I also saw Dr Filler early on in the process. As the lone scalenectomy provider in LA of course he was going to be on my list.

Surgery aside, I was definitely curious about the MR Neurography. For me, I think it has been the most successful test next to Dr. Jordan's ultrasound in finding the anatomical anomalies.

I went to see him twice in his office, and he ran miserably late both times. The second time I had called ahead and arrived late so it wasn't a big deal. The first time I was running late myself and got to his office all smelly because I hadn't had time to take a shower....I wasn't any better after waiting two hours for him, but I guess he got what he deserved!!!

SHeila was very nice, the Nurse practitioner, she took my history and then went to report to him. It felt a little disjointed, though....like I didn't know how much she had told him of what i told her. HE also talked to the ceiling the whole time i was there which was kind of annoying...however, i wokr at a company of very bright but socially maladjusted engineers, so i am sort of used to this stuff.

I was somewhat alarmed that after talking to me that first appt, he seemed willing to operate without even taking an MR neurography. That was my first warning sign. In any case, I had just had my second round of Botox injections at the time, so I wasn't quite ready to jump into the operating room yet. We agreed that in six to eight weeks I would have an MR neurography of both sides of the brachial plexus and see what it showed.

When he came time to schedule and the MRN. I had to ask the office to change the order for both sides of the brachial plexus, because as some other doctors have done in the past he was convinced that I only have problems on the right I'm not sure what it is that I say that give people the impression. But seeing as how I'm having the laft side operated on first I certainly don't think my symptoms are only on the right.

The neurography was pretty cool. It showed distortion of the course of the brachial plexus consistent with thoracic outlet syndrome on both side. It also showed some irritation of C8 on the left side, which is the nerve that comes out at the cervical and thoracic spine junction.

Interestingly, the approxiamte location of C8 is where I have the constant butcher knife pain that never goes away so for me. I think the MR neurography was dead on.

Also, interestingly, Dr. Riel was very happy to talk about the neurography when I brought the results to their office probably this is because it supported letting them operate on me :P

In the end plan met with Dr. filler to discuss the results of my neurography's, I was unimpressed with his ideas and a few things that you mentioned "remembering" that didn't make it into the report of my scans, and he was basing his surgical recommendations on these "memories." Seems to me that if it was that important enough to base a surgical recommendation on, it should have been in the report.

He did reccomend a scalenectomy and neuroplasty, and said that the neurography did not show that my rib was causing any compression. He would come in supraclavicularly and cut out a few inches of scalene muscle, clean up the nerves, wrap them in seprafilm, clise me up, then come in axiallarily adn lean up and scar tissue in the distal portion of the brachial plexus (front of shoulder area)

The other thing that bothered me about Dr. filler was that his scalenectomy only involves cutting out a couple inches of one scalene muscles seems like that's a lot of muscle to leave behind to reattach somewhere else. It bothered me more after I thought about how doctor Ahn does his surgery-he's leaving 4 inches of muscle and 25% of the time still going back in to remove it.

The other thing that finally killed all thoughts of having surgery with Dr. filler was that I told him I couldn't possibly make arrangements to have surgery with him unless he could tell me how much I was going to have to pay out of my own pocket. His office offered to call Blue Cross of California with procedure codes and charges. Now I happen to know the Blue Cross of California is especially difficult about this kind of thing when you call them and say here's the procedure coding here's the charge for whatever reason they can't tell you how much you're going to end up having to pay. However, I don't feel like his office made a particularly strong effort to get that information for me and I specifically told him I couldn't sign up for surgery without it.

So filler was probably my first elimination. However, I found the neurography results to be very useful.