Hi Tristie,
I am so sorry to read of your complicated issues with TOS, injuries and surgery. A few things come to mind; when the surgeon does the pre-op, he has to give informed concent. Not only the types of problems that could arise, the percentage, he can tell you ahow frequently in the first surgery and how in the redo's it is a much higher chance as the phernic nerve is not longer virgin laying in the scalense, it has likely migrated by gravity toward the spine. So it is chanc'y doing cleanup and the hidden phernic can be cut.

I understand also several doctors, if there are symptoms, or some just will do a sympathectomy. One in Dallas does, it is not Dr. Nath.
I am surprised that Dr Nath took you on, he is not considered a Thoracic outlet Brachial plexapathy doctor by any prominance of his own speaking.

I saw him, and he noted that the guys in Denver are surgically into areas he is not in their expertice to venture, nor desires. He seemd to only do a realese, perhaps it was th long thoracic, never got that far. But, my daughter with a history of thoracic surgery he would not offer her any help. She is too far into things.

Again, with informed consent, the Dr. has to tell you what the odds are and how treatment will be taken if the bad does happen. Let you know if there is a history of the phernic being injured, or other complications. How often the doctor had that happen and what can be done if the complication happens. All doctors have had something sometime in their career go wrong, the great doctors tell you what that is so you are prepared for the worse.
I know of one top doctor that not only cut a phernic on one side , but also did the other one too. Although, he never reveals it in informed consent. He also will do a sympthectomy if he feels there is involvement of RSD. There were unfortunate patients that had this difficulty, by other doctors.

Consulting and having a great deal of knowldge means that you are not at the hands of the doctors expertice, you have your own and can make a good decision. Surgeons are that, they do surgery! Always have a second opinion. Don't go by gut reaction, do homework, and if it doesn't sound realistic then take your time making a decision.

The only thing I can suggest is finding an attorney that handle medical negligence, get all your records, see a top specialist that can review and give you an opinion to your options. I know in the cases of pherenic nerve paralysis there was litigation.

Some people just have bodies with anomolies that are real bad, and the surgeries if they have bad outcomes, live trying to find relief. It sounds like your body is creating a lot of scar matter entwining the brachial nerves that they have been do a clean up on.

I will read more of your history later. I was looking for the article though, is there a link.
TOS surgery by any surgeon should NEVER be told of as a cure...if they do say that, RUN! However, in some cases ther is improvement to a life in disaster of pain.

Many surgeons are trying to find less envasive ways to treat, and also not doing surgery on neurogenic. IF there are C-ribs, vascular problems etc, they have better results.
Now, that is my opinion, not from any peer medical article, just from reading and asking many specialist a lot of questions, and meeting hundreds of TOSers over the last 10 years.
Dianne

ps: sorry for typos, my hands are mess, I am trying to get the last of housework and cooking done before guest come.