Update 2 | Got my CTA/CTV results | SCM compressing my left IJV in neutral position

General
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Hello all,

Thought I share this update with everyone as this may help people with their journey.
I visited Dr. Jeffrey Middleton in Fort Lauderdale last week. He did a unique 4 phase CTV which combines CTA and CTV.

I am so happy to finally know what my intense brain fog and anxiety come from.
Left side: The left IJV hardly let any contrast through and it shows my left SCM is Huge.
Right side: The right IJV is strangled by something we can’t see around the C1.

Plan of action:

  1. Get botox in my left SCM to improve the venous flow as soon as possible. I already tried massage, exercises and acupuncture for 1 year. Results don’t last.
  2. If the left SCM is calmed down and I still feel brain fog then I will get surgery done by Dr. Ferdinand Hui in Hawaii. He opens it up to see what is wrapped around the IJV on the right side and possibly, if needed shave down the side of C1, remove styloid, clip muscles.

I added a video link below the images.

Back view
Back view1920×2624 264 KB

Front view 4 phase CTV
Front view 4 phase CTV1077×2551 230 KB

SCM view
SCM view907×1866 151 KB

Right IJV compression
Right IJV compression1681×2641 303 KB

Very interesting video from him about venous flow obstruction: https://l.facebook.com/l.php?u=https%3A%2F%2Fyoutu.be%2FSk-V3EbKIqA%3Fsi%3DYoyPCGME-qLpFVsh%26fbclid%3DIwZXh0bgNhZW0CMTAAAR1qU1sVRSRPC6u21WdFpaQIsuSbNxtIG8gXKokM1NloCPQVOqyImYzG5pQ_aem_AToNVP42kvcoIulL3bukElaQX8712jHgIv0-ABaZeRgZX0Tt95UlapI-qFKF-ea40q-JeW4soGVrIrgYFTqh56Rb&h=AT2A3dMAqNIBAYtc_FrepkCsyfI8druBE-bQuEOrqviSvc_Y0D6G5goCt3c161smNsRwZrY8CIpATAb9yFwx4YNcBtSi0wtWpP6m3tH9aLcZWpfkAGbarcBy9tny6A0-SvaZ7qfITvYAgBrDo_Cw&__tn__=R]-R&c[0]=AT1h-CHiHszFk50KjZCfUzt8NYZ4QOBzyyKsdoMeywvwKLMZnUK7QSnfxAjHNSNteR1GmDgVmax-w47spjUPKkx2jmtxtdQMdhD5crxXgEchkD-QgnQ4ryxSi4H4CnhumP0lO2OF2z9U4jjvAZiEDPNYNAwIPkufoZ4bq1zlxRb9fBfSG7ZLSAnNaCZPIxH6

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I already watched Dr. Middleton’s video yesterday, and I instantly recognized that it’s about your case, so it was a nice surprise. The imaging he does is really very good from a diagnostic standpoint. I think the plan with botox into the left SCM is a good idea for this probably unusual cause of IJV congestion. I am really curious and really hope that you will get long-lasting relief with botox and that you will not need the surgery.

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I’m glad that the imaging shows what’s going on, & that you have a plan with Dr Hui moving forward…if the botox doesn’t help, :pray: that it does!

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It’s great that you got some answers after traveling so far. Thank you, too, for reposting the link to the venous outflow webinar. It’s been a while since it was mentioned on here, & it is definitely filled w/ useful information.

I don’t think Dr. Hui himself does styloidectomies as he is an interventional radiologist. From what I understand, he only puts in stents, but he works with a team of other doctors who are being trained by Dr. Hepworth to do IJV decompression, styloidectomy & possibly C1 shaving.

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