Hi, I recently underwent a first rib resection and a partial scalanectomy. I was diagnosed with Paget Schroetter syndrome back in April (about 5 months ago). Initially I spent 4 or 5 days in the ICU on blood thinners and clot busters. I was meant to have the first rib resection shortly after that, but instead elected to take a couple more courses at my university before undergoing the surgery.

The surgery was on April 13th, about 4.5 weeks ago, and I'm pretty much back to normal. I've been working out again for a little over a week now, which is huge for me since I had gotten quite a bit out of shape over the last 5 months (by my standards at least, usually over the summer I spend about 1 - 2 hours a day working out). I was back to work a little over a week after the surgery; it probably could have been sooner, but my mom wasn't having that.

I honestly experience NO real pain. Some muscle soreness sure, aches and pains here and there, but nothing to write home about. I had an AMAZING surgeon. That's about the gist of it. I'll spell out the details below, for anyone who's interested.

The Long Story
Back in April, I was doing a workout that I've probably done a hundred times before when my arm just started to feel like it was going to explode. My friend who was there with me, doing the very same workout was a bit freaked out at how visibly swollen my arm had gotten. The veins were hard and bulging in a way that neither of us had ever seen. I tried to push through the rest of the workout, but the arm was just too discerning.

That night we went out, had a bunch of fun, I had almost forgotten about the incident with my arm. Then over the next couple days, I noticed I was beginning to have severe pain whenever I tried to move my arm. There was massive swelling throughout the arm and into the chest. Before long I could barely move the arm at all. I began seeing doctors a few days later and no one was sure what was going on. Muscle tear was what I kept hearing, but it just didn't really add up for me. I kept explaining that it had felt like blood was going into the arm and not coming out.

Eventually, I got an ultrasound. There was about 15cm of clot in my right subclavian. I was rushed to the ICU for an emergency procedure. I spent the next 4 days in bed, not allowed to move AT ALL. When it was over, I felt a lot better. I had regained about 60% of my range of motion (ROM) by the time I had left the hospital. A couple days later I had no mobility problems what-so-ever in my arm. At that point things felt pretty normal, but I only had to stress the arm just a little bit to be reminded that there was still a problem. I would need surgery to decompress (or releive pressure on) the blood vessel.

I spent the next three months on blood thinners, taking it easy. No strenuous activities, no alcohol (okay, I'm in college, so maybe a little alcohol). About a week before surgery I caught an annoying cold. By the date of the surgery I was just getting over it. Still quite a bit of drainage, and some sinus issues. A bit worried about that..

I went in for surgery, got prepped. When they rolled me into the OR, I was expecting to get a chance to talk to the Doc one more time before the surgery. I remember feeling really anxious, then the nurse asks"How're those drugs treatin you?", I go "What drugs??".. The next thing I know, I'm waking up 4 hours later in recovery. No real pain besides a soar throat from the chest tube. I could feel the pressure from the ice and bandages on my side, but for the most part it was all beautifully numb.

I do have to say that, despite virtually no real pain resulting from this surgery, there were a few things worth mentioning. 1. Blowing your nose, will hurt. 2. Coughing will feel like a thousand microscopic BOMBS going off in your chest. 3. In the moments before sneezing you may consider whether or not it would be easier to just shoot yourself in the face before the sneeze actually happens... SNEEZES WERE THE WORST. None of these things were a problem about 2.5 weeks after surgery.

During surgery they had inserted an anesthetic delivery system directly into the incision. It was called Symbios, and it pumped a steady stream of wonderful into my side for a whole three days after the surgery. I stayed in the hospital over night after the surgery, every one was so nice. I had about 70% ROM after about 5 hours after surgery. By the time I was released the next day, I had pretty much 100% ROM.

They prescribed me some Percocet, and I had like 3/4 a bottle of Vicodin left from when my arm had first started acting up. Fortunately though, the Symbios kept me pain free over the next three days. At the end of the third day, in apprehension of some overwhelming pain to befall me once the Symbios had been used up, I took half my dosage of Percocet. Six hours later, I woke up so high I didn't know where I was. I spent the rest of the day tripping in my bed. When I finally came to my senses and the drugs had worn off, there was no actual pain to speak of. So I tossed the Percocet.

With no real pain, I didn't really need the drugs. I had been well enough to go out to the mall and hang out with family a day after surgery, but I think emotionally I was a bit worn out. I first five days after surgery taking it easy. Then I started getting back to hanging out with friends. On a day where I expecting to be out and about, I'd take a precautionary Vicodin (didn't want to be 30 miles away from home and realize I should have taken one). After about 2 weeks after surgery, the precautionary Vicodin wasn't even necessary.

I had been working again since 1.5 weeks after surgery. 3 weeks after surgery, I had been given the go ahead to start working out again, and I was back to my normal routines.

Working out again was scary at first. It was hard to know how to approach the arm. How much pain was too much? How much activity would be pushing it too far? But, you figure it out. Right now, I'm just under 4 weeks post OP, and I'm doing push ups and pull ups and whatever else I feel like doing. The only real limitation is how out of shape I've gotten. I'm probably 8 pounds heavier than I was at this point last year, but I plan to take care of that in a month or so.

On a side note, after beginning to work out again, I noticed that a certain muscle on my right side wasn't flexing (as in, when I go to use it, nothing happens). It's called the serratus anterior, I expect there may have been some nerve damage resulting from the surgery.. to be expected. Nerves heal, so I'm being patient with it at the moment. There was some numbness in my inner arm and of course near the incision after the surgery. The sensation in my inner arm FELT more like hyper sensitivity, it would just feel like my t shirts were rubbing the skin raw. That has definitely subsided at this point; the incision area is still fairly numb, but that doesn't bother me at all.

Sorry about how long winded that ended up becoming. I just wanted to be thorough. I had been reading this forum a few months previous to my surgery and it really helped me to understand what I should expect from this kind of procedure. I'd like to thank each and every person who has shared their story here. It meant a lot to me.

Best wishes,
Len