bound much of the time, CCI, hyper mobility, May Thurner, elongated and calcified styloids and a few other gems. I first became notably ill in 2013 and have been searching for answers/diagnosis/treatment ever since. So…I feel you, as they say. I do indeed know what you mean when you say that your nervous system just stopped working.

And…I also understand what I take to be a familiar feeling of slowly wasting away in the corner while others seem to be charging ahead with healing. I know that in the wake of so many people dealing with long covid, I felt frustrated, particularly when I encountered those who were bemoaning the fact that it took 10 whole months to get a diagnosis! (I am sure at 10 months in I also thought I had spent waaaay too much time trying to get answers; I just had no idea that the months would become years–no perspective on that).

But here we are, armed with so much more info than we had last year or the year before and with plans to do something. It is hard to wait, but you will get there. I loved the idea of surgery with Dr Nakaji but he declined me due to MCAS and Hypermobility. If I were you, I’d contact his office today (online form!). You did not mention either of those co-morbidities, so perhaps he will take you. And I was initially offered a surgery date within six weeks of my original outreach. Dr Constantino is also a great option to pursue. Get on his calendar for a consult if you can. I second @Isaiah_40_31 ‘s suggestions, and while I would love to see Hepworth, I just don’t think I can wait that long.

I am having my first of two styloidectomies in a couple of weeks and will report back as to what miraculous–or merely beneficent–impact it has.

[Jules]

We do find that quite often members have their surgeries & then disappear, if members are still experiencing symptoms after surgery then often they stay here for support, so sometimes it can look like there’s more people who don’t do well after surgery. And also those with complicated medical situations find that although ES surgery helps, it can be just one surgery in a list of surgeries which are needed, like layers of an onion being peeled.
From personal experience, I had nerve pain and jaw/ ear aches for quite a while before I was diagnosed, without realising it was ES. I later developed the vascular symptoms & had bilateral IJV compression, it was probably a year of having those symptoms before I had the surgery. The vascular symptoms went quickly after the first surgery, but then I didn’t have C1 compression as well & hadn’t had it too long, so I do agree that perhaps those who don’t do as well have had compression for a long time. I did have a discussion with my doctor that if the veins didn’t re-open, then stenting could be done, and some members have needed angioplasty afterwards.
My nerve pain hasn’t gone completely, but is better than it was before. I’ve always felt like you say that if the nerves have been irritated for a long time, potentially rubbing away the myelin sheath, then this might not heal properly? There doesn’t seem to be a definite answer for this with members who’ve had surgery, as some do seem to heal with time.
You might find this discussion helpful:
Successful Surgery for severe Vagus Nerve Compression - General / Eagle Syndrome Stories - Living with Eagle

[Glitterbats]

Hi Isaiah,

That’s good to know there are some other “long haulers”(but not in the long covid sense ) in here.

It makes allot of sense that the response and benefit may be partial for some that have had compression for many years, while others may be lucky enough to have full remission. I’ve tried countless medications for “nerve pain” and none have helped unfortunately, but I’m glad they help some people.

That is great to know that even complex patients can have very good outcomes from ES surgery as well.

It sounds like you’re not too familiar with CCI. I don’t think there is much( valid) debate when it comes to the possible dangers of removing(any) anterior support from the neck in CCI patients. Let’s not forget there are a number of Drs who do not even “believe” in CCI to begin with.

Not only that, but it is the anterior ligaments in the neck that are often the main issue for many with CCI/the treatments for this are very limited or mostly effective to a degree.

Even if the styloid itself is not weight bearing, it influences soft tissue stability via attached muscles and ligaments linking skull, hyoid, and jaw( which are severed or detached during this surgery).

Considering that the wind blowing the wrong way can cause a CCI patients neck to dislocate, surgery in this area is highly dangerous. “Shaving” C1 or making direct changes/ applying pressure to C1 is downright scary. In CCI patients who have found some relief with upper cervical chiropractor, any changes to C1 could also mean that their vectors no longer work and that they need new ones( for me, getting new vectors would involve traveling to another state to get specialized type of MRI insurance doesn’t cover and then crossing my fingers that the new listings work). It can take months or even years for someone to stabilize after any significant set back like this or more medical procedures like prolo injections or even fusion may be needed if instability continues.

CCI really exists on a spectrum, so there is a huge difference between a patient that says they have CCI and has a very mild case or worse, is self diagnosed and doesn’t have it( this is actually not uncommon), so some confusion among Drs may be due to that.

