Vascular ES .... How to get attention sooner rather than later

Good morning, I’m 6 weeks into an acute problem with what is presumed VES. I have passed out twice, when lying on my side (without good support)… Initially my internist suspected I had a vaso vagal response to neck pain. I do have a compromised neck from a car accident years ago (in treatment again for it before this ‘acute’ situation happened).

I have a longish (?) pointy styloid on my left side (where all my problems are), which showed up on a panoramic X-ray via oral surgeon.

I’ve not passed out in 5 weeks, but have had several episodes where it felt like I was going to (and have the seemingly vascular symptoms with pulsing at brain stem, head pressure, etc.).

If I am at risk of stroke or other from this, how would I go about getting anyone’s attention (other than the ER… which I did go to in between the two syncope events)? Have been scouring all the posts, but don’t see anyone with an expedited surgery due to risk.

I do have two appointments coming up in two weeks. One is skull base surgeon and the other is a interventional vascular neurologist.

Spoke with my internist yesterday and he will order the CT w contrast (positional)… so thinking those results would potentially mean something to someone (???). How long does it take for CT results?

Any guidance would be greatly appreciated.
Many thanks,
Leah

Really good that your internist is helping you & if you can get a positional CT with contrast done that’s brilliant! I can’t comment about timing of results as I’m UK & we have to wait 6 weeks at least! Maybe someone from the US can answer, and again about how to get surgery expedited if you’re more at risk- your internist might be able to help you with that one depending on your results? Different doctors have different waiting times so that would be difficult to predict, I guess they’re the best ones to have that discussion with when you see the doctors in a couple of weeks.
Strokes are very rare with ES, so I hope that helps give you a bit of comfort, but of course go to ER if you do experience any of these symptoms again. Sending you a hug :hugs:

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Thank you so much. Yes I am incredibly fortunate to have a long term relationship with my internist. As i suspected, even he didn’t know what to do with this information. Luckily, from you all, I had it planned out as to what I needed from him and he was agreeable to all requests.

On the other hand, every other doctor I’ve seen for neck issues in 10+ years have been incredibly disappointing in thinking out of the box to determine a solution or diagnosis.

Most recent example … (and say this for others who are and have gotten blown off by their doctors) … Took my panoramic x-ray to my Physiatrist … His comment “I don’t know anything about this, but I don’t think it is the cause of your problems”… which of course is an illogical and uneducated ‘opinion’ …

So grateful for all of this incredible information.

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How helpful was that :woman_facepalming: glad you do have someone listening to you!

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I have the same and was diagnosed with Eagle’s by an ENT doc who referred me to a head and neck surgeon. The head and neck surgeon wanted me to be seen by a neurosurgeon, who confirmed the finding and also instructed me not to drive until the right styloid is removed. I did not need a dynamic CT for them to determine that my right carotid is impacted, just a regular CT was enough. I have begun using a cane sometimes on days that I notice my balance being off, but I doubt it would help with the passing out that I’ve also experienced a few times. Good luck to you - you’re not alone!

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I’m so sorry for you suffering (((. Do you have surgery scheduled? Hope you are quickly relieved of pain and risk.

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@Leah,

I’ve had several MRIs & a CT scan already this year (for another problem, not ES) & my results were available same day or by the next day via the patient portal for the radiology lab. I expect your results should be available this week or early next week at the very latest. Some places won’t post them until after you see the doctor because they don’t want patients being confused/concerned by information they may not understand.

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@AS2005 - have you gotten any word yet about whether or not your case will be expedited? I hope for your sake it will be!

I have not. I am hoping when I get CT results (order should have been sent today) , I will have something to work with. I do have recent cervical MRIs and a member just showed me how to look for IJV… so will see what I can do with that in the mean time. TIA

@Isaiah_40_31 Oops thought this was to me … (brain fog of course) :face_with_head_bandage:

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Not yet - on a waiting list!

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Not yet… still waiting and hoping! :slight_smile: :slight_smile: :slight_smile:

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Hi @Leah,

I know we were talking in the other post yesterday, but I will try to keep my comments in this one so the info isn’t split.

If you can get a CT with contrast, that is the best form of imaging for looking at VES. You get to see the styloid bone and the veins in the same image. Your lucky that you internist will order that type of scan for you. My ENTs and neurologists were reluctant to ordering imaging.

If you are getting this done at an imaging facility tell them you will wait and want the “DICOM images and viewer burned on a CD”. If it’s at a hospital they may make you wait a day, but either way that is your health record and they are required to provide it to you in a speedy manner, but only if you ask. Radiologists generally will generate a report within a day or 2, but I would want to see the imaging for myself. Several radiologists missed my IJV stenosis.

Hopefully you have access to a computer/laptop with a CD/DVD reader on it. Sometimes imaging facilities will provide you with a portal to view the images online, but currently the CD method is an industry standard.

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Good morning @GCD
Fantastic information. Thank you so much. Bought a external CD/DVD last night. Sorry you had difficulty getting imaging. I would absolutely be in the same boat without my internist. He is a rarity these days.
Leah

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3-D …request that the CT with contrast be also converted to 3-D.

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