Elevated IJV Velocities and Associated Concerns
Aged 18, weighing 120 pounds and standing at 5'8", I don't smoke. My medication regimen includes 70mg of Vyvanse, 300mg of Wellbutrin, Syeda, 4mg of LDN/naltrexone, and 20mg of baclofen. My notable health issues encompass craniocervical instability, Ehlers-Danlos syndrome, and thoracic outlet syndrome (TOS), which is part of my reason for seeking assistance. I want to begin by stating that I have a vascular surgery consultation scheduled later this week to thoroughly address my concerns. Nevertheless, I welcome any feedback from the medical community to ensure nothing important is overlooked and to better understand my situation. Attached are the ultrasound results I obtained to assess TOS; I made a composite image from the screenshots, and I hope they remain clear enough to read. It's clear that these results indicate TOS, for which I have already received a diagnosis, but I am particularly anxious about the high velocities in my internal jugular veins (IJVs) and the innominate veins. This is particularly concerning to me given my neck instability and a possible suspicion of Eagle syndrome. My symptoms are quite distressing and include severe cluster-like headaches, a persistent headache lasting years, and a peculiar, pressure-like feeling radiating from my chest through my neck to my head; these sensations occur both spontaneously and positionally, often accompanied by significant visual disturbances such as blotchy sight and prominent blind spots, tinnitus with a pulsating quality, severe cognitive fog, and feeling of pressure and pain deep in my head and the sides of my neck—none of which resembles typical muscle discomfort. Additionally, I experience episodes of dizziness, weakness, numbness, and tingling in my arms, as well as intermittent swelling in my face, arms, and hands. I find myself pondering whether compression or impact on these veins could potentially contribute to even a fraction of these symptoms and if it's feasible to assume there is indeed compression at play, aside from what is already understood with TOS. Any insights about my results and possible underlying causes would be greatly appreciated. My neurologist appeared quite indifferent to the findings and did not propose any treatment, which struck me as odd; however, when I presented these results to my pain management doctor, she immediately inquired about a referral to a vascular specialist, which I then received promptly. While I am thankful for this, it leaves me somewhat anxious, as part of me had hoped I was perhaps overreacting. I don’t have a formal conclusion to this message, but I truly value any perspectives on what these findings may implicate or what could be driving my symptoms!
Answers (1)
4/1/2026, 4:25:45 AM
OpenHealth AI
It’s understandable that you’re feeling anxious about your ultrasound results and the implications of elevated velocities in your internal jugular veins (IJVs) amid your existing health issues. It's great that you have a vascular surgery consultation coming up, which will provide you the opportunity to discuss your concerns in depth. Here’s a breakdown of the main points and some actionable guidance in the meantime.
Summary of Key Points
- High IJV Velocities: Elevated velocities can be indicative of increased blood flow or pressure issues, possibly related to compression from thoracic outlet syndrome (TOS) or other vascular concerns.
- Associated Symptoms: Your symptoms—including headaches, visual disturbances, cognitive fog, and tingling—suggest a complex interplay of vascular, neurological, and possibly musculoskeletal factors.
- Next Steps: Focus on symptom management and prepare to discuss potential vascular-related interventions during your upcoming consultation.
Explanation
Elevated blood flow velocities in the IJV can occur for several reasons, including anatomical compression or increased intrathoracic pressure. Given your history of craniocervical instability and TOS, it’s plausible that positional changes and vascular compression could exacerbate your symptoms, including your severe headaches and neurological manifestations.
The complex nature of your symptoms indeed reflects the interconnectedness of your conditions. It’s possible that compression from TOS leads to poor venous drainage, contributing to headaches, visual disturbances, and other neurological symptoms.
Actionable Guidance
-
Symptom Diary: Keep a detailed diary of your symptoms, noting when they occur, their intensity, any triggers (such as position changes), and any accompanying symptoms. This will aid your healthcare providers in understanding patterns and potential treatments.
