I want to sincerely thank you all for helping with my question. This forum is clearly very active and most impressive. I never imagined that an innocent water ski day would make me a member of a such a club as this, but I'm overjoyed to know there are people out there like yourselves so willing to help. Hopefully I will get through this awful experience, and maybe lend a helping hand to somebody else one day in return.

So Sea Pines 50, your posting is comprehensive and much appreciated. (But you sure do know how to give a guy a first degree panic attack ) Perhaps some more precise detail about the injury and sequence of events would be interesting, and also help to see my situation more clearly. (so here goes, sorry for a long winded posting...)

I actually got this injury one year ago, aug 13th, last summer. The injury was to my right arm and happened just as I said in my original posting. The following morning I spoke by phone to a shoulder surgeon about this. His advice: give it a week or two and see if it resolves. Probably stretched the BP, and a few muscles as well. So I followed this advice, and in about 4wks I was nearly symptom free. I did have a minor flair up of muscle pain after throwing some bread to the ducks, but no nerve symptoms.

Then I went a full seven months symptom free. I figured this scare was behind me. Then I got rotator cuff repair on the left shoulder, by the surgeon I previously mentioned (did quite well with that). So the right was now my dominant arm for at least two months while left was in a sling. This must have aggravated whatever situation I have going on in there. The muscle pain came back fairly sharp, still no nerve symptoms. I gave it the usual 4-6wks to heal and it did. But then at about 8wks I pushed myself up from my chair using my arms and got the nerve twinge in the first three fingers and thumb. It was the same feeling I had at the time of the waterski fall.

So it has now been 3wks since the return of these nerve symptoms. They seem to come and go, and it feels as if I have a little knot inside my right armpit, causing nerve symptoms down my arm into the median part my hand. But there are no knots or abnormalities that I can feel to the touch, it's just the sensation I have. This sensation of a little knot and the pins/needles of course causes me to have a very large knot inside my stomach -- it causes me great anxiety with which I am now struggling (and suffering might add).

Here is what I've done so far. Saw an ortho PA at top rated New England Baptist Hospital (NEBH). He ordered shoulder MRI which we reviewed to find nothing abnormal. He referred me to a good shoulder surgeon at NEBH (but not the same guy that did my cuff repair). He said shoulder MRI was not the correct study, that a BP MRI should have been ordered instead. So he did a full shoulder exam and said I may have injured BP, that it could take 1-2yrs to fully heal. Otherwise shoulder seems fine, and pec major/minor are not torn. He referred me to physiatrist that I will see this friday for EMG, and to decide if BP MRI should be ordered. My sense is that this surgeon is extremely competent, but maybe not so well versed in TOS/BP issues (?)

Also saw my general practice doctor who gave me the following advice: (1) continue on the present course with NEBH and demand BP MRI (2) try not to worry too much about this because if symtoms resolved completely for seven months then nerve is likely in very good condition. Probably inflammation or scar tissue secondary to muscle injury causing nerve irritation or compression. (I don't know how much credibility to put into this advice, but he is quite a good doctor in my past experience), and (3) consider SSRI based on fact that I've had such a string of injuries and difficulties in the last 1-2yrs that it has put me in a not so healthy frame of mind.

I looked up Dr David Kline, and found he has excellent experience, but is in Louisiana (I'm in Boston). But could not find a phone contact for his office. On the one hand he seems to be exactly the type of doc I'd like to have overseeing this, but on the other hand I don't want to create chaos by contacting many doctors in parallel. But I do want to get connected with one lead specialist that knows about TOS/BP that can run the show effectively.

Maybe I should find a neuro doctor specializing with BP and peripheral nerve injury. If anybody has contact info for Dr Kline I'd be really appreciative. Or to other good TOS/BP specialists in the Boston area: MGH, BIDH, NEBH. Any other comments or feedback based on the above additional information, also greatly appreciated. Many many thanks!