hi, jane,

i'm so sorry you're having such a hard time right now. i think part of what's going on with you, if you don't mind me being so bold, is that maybe you are coming to the terms with the sad realization that you may not be able to return to the profession you trained so long for, worked so hard at for so many years...and were i'm sure, so very good at!

TOS takes so much from us, on so many levels. what i hear in between the lines of your posts is pure grief. you are a W/C case, if i'm not mistaken, and this is a work-related injury for you. keep very careful records. are you seeing a pain psychologist to help you through this? i think that might be very helpful for you, jane. just something to think about. and there is absolutely no shame or stigma attached to it, i want you to hear that loud and clear. now, it would probably need to be "approved" or whatever by your primary W/C doc, i would think, but maybe the referral would be better coming from your PM doc or even your PT (that PT sounds like someone that's willing to work with you, do research on your behalf and that is awesome, jane!). i hope this doesn't offend you in any way, it applies to a lot of us. TOS'ers tend to be workaholics - take away our ability to function in the workplace and you've got some very unhappy type A personalities on your hands, people! think about it.

the EMG/NCV isn't likely to show much in the way of TOS, i'm afraid. most of us come back "normal" on those studies, with 2 major exceptions. if there has been EXTENSIVE damage and you're a very advanced case, a regular EMG/NCV might show some abnormalities. or, if they are using the evoked potential technology to test all the way up across the brachial plexus to the C-8 and T-1 spinal nerves to look specifically for TOS, then that might show something. the so-called SSEP test.

dimarie sometimes posts about this and is much more knowledgable than i about the reasons why. but in a nutshell, i think that TOS affects the smaller sensory nerves first, and it's the larger motor nerves that get tested in these clunky basic electrodx studies. so unless you are having the SSEP done, don't expect to get a TOS-specific result. what they ARE useful for, however, is ruling other stuff out or in in your case, like carpal tunnel syndrome or cubital tunnel syndrome, or even setting the stage for dread "double-" or even "triple-crush" stuff. i have that. we are all vulnerable to it, once the ulnar nerve is damaged at the BP level. if you take a look at dr. fried's site at http://nervepain.com there might be more info there for you, or PM dimarie or perhaps she'll take the bait and chime in on this thread (mommy? are you reading this? come home, all is forgiven!)

anyway, keep taking good care of yourself, hair....oops i mean jane !

this, too, shall pass.

alison

p.s. the MRI of the neck won't show much either... it's no big deal. search tshadow's thread on testing for TOS - she goes into a lot of detail about some of the hoops they have us jump through (not to say your docs will order each of the tests listed, by any means!). it's all a process of ruling out other stuff, mostly. some day hopefully there will be an AFFIRMATIVE diagnostic test for TOS, but we're not there yet except in the rare case of C-ribs or something like that; even then it can be touch and go. the dx is fraught with controversy. W/C will fight it to the bitter end. just keep doing what you're doing - you take care of YOU and let your lawyer worry about the legalities.