mtnmom - thanks for the search suggestions! The effort thrombosis descriptions described the symptoms almost to the T.

(Broken Wings) - unfortunately, I am already aware of what happens in surgery for TOS. I had my other rib removed a few years ago as a result of a MVA. The shoulder/arm was injured in the car accident triggering the TOS. I was predisposed due to an abnormal 1st rib. At this time, I am still symptom free on that side. Knowing now what the recovery time was like and knowing what they do in there, I don't know if I could do it again. However, if it came down to developing blood clots or progressing symptoms, I'd consider it again.

If this surgeon says I need to have the rib out, I'll seek a 2nd opinion with the surgeon who did the 1st surgery.