Jo, thanks so much for moving my intro to somewhere where people could see my questions! I think I'd better clear up a couple things about my history, just so everyone that reads this can understand where I'm at.

I am rescheduling my first surgery from this week to August, when I will be more prepared for it! Also, I just found out that I have the cervical ribs, or at least that's the procedure code used for the surgery.

Everyone, it's actually a thoracic outlet surgeon/specialist that is also a professor of surgery at the University of Minnesota-Minneapolis, Dr. Ernesto Molina, that is suggesting the surgeries. I actually found his name on your board's doctors list a couple of months ago. I tried to get a third opinion from Dr. Paul Gannon in Coon Rapids Minnesota, another name on your list, but he retired two years ago. I had already been going through physical therapy for a year exclusively for TOS prior to consulting with Dr. Molina. He did not go over things thoroughly with me during after exam, but I know that I lost arterial blood flow in both arms at 180°, and venous at 180° in my left arm, all shown by a Doppler ultrasound of my thoracic area. Compared to what I'm reading here, that doesn't seem so bad, but I do have a lot of pain in my hands and neck primarily, though it flirts around in my forearms, elbows, and shoulders on occasion. My EMG/NCS for my upper body was normal, but I had that done in Duluth and let's just say they didn't check all my nerves or even both arms completely, even though I asked them to. But as someone noted, the EMG can't pick up sensory nerve damage.

The doctor who initially diagnosed me with TOS was an orthopedist, and that was in the spring of 2006. He did arm posture tests and felt for my pulse. The physical therapy I initially had was working on stretching, posture, and using Graston (those metal tools! HORRIBLE! I cannot recommend!). Now, I don't really have a problem with my posture, but stretching my neck has been difficult since some months after the car accident (June 2005), I'm assuming because of scar tissue buildup in my muscles. The physical therapist I am currently seeing just does light myofascial release and cranial sacral work, which has helped. I visited one other physical therapist who basically only give me strengthening and aggressive stretching exercises which flared me up horribly, and though I have checked around Duluth, there isn't anybody that I can find who really specializes in a lot of TOS here. I would have to find someone who could drive me 2 1/2 hours each way down to the Minneapolis area in order to see a trained TOS physical therapist. I also see a chiropractor, but finding one that knows anything about thoracic outlet syndrome seems impossible. The chiropractor did give me a good chest stretch where I lean into a corner, though that can irritate me sometimes if I do too many.

The long and short of it is, a lot of my family and friends are encouraging me to have the first surgery on Wednesday, though a few are cautioning me not to jump into anything that might cause more harm than good (which is what my own gut is telling me). Unfortunately, the surgeon will be retiring shortly which will limit my options for future surgeries. I am unemployed because of my injuries, a graduate student who would start classes in September, and I do not have the financial means to travel out of state for any surgery, nor do I want to become a more of a burden on my family than I already have. I do have the option of waiting until the end of July to have the first surgery performed, and that is what I'm leaning towards because it will give me more time to have things done like a scalene nerve block (though I will have to go to Minneapolis for that). I also have foot problems, bursitis on the backs of both heels, which makes it difficult to walk or stand for long distances, so it kind of sucks to have all four limbs with some sort of dysfunction.

Anyway, as you can see I'm in a bit of a conundrum. Maybe losing my blood flow at 180° isn't even that bad, I have no clue. X-rays didn't show a cervical rib. I had an MRI done of my neck previously which only showed loss of cervical lordosis (curve). But this weakness in my hands and arms is driving me nuts! Any more advice would be appreciated, as I really need to hear from people who are going through this! I am also reading your posts, which I'm finding really helpful.

Thank you!

Melissa