I saw Dr. Schneider yesterday. A resident doctor (who assists him) saw me first and asked me to explain what was going on before looking at my reports and dr's notes. He then performed the Adson's maneuver. When Dr. Schneider came in, process was similar he had me explain all of my symptoms and all of the conservative treatment I have done. He then did several physical tests which were very painful, moving my arms around, pressing on my brachial plexus, on my cervical spine and Adson's maneuver again.

He then told me that he believes I do have TOS and said what Dr. Adelman said about it being a diagnosis after everything else is ruled out. He said that given the severity of my symptoms and my lack of success with conservative treatment, surgery is most likely necessary. However, he also said that I had not been receiving the correct PT treatment as stretching and strengthening always makes TOS much worse and he wants me to try out Edgelow's therapy for about 1 month although he believes I will need surgery anyway. He said that it might help and learning the exercises pre surgery will be good for me so I am familiar with them post surgery. Dr. Schneider is originally from UCSF and seems pretty familiar with Edgelow. He said I would have to purchase the home kit because he does know of any PT's in NYC who specialize in TOS treatment. He said that HSS (the Hospital for Special Surgery) claims to treat it, however he does know how well they do with this and how much they really know. Anyway, so I agreed to try Edgelow's for one month and see him for a follow-up. I also thought "why not" since I will be using the next month to get more opinions anyway as 2 is just not enough for me. Before purchasing it, I wanted to know if anyone has done this therapy and if it has helped? I might post a new thread with that question.

As for the surgery details, he said he has done 150-200 surgeries to date, that patients report 70% improvement in symptoms, and a 70% success rate. He said he would do a cervical rib resection (first rib if necessary) via the supraclavicular approach with a scalenectomy and BP neurolysis. I would be hospitalized for 3 nights, and would be in discomfort for 2 to 3 weeks. I would need 1 to 3 months off of work. He said he would wait 6 months before considering doing the left side because my right is so much worse and he believes it is possible my left will get better without surgery as some of my symptoms may be from overuse. He said that it would take 6 months to know for sure if the surgery was a success.

After my appointment, I had forgetten a couple of questions, one of them being about the Pec Minor syndrome so I spoke with his assistant. He told me that he has heard of it but is not familiar with it and that if I had any sort of compression there, Dr. Schneider would probably decompress that area as well. He was also not familiar with the nerve block for this. I also asked him if there any more diagnostic tests I should have done, he said based on what I have so far, he does not believe I would need anything else, thought I wish I was able to ask Dr. Schneider this directly.

Overall, I liked Dr. Schneider, felt like he definitely was more experienced with TOS, however I still feel I want to get opinions from doctors who have done a lot more surgeries than 200. Like I said before, I want a very experienced surgeon so I would not even mind flying out of state for this. I am definitely keeping Dr. Schneider in mind if I choose to do the surgery in NY.

However, after speaking to him about the recovery process I am now getting concerned about that, as it worries me there is no experienced PT here and recovery is just as important as the surgery. That is one major reason I am considering doing the surgery elsewhere and then staying in SF Bay area for 2 months for PT (I have a very close friend who lives there). For anyone post surgery, what kind of PT exercises are you doing? I am also considering PT in Toronto (where my family is) as long as I can find someone with experience over there.

My next step: I am planning on contacting Dr. Gelabert, Dr. Angle, Dr. Sanders, Dr. Jason Lee, and Dr. Harold Urschel (Dallas) via phone and deciding whether or not I will be flying out of state to see any of them (besides Dr Sanders who does not operate but may possibly see Dr. Brantigan or Dr. Annest in Denver).