In patients with a history of documented disabling CCI, the risks are quite high. Not to mention that we require a special intubation protocol and that head/neck alignment during the surgery cannot be ignored- so any surgery, even if it was on another part of the body, would be high risk.

All that being said, I think having certain structures compressed in the neck is so bad for one’s health, that the hope is, the risk will be worth it.

Anyway, I appreciate the Dr suggestions. I met with Osborne who technically diagnosed me- however he does not seem like the right surgeon for complex patients with VES, so I’m not sure why so many are recommending him to me. I have heard that Dr Nakaji has not accepted other patients due to their having MCAS and dysautonomia ( which I have), but I may still contact that practice as in general am not very familiar with him. Of the ones that you mentioned, I’m only aware of Dr H as being a prospect and he is booking out about a year and a half right now. I wish I just needed the styloid removed and didn’t need a Dr that understands how these different things are connected, but unfortunately it seems I do need that level of specialization and expertise.

All that being said, I would love to have surgery in immediate future and I’m open to any viable alternatives or options/ maybe there is a Dr or two I’m not aware of.

[Glitterbats]

@jyoti I’m so sorry to hear you’ve been dealing with similar for a comparable amount of time.

Btw, I totally get what you mean about the long covid folk. I’m in a “chronic” illness support group with some of them, and while I know they suffer quite allot, it’s just not the same. I remember where I was 3 years in, and it is just different, mentally and physically. It feels like at a point, the waters get muddied and we all got lumped together, when really, each of our situations is unique.

I’m not sure where you are with the May Thurner, but I’m also looking into whether that is something that needs surgical treatment. I would rather do ES first personally but not sure if that will be an option.

I’m not very familiar with Dr Nakaji but I also do have MCAS and suspected hypermobility( although not textbook EDS), so if he didn’t accept you for those reasons, he may not accept me either. I wouldn’t say my MCAS is so severe that I go into anaphylaxis, etc, but it seems to drive pain and severe fatigue as well as maybe some of the dysautonomia. I’m actually off some* of my MCAS meds atm due to having formal MCAS testing on Monday, and boy, I can sure tell the difference when I’m not taking my Allegra or quercetin . I’m was considering Dr Constantino, but due to certain reasons, I’m not sure he would be the best fit for me in my particular situation. I’ve heard he is great for some people though.

So excited you’re getting your ES surger(ies) soon! I really relate about not being able to wait, but considering what a big deal my CCI has been, most of the ES surgeons do not seem right for me- I’m not sure what to do yet, as part of me just would hope that getting the styloid out sooner would be best, but I cannot emphasize how much I cannot afford to have my neck destabilized.

Anyway, who knows if we already know each other from FB or something but I’d love to stay in touch and am also curious to know which surgeon your going with

[Glitterbats]

@Jules Thanks for sharing about your experience and I’m so glad the procedure helped you.

That makes allot of sense about patients leaving when they improve or being more active when they have complications. I suspect that is also why many of the FB groups are in the state they are in , although this community is probably better than the FB groups.

I’ve definitely spoken to CCI patients who had fusions so that their C1, etc, wasn’t on their jugulars anymore who have shared that the jugulars don’t always pop back open on their own as hoped/ especially if they were smashed for a very long time, and so required stenting. I know of one case, where a very athletic guy in his late 20s needed to have jugular stenting done post fusion and he only had bad CCI for a few years, although it seems everyone is different.

There is also the issue of the myelin sheath being affected like you noted.

I really have no idea what type of response I would have as my symptoms have been constant( atypical trigeminal neuralgia on left in addition to countless other things) this whole time. Seems like, it’s just a have the surgery, cross my fingers and wait type of situation.

That is fantastic to know that your vascular symptoms went away quickly after surgery. I’m not sure when your surgery was, but I hope the nerve pain will continue to lessen- I know they always say that nerves take the longest to heal.

[TML]

My two cents on ES and CCI:

I think that leaving problematic styloids in someone’s neck because they have CCI is a bad decision (in my opinion). For a couple of reasons.

#1. If you have a hypermobile C1, than you risk repeatedly '“smashing” or pressing your styloids against C1. While this may sound like something that could be helpful to reduce CCI (because it may keep C1 from moving even further forward), you risk damaging vagus nerve, hypoglossal nerve, and spinal accessory nerve, and IJV every time it hits. So is it better to risk permanently damaging vital nerves with every head turn, or allowing C1 to move a slightly more? It depends on the CCI severity. However, this brings me to #2.

