Yes you called it. My curve correction doctor who does dry needling of muscles and fascia, did an ultrasound of my left neck and physically pulled on the large muscle under the ear, outwards. It was not comfortable but the ultrasound showed that the IJV opened up at that point. So there is muscular compression. But how to prove that to a surgeon who can take my case, I’m not sure. I’m hoping when I speak to my new “in network” PCP and I tell him about this stuff, he won’t look at me like I’m making this up or dismiss this.
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@MisterFrodo - The muscle you’re referring to is the sternocleidomastoid muscle (SCM). It attaches on the sternum (sterno), collar bones (cleido) & on the mastoid portion of the skull. It’s the largest of our neck muscles & facilitates some types of head & neck movement & breathing.
We’ve heard of doctors shaving the SCM a bit to make more room for the IJV. I recall it’s Dr. Cha who does that, however, I don’t know that she does other aspects of IJV decompression i.e. styloidectomies & shaving of the TP of C1.
I hope your PCP would be willing to have a conversation w/ your chiropractor if he doesn’t believe what you tell him.
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If you were able to get a consultation with one of the VES doctors, it’s worth asking about this, hopefully they would look into other compressions as well as the C! and styloids, Dr Costantino for example has partially resected the digastric muscle & mentions the omahyoid muscle which can both cause compression…
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I consulted with my PCP and it was having to go through everything from the beginning. I’m sure even he couldn’t imagine the symptoms that would be thrown at him. To make a long story short, they are going to look at referrals but are waiting on my neurologists notes. However it almost makes sense to go to my neurologist to refer me directly to one of the doctors like Dr. Cognetti. In the meantime, I’m contacting Dr. Hackman’s office for a followup consult about the progress of my condition and hopefully find out what he thinks regarding the venous compression. Other than the chest spasms, I have gastroparesis which is a slowing down of digestion. And it’s really bad right now. And with the Dysautonomia I have exercise intolerance which means any physical activity will trigger a nervous system response and Vagus nerve spasm. I feel basically a mess, but have to keep holding myself together and keep pursuing to get the help I need. BTW the Beeviewer was informative and I was able to make this still of the troubled left side.
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I’m not sure of what the blood vessels are between your styloid & C1, they all look narrower than we normally see in scans? But it does look like the C1 could well be involved with some compression. And would be possible that the vagus nerve is also being compressed. Your hyoid looks like it could be a bit chunky too, but can’t really tell as not all of it shows.
@MisterFrodo - Here’s your image with some basic annotation. You clearly have IJV compression on your left side which looks to be predominantly caused by the TP of your C1. That would mean seeing Dr. Cognetti, Costantino, Liu, Hepworth or Nakaji would be your best bet for symptoms relief. Dr. Hackman could surely resect your styloids, but I don’t think that alone will relieve your symptoms. Can you also post a pic of your right side so we can check for bilateral compression?
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Here’s the right side. Not beautiful pictures to be sure. I did hear back from Cognetti’s office and they are getting my reports from my doctor, however they need imaging. I’m not sure all what they need but I will send them these CT scans w contrast from 2024, as well as my most recent cone beam CT scan and probably angiogram with my recent ultrasound that indicates the compression. I wish they had a portal to upload everything through but sounds like they want me to send everything on disc via mail. Then they will decide whether the doctor will want to take my case.
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