Copied this from a informational sheet he gave patients.
It was nice of Dr.T to call today, just wanted to chat he was thinking of me.
Di

Plan For Self Management
Thoracic Outlet Syndrome, neurogenic, can be a chronic illness with significant impact on daily living, work, and interpersonal relationships.

Most people with Thoracic Outlet Syndrome are depressed, miserable and misunderstood. Rightly so. Your lives have been changed and you do not like it.

Few people will understand what you are going through-appreciate your distress you are experiencing. And it is hard to communicate with them. They may be your spouse, your "best friends."

You can help yourself. You may be the only one that can help your self. By taking charge of your illness you can and will modify your illness and the distresses you experience. Thus you will be able to participate more in life.


You can help yourself through it:

General Principles.
Suggestions

If you can keep a diary of every day experiences, particularly the ones that cause more pain you can learn more about your illness and go further to modify what you do and how you do it.

The how is frequently more important than what you do.


TOS General Principles for self-care.

1) Have a plan for each day. It sounds like you have to be very organized....It helps.

2) Do what you can reasonably do. Do Not Overdo.
Err on the side of Less than More...Succeed comfortably.

3) Pace Yourself. Do in small time frames. If the activity takes 30 minutes break it up with small periods of rest.

4) Listen to your body. Do not push yourself. Guide yourself.

5) Be wary of using your arms for long periods of time much above lap level, push-pull or lifting. This may cause more pain.

6) Be wary of using your arms repetitively. Again succeed in comfort not pain.


SUGGESTIONS:

1) Walking; support arms in a coat pocket, belt, with a sling or shoulder harness.

2) Sitting; support arm(s) with a pillow, coat or cushion etc.

3) Driving; Keep arms low on the wheel, Support arms with pillows.

4) Driving long distances; Break it up into segments of 30 minutes, Stretch, change positions.

5) Phone; use a speakerphone or headset. Do not hold the phone in your hand.

6) Reach; avoid reaching for objects use a step stool. Bring things down to your level what you frequently use that is above shoulder level.

7) Reading; Prop, do not hold the book. Try to keep your head in a neutral position. Do not read in bed.

8) Television; Sit in a comfortable chair, not in bed.

9) For women; If you have heavy breast support them with a corset from below or a good supporting bra. The corset will keep the bra straps off your shoulders.

10) Purse; Do not carry a heavy purse, use a fanny pack.

11) Computer; Needs to be ergonomically efficient. Keyboard in lap and screen at eye level. Change positions frequently.

12) Relaxation; Break up activities (Pace) with periods of no work. Support your arms, Dream, meditate, Rest. All needed to decrease stress and work load on the traps.

13) Posture; Do activities with good posture.

14) Heat; Use heat of ice which ever works best, frequently. Start and end the day with hot baths.

15) Think first; Try not to be impulsive. Remember there are green light, Red light and Yellow-light activities. Know which one you will be doing.

16) Walking; Include walking in your schedule at least three times a week. This is your time to relax, change your perspective and forget about your illness. If done on a routine basis it can reduce the total distress you are experiencing.

17) Good Days and Bad Days; You will have them. Do not try to accomplish everything you have to do on a good day.

18) Work at it; You will have to work at it, it will not come easy. It is a change from the way you use to do it.

Dr. Allen Togut