Dr. I find it quite amazing how little many doctors know about TOS and I am not saying this in a condensending manor, just that parts left out or qucikly passed over. I worked 16 years in a hospital laboratory and never a once never heard it mentioned once. I have had previous cervical injuries and surgery, but when I went to see the neuro-surgeon there just was not something sitting quite right with me and his DX and when I got home and went into a search engine relating to my symptoms Brachial Plexus Disorders kept coming up more solely TOS and low and behold there was a specialist within my area who told me to make an appointment and should he not be able to help me, he would help me find someone who could. I do not know if it was fortunate or not, he performed an extensive exam lasting almost 3 hours of twisting probing and prying looking over my MRI's and X-Rays and he came to the conclusion of TOS with the final clincher being an EMG! After seeing Dr Togut, he took me out of work for any form of gainful employment, which my emplyomer, the insurance company and their lawyers disputed!
In the mean time I contacted my own counsel and also made an appointment with a highly acclaimed surgeon out in Colorado whose specialty was TOS at which time I was also DX with CRPS (RSD)... yeah another DX. His recomendation was surgery on the left to include removal of the 1st rib scalene, trapezius and pectoral minor muscle as well as on the right opening the scalene and pectoral minor areas.
I consulted with my GP who had been with me through all my cervical problems and he added some more to my already amassing diagnosis's these being myfascial neuralgia and fibromyalgia. It just seems the longer I wait and the more the lawyers and insurances play around the worse I get!
When I went to see their specialist it came out that his true specialty was not that of TOS and also the person who did my EMG was employed by him for many years prior to a falling out between the two of them. If I were a patient of his whose diagnosis was based on by this man who performed my EMG, it would make me want to take a second look as to why they parted ways! I have had 2 EMG's in the past and this man seemed very thorough and competant, maybe it was not the man providing the EMG, but the Dr. reading the results the wrong way, since he was able to state weather or not to carryout the procedure.
I am not saying we all should be in a hurry to carry out frivolous lawsuits, I personally, just want to be fixed and if a doctor is unable to carry out the procedure, they should be able to help and identify one that can. And in my case I am starting to change my opinion that by waiting due to legal hold ups, that these law firms should be held liable for any negative changes that take place!
Dr. This note to you has taken almost 2 hours, due to taking breaks between typing and changing positions and yes I did use pillows under my elbows to take pressure off!!! You have found an amazing site where others come out to help one another in information that they have gathered, hope we can help even a learned person such as yourself as you may be able to share with us!!!!!!!!!

~~~Mark-n-Goober~~~