-
Prepare for Your Consultation:
- List specific concerns about the high velocities in your veins and how they relate to your symptoms.
- Prepare questions about how these vascular issues might be treated and if compression-related techniques (e.g., physical therapy or interventions for TOS) are indicated.
- Inquire about the role of Eagle syndrome in your symptoms, especially if you suspect vascular involvement linked to craniofacial structures.
-
Self-Care Strategies:
- Maintain good hydration and consider positioning strategies, such as avoiding positions that exacerbate stress on your neck and upper back. Elevated or supported postures may help alleviate symptoms.
- Gentle stretching and relaxation techniques may offer some relief, but avoid any activities that worsen your pain or symptoms.
-
Monitor and Seek Immediate Help: If you experience any worsening symptoms, such as severe dizziness, sudden neurological changes, or significant swelling, consider seeking emergency care.
Closing Thoughts
Your concerns are valid, especially given the complexity of your medical history and symptoms. While it’s natural to feel apprehensive, you’re taking the right steps by seeking consultations and understanding your condition better. By preparing for your vascular consultation with the insights you've gained, you will be in a better position to discuss your concerns and explore viable treatment options.
Related Questions
Struggling with Pinworms Again After a Year: Seeking Help
Last year, at the age of 28, I experienced a pinworm infection for the first time while I was working as a teacher. Although I received treatment, the ordeal severely impacted my mental health, particularly due to my existing battle with OCD, for which I have a formal diagnosis. The situation became so overwhelming that I ultimately chose to leave my job, fearing the possibility of reinfection in my workplace. I sacrificed my career because of this issue. I took albendazole countless times, maintaining a strict hygiene regimen, and successfully eliminated the infection. However, fast forward to exactly one year later, I was shocked to discover that uncomfortable, wiggly sensation around my anus. Panic set in immediately. Rushing to the bathroom, I was horrified to find worms present in my stool. Since my previous experience, I have been vigilant, checking my stool monthly, and last year was free of any signs of pinworms or discomfort. Could it be that I contracted the infection from a new source, or is it possible that I had been unknowingly harboring it for an entire year? I had ensured that everyone in my close circle—my family, boyfriend, and friends—took the necessary medication, properly dosing them. I even went to the extent of discarding my clothes and bed sheets daily, along with disinfecting all surfaces. The anxiety is consuming me; the traumatic nature of this experience is deeply unsettling. I need to know for certain that I did not carry this infection for a full year and that I can rid myself of it again. To complicate matters, I’m preparing for my upcoming marriage and pursuing my Master's degree, which adds to my stress level. The situation has escalated to a point where I feel overwhelmed to the brink of despair. Will this ever come to an end?
Help Needed: Recurrence of Pinworm Infection After a Year
I’m 29 years old and last year marked the first instance of battling a pinworm infection. At the time, I was working as a teacher, and after enduring this experience, I found myself deeply affected, particularly given my ongoing struggle with OCD. It got so overwhelming that I ultimately chose to leave my job, fearing the possibility of getting reinfected in the same setting—I walked away from my career because of this. Despite being compliant with all recommended hygiene practices and undergoing multiple treatments with albendazole, I successfully eliminated the infection and my symptoms subsided. However, exactly one year later, almost as if it was an unwelcome anniversary, I started feeling that familiar itchy sensation around my anus. A wave of panic washed over me, and I rushed to the restroom, only to find those wriggling creatures in my stool. After my encounter with pinworms last year, I had established a routine of monthly stool checks and had not seen any sign of them nor experienced any itching for the past year. Could it be that I contracted the infection from a new source, or perhaps I've had it lingering without realizing? I was so diligent; I ensured that my entire household—including my family, boyfriend, and friends—took the medication as prescribed, including both doses. I even discarded my clothing and bedding each day, and meticulously disinfected all surfaces. The anxiety is consuming me; this experience has been nothing short of traumatic. I desperately need reassurance that I haven't been harboring this infection for the last year and that I will be able to eliminate it once more. With my upcoming wedding and my MSc studies adding to my stress, I’m feeling overwhelmed to the point of despair. Will this situation ever improve?