#2. When there are elongated styloids and IJV compression, the body will do miraculous things to compensate. The only way to open up the IJVs/nerves is with forward head posture and/or upward gaze (these motions increase the space between styloids and C1). The problem with this is that these postural positions chronically lead to weak anterior deep cervical neck flexors - muscles vital for cervical stability. And it is quite literally impossible for someone to exercise these specific muscles because typical exercises include chin tucks and maintaining proper posture (head over shoulders) which compresses the nerves and IJV between the styloids. Some doctors think CCI leads to ES, but I think it’s much more likely that ES can lead to CCI due to asymmetrical and inappropriate muscle imbalances.

Getting styloidectomy will open the IJVs and nerves, and allow you to engage in full and proper range of motion in the neck and use muscles in the neck what they meant to be used for (e.g., deep anterior neck flexors for neck stability rather than SCMs, suboccipitals, and upper traps). CCI symptoms may worsening immediately after styloidectomy since you dont have the styloids anymore to stop excessive C1 movement, but once the deep neck flexors develop properly, CCI should get better.

But yeah, not a doctor these are just my two cents about what intuitively makes sense to me.

I will not speak to C1 shave and it’s potential impacts on CCI, because I am less confident in that realm.

[TML]

I frequent the CCI Reddit page and I often point out to people elongated styloids that they literally had no idea about. I’ll read their symptoms in their post and they’ll upload cervical xrays. For those who haven’t received CCI diagnosis (but think they have it) about 50% of the time they have elongated styloids. It can be really hard to differentiate the symptoms between CCI and vascular/vagus ES, and I think a lot of people who don’t have a CCI diagnosis but think they have CCI actually have ES (and maybe CCI too, but definitely ES).

[Glitterbats]

I personally do not think symptomatic ES occurs in as many as 50% of CCI patients( just IMO/ anecdotally), but I do agree that there is definitely strong overlap with CCI, ES, EDS( not to mention many other acronyms). Many likely have elongated styloids and don’t have symptoms unless their CCI gets bad.

[Glitterbats]

I’m not sure if you were responding to my comment directly, but just to clarify, I never said that someone with CCI should avoid ES surgery. I am just pointing out how high risk it is.

I’ve also spoken to one or two people who have CCI and are absolutely not ok even many months after ES surgery because their neck destabilized. I’m not saying this is the majority of people and don’t know these patients situations well, but I know one is pursuing a fusion.

Both CCI and ES can cause major issues and like you said, together it can be much worse since they play off of one another.

I’m not sure if you were saying that you believe CCI is caused by a muscle imbalance( caused by ES) but that’s not what CCI is caused by.

By definition, CCI is caused by ligamental damage or laxity. Muscle imbalances would only aggravate but not be the root cause of CCI. One of the major problems is that muscles can never completely fill in for the job of the compromised ligaments in this part of the body.

I’ve definitely heard about the connections between ES and forward head posture. That’s one of the things I’m kind-of gambling on, that the effects of loosing some anterior support would be compensated by better posture and spinal alignment.

I’ve worked very hard for years to get the neck stability that I have and an atlas that hasn’t dislocated for a year and a half, but I know what it’s like to have cervical instability and how much we( people with CCI) cannot f* around.

I think if someone has severe CCI, they may not be able to have an ES surgery, and for those of us in the middle of the spectrum it is still high risk.

I also have no idea in regards to the C1 shave in a CCI patient but considering that I personally don’t let anyone touch my C1 with a 10 foot pole( unless it’s an AO machine), I cannot see how messing with it in any way would be a good idea.

The best I can hope for, is to work with an ES surgeon who believes CCI is real, who understands the mechanics of how CCI and ES impact one another, is in ongoing conversations with upper cervical specialists + is actively trying to learn more about how these things are interconnected.

[jyoti]

@Glitterbats A couple of things. May Thurner– I was told by MIPS in Denver to come and get final imaging followed by a stent when I want to after looking at previous MRIs. It was actually quite tempting to think I might be able to go get this relatively simple procedure and it would take care of POTS and IIH. But further investigation found that few patients with my profile have had improvements in autonomic symptoms from this stenting. Not none, but few. And then several doctors I respect said: HEAD first!!! Open the veins in your head and neck first! That made sense to me, though it is a much more complex path. Where are you with it?

