Once I figured out that raising my arms exacerbated my symptoms and some of the symptoms had become vascular, I started seeing vascular TOS specialists to determine the severity. The vascular issues and loss of strength pushed me to surgery.

Learning the extent of your vascular involvement is important when considering surgery. Unless you are experiencing a loss of strength or severe radiating ulnar pain, surgery is not a necessity (but could still potentially offer relief). Neurontin or Lyrica can provide some decent relief to the neuropathy. Adding Cymbalta or Pamelor to the cocktail can offer even better relief. They really just dull the neuropathy vs completely covering it up like narcotics. Do whatever you can to keep your elbows by your side while you sleep.