Fresh Los Angeles recommendations
 

I'm putting a call out for fresh recommendations for professional help in the Los Angeles area:

- A PT familiar with TOS, hopefully including first rib adjustment.

- Chiro.

- Vascular specialist/surgeon.

I know there's a sticky thread for this, but I wanted to see what the latest recommendations are. We can distill and add new results after this thread stabilizes.

Aw, come on. Aren't there any trigger point therapy and/or myofascial release masters in SoCal?

i was desperate so i started looking on pt boards

http://www.somasimple.com/

i went here and asked, they gave me a great rec

or you could try http://www.aaompt.org/
but just bc theyre certified doesnt mean theyre gonna use it on you

For awhile we had quite a few members from CA, but not many posts at all from them in the last couple years.
Some had work comp claims and severe pain/symptoms so getting good quality PT didn't happen very often for them. Everything has to be approved by wc and rx'd buy treating dr of record..

Joyce wilkenson in santa monica was mentioned - but without looking a map I don't know how far away from LA she is.

SantaMonica is a suburb of L.A., just north of Venice Beach.

I'm in SoCal. (Orange County)
Can't say these are "experts" but here's who I've found and used. So far, I'm managing - albeit with good days and bad:

PT:
They were familiar with TOS:
http://www.gmspt.com/

And Vascular Surgeon I saw for an opinion:
http://www.niren-angle.com/

I don't know about the first rib adjustment, but this place is pretty good:

Pro-Health Rehab & Sports Medicine
4727 Artesia Blvd., Suite 105-B
Lawndale, CA 90260

310-371-4774


Several of their staff members have TOS experience. My husband started with them in 3/11 and they've really helped him.

Fresh call
 

HI Chroma
Im in the OC and checking on some PT referrals for you in the LA area...

PTs, always look for a therapist who has experience in TOS. Dont be shy, ask specific questions of their education and expertese. Did you know that DO's; yep DO's, learn about TOS in the first year of medical school and medical students have no clue what TOS is unless they advance their education into Neuro and then its minimal? I have found relief from even DO students who know how to adjust the ribs and relax the spasms, dystonia and even swelling. amazing

Vascular surgeon: Gelabert @ UCLA. a conservative surgeon with TOS intervention experience. http://venouscenter.ucla.edu/body.cfm?id=13

There is a new surgeon @ UCSD by the name of Justin Brown who we met with recently. He was with Washington University and received complicated post tramatic cases and TOS pts who did not fair well with post op TOS rib resection, etc surgeries. He uses a common sense approach relating to the peripheral nerves which are the "pain" receptors.
http://neurosurgery.ucsd.edu/justin-brown-md/

olecyn, thank you very much!

I'm seeing Dr. Gelabert. He schedules 30 minutes for the first appointment. He goes over your history and your tests (assuming you've already had an MRI/MRA and nerve testing elsewhere) and also does a physical examination. I was seen at my actual appointment time and didn't have to wait! All of the staff was very nice and courteous. My appointment did not feel rushed and he answered whatever questions I had. He seemed very competent and I felt at ease with him. We talked about conservative treatment (PT, posture changes, lifestyle changes) and also the next steps as needed (scalene injections). Surgery was discussed but he's very conservative and wants to exhaust all other options before surgery.

I forgot to ask him something and emailed him the next day and he replied within ten minutes! I emailed back again and he responded quickly as well.

Also, it took over a month to schedule the first appointment so have patience if you want to see him. Dr. Gelabert is generally only in the office on Wednesdays. All other days he's in surgery! I hope to only see him on a Wednesday :)

Thanks, Shadow1. So are you doing PT? If so, for how long and how is it going? If you don't mind my asking...

Yes, I'm doing PT. It's been two full weeks now of PT, 6 sessions and I really do think it's making a difference as far as neck and chest/clavicle area tightness. My problem is bilateral so I get the same treatment on both sides. During every session, she massages nearly all the muscles around the shoulder, pecs, neck, does some light traction, light stretching, and nerve glides. I do some light theraband exercises and need to focus on not using my scalenes to breathe. I do my exercises 2-3 times a day on my own, usually about 10-15 reps per session of each exercise.

I also asked her advice on a pillow as I was having a hard time finding something that worked for me and would wake up every morning feeling like I was sleeping with my chin to my chest all night. It was a horrible feeling. Anyhow, she had me try the McKenzie cervical pillow which really has helped me keep my head in a good neutral position when I'm sleeping! She gave me the soft one and doesn't recommend the hard version. While it might not work for others, just wanted to pass along that it's helped me and I don't feel as tight in the morning.

Overall I still have symptoms of cold and splotchy hands and some chest/clavicle/neck tightness, I truly do think they are less than when I started a few weeks ago.