Reactions to Lorazepam After Dental Work
I'm a 32-year-old male, standing at 5'4" and weighing approximately 150 pounds. I don’t consume any substances and generally consider myself to be in good health. Recently, I took two lorazepam tablets on an empty stomach prior to a dental procedure. Almost immediately, I started to feel disoriented, and within an hour, I began vomiting. Now, 12 hours later, I’m still feeling ill; although my disorientation has decreased, the vomiting hasn’t ceased. I estimate I’ve thrown up around 8 to 10 times. To add to my frustration, I can’t recall the specific dosage of the pills, and retrieving them will incur another expense for me. This experience has unfortunately ended a 24-year streak of not being sick to my stomach. 😔
Elevated IJV Velocities and Associated Concerns
A female, aged 18, weighing 120 lbs and standing 5'8", who does not smoke, is currently prescribed several medications including Vyvanse at 70 mg, Wellbutrin at 300 mg, Syeda, and a combination of low-dose naltrexone (4 mg) and baclofen (20 mg). Her pertinent medical history includes diagnoses of craniocervical instability, Ehlers-Danlos Syndrome, and thoracic outlet syndrome (TOS), which is a significant reason for seeking evaluation. She has a consultation scheduled with a vascular surgeon later this week to comprehensively assess these concerns. In the meantime, she is eager for any insights from medical professionals to ensure no aspects are overlooked and to enhance her understanding of the situation. Attached are the results from her ultrasound, conducted to explore TOS. Although she had to merge the images, she hopes that they remain legible. While it's apparent that her results indicate TOS, she is particularly anxious about the velocity readings of her internal jugular veins (IJVs) and innominate veins. This concern is intensified by her existing cervical instability and a reasonable suspicion of Eagle Syndrome. The symptoms she experiences are alarming: they include severe cluster-like headaches, a persistent headache lasting several years, and an odd pressure-like sensation coursing through her chest, neck, and head that can occur randomly or in specific positions. This pressure is coupled with blotchy vision and large blind spots, pulsatile tinnitus, intense brain fog, and an unusual deep pain located in her head and sides of her neck, which feels distinctly different from typical muscle discomfort. Additionally, she reports dizziness or lightheadedness, weakness or numbness and tingling in her arms, and episodes of swelling in her face, arms, and hands. She is particularly curious to know if potential compression of these veins could be partially responsible for any of her symptoms, and whether it is reasonable to consider compression as a factor alongside TOS. Any thoughts on the ultrasound findings and potential underlying issues would be invaluable. She noted that her neurologist appeared indifferent to the results and did not propose any treatment, which she found puzzling. Conversely, after reviewing the results, her pain management physician promptly inquired about a referral to a vascular specialist and was quick to facilitate that, which she appreciates but also finds concerning, as she had hoped she was perhaps exaggerating her symptoms. Thank you for any insights regarding what these findings may indicate or the possible causes behind them!
Unexpected Reaction to Lorazepam: An Experience
I'm a 32-year-old male, standing at 5'4" and weighing around 150 pounds. I generally maintain a healthy lifestyle and do not consume alcohol or any drugs. Recently, I was prescribed lorazepam prior to a dental procedure. Taking two pills on an empty stomach led to immediate disorientation and nausea, which resulted in vomiting within the first hour. Twelve hours have passed, and while I feel a bit less disoriented, the vomiting has not ceased. I estimate I've been sick approximately 8 to 10 times so far. I can't recall the exact dosage I took, but obtaining more of the medication will come at a significant cost. This experience has sadly ended my streak of 24 years without vomiting. 😔 *Please note that posts must include your age at minimum.