Wow-your doppler ultrasound took 4 hours? I think mine was maybe an hour at the most and they had me do more than two arm positions. They had blood pressure cuffs on both arms and the little plastic pinching things on one finger on each hand. Did they test both of your arms? I sure hope so, otherwise the test doesn't mean much--it should compare one arm to the other. The guy that did the test was super nice and showed me on the monitor right away how the blood pressure, etc. was different in one arm. That was my first test, then I had a chest CT, WITH CONTRAST (very important to get it with contrast so they can see enough detail). For that they inject you with a liquid before putting you through the CT machine (goes very quickly). The only bad part is the needle stick, which lasts just a second. When the liquid goes into you, it kind of makes you feel like peeing, but you don't actually do it.

I think the reasoning behind doing the ultrasound before the CT is cost. The ultrasound is much cheaper than a CT and is sort of used as a screening test. If that is positive, then the more reliable/specific CT is done. Then, if that is positive, as in my case, an arteriogram and venogram are done. These tests show you EXACTLY where the arteries or veins are compressed, and to what degree. I've heard sometimes they do X-rays to see if you have an extra rib or other bony abnormality (I don't), but my CT already covered that. I had the venogram and arteriogram done at the same time (in the hospital). I went there early in the morning, had the tests done, and then had to stay until about 5 PM. For the arteriogram, they insert a thin wire through an artery in your groin and thread it up to your subclavian arteries. They have you put your arms in various positions and take X-ray-type images of your arteries. For the venogram, they insert the wire through your arm veins. Don't let this gross description scare you--they give you a sedative that relaxes you and for me, at least, it was no big deal. And I'm TERRIFIED of needles. They keep you for a while after the tests to make sure you have no bleeding from your groin. You are told not to do any heavy lifting or running for a week after that. I really didn't have any pain at the groin site. My best advice to you is study as much as you can about this on the internet, because knowledge really is power. I think the more you learn, the more in control you will feel, and you will know what questions to ask the doctors. My surgeon told me I will be in the hospital around 3 days, give or take, depending on how I'm feeling. He uses the transaxillary approach (going in underneath the armpit area). I asked him if I will be able to function on my own when I get home from the surgery as I live alone (get to the bathroom by myself, take my dogs out for walks, etc.), and he said absolutely. In fact, he WANTS me to move my arms around afterwards to prevent blood clots (just like in other surgeries). I will have pain meds of course, so I'm really not too concerned about that aspect of it. I think I will be so relieved to get this nightmare over with that I will be able to handle that pretty easily.

I'm very lucky in that I live in the Washington, DC metro area, close to some excellent TOS specialists. Two other things I would recommend, if you're not doing them already, is take a notepad to every doctor visit to write down everything important. It gets so stressful that it's easy to forget what they tell you. Also, even more important, get your own copies of the radiology reports AND the CDs (with the images on them) for any tests you get done (like CTs, ultrasounds, arteriograms, etc.). Where I live I am not charged for those. This way if you go to a different doctor, you have your results and images right there with you for the doctor to look at on his/her computer. That will save you time (and money).

I'm happy to answer any other questions you may have**