Ada- you are really right. There are good doctors around everywhere, and the numbers for TOS are thankfully growing. I have struggled so much with this because I am in LA where there are several highly qualified surgeons. I was torn between rib and no rib, since I have a pretty straightforward case of vascular/neuro but no cervical rib. I have been working a lot over the past few months to figure out what will be the right answer for me....

I have come to the conclusion that I would like to have as many diagnostic tests as possible because it will make me more comfortable if 5 different docs all tell me, yes we can do a successful surgery based on [our favorite test results]. I figure the more pictures of whatever sort there are, the better chances of anatomical anomalies being known before cutting me open. I am very fortunate to have the means and the time to be able to travel all over getting this done...

In the end, I expect I will follow me neuro's original advice (he is a top TOS doc, after all) And I even set a date yesterday assuming I will find what I expect to find on my upcoming trip to Denver. I will go with one of my local Los Angeles surgeons who is very highly regarded and get the rib resection. However, the part where I know I did my homework makes me much more comfortable with this decision than if I had just taken the advice blindly.

I guess what I men is, everyone has to find there own way. I do believe you should not have surgery with someone who has only done a few TOS rib resections. I think most of the current top TOS surgeons (ahn, brantigan, sanders, annest, for ex) worked with the original TOS surgeons (machleder and roos) for years, and now have junior partners (ahn has Reil, and I know brantigan has someone) who have and will continue to work with them for years learning the proper way. My neuro did tell me he sees a difference in scar tissue left behind for each surgeon, even those doing the exact same proceedure. A good one will leave behind minimal scar tissue. We all know that scar tissue is key in these surgeries. A bad surgeon can cause horrendous scar tissue problems, even on a simple surgery.

I would also echo that you need to receive adequate care from your doc...but whether or not he is a nice guy is secondary to whether or not he is a good surgeon. If you can find both...you are lucky, indeed!!!

Ozzy- I really hope there is someone close to you who can adequately perform the surgery. I do think Cervical ribs are an easy decision...here in the US you would be reccommended for surgery. They would porbably take your cervical ribs and your first rib when they did it. I don't know if I would be comfortable with someone who had only removed one set.

Bettertoser- I knwo you mean well to give poeple advice based on your experience, but you do have a way of being abrasive and confrontational. Some of your scomments might be better received if you kept that in mind. (I know sometimes I come on here and I want to comment but I don't have enough energy to be very thoughtful in my posts...just get out what I want to say and move on before my arms fall off. That can really be an issue and sometimes on those days i just don't post at all unless i think my comments are very very valuable bc i don't want to step on people's toes) I appreciate your experiences and it makes me very happy to know that there are people out there who are feeling better after surgery. I really hope to be one of them soon. Thanks for letting us know you are out there, and that you like Dr B so much. I am sure he is a very talented doctor and I look forward to meeting him.

Ihtos-It must have been totally frustrating to have Dr B's office tell you he would call and then have him not call. That is a very tough thing to deal with from far away, and a valuable thing for others to consider. It would be different if his office gave you an answer or said 'we can't help you' or 'dr b is really busy this week/month'. Have you tried to talk to them since to have some explanation? Your story is certainly not one I have heard from anyone else on this board (not to say it hasn't happened). [how are you btw..any closer to surgery?]

to all- good luck and happy low pain day to you.
I havne't proofed this post, so I hope i followed my own advice and didn't say anything too abrasive....bc my arms sure do hurt.


Johanna