OpenHealth Q&amp;A

Elevated IJV Flow Rates and Additional Issues

A 18-year-old female, weighing 120 pounds and standing at 5 feet 8 inches, who does not smoke and is currently on a regimen that includes Vyvanse 70 mg, Wellbutrin 300 mg, Syeda, LDN/Naltrexone 4 mg, and Baclofen 20 mg. Her notable medical conditions comprise craniocervical instability, Ehlers-Danlos syndrome, and thoracic outlet syndrome, which are contributions to her visit today. She begins by stating that she has an upcoming consultation with a vascular surgeon later this week to thoroughly assess her issues. Nonetheless, she seeks input from medical professionals here to ensure that no critical aspects are overlooked and to gain a clearer understanding of her situation. She has included her ultrasound findings intended to investigate TOS, having merged the screenshots into a single image for better accessibility. It’s evident that the ultrasound results indicate the presence of thoracic outlet syndrome, a diagnosis she has already received. However, she expresses greater concern regarding the flow velocities noted in her internal jugular veins and innominate veins, particularly in light of her neck instability and the possibility of Eagle syndrome. In summary, her symptoms encompass severe cluster headaches, a persistent headache that has endured for years, a peculiar pressure-like sensation that travels through her chest, neck, and head—occurring both spontaneously and in relation to position—accompanied by significant visual disturbances including blotchy vision and large blind spots. She also experiences pulsatile tinnitus, intense brain fog, pain and pressure in her head and neck that feels unlike typical muscle pain, dizziness or lightheadedness, as well as weakness, numbness, and tingling sensations in her arms and periodic swelling in her face, arms, and hands. She questions whether the potential compression of these veins might partially contribute to some of her symptoms and whether it’s plausible to consider the involvement of compression beyond the diagnosis of TOS. Any insights on her ultrasound findings and possible underlying causes would be immensely valued. While her neurologist appeared unconcerned about the results and did not propose any treatment, her pain management physician quickly inquired whether she had been referred to a vascular surgeon. Upon learning that she had not, the pain management doctor promptly arranged a referral, which she appreciates but finds a bit alarming, fearing her concerns might have been excessive. There is no formal conclusion to this post, but once again, she is sincerely thankful for any guidance on what these results could imply or the underlying causes that might be at play!

Elevated IJV Velocities and Additional Concerns

Female, 18 years old, weighing 120 pounds and standing 5'8", non-smoker. I am currently prescribed Vyvanse at 70mg, Wellbutrin at 300mg, Syeda, LDN/naltrexone at 4mg, and Baclofen at 20mg. My relevant medical conditions include craniocervical instability, Ehlers-Danlos syndrome, and thoracic outlet syndrome, which is one of the reasons for my visit today. I want to preface this by noting that I have an upcoming appointment with a vascular surgeon later this week to thoroughly assess these issues. However, I would greatly appreciate any insights from healthcare professionals here to ensure that nothing is overlooked and to better understand what might be happening. I've included the results from my ultrasound that was conducted to evaluate for thoracic outlet syndrome; I've combined the screenshots into one image, and I hope it’s legible once accessed. While I understand these findings suggest thoracic outlet syndrome, my primary concern revolves around the elevated velocities in my internal jugular veins (IJVs) and innominate veins. This is particularly troubling in light of my neck instability and the possibility of Eagle syndrome. To summarize my symptoms, they include severe headaches resembling clusters, a persistent headache I’ve endured for years, and a peculiar pressure-like sensation traversing my chest, neck, and head—this occurs both randomly and when changing positions. I also experience significant visual disturbances, such as blotchy vision and large blind spots, pulsating tinnitus, extreme brain fog, and pain that feels very different from ordinary muscle aches. This pain is deeper, along with dizziness, lightheadedness, weakness, numbness, and tingling sensations in my arms, paired with occasional swelling in my face, arms, and hands. I am particularly curious whether potential compression of these veins could be a contributing factor to some of these symptoms, and if it is plausible to assume that there might be any type of compression present, aside from what is typically associated with thoracic outlet syndrome. I would truly welcome any thoughts on these findings and the possible underlying causes. My neurologist seemed rather indifferent about the test results and did not recommend any treatment, which struck me as odd. Conversely, my pain management doctor reacted differently; she promptly inquired whether I had been referred to a vascular surgeon, and upon learning I hadn’t, she submitted a referral immediately. While I am thankful for her proactive approach, it also leaves me with a sense of concern, as I had hoped my fears were unwarranted. I appreciate any input regarding what these test results may indicate or potential causes for my condition. Thank you!

