I’m very excited that my surgery with Dr Hepworth is finally coming up in about two and a half weeks! It can’t come soon enough given how poorly I’m functioning but very hopeful this will solve most of my problems.
What’s planned:
Right styloidectomy and jugular vein decompression
Ethmoidectomy to look for and repair CSF leaks
Left femoral and left renal vein catheter venograms to evaluate possible abdominal compressions for future treatment if necessary
I’m basically unable to be upright for more than maybe 20 minutes at a time. I have a lot of symptoms that suggest severe vagus nerve compression which I hope resolve after surgery.
I forgot to ask Dr Hepworth, but I have a deviated septum and would an “ethmoidectomy” imply a correction of the deviated septum even though he didn’t state that explicitly on my notes?
Am I also correct that Dr Hepworth will look for constrictions on the jugular all the way down to your clavicle? Meaning, if he finds compression at the omohyoid he’ll deal with that even if it wasn’t determined beforehand that it was a source of compression?
Also, my understanding is that Dr Hepworth does sometimes shave C1 if it’s found to be a significant source of compression but he prefers not to do this and only does it when absolutely necessary. Do I have that correct?
Very hopeful I can come back and report a very successful outcome in a few weeks!
@jrodefeld - I’m sorry your symptoms are so bad & that your surgery will be so extensive but I’m glad it’s coming up soon.
In answer you your questions:
Q1 - I’m not sure. You can ask a bout this at your pre-op appointment.
Q2 - I don’t know if Dr. Hepworth looks all the way down to the clavicle, but he is pretty thorough in checking to make sure he takes of the constrictions he sees in the IJV. This would be another question for pre-op.
Q3 - Dr. Hepworth didn’t used to do C1 shaves at all but seems to be doing them more often now. His old approach was to move the IJV slightly away from C1 if it was the cause of compression. It may be that he’s found shaving C1 gives more enduring results.
Thank you, I’ll be sure to bring these questions up at the pre-op. With most surgeons I’d be more concerned but with Dr Hepworth I feel confident in allowing him to do what he feels is best given his experience and what things look like once he goes in and looks.
With regards to pre-op, do you mean when I see Dr Hepworth before the surgery at the hospital on the day surgery is scheduled? Because I plan to fly out on the 10th and fly back on the 19th giving myself the ability to have a one-week post-op visit in person.
Would there be any scenario where that would be too soon to fly back?
I also will be speaking with Stephanie on the phone presumably a week or so out to coordinate everything.
You should already be scheduled for an appointment the day before your surgery. This is your pre-op appt. It used to always be with Dr. Hepworth, but I recently heard that some pre-op appts are now being done by Sarah Reynolds, his NP.
