Hi, Terri,

This has got to be hard for you. As moms, we want to take their hurt away, and TOS surgery is one big boo boo you just cannot fix! But as I'm sure Dr. Riefsnyder has told you, there is recovery from this; it can be a slow process, however. Steady wins the race. (I realize that's not particularly helpful to hear right now, as at only 5 days out, of course Sara is still in an acute postop phase recovery-wise).

As a nurse, I know you understand what an insult major neurovascular surgery is to the mind and body. What Scott says I think is very true, Sara's no doubt got some very angry and irritated little nerves coursing through her thoracic outlet and upper extremity right about now. They are letting her know it, too! The first rib resection is a delicate operation requiring special surgical skill; yet, it still manages to stir everything up in its execution, no matter how skilled and sure the hand of the mighty surgeon may be.

For me, I found as I stumbled along through recovery (from the same surgery your daughter just had), it helped to know that some of those painful (and sometimes bizarre) nerve symptoms were actually signs of healing, as my severely damaged ulnar nerve started to come to life again after being decompressed by the TOS surgery.

Has Sara got some PT or even OT (good for work on the hand) lined up for her, or already begun? Assuming you guys can access someone who is TOS-savvy, and won't have her doing any aggressive stretching or strengthening (at all), no theraband, no traction or UBM, etc. unless and until her pain and other symptoms have been brought down to a manageable level.

But, if she's not already, you might want to think about having her start to do some gentle nerve glides, ROM movements, posture work, and things like that… under the supervision, of course, of a knowledgeable physical terrorist - oops!!! - I mean, therapist (really!), who will probably also have a few tricks up their sleeve in terms of therapeutic stuff she can use at home to make her feel better, like: cold packs (I used frozen bags of peas, as I had traveled out of state for my rib resection) for the surgical site, or wherever she's hurting or spasming; hand putty (she can play with this while watching tv, it'll help her hand issues); container of heated grains of rice (again, for her hand); hot packs (moist heat is best - try alternating hot and cold packs, 20 minute intervals); simple stretches (none to point of pain); deep, diaphragmatic breathing; epsom salt baths. For starters.

Sorry to blather on like this, Terri, but my heart just goes out to Sara and to you. You are both going through a lot right now. I hope that Sara starts to feel better soon. Please stay close and let us know how you each are doing, will you?

Alison