Hi!
I had surgery just this past Monday, August 30th. I am home now, and on the road to recovery. My TOS is bilateral, with the right side worse. Surgery tackled the right side. I am expected to go back in for the left side in the future.

Here is how my recovery is going.... maybe it will help give an idea....

My surgery took about 1.5 hours... from 13:00 - 14:30 or so. I awoke around 16:30. Upon awakening, I felt like I had been hit by a truck. Don't be fooled; this surgery is very invasive! Basically, the surgeon explained that they had to position my arm in a way that just about dislocated the shoulder. The entry point was my arm pit - a 1.5" to 2" incision. My pectoral/chest muscles had to be lifted away from the rib cage/lungs area to access the surgery site. The entire first rib was removed. That one nerve (forget the name) was cut to prevent permanent nerve damage. And some muscles were also removed. According to the surgeon, I had quite an odd bundle of muscle "cording" wrapped around places that definitely contributed to the compression. That "cording" was removed. Then I was sewed back up. Ahh... simple.

After waking from surgery, I was kept in the recovery room until my pain level decreased to a 4 (on the 1-10 scale). That took quite a bit of pain meds pumped into the IV. Once down to a 4, I was moved to my main room.

Eventually the IV pain control was too much for my stomach, and I suffered extreme nausea and vomiting (ugh, that was awful). They took me off the IV and gave me anti-nausea meds. I began taking the pill form of pain killers (coupled with ibuprofen, and my usual neurontin) earlier than most people, because of my nausea.

I was very weak that first night. I was able to maneuver myself to and from the bathroom, but with much effort. The next day, I could manage the bathroom trips quite well, but pain was still there.

The day of and after surgery, I had to cough quite a bit. Coughing (and laughing, sneezing, vomiting, etc) is excruciating at first. When coughing, I recommend tucking a pillow under your injured arm and applying the most tolerable amount of pressure you can manage against the pillow. I screamed out in pain after each cough for the first couple of days. Now I just wince.

I only spent one night in the hospital. I chose to leave the next afternoon, around 16:00. I just couldn't bear staying in the hospital for long.

I am currently staying with my parents, who have been a great help. Be sure to have an able-bodied person with you after surgery, to help you manage your daily routine. Don't be afraid to ask for help with the smallest things. As an independent person, this aspect of recovery is frustrating. But I also recognize it is not wise to stress my right side during this time.

A reclining chair is important for general comfort. To sleep through the night, I have constructed a pillow barrier around my upper body. It keeps me from rolling to either side. It also provides a nice cocoon-like feeling.

I have been regularly icing all around the surgery site. Tomorrow, I will begin to add heat to the routine.
I was sent home with pain killers (oxycodone), anti-nausea pills, regular ibuprofen, and a prescription for a stool softener that I did not fill (you may not have a bowel movement for days after surgery due to everything that was pumped into your body... so there's the potential for your first poo to be difficult). I am weaning myself off my neurontin. I only take the oxycodone when absolutely necessary, since they kick in pretty fast anyway.

I wear an ace bandage around my breasts. You'd be amazed at how effective this is for pain control and mobility.

My breathing has been labored. I actually have to concentrate and make an effort to breath well. I tried taking a short walk, but had to stop early because of the fatigue and breathing issue.
However, I am making a point to do gentle moving and stretching. It is not wise to protect your arm/side so much that it deters healing. Just do what you can do, and be smart about it.

I believe my recovery is going quite well, compared to other stories I have read. I hope that gives you some optimism going into your surgery. So far I am glad I had it done. But it is still very early to know for sure. Consider this: my TOS had progressed so much that I had awful, chronic referred pain in my jaw area (like TMJ). Upon awakening from surgery, it was gone and hasn't come back! The pain and discomfort I presently feel, I contribute to the surgery, not TOS. So I am hopeful.

Feel free to ask me anything if you want more details.
And good luck!

-Melanie