Bilateral transternal first rib resection
 

Got my surgery date: 01-03-13. My surgeon, Dr. Robert Lowe, seems to know what he's doing and has done many TOS rib resections so I'm going to go for it. I feel like I can trust this doctor unlike the ones I encountered at Yale.
I see a lot of people on here (myself included!) asking for personal experiences to help them prepare for their own surgeries so it is my intention to use this thread to document mine!
I've been diagnosed with arterial, neurogenic, and to a lesser extend, venous thoracic outlet syndrome on both sides. My surgeon believes that it's better just to get it over and done with especially since I am young so I will be having both sides done at the same time. His approach is transternal so he can get out as much rib as possible and have a full view of the area. He said that since he is doing both sides at once, my sternum will need to be wired to help it heal back together properly. I've never heard of this approach before, but I do feel like he knows what he's doing. I was told to expect a 3-5 day hospital stay if everything goes according to plan and for surgery to take between 3.5 and 5 hours since both sides are being done at once.

Wish me luck! I have high hopes that next year is going to be so much better than the last!!

Both sides at once, wow.
I hope you have lots of helpers after you get back home.:grouphug:

Prepare a comfy place at home with a table or tray for everything you might need close at hand.
I'm sure you've seen most of the post op/recovery posts & tips.

Do you mean transaxial? I have never heard of transternal either.

I'm very fortunate that I have plenty of help. I'll need to do virtually nothing until I feel ready to do so. My significant other works nights and we live with my mother and stepfather who will be home in the evenings. I've got a close-knit family and a few great friends also who will be a big help when he needs a break. I work per diem, so getting time off is as easy as not taking shifts until I feel up to it and can take as few as I want when I'm ready to start up again. I'm actually really happy that he's doing both sides at once. He said that he really didn't want to wait because even though my right side is not near as symptomatic as my left, it is being restricted of just as much blood. He also saw that my left side is wasting quite badly which I didn't even notice until he took circumference measurements. I'm a little nervous about this sternum wiring thing but he does tons of these surgeries and I have a "feeling" about him that I can trust him so I'm going to go for it.

Nope, transternal so he can get both sides. He wants to be able to see everything and get the entire rib. He's going to cut clear across my chest right under the collarbone.

I've never heard of this approach and it sounds unnecessarily risky. Have you least found a journal article on this? I wouldn't rush into this and I don't recommend having both sides done at the same time.

Yes, I did find a journal article on it. It seems like the go-to approach when both sides need to be done at once due to artery compromise and the best way to get a good look at all artery damage. I guess it's not the perfect approach, but when arteries are the problem that's what they recommend. The journal says that the outcomes are good from the surgery. If you're a non-smoker and young (which I am) you heal up from it quite will with no additional complications from it. I think he's downplayed how bad things are getting with blood flow because he very sternly told me that even though my right side is not near as symptomatic that it can't wait and absolutely needs to be done.

this is what he did for my friend. Both sides at once. and he fixed her veins which were blocked.

I wish you great luck and hope the best for you. Please keep us posted on your progress.

Post the journal article if you can.

I can't find the article I read last night (of course) but I did find this which seems to be more helpful. I guess another word for the approach is infraclavicular but because he's doing it bilaterally it crosses the sternum calling it a transsternal.


"Infraclavicular First Rib Resection
The patient is positioned supine with a pad to elevate the scapula and shoulder, with the arm abducted. A muscle-splitting incision approximately 12 cm in length is carried through the pectoralis major muscle to expose the first rib below the clavicle, beginning medially at the costochondral junction. The periosteum is elevated subperiosteally from the rib, and the costochondral junction is removed piecemeal with the Leksell rongeur. The pleura can then be stripped from the posterior surface of the mobilized rib with careful blunt dissection. The rib is next retraced inward, and the neurovascular bundle traversing the costoclavicular space is palpated and retracted with the index finger. With the neurovascular structures thus constantly protected beneath the index finger and the pleura retracted, the rib with its periosteum is rongeured away, scraping off the insertions of the anterior and middle scalene muscles. Posterior to the neurovascular bundle, rib removal is accomplished by feel rather than under direct vision, but usually can be taken back to within 3 to 4 cm of the transverse process without excessive retraction of the neurovascular bundle; and in some asthenic patients, to within 1 to 2 cm of the transverse process. If a cervical rib is present,
5
it can also be trimmed through this approach. This incision can be extended slightly downward to the deltopectoral junction if the pectoralis minor tendon is to be divided. If a tear occurs in the pleura, it is closed around catheter suction with the lung inflated. The pectoral fascia, subcutaneous tissue, and skin are closed in layers. Bilateral rib resection can be done as a one-stage procedure by this technique."

