Vagus nerve issue versus sympathetic...what is mine?

[Turtle628]

I take Metoprolol for control of HBP and to try to curb my heart rate and blood pressure during “episodes” of sympathetic activation. I’ve had these issues prior to any surgeries, pretty much my entire life. I was injured in a car accident years ago which herniated discs in my c-spine. I’ve had 2 cervical fusions and 2 thoracic outlet surgeries over a 4 year span. I have chronic neck/shoulder/arm pain daily. I recently tried an external vagus nerve stimulator; which, has only made all symptoms worse and episodes more frequent. Just looking for a direction to go from here.