UNC Dr. Hackman bilateral surgery 6/5/2024



Hello from NC, SACU House all. hank you for your prayers! I checked into the hotel on 3 June, and had surgery at roughly 2pm on the 5th. Today is day 3, post recovery and it’s been rough, but not as brutal as expected.

Pre-operation it was difficult to maintain mental clarity as I’d been fasting, and though I prepared as best I could, I didn’t have a list of questions written down, and each doctor or nurse did a job, left, and was replaced by someone else like a rapid opera. Plus a patient in waiting room was feinting and I had to call for a nurse. The waiting room area was full of other patients including cancer patients so I struggled to focus on “me.”

I experienced a profound spiritual event moments before going into full anesthesia as the surgical team was around me (I estimate 8-12 people??), I remember telling them “She’s here! She’s here!” but I could not see Her. It was Our Lady and I could feel her in the room. Her presence was literally of the Divine Mother, total love. Then I blacked out.

The evening of the 5th right after surgery was the worst. Turns out that aside from anesthesia, I was also incubated so my lungs had to be drained in the post-surgery area, but I wasn’t given instruction by the recovery nurse. Rather, as I laid in the recovery bed, I wondered to myself how I’d managed to get my lungs full of muck so quickly, and thought I had the flu! I also woke to find that I had two plastic drain tubes attached to two small plastic collection vials strapped to my gown. Their purpose was to collect blood discharge from the upper ear areas. The tubes were maybe 2" into my head entering right below and behind each ear lobe…NOT fun.

Unlike other patients of Dr. Hackman, I was not hit by nausea but I did have a lot of drainage and pain in the right ear where the incisions were largest about 1.5 inches (and the largest styloid though I don’t have pictures yet). I expected he would cut into my neck, and did not. But I was told by the post-opt team on the 6th at 6am, that “both styloids were angled inward, no facial numbing and that the surgery went very well.” Because of foggy brain, I wasn’t able to ask more specific questions of them before they whizzed off.

The epiphany I had about my styloids is that they seemed to me to be a crown of thorns at the base of my skull. The stabbing sensations at the base of my skull alone have been “surreal” and sheer torture since 2021. Post surgery, some of my other symptoms are being affected, like tinnitus went away for a bit but it returned now (6/8/24). Also when I lay my head down on a pillow, I no longer feel sharp rocks being pushed into the back of my skull (like literally).

I was discharged on the 6th and have been in a walking daze at SECU House taking Norco and Tylenol as well as prescribed steroids as part of my recovery. I can FEEL the unobstructed blood flow to my brain!!! :slight_smile: However memory remains a real problem, and I think this has probably to do with the concussions I’ve suffered from being rear-ended, first in 2012 and then by a semi-truck in late 2023; all being compounded by the restriction of blood flow caused by the styloids impinging both jugular veins for years…Hence severely impairing my ability to function. What I don’t have yet, are the pictures of the actual size of the bones removed. Dr. Hackman had told me that my styloids were not ‘elongated’ but in reviewing the Surgery Pathological Report exam provided by UNC, they were LARGE. Like larger than a popsicle stick!

Gross Description
A. “Left styloid,” consists of an elongated fragment of bone with attached unremarkable soft tissue (2 x 0.5 x 0.4 cm overall). No sections are submitted to histology-the specimen is submitted for gross evaluation only.

B. “Right styloid,” consists of an elongated fragment of bone with attached unremarkable soft tissue (1.7 x 0.9 x 0.4 cm overall). No sections are submitted to histology-specimen is submitted for gross evaluation only.

I’ve been able to eat, albeit SLOWLY :slight_smile: I have gotten shooting pains mainly on my right jaw but that’s been the extent. Sleeping is another matter, and I’m about to walk to a local pharmacy to buy more gauze so as to cover the two small holes that remain at the bottom of my ears. I’ve also had some blood drainage that’s soiled at least one hotel pillow. Another issue has been constipation caused by Norco, which was made worse by the negligence of the nurses who did not prescribe stool softeners despite dispensing 10mg or Norco every 4 hours. Fortunately I’d prepared for that by buying stool softener at Costco before surgery 

Lastly, I continue on Norco, and sleep is getting slowly better! I need to add, the UNC online web portal is NOT user friend…you gotta tinker with it. My styloid pictures were uploaded but I had no idea which subdirectory to find them in until toady (6/15/24). I’ll include them above.