Just got a call from the doctor's office... they're having me go in for surgery a day earlier. One less day to prepare and I feel like I've been thrown for a loop! 5 more days. There will never be another Friday that I spend with my 1st ribs. I'm feeling rather sentimental!

Well, it's go-time. Tomorrow I'll be headed in for surgery. I'm definitely nervous and this 0.5mg of Ativan they gave me has helped exactly not at all.
Wish me luck and I'll be in touch soon to let ya'll know how it went!

Best of luck!

Hope it went well....

It did. I'm in pretty good shape. I'll write more as I regain function as the lidocaine wears off,

Wishing u a speedy recovery.

Wow!!!! Good luck

Do they cut the scalenes at all ?

They left the scalenes in (scaleneotomy) in the end but when I touch them (which doesn't hurt at all btw) they are soft. There is a ridge in them that you can't see but can definitely feel so I think they're just kinda hanging out.

I'm gonna work on a post with my experience as of day 1!

So, surgery started around 2pm yesterday. I had an arterial line put in which was absolutely no big deal after a big honkin' dose of anti-anxiety meds which the anesthesiologist gave me just to be nice. I have a feeling that it was supposed to hurt a great deal but between that and a numbing agent, it was not at all a big deal.
Got out of surgery and things were a bit hazy until my boyfriend joined me. I was told that everything went well and they took an x-ray of my chest. My boyfriend told me that both of my lungs had collapsed during surgery. I was surprised to notice that my throat wasn't really very sore at all.
I was moved up to my room for Vascular/Thoracic patients and, to my surprise was rooming with a girl a few years older than me who had the exact same surgery with the same doctor just a couple hours previous to me. My pain coming out of surgery was probably an 8 out of 10 but, then again, so was my normal daily pain so it wasn't anything too unmanageable. I was given a few shots of dilaudid and it was under control. The doctor did forget to order a pain pump for me so I went without until about 8:30pm which sucked but once I got that I was pretty comfortable. I also had a "pain ball" filled with lidocaine. It was great at first, but started to spread down my arms to the point that my arms were completely numb and almost completely useless. It's still in me, but it's clamped down so I'm not getting the meds anymore.
I have a vacuum thingy hooked up to 2 chest tubes draining fluid from my chest. I don't find this bothersome.
Surprisingly, I've found the IV Tylenol they're giving me to be fantastically effective at relieving me of the achy feelings I have in my neck and left arm. If I had to guess, this aching is blood flow being restored to my arm as I've never felt anything like it before and seems to coincide with the pulling feeling I get when moving my neck.
A lot of pain seems to have been relieved and a lot of old sensation restored. I feel more strong and my shoulders have fallen back into place. I know it's early, but I feel like when I heal up I'm going to be a very happy camper.

Edited to fix typos because apparently the hydromorphone has affected me more than I thought!!

Oh, I did want to mention as well that my range of motion is great. I can easily lift my arms over my head and carefully up
behind my back. Out to the side is harder and I can make about a 120 degree angle that way. I would be willing to post a picture of my incision if anyone is interested as it is a transsternal approach. I don't want to gross anyone out though.
I did find out why they cracked the sternum. Apparently, they lift it up a bit so they can get the last little bit of rib out from the back and since they were doing both sides at once it needed to be cut. I have pain while deep breathing but only a little. No worse than when I cracked a rib coughing during pneumonia. I can do the blowing exercise thingy with ease (inhaling over 3000 cc's of air) and I cough when I'm supposed to without using a pillow because it's just not that necessary. I do have a high pain tolerance, but I can honestly say that I'm quite comfortable.

Sounds like you are doing great. I would be interested in the incision picture (just curious I guess). And am also very amazed at how well your breathing is doing since you had the lung issues. Keep it up, but don't over do it.

I'm glad everything went well. Sounds like you are doing great with the spirometer. I'd like to see pictures as you are the first person that I know of on this forum to go through this approach.

