Mary,

Hi, you sound as though you have things well in hand for your surgery! I hope Murphy is conveniently far, far away on that day (perhaps bothering an insurance agent or IME physician?? One CAN dream!!). Your response to the Botox injections and the amount of ROM you've retained are both very positive signs.

I will echo what others have said re: the PT. Dr Freischlag is of the So. Cal philosophy rather than the Denver school on this, and while geography in itself does not matter, the Denver trio of surgeons seem to have the edge at developing PT that works by collaborating with the actual therapists who see their patients post-op. The resulting PT is done 5 days a week the first 2 weeks post-op with a Denver therapist, then continued at home with a local therapist who has familiarized him/herself with the protocol.

It begins with gentle stretches, nerve glides and ROM, and proper positioning of scapular muscles, proceeds to non-weight-bearing exercises on one side of the body, then to cross-body, before moving to light weights. But the key is that never do you push if you are experiencing any nerve sx - tinglinging, numbness or nerve pain. Those sx are a sign of too much, too soon. This is what you MUST listen to your body for, and if you feel, stop what you are doing and let the PT know, then ease up til the point the sx don't appear.

As your body recovers, exercises requiring heavier weights, other upper body movements, and programs such as Feldenkrais and/or Pilates may be added. Again, do these activities at your body's pace and level of tolerability; while you may have a low patience factor, our bodies require time to heal from surgery, as well as food and restorative sleep.

The block I received to help keep my RSD from worsening was (I believe) a stellate ganglion block. This is the sympathetic nerve ganglion at T-2. Other Drs may choose to do a plexus block or another form of block, there are several types, but the stellate ganglion is the likely choice.

If it helps, I did catch myself with my head leaning toward the non-operated side the first few months, but quickly re-trained the remaining muscles to hold my head upright. And I never wobbled.

Best wishes,

beth