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Thank you so much for the in depth detail. Ive been so scared to get surgery. And everyday I wake up thinking I should then the next I think I shouldnt. Please keep us updated

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I’m glad you’re through with surgery, sounds quite a rough recovery but hopefully you’ll heal quickly and start to feel the benefits of the increased blood flow :pray:

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So good to hear from you, @HappyBear! Glad you’re through and on the road to recovery! That’s amazing that he only had to make incisions at your ears. It will feel weird for a little while. 2.5 weeks post-op, and I still feel weird pulling sensations (no pain, though). The neck incisions are worse, so I’m glad you only had the ears! And how awesome that you’re already noticing a difference! I was also intubated (had a sore throat for a few days) and, honestly, kind of forgot about the drain tubes. I was much more out of it for a bit after surgery! Keep us posted on your recovery, and welcome to the club, lol!

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@HappyBear - Thank you for the update & pictures. Your brain fog & the symptoms you still have will most likely be with you for a while but will gradually decrease as your swelling goes down. I expect your mind will become more clear as time passes.

Sleeping with your head well elevated for the first couple of weeks after surgery is very helpful for reducing inflammation in your neck & throat areas. All in all it seems like everything went pretty well. Being in the hospital is never fun & medical staff are often stretched a bit thin but I’m glad your overall experience wasn’t too bad.

It’s good you’ll get to go home soon. If you haven’t requested a wheelchair at the airport at both the NC & Los Angeles ends of your trip (& in between if you have a layover), you should do that as it will expedite the trip to & from your gate in each place plus you won’t get so tired.

Please continue to update us as your recovery progresses.

:hugs: :pray:

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Cancelled out

I am so glad that surgery went well for you! Dr. Hackman truly is the best. I am going in for my second surgery with him on August 2.

Just so you know, and for everyone else that hasn’t undergone surgery with general anesthesia before, being intubated is a normal, expected, and required part of undergoing general anesthesia. I’m sorry that you didn’t realize this before being put under! It’s a lot easier to deal with it (mentally) after waking up if you know what to expect (also mentally) beforehand. A sore throat is common and it’s important to keep clearing out your lungs for about a week afterwards. This helps prevent the development of pneumonia.

I hope that you get all of your answers at your postop. I’m also looking forward to pictures, should you be able to post them! My right styloid was 2.5 inches long. Can you believe it? Here’s a picture since you seem to be into that!

I also did end up with a neck incision (styloid was so long + thick due to calcification and combination with styloyoid ligament that he had to break it and remove each end from the corresponding incision), in addition to the one along my ear, and this is what that looked like.

Keep us posted on your recovery!

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Great update! Glad surgery went well and hope you get answers to your questions in you follow tomorrow. I wish that had taken thin sections of your styloids. Looking at the the internal structures of a styloid in thin section will show it’s morphology. My styloid thin section shows clear signatures of ligament tears and I imagine that yours would as well given your injury history. In the images below the yellow arrows point to sinusoidal pull-apart structures as portions of the ligament began to fail. The black arrows point to the 90 degree doglegs at the end off the sinusoidal pull-apart structures and demonstrate complete failure of the ligament tissue resulting in a tear. It is clearest in the soft tissue at the tip of my styloid where the styloid was extracted and pulled away from the surrounding ligament tissue. I believe the larger bulbous cavity sections are caused when the vascular structures in ligaments are also torn and fluids traveling into the ligament have no way out. Best of luck with your recovery and trip back home! :pray: :heart:

Oops, it won’t let me upload the images to this post. I am putting together a video for YouTube that will demonstrate all of this

I just updated your account so you can post images now, @Herd_Mentality_101.

Interesting information you provided about what a thin section of styloid can show!

Hi Isaiah,

Thank you for the update! I’ll go ahead and upload the images to the post. I am still recovering from tethered cord surgery so the final presentation of this will come out in a month or two.

Best,
Kevin

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I’m sorry you’ve had two rare syndromes to deal with @Herd_Mentality_101. Who did your tethered cord surgery? We have another forum member who had that surgery a couple of months ago.

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I actually have several other “rare” syndromes/diseases. Meniere’s disease, thoracic outlet syndrome, and superior semicircular dehiscence are the main ones along with ES and tethered cord

I went with Dr Petra Klinge in Providence, RI for tethered cord surgery. She is amazing!

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That is rough- we have had quite a few members recently who have TOS, and a couple with SCDS. It does seem as though some people are ‘prone’ to vascular obstructions, and also there is thinking that if the jugular veins are compressed then the increased intracranial pressure perhaps wears the tiny bones causing openings like in SCDS. (If you didn’t know already…)

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" surgery with general anesthesia before, being intubated is a normal, expected, and required part of undergoing general anesthesia. "
— Appreciate the clarification. This detail was not explained by any of the nurses pre-operation or post-operation. To the point, I had no idea I’d be intubated.

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Update: American Airlines (AA) Flight from Raleigh to LAX was nearly a disaster.