Well, things quickly went south here at the hospital. I can say that I still feel the surgery itself was a success. I'm feeling better TOS-wise and my hands/arms are still very warm. I think that, in the long run, this surgery was a good thing.
That being said, I've had IMMENSE issues with the medical staff here. It started right after surgery. The doctor forgot to order my pain pump so I was without it for over 3 1/2 hours while they "sorted it out." Then, my arms went totally numb because of incorrect placement of the lidocaine pain ball. This had to be turned off resulting in more pain but at least I was functional. Then, the next morning after being promised I would be fed breakfast and the doctor changing my orders from liquid diet to a regular one, I still received a liquid breakfast and did not receive actual food until 11:30 am (over 36 hours since my last meal) despite the need for food to sustain lactation and several doctors AND nurses telling me they were getting it and it was on the way. I had noticed that yesterday morning that the girl next to me that had the same surgery on the same day was getting more examination than me. The doctor wasn't checking my range of motion or asking me how I was feeling. He spent significantly less time with me.
What really took the cake happened last night. a resident came in and asked me if there was anything I needed. I had asked throughout the day if I could have some sort of sleep aid or anxiety medication as I had been up the whole night before with what they thought were anxiety attacks and what I thought at the time was pulmonary embolism. Regardless, I could accept that they could be right as I DO have an anxiety disorder and surgery is a major stressor. Well, I was told that they would look into Serax, Ativan or Ambien for me. I looked up how it would affect my baby and was okay with any that they chose. Then, the resident came in and told me she would give me nothing because it is not safe as it is pregnancy class D. I'm not pregnant, I'm lactating, and the medications are in safe lactation categories. They refused to let me take any medication and then tried to bully me into taking an antihystamine to wean. They refused to look up half lives. I dropped it, I'm not going to pretend to be a doctor so I didn't even argue that they were wrong. Instead, she asked me why I thought it was okay in the first place, why I thought I needed something to sleep when I never had needed it before and just got downright nasty to climax with the statement that I must not care about the welfare of my child to put her in this sort of risk. By now, I was hyperventilating, gasping for air, crying and begging her to just leave and give me some space. I really don't think that was too much to ask for but she put me in a place where I absolutely needed the medication (in front of my dad no less!) then walked away. She came back later, and did the very same thing again. Then, changed my medications so my nausea medication was HALDOL which is not okay while breastfeeding and moved me from colace to senna even though I've not complained about constipation. All without my consent. I told her that I couldn't trust her anymore and I wasn't going to use my PCA pump because I needed to be clearheaded to deal with her. By 3am I was asking for a muscle relaxant because I was so stiff but no one would get back to me. At 8am, the doctor seemingly decided to teach me a lesson by taking away my base IV pain medication so I would have to press the button in a power play. By 10am, the only pain medication I was under the influence was, was 2 tylenol. Despite telling everyone who would listen that I was in a boatload of pain (10/10 when I woke up at 3am and 8/10 after having to move around a bit and getting some endorphines flowing by 11am) I was continually brushed off in my concern that I couldn't trust staff to bring me safe medications or to care for me if I was too out of it. The nurses were taking 45 minutes to respond to the call button and then rarely came back to preform the requested task.
I requested a patient advocate or ombudsmen to speak with, and I was told a case coordinator would see me by 7pm today which was A. unacceptable to think it was okay for me to have completely uncontrolled pain for about 24 hours and B. a case coordinator is NOT a patient advocate. The coordinator came in within a half hour after I complained about that and then started asking me if I had a case manager and about setting me up with a social worker. It was obvious they had written me off as loony and weren't taking me seriously.
I ended up calling my mom and stepfather to come advocate for me since no one else would. I felt so bad for my roommate who had to listen to all of this but I know she didn't think I was crazy... I overheard her talking to her boyfriend about how bad she feels for me and she doesn't blame me for being upset so at least I know I'm not crazy. My mom and stepfather had a meeting with the medical providers and made it clear that I'm not crazy, I'm not an idiot, and I do deserve information and a say in my medical care. Things seem to have turned around in regards to their attitudes, but I'm still in a lot of pain and it's so irritating for my roommate to complain of needing to get some sleep so they bring her out some xanax but when my neck muscles are completely spastic and I've tried massage and heating pads that I can't even be considered for a muscle relaxant.
Guess I just needed to vent a bit, the surgeon seems to have done a good job on the surgery thus far but he's really spun my psychological well-being around.

I'm so sorry you are not getting the treatment you feel you deserve. Sounds like this is a University/Teaching hospital. True?

