joyce wilkinson is an excellent PT on your side of town. she is in ocean park. board certified orthopaedic clinical specialist, superjoyce (as she's known around these parts, joshua--) does manual physical therapy, orthopaedics and sports physical therapy in her busy practice.

dr. samuel ahn is an excellent surgeon. you don't say whether your TOS is primarily vascular (i.e., veinous and/or arterial) or neurogenic in nature, or a combination of both. many of us are neurovascular. the fact that you do not have much pain tells me that you may not have many neurogenic aspects at this time, however. at the same time, loss of hand function almost always involves nerve damage or at the very least, compromise... so i really couldn't say.

vascular TOS'ers tend to have better outcomes from TOS surgery, as you may be aware. you are absolutely right to be cautious, but with all due respect i don't think dr. ahn would be recommending surgery if he thought PT would address your issues. (i know that is not what you want to hear, and i'm sorry but it is the truth.) if you would like to obtain a second opinion from another top TOS surgeon who thinks quite differently from dr. ahn, then you might consider an evaluation with dr. fred weaver, who heads up the vascular surgery division over at the keck school of medicine at usc.

and it goes without saying, joshua, that as we are not MD's we cannot give you medical advice here. support and information, yes. benefit of experience, you bet! and you'll find that we have LOTZ of opinions, oh boy howdy do we ever! and each of us has his or her favorites when it comes to docs and PT's.

the fact that dr. ahn has a concern about a clot forming is nothing to be taken lightly. at the same time, many are leaning more these days towards a good long course of the RIGHT type of PT and bodywork (e.g., hellerwork, feldenkrais, etc.) prior to any thought of TOS surgery as an intervention against the TOS beast. it is a very personal decision, however, and there are always exceptions.

one of those exceptions, actually two, you touched upon in in your posts today. loss of hand function and risk of blood clot formation. dr. weaver is a rather conservative surgeon, so know that going in. i would also highly recommend that you see dr. sheldon jordan, a pain managment specialist on the westside with a background in neurology. let him drive the show and he won't steer you wrong, joshua. but you must be an active participant in your own care and start learning all that you can about just what you are up against.

joshua, the fact that you have, in all likelihood, received a relatively timely dx, are young, in otherwise good health and in excellent physical condition are all very much in your favor, as is your being of the male persuasion (smile). if i were you, i would take a careful readthrough of johannakat's fairly recent thread in the 'DR'S & PT' sticky called "how i chose my surgeon." i think you will find it most interesting. also, start fooling around with the 'search' and 'advanced search' bars in the upper righthand portion of your screen; you can call up almost any topic you can think of that way, by key word or by poster. and obviously use the links posted in the stickys to get to the medical literature and so forth, as you are able.

PM me and i will be happy to give you my phone numbers. i live in LA, too. there are a few of us here. not exactly joyful about it, but we are here. and here for you.

happy you've found us, man. sorry for the reasons why, though.

but it's gonna get better now... i promise you that!

alison