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Originally Posted by cyclist
* Did Dr D do a neurolysis of the brachial plexus?
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I don't think so. I'm not sure what this is. I don't recall reading anything about neurolysis during the surgical proceedure. You can find Dr. D's 10 page description of the procedure via Google. I can't post links yet. Just search for "first rib resection." It's one of the initial results.
For people with nTOS I think they do Botox injections and PT for a while before considering surgery. This wasn't an option in my case.
I had no nerve pain at all before the surgery. After the clot, occasionally when reaching my right arm over my left shoulder, I would feel a little irritation, but that's it.
I was pain free before the clot, showing no symptoms. After the collateral veins formed, I'd say in about a month, I didn't have any pain from the clot.
My right hand has been dusky ever sense. And my right arm swells a little bit during vigorous activity. The collaterals can't keep up.
Quote:
Originally Posted by cyclist
Did he mention anything about having to remove scar tissue from the nerves?? This may not have been necessary given that you had venous TOS.
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Yes, the surgery took about 3 hours, a little longer than normal. There was a lot of scar tissue in the area. He expects that the vein is very damaged. We'll see when I get the venogram.
The nerves were slightly irritated after the surgery. I had a mild tingling in my little and ring fingers for about 2 days. It's completely gone now.
Quote:
Originally Posted by cyclist
* Did you have the full rib removed? For vTOS, some docs remove just the anterior portion of the rib (the most problematic section for venous compression), while other docs remove the full remove. Each approach has advantages and disadvantages. What did you have done?
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Yes, the full rib was removed. You don't want parts of it growing back. This is standard from what I've read. They expose it and then cut it in half in the middle. Then they yank out the two pieces.
I've had a little irritation in my upper back since the surgery. It's fading now. Again, the discomfort is minor.
The surgery was performed via the supraclavicular approach. No major muscles were cut. This is more technically demanding than the transaxillary approach, from what I understand. But recovery seems to be better. I don't think they can get in from the arm pit without cutting through some muscles. But I'm not sure.