It is absolutely remarkable that you are able to do so much typing. I hope you can get some pain/spasm/anxiety/sleep relief.

I agree that it sounds like I'm at a teaching hospitals. However, that is false. I'm at Hartford Hospital where they technically are a teaching hospital, however, they don't really let them get too involved as they're teaching the general surgeons/general doctors or something. Anyway, they weren't really involved in my surgery itself (thank god) but are providing most of my care while I'm hospitalized.

I'm trying to keep things in perspective. Even though I have to fight for whatever medication I need and whatnot (last night I got half a pill of baclofen despite my neck being completely seized up) my hands are 100% more functional than they were before surgery. I have more stamina, less clumsiness, and more sensation than i've had in many months. My familiar pain is gone and replaced with new, surgical pain. There are parts of my body that hurt that I just know are related to not having a rib there anymore and needing to adjust.

My chest tube is driving me crazy. The stitches are pulling out of my skin on one side and even though I keep complaining about it, I keep getting a whole lot of "yeah, that could hurt, hopefully your pain meds take the edge off it and they take your tube out later this morning, let me know if I can help with anything!" Ugh. So annoying! YES you could help me by making sure it's not pulling on my skin! I could also use more than half a muscle relaxant.

I think I'm getting released today. After all the issues I've had, I think they want to get me the hell out of their faces.

Anyone who's had a scaleneotomy instead of a scalenectomy have any suggestions for post op neck pain? I could really use them right about now.

So did the surgeon turn over all the pain relief options & duties to the hospital staff drs/nurses?? :confused:

If you get released today will you be able to get good pain relief for at home?

I hope all gets better for you.
:grouphug:

The doctor decided to change the plan. I had been totally open with him about my goals, my breastfeeding plans, my research, and my "acceptable medication list." Apparently, the hospital has a policy that all medication prescriptions must be approved by the hospital pharmacist (ever heard of such a thing??!!) and they kept no-going everything. They were not looking at the lactation recommendations and instead were going by pregnancy recommendations which are completely different. My situation is very different as well because I can schedule my pumps around my doses and my baby is over a year old so she drinks much less milk than an infant and I have a freezer stash to cut the milk 50/50. Her pediatrician, my PCP, the LLL, the infantrisk Center, and Dr. Hale's research all backed me up.
My surgeon then backed his resident who was completely inappropriate to me and even fired me as a patient. I'll have to see a different thoracic surgeon for my post-op. My parents ended up having to come to the hospital to advocate for me and convince them that I'm not some crazy person nor am I a drug seeker. I just needed some relief and respect. That worked well for the medical staff on that shift, but everything went back downhill once the shift changed. I was refused a muscle relaxant for a long time and when they did bring it up, it was such a ridiculously small dose it was literally laughable. They gave me half a pill of the smallest dose available. When the staff from the original shift were back this morning, they upped my dosage and decided to discharge me as my fluid output levels from my chest tube were low and they recognized I'd get better care at home and would heal better if I wasn't so stressed and I could actually sleep.
So here I am, I was given 2 days worth of narcotic pain relief and 10 days worth of muscle spasm medication. I've reduced how much I'm taking to make it last and I think my PCP will be helpful if I need him especially with the muscle relaxant. I have a high pain tolerance, so I'm doing okay. I'm down to 10mg of Baclofen every 8 hours and 2mg of Dilaudid every 4ish hours. Also, 2 tylenol every 4 hours.
Some numbness has returned to my arms. My forearms are almost completely numb as well as my right pinky. I'm also getting some numbness of my lower face, shoulders and upper arms. I'm hoping that it's just part of the healing process and that these sorts of symptoms will come and go during the first weeks.
My left pec minor is very sore and aches down into my arm. My incision site feels great and isn't bothering me at all unless I poke at it. My left scapula is quite a bit sore too and my entire neck is VERY stiff. If I'm still though, I'm quite comfortable.
I don't have a lot of stamina, but I have been able to successfully shower, dress myself, and got some grocery shopping done (in a scooter of course). I can raise both arms above my head and up behind my back. I'm obviously able to type with little difficulty- much less than before my surgery.

Does anyone who's had bilateral 1st rib resections done know if you have that weird "caved in" look under your collar bone forever? I don't know if I'm just swollen or if it really is caved in. It looks...sickly... and I'm hoping that it goes away.

Thank you all for being here for me. I've really valued your listening ears.