Arrived at about 5:40AM for the 7:50AM flight and checked into 1st class counter. Was then directed to wait for a wheelchair at a “Disabled” area. And wait and wait and wait I did until about 20 minutes before boarding. With no American Airlines employees available, I walked through TSA pre-check to the gate, else I would have missed the flight. I paid a price for that walk with my backpack as my neck was strained. I insisted that a AA employee “wheelchair” me down the aircraft boarding bay. Breakfast itself was a crime. As aircraft interiors are generally loud, I could not hear the stewardess clearly when dish options were offered, and I accepted the “exotic meal” . It turned out to be gammy pork ham, almonds, figs and a single hard boiled egg. When I told the stewardess that I could not eat the breakfast brought she basically said “too bad, we’ve distributed the breakfasts provided…I can bring you chips.” Two warnings to you all for AA; 1. Even though you request a wheelchair, you may not get it because AA employees are loafing in combination with a large number of (and this is what I saw at Raleigh literally) obese older women and 2. You’re allowed 48 hours I think to select your foods before hand; Highly suggest you do so and not trust the airline to serve a dish that you assume you can eat. From my experience, you won’t be able to chew almonds or gammy prosciutto ham. See AA review here:

Here is the breakfast dish served on a $725 1st class flight:

I thought your ES was already addressed and solved via surgery with Dr. Osborne?? Or was it that it was only one side, and the other got worse?
The tethered cord surgery…When was it? And how long is your recovery?? That sounds VERY intense and I admit to having no knowledge of the procedure. I will pray for you man.

That’s a nasty experience travelling home, especially on your own…I hope that you can rest now & start healing! I definitely wouldn’t have been able to eat that breakfast either, it’s a weird one too! :pray:

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I only had one styloid on my right side. Dr Osborne was able to remove most of it in Feb 2023 but the remaining stub can still occlude my jugular with a chin tuck. I often wake up hypertensive with a massive headache and racing heart beat. The racing heart beat is from left vagus nerve irritation from CCI. CCI is getting better but my neck is still pretty weak. I recently saw Dr Annino up here in Boston and he said he couldn’t go any deeper to remove it either so just something I’ll have to live with I guess or wait till I can find someone to remove it

Tethered cord surgery was May 1st and recovery is going fantastic! Before surgery I walked hunched over with a neck collar and a cane. 100 yards was a really long walk. Today I am just starting my 7th week post-surgery. I only wear the collar when I ride in cars and I can do uphill sprints on my best days. Still have lots of ataxia and neuropathy but most things are coming back

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My 2 cents — Make an appointment to visit Dr. Hackman for a 3rd opinion on removal of that stub.

Also if I may, pray to the Apostle of the Impossible, St. Jude Thaddeus before visiting Dr. Hackman if you decide to. For you edification and that of the group, I’m including the “Right Styloid” removal procedure below that I just got a hold off (not including the rest…it’s too long). I recommend you read through it, and then compare with the surgery procedure report you got from Dr. Osborne when he and his team were done with you. I feel that this information may shed additional light and understanding for you and others.

IF Dr. Hackman thinks he can help you? Then do your best to get into SECU House per instructions, if not, you can stay at hotel using discount rates.

As for Tethered Cord Surgery? WOW!!!

Begin Procedural Report for Happy Bear:

We moved to design of the right preauricular incision extended from the superior aspect of the tragus down to just underneath the lobule of the ear. This was marked out along the skin crease and then injected with local anesthesia. We then incised through the skin and subcutaneous tissue and identify the cartilaginous ear canal. We then began dissection along the perichondrium of
the ear canal retract the parotid tissue anteriorly and dissecting down until we reached the bony cartilaginous junction of the ear canal. We further opened this plane from superior to inferior identified the styloid process originating off the skull base. After doing this, we then moved our dissection inferiorly and laterally and identify the main trunk of the facial nerve which was traced
out towards the pes anserinus. At this point, we had identified the superior aspect of the styloid process deep within the
infratemporal fossa. Periosteal elevator was used to dissected the soft tissue attachments around the styloid process down to the
inferior aspect of the calcified tip. We were fortunately able to dissect down to the inferior aspect. We therefore used a rongeur forceps to fracture the styloid off at the suture line to the skull base, and then retracted superiorly out of the preauricular wound
using a periosteal elevator to release the soft tissue attachments and bipolar cautery for hemostasis. The entirety of the process was removed and sent off to pathology. The facial nerve was tested after removal of the process, and the nerve worked normally
with stimulation. There is no significant bleeding. The wound was copiously irrigated with sterile saline, hemostasis obtained with bipolar and confirmed with Valsalva

7 round Blake drains were placed bilaterally. We then began with wound closure. The preauricular incisions were closed with deep interrupted 4-0 Vicryl sutures followed by tissue sealant for the skin.

At that point in time, the care of the patient was returned to Anesthesia staff who successfully reversed general anesthesia without complication. Happy Bear awoke and was transported to post-anesthesia care unit in stable condition.

There were no immediate complications.