I have predominantly neurogenic, but i think there could be some arterial involvement too (my dr. was pretty vague about this though) - and its not nearly as bad as some of the other aTOS cases I've read on this site! My main symptoms are nerve "stretching" when i straighten my arms, nerve pain especially down into my thumbs (about a 9 out of 10 for pain), arm weakness, really cold hands, pain in my neck and near my collarbone, occasional pain while breathing (I've been a chest breather for several years and I'm just starting therapy to breathe through my stomach), toothaches, headaches (near the back of my head and that wraps around - probably a tension headache), loss of dexterity in my fingers i.e. writing becomes really hard after a while, a deep throbbing pain when my symptoms are really bad.

When the pain becomes really bad, traditional pain killers dont work, and I end up feeling dizzy and nauseous (which is never too much fun..) I decided on the surgery because it was the fastest and seemingly most effective way to get back to swimming, and back to real life even (like brushing my hair.. ), and since I've been doing conservative treatment and PT for months with absolutely NO improvement, it just keeps getting worse and worse.

I was really on the fence until about a month ago, so I totally understand wanting to weigh all the options before making a decision. I was pretty adamant against the operation until I went in for an ultrasound which proved a total loss of bloodflow into my hands when I raise my arms, which made me a "very good candidate for surgery" according to my doctor. He said that conservative treatment might help my symptoms so long as I don't do anything to aggravate it, but that they would all probably come back as soon as I started swimming again. Costs were also a big issue for me, but luckily my student health insurance is covering most, if not all, of the costs. I got an official diagnosis of TOS at the ultrasound appt (which was mid-october i think) but I've been dealing with a "tentative" TOS diagnosis for almost a year (the town where I'm from doesn't have the medical equipment necessary to confirm the diagnosis, so I kept flying out to big cities like Vancouver or Edmonton to get tests done, and unfortunately the Canadian health care system is really slow and nothing was determined before I left for school).

So thats pretty much how I got to where I am now..of course, this surgery isn't even close to the end of the road seeing as I have to go through it all over again on the other side, but it's a good start

I hope this helps! And sorry that it's about the same length as a novel...haha