Things I never thought I'd be able to do while recovering from bilateral first rib resection surgery that I'm capable of...

Shaving my armpits (been doing it since the day after surgery)
Typing on the computer- easy ever since getting the pain ball out.
Washing my hair- tricky, but doable.
Putting on a bra (was told to wear one to minimize the scaring of a transsternal incision)

Just thought I'd post a couple examples so those looking at having surgery can prepare. Both of my arms were affected by surgery and I am able to do many things! That doesn't mean that it will be the same for everyone but I know that, personally, I'd like to be able to prepare for everything because if I can shave my armpits, that's definitely going to happen.
So for those of you going into surgery and getting ready to pack your bags... I recommend bringing things that will make you feel better about yourself (for me, it was hygiene stuff) and you may be surprised what you're able to use. I also recommend bring (if you're a woman) vaginal wipes because bed pans are yucky and if you can't shower while having a chest tube it's nice to feel fresh, very good quality shampoo and conditioner so someone else can easily brush/wash your hair with minimal tangles, body WASH so it can be put on a loofa, a loofa on a stick, bring something to get hospital sticky stuff off of you- it was driving me crazy and I had nothing, your own toothbrush and toothpaste because their stuff is crappy and falls apart in your mouth, your own slippers that slip on so- hospital socks never fit right and are hard to get on by yourself, a razor, and if you have silky pajamas- that makes life so much easier to get in and out of bed on your own when you're ready.

How are you doing now?
 

Hi, how are you doing now? I also had bilateral rib resection, but had two separate surgeries two days apart, my incisions are under my armpits. My surgeries were December 3 & 5 2012, so I am just over a month into recovery and doing pretty well, but still experiencing arm pain, particularly in my elbows.

One week today and I'm doing pretty well. My right side much better than my left. Everything around the incision site feels pretty good unless you press on it. If it were only that, I'd be on no pain killers at all. I have some stronger pain in my back and behind my left shoulder blade. I think my back is where they cut the ribs off on the back side and under the shoulder blade is transferred pain. I also have some tightness and stronger pain right next to my left armpit in the front where the pec minor is. Not sure what that's about. I do get some pain down my left arm especially when I tighten things up or extend it out from my body in any way. I think this will pass with time, it doesn't feel like the radiating pain before surgery. I get intermittent numbness in both my forearms that I assume is from post-surgical swelling? Not sure, but again, since it's not all the time I think it's part of the healing process.
My hands no longer feel like I need to "wring them out" and my arms/hands feel a LOT warmer these days. To the point that sometimes it's uncomfortably weird. I'll get over it :wink: My left arm always needs to be supported, my right arm does not. I do have a lot of tightness in all of my neck muscles that usually baclofen deals with, but sometimes doesn't. It's a weird sensation since they didn't take the scalenes, they just let them kinda...hang in the wind. I also have a visible "collapsed in" portion of my chest under the clavicle. It really makes me sick to look at. I don't know that anyone else would notice it if they weren't looking at it but I'm hoping it's more of an optical illusion due to swelling rather than really being sunken in because of the lack of rib there. Or at least that I'll get over it!
Overall, I'd say I'm healing fast and that I think this will be a good thing once all is said and done. It makes me a little nervous that my left side is so much worse than my right but I'm going to give it time before I freak too much. My left side was much more symptomatic and there was muscle wasting so it was not in as good shape. It was also not my dominant side so I'm going to assume that it's just going to take a little more work to get it where it needs to me. I hear that the better shape you're in, the easier and faster you heal. So it would make sense that my right side is doing better than my left.

I'd love to hear how you're doing a month out now so I can have an idea of what to look forward to. I just have a nagging feeling that I'm going to need a pec minor tenectomy on my left side and that maybe these scalenes are going to have to be removed in the end. Crossing my fingers that I'm just being a bit of a hypochondriac after having so many issues for so long!!

Funny you say your left is worse than your right side - mine was (and still is) too. The scar on my left is also much larger and I did have a complication on the left with the chest tube, it was hitting a nerve so I couldn't stand up after my left surgery, very uncomfortable, pain through the roof until they took the chest tube out then it was much better. The pain on my left side was also much worse, and like you said, in the back between the shoulder blades. When I came home from the hospital and was off the really good drugs I had a hard time sleeping, it was very uncomfortable on my back and of course I couldn't sleep on either side for the first few weeks because of incisions on both sides.