Nakaji –he apparently did not want to operate on me because he felt that due to MCAS and/or hyper mobility I might be more likely to have post-surgical complications and since I am not local he could not follow up. I am the same as you vis a vis MCAS as well—I do not have much in the way of allergic reactions and never anaphylaxis, but if I don’t take fexofenodine and quercetin, my whole system goes wonky. Further, I had the opportunity to stay in Phoenix for a month or two if I had needed to, but never got to discuss his concerns and how to alleviate them. I was not offered the chance to speak or consult with him except on the day prior to scheduled surgery and he made the decision to offer me surgery initially without any real info about my medical history. Just the angiogram and a CT. So he had no understanding of the breadth of what I am dealing with, as evidenced by his withdrawal of that offer when I asked his surgical coordinator to confirm that he was comfortable dealing with those two conditions. I am sure he sees enough people with similar profiles, but in retrospect, I am a little unnerved by the protocol of having no contact other than to set up surgery until the day prior.

I am (somewhat reluctantly) having styloidectomies with Dr Bolognese. I know he is not well-loved on this forum and I fully comprehend why. I have my concerns too. But he does understand CCI and I think it is uppermost in his mind with most of his patients. I know that as I begin to dismantle the rat’s nest in my neck there is a good chance it will lead to other CCI-related neurological emergency. I decided to go with Dr B because unlike Osborne (who sounds dreamy for the right patients) he will do C1 shaves and complete decompression, but he will not start with that. He will do one styloidectomy only and follow that two months later with the second (in my case, I need bilateral). And if these do not provide significant relief, I will be dealing with someone who does have that bigger CCI picture in hand. Like you, I am quite concerned about starting this process and ending up with a CCI catastrophe. It does happen.

[jyoti]

@TML

When there are elongated styloids and IJV compression, the body will do miraculous things to compensate. The only way to open up the IJVs/nerves is with forward head posture and/or upward gaze (these motions increase the space between styloids and C1).

Incredible! I am so grateful for your anatomical knowledge and sharing. Yes, yes, yes! I have been wondering why it is that these two positions feel so much better for me, why I feel like I can take a deep breath only in these positions. Very helpful to know. Thank you.

[TML]

I don’t think 50% of CCI patients (people who have confirmed CCI) have ES either. I was saying that it seems about 50% of the time people who I come across saying they have CCI symptoms (but have not been diagnosed and imaging has yet to show it) have an elongated styloid. Just an estimate from what I’ve been coming across on various forums. - at least in those who post images of odontoid xrays (obviously can’t assess styloids in the typical MRI imaging people post when looking for CCI)

[TML]

I know you didn’t say people with CCI should avoid ES surgeries, I always just like providing my rationale on it to further provide hope for those with both CCI and ES that sometimes getting styloidectomy could help both.

Intuitively, muscle imbalances/weakness cause ligaments in the neck to be more prone to damage in events that can cause damage. Imagine if someone was standing in front of you holding your skull and quickly twisted it (like the way ninjas kill people in movies). Imagine how much head rotation would occur with someone with no muscle tone in their neck, versus someone with a strong neck. I would imagine (again, intuitively) that the person with the weaker neck would experience greater rotation and in turn ligament stretching/damage. And you could extend this thought process to more realistic events like car accidents and whiplash. There are obviously people who are at risk of CCI for genetic/health reasons (hEDS, RA, etc) where the root cause is some underlying health condition. Then there are those with CCI-like symptoms like me who have tested negative for everything except ES, and yet simply turning my head in bed will cause a deep “crack” at C1 due to hypertrophied SCM and a shoulder drop with it (I basically propel myself too fast with head turn) and then I’m in a neck brace for weeks at square one feeling like my skull is going to slide off the top of my spine and a deep burn at the base of my skull. The neck snapping and worsening of my CCI-like symptoms wouldn’t occur if my muscles were balanced properly - i.e., if I wasn’t giving myself whiplash. Cracking at the top of the neck /base of skull is a commonly reported symptoms among ES people on this forum.

I see the CCI / ES possible combinations as follows (you can correct me if I’m wrong regarding the CCI possibilities since you know more on the matter):

1. Chronic (pure) CCI - caused by underlying health conditions leading to increased risk of ligament laxity

2. Acute (pure) CCI - neck injury such as whiplash where the ligaments will eventually tighten/heal

3. Chronic ES - elongated styloid(s) that can cause chronic muscle compensations

4. Chronic ES + chronic (pure) CCI - this sounds like where you fall under?

5. Chronic ES + acute (pure) CCI - this is where I fall under (every time I self-whiplash)

(Glad to hear about your atlas staying put for the last year and a half!!)

[Jules]

It does sound a horribly complicated & risky situation for you @Glitterbats , and not at all an easy decision…we have had some members get in a bit earlier with all the doctors by going on a cancellation list but I don’t know if that’s possible for you with having to travel?