Mark, I think we all know and understand that alterations in the blood flow to the brain are a reality for many who have undergone radical neck dissections, and all these comments, mine included, were just an opportunity to try to lighten things up a little. The issue of thoracic outlet syndrome, and other vascular related restrictions to cervical blood flow, take up a whole chapter in my head and neck surgery text. They are indeed a reality. Obviously the issues attached to this leave us all with a variety of compromises in our lives depending on how severe and extensive our surgical intervention was. Vertigo is the most common, but even things as remote as blurred vision and nausea can be related to this issue.