Hey there. I’ll be going in for surgery in a few weeks with dr. Costantino. He has an excellent reputation and I trust him,but I’m starting to feel that I might be spinning my wheels. Success stories are just so few and far between. It feels like this issue is something we might need to wait out until the techniques and consensus matures.
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@Msdstc - Getting cold feet prior to any surgery is very normal. Your surgery is booked with one of the most experienced vascular ES doctors we know of.
Success stories are more common than those of failure. It’s just that recovery can take quite a number of months, & by the time the patients w/ good outcomes feel well, they’ve moved on with their lives & often don’t come back to our forum or elsewhere to give positive updates. Please bear in mind that many of our members who update us soon after surgery are still in a lot of post op pain & symptoms are still rearing their ugly heads. ES symptoms come & go & come & go as nerves heal which can be discouraging, but they do fade over months/years.
In cases of vascular stenosis (IJV in particular), it can take a number of months for the brain & CSF to readjust to the new level of blood flow. Additionally, in bilateral cases, many have found they need to have both IJVs decompressed to get the best results, even if their dominant IJV has been re-opened.
You need to do what’s best for you, and if you can lead a productive life w/ the symptoms you have, then putting surgery off is an option. One concern that has come up on our forum is that if one is booked w/ a an experienced surgeon, & surgery is put off, symptoms may, get worse & that surgeon may no longer be available or the wait could be excessive, so there is that to consider as well.
Dr. Costantino doesn’t offer surgery to every patient who comes to him, only those he feels he can benefit via surgery. The fact that you’re on his surgical calendar means he sees you as a good candidate to be helped by the surgery he’d do for you.
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I appreciate it. The one thing that scares me about this most is the loss of the artery. I know it’s technically redundant but it just stinks that I’ll likely be losing it.
I didn’t know he removes or cuts an artery. I know he removes the posterior digastric muscle & cuts the GAN (which Dr. Tobias repairs). Which artery is lost?
Occipital artery.
Maybe I have heard about that. Did he say what his reason is for removing it or is yours obviously adding to your IJV compression?
Because it runs right over the jugular vein and often chokes it off. I’m hoping I’m one of the cases where that’s not involved. Studies show that it’s redundant and not necessary but it’s better to leave it in most cases.
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Tell Dr. C that you’d like it to stay put unless it’s causing a problem. Hopefully then he won’t remove it unless it’s really necessary.
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Thank you @Msdstc for writing about the removal of the occipital artery as Dr.Hepworth made a suggestion of removing the carotid artery during my daughter’s upcoming surgery. The reason to remove it would be if he cannot untangle the carotid artery and jugular vein and then need to remove the carotid. And like you @Msdstc thought it would create a problem but from what research I did about that, Dr. Constantino says it is not a main artery that gives an important blood flow. It seems these doctors are skilled in knowing what they are doing!
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Yeah it’s a redundant artery that can be sacrificed, but they recommend not doing it if you don’t have to.
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