While I'm on a good path, of course there are moments when I feel like there's no difference but those are usually times when I'm totally stressed out and feel myself constricting my scalenes with poor posture. But I just try to stay on top of things, paying attention to all the important things (breathing with diaphragm, posture, avoiding certain arm positions, avoiding static positions for long periods of time while at work, etc)

It's been a couple of months since this post. How long did you do the PT? How much did it help? Any downside? Are you still doing it?

Which PT are you seeing here in the LA area?

TIA!

Hi Chroma,
I'm still in PT and my therapist is in Irvine. She basically massages all the places all of us TOSers need it, traps, scalenes, SCM, pecs, etc. She also does first rib mobilization and nerve glides. I've toned down the theraband exercises a bit to maybe once a day or sometimes even less, I only do them if I'm warmed up (i.e. have done some cardio so my body is warm) or sometimes after a hot shower. We just started doing the 90/90 hip shift exercise from the Postural Restoration Institution. Too early to tell if it's making a difference but it can't hurt. I still do stretching and a lot of lying on the foam roll. I don't think there's any downside to PT at the moment.

I'm still taking my Alexander Technique lessons but haven't been able to fit in a lesson in about a month and really need to take one. Last week was a horrible week for me with personal stuff so and I actually had some heart palpitations related to anxiety!! I'm fine now but it was kind of scary.

So I've had some setbacks, plus I'm still working three days a week (every other day) and have a child so it's not like I can lay around and do nothing in my attempt to recover :( My numbness is still there in the fourth and fifth digits with occasional tingling in the first three fingers. All of my symptoms are bilateral, what fun.

As recommended by Dr. Gelabert, I'm pursuing a scalene block in the near future. I will keep everybody posted on the scalene block etc...stay tuned.

Thanks for the update. Sounds like despite various efforts, you're still having problems. At least you're on a forum where many people can relate to that. :)

Please let us know how the scalene block goes. I'd also be curious if Dr. Gelabert mentions anything about botox.

https://www.google.com/search?q=thor...rome+botulinum

He did mention botox in our first appointment but we didn't really talk about it on my last visit. After my scalene block, I'll go back to see Dr. Gelabert to decide a course of action.

Also I came across this, not sure if you or others have seen it.

http://www.pureperformancetraining.n...thoracicoutlet

I'm hoping some of us (unfortunately, not me) may be in a position to try all or some of these modalities. I tried the first rib mob with stick as demonstrated in the video and felt my rib drop. I've done the fourth exercise (standing by the wall with a ball) but I modified it using the stick with a ball so I was standing further from the wall. I was then able to press on the pec minor and subclavius using body weight. I could also gently move my arm while pressing on trigger points, similar to active release.

I can chime in here about Gelabert's opinion on Botox. I just saw him Wednesday for pre-op.

If you have strictly NTOS (no venous involvement) he'll want you to try the scalene block before Botox. He said he definitely recommends at least trying Botox if you have a positive scalene block (pt & sx dependent, of course.). But a positive scalene block usually equals a positive Botox result in his book -- at least that's what he said to me. He's very much a believer in the scalene block as a HUGE dx tool, whether for Botox or surgery, that much was evident.

Hi
 

My injury date was ten years ago, so you all know me.

You are not going to believe this but the insurance companies pushed on the DEAs to close down class 3 drugs, which are most of us, and they put the pharnacies under order to show our med records that validate primarily oxy.

thank god, on my switching pattern I am not one of those - but my poor friends are losing doctors, the pharmacies are refuse old customers, and feel sorry, but the DEA is like the IRS -

So I say share doctor names by phone, get a little smart about it.

I didn't believe it at first, but I do now, and we've done nothing wrong - they end up tellling you, but of course our bodies are being put through absolute hell for the weeks they look. The ins. companies I am going after contempt because they are refusing to appear for supoeanae, do the orders of the judge, and

DO NOT GIVE UP tHEY ARE TRYING TO BANKRUPT US - SO BE IT, NEURO TOS IS A REAL INJURY - WHICH THEY ARE NOW USING DRANGON AND EVEN DOING COMMERCIALS ABOUT IT. FIGHT MY FRIENDS, WE ARE NOT WASTE, WE WERE OVER WORKERS, WE WERE THE A PLAYERS, WE WERE HEADED TO THE TOP - EXCEPT THAT THE DAMNED KEYBOARDS WERE IRRITATING OUR NERVES AND WE DIDN'T UNDERSTAND IT.

SO DO NOT GIVE UP. i STILL OFFER A MEETING IN OUR HOME IN THE DESERT HERE, IF YOU HAVE A WAY OR CAN STIL DRIIVE:hug: