Quote:
Originally Posted by jkl626
I saw Dr. Gelabart at UCLA today and he is by far my favorite Surgeon out of the 3 that are in L.A. A really caring and nice man. Fairly thorough although did not look at my mri's,just saw reports.Asked alot of questions.Kept saying "Interesting" when he was examining me He said that Dr. Jordan usually only refers patients to him that have failed his injections .etc, He saw no arterial and venous symptoms. Suggested I try Facet Block injections or Cervical Epidural just to rule out the disc bulge and stenosis being the cause of my pain before doing Surgery. He does Trasaxilary Rib Resection and partial scalenctomy.He thinks this is the superior way to go. says he has a 90% success rate. Once in a while a patient comes back to get a full scalenectomy. He says the scalpular pain only has about a 50% chance of getting resolved but arm pain is usually better. he didnt know statistics on the shoulder pain (Traps,pec minor) etc because not everyone has that pain so they dont keep track of that. He relys mostly on the scalene block test( They all do) so I would want to repeat that if I decide to proceed with surgery since I think it was questionable weather it worked or not. He didnt think Ahn's Angiogram or angioplasty test was a good idea,or that the MRA was necessary. he was so-so on a Mac or SSEP test.(Has anyone had either of these? Were they helpful in the Diagnosis? Where did you have them done?I'm particulary interested in the Mac,because my pec Minor is really tight.)
He gave me a 3 page doc on TOS which describes all the tests etc.
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I agree that you should try the facet and epidural injections to know what pain is coming from where (I got relief from my cervical symptoms from the facet blocks). Gelabert wanted me to do SSEP only because I had a negative scalene block previously. He also wanted to repeat the scalene block as well. He said the MAC wasn't necessary as I had a recent EMG. He referred me to David Fish at UCLA for this testing. It took weeks for Dr. Fish's office to receive the official referral from Gelabert's assistant and offer to schedule me for testing. By that time I had found Dr. Angle and was already scheduled for surgery. Dr. Fish's office seemed very nice though.
Dr. Ahn and Angle were unimpressed that my scalene block was negative as they felt it was not a reliable indicator for surgery. My problems turned out to be my ribs and not my scalenes. I wish I would have learned more back in 2010 when I failed the scalene block and I thought I didn't have TOS.