Elevated IJV Velocities and Other Concerns

A female patient, aged 18, weighing 120 pounds and standing 5 feet 8 inches tall, is a non-smoker currently taking Vyvanse (70 mg), Wellbutrin (300 mg), Syeda, low-dose naltrexone (4 mg), and baclofen (20 mg). Her pertinent medical history includes craniocervical instability, Ehlers-Danlos syndrome, and thoracic outlet syndrome, which is a primary reason for her visit. She has an upcoming meeting with a vascular surgeon later this week to thoroughly assess her condition. However, she seeks additional opinions from medical professionals to ensure nothing is overlooked and to gain more understanding of her situation. Included in this discussion are the results from an ultrasound performed to investigate thoracic outlet syndrome; they have been compiled into a single image for easier review. While she recognizes that the ultrasound findings indicate thoracic outlet syndrome, her main alarm revolves around the velocities observed in her internal jugular veins and innominate veins. This concern is compounded by her pre-existing neck instability and a reasonable suspicion of Eagle syndrome. Her symptoms encompass severe cluster-like headaches, a persistent headache lasting several years, an unusual pressure sensation that ascends through her chest, neck, and head (these symptoms can occur unpredictably or in specific positions), along with vivid visual disturbances including blotchy vision and large blind spots, pulsatile tinnitus, significant brain fog, and discomfort that feels distinctly different from typical muscle pain—deep and perplexing. She also experiences dizziness and lightheadedness, tingling, numbness, and weakness in her arms, and episodic swelling in her face, arms, and hands. She is particularly curious whether compression of the veins could be influencing some of these symptoms and if it might be reasonable to consider the possibility of such compression existing, in addition to her diagnosed thoracic outlet syndrome. Feedback regarding her findings and potential underlying causes would be greatly valued, especially as her neurologist seemed unfazed by the results and did not recommend any further treatment. This was puzzling to her. However, after presenting the findings to her pain management doctor, she was promptly advised to seek a referral to a vascular specialist, which she feels grateful for yet remains concerned about, hoping her worries might be unwarranted. Once again, she welcomes any insights on the implications of her results and what might be driving her symptoms!

Concerns About Potential Melanoma

A 27-year-old woman seeks insights regarding various skin lesions while sharing her health background. She intends to upload several images of these moles, yet can only share one at the moment and will continue to add more pictures in the comments. Here's her story and inquiry: Greetings! I have a query tied to health, particularly in the realm of dermatology. Being a redhead, I’ve come to understand that we might be more susceptible to melanoma. As I’ve researched, it seems that melanoma typically does not persist for decades; it often emerges and advances within a few years. One mole of mine transformed from brown to black approximately 11 years ago. Its size hasn’t changed significantly, but it has altered from a perfect circle to a more irregular shape, and I became aware of it due to the color change. I initially dismissed it, but considering my recent stomach issues, which I’m trying to address, I find myself reevaluating this mole since it’s located on my lower abdomen. There’s also a pink nodule on my back that has concerned me. I noticed this growth a few years post-pregnancy, and although I disregarded it initially, it has persisted. Has anyone experienced anything similar? Lately, I’ve encountered various health issues, including consultations with a neurologist, and have felt extreme fatigue, tremors, and symptoms resembling sarcopenia alongside consistently low creatinine levels. This situation resembles reactions I had to the Depo shot, which I had been using for nearly nine years—starting two and a half years before my daughter was born, followed by a nearly two-year break, and then returning for another seven years since her birth. I’ve never undergone an MRI until recently, and a couple of weeks ago, I had a CT scan without contrast to check for stones, advised by my new primary care physician. Unfortunately, this doctor seems to avoid addressing my specific health concerns. Consequently, I have taken the initiative to investigate my conditions to advocate for myself and request three separate appointments over nine months (one every three months) to receive a referral. This new primary care physician, recently relocated from Florida, has not noted the health issues I raised two years ago, which makes it seem as though they were never acknowledged. She is primarily focused on the medications I’m on, including ADHD medication, rather than my overall health state. Two months ago, I underwent a procedure to remove a mass from my throat, which took a year to get addressed after enduring numerous tests that seemed largely irrelevant to the medication gabapentin, which was prescribed to me by my previous doctor over seven and a half years at a very low dosage. I would appreciate any guidance or support on these matters.