But after a few days at home the pain got better. Every day it was amazing how much better I felt. Very tired though, lots of resting. But I was up and we were out doing things right away, hubby had to wash my hair over the tub for me the first few days. We have horses and I found that a long polo bandage meant to wrap around a horse's leg felt great wrapped around my chest up high under my boobs, it felt like it gave me support and held everything in. Breathing was tough the first bit - a sneeze is hell! But again, it gets better every day and returns to normal.

By the way, I am 44 yrs old, no kids, but we do have horses and I live a fairly active lifestyle, was riding and running regularly prior to surgery so am fairly fit - I am not a super athlete type but try to stay healthy. I think that helps as I saw people coming out of the same surgery I had in really rough shape, but maybe it is just different reactions to the anaesthesia, etc.

One bad thing was we sold our house and had to move when I was a week out of the hospital - we hired people to move stuff and to clean the house but of course I still ended up doing stuff, more than I should have and was pretty sore after that for a few days. Timing sucked but you gotta do what you gotta do!

Ok, so it is 4 1/2 weeks post surgery - saw surgeon last week - he ok'd me to start Physio now - I have an appt tomorrow. He also said I can start light exercise again (no weight lifting though, ha ha) and yoga classes. I have been taking my horse for walks through the snow for the past few weeks. They say to not drive for a few weeks - I was able to drive after one week. I went to a yoga class a few days ago, it was tough and I had to modify poses and do a lot of child's poses (resting pose) but I made it and it felt great, and I wasn't sore the next day.

I have been back doing normal daily stuff like cooking and shopping, cleaning, but I only do a little and then rest. The first month I noticed I was really tired a lot and needed a lot of rest, feeling more normal now. Everything is modified from normal of course, but then it was always modified before surgery anyhow, so not a lot of change there.

Oh yeah, and my hands are warmer too.

I have two more months to recover before I have to return to work so I hope that things settle more in that time. My GP is quite optimistic. The surgeon is too, he thinks I'm currently at 50% better and before surgery and things will continue to improve over the next 2 months.

My problem is that I feel pretty good so its hard to not do too much. But I am still amazed that I feel as good as I do for having just had such a brutal surgery. It's pretty funny to see people's reactions when you tell them you just had two ribs removed - they look at you like you are from Mars!

For sure, I am no worse off than before surgery, my shoulders don't ache as much, upper arms not as bad, forearms hardly at all now, but elbows do still hurt, some neck stiffness but not as bad. The pain in the back between shoulder blades from surgery is lessening, only feel it once in a while now and it is mostly on the left side, hardly ever felt it on the right. At first I did feel a lot of strange almost firing or pulsing sensations in my arms but that went away.

I guess it's all just a waiting game. But take heart, it does continue to get better!

Thanks for sharing! Sounds like things are going well. I think I'll be good as new in no time. Hopefully this time it sticks! I felt great after my shoulder surgeries only to be bombarded by TOS only a couple years later. I mean, jeeze, what else could go wrong in there?!

1 week 2 days post op. Using breast milk to reduce scarring/inflammation/redness. Better photo of transsternal approach.

http://i1320.photobucket.com/albums/...ps857c3e0f.jpg

:eek:

that is crazy!!!!!!!!!!!!!

i can understand wanting to get the incision there tho, further from neck the better imho

Since it was bilateral and AVTOS he wanted to be able to have good access to the vessels and he had to cut across the sternum. Would have been nice of him to make it straight though... would have made it look like he took his time and was careful! Now I'm stuck with a lopsided scar lol. At least it's healing well!

Three weeks post op and I'm feeling about the same as I did 1 1/2 weeks post op. I know I really need to get into PT but apparently the surgeon who saw me for my post op appointment thinks that should be left up to my actual surgeon to order. I'm frustrated. I know I need PT and it takes a couple weeks after a prescription is sent for it for everything to be scheduled. I'm really scared about frozen shoulder or other nasty things happening while I'm waiting for someone to decide to care enough to get me some help.

Physically, I still have some pain behind my left shoulder blade and tightness in my left pec minor, my entire chest, and my entire neck- front and back. I'm taking baclofen only these days and it's just not doing the job. I've got one day left of it and my doctor's office doesn't want me on any more pain relief of any kind, but, won't help me feel better by giving me a PT rx either!

I'm not doing so much sleeping and my incision is healing up as nicely as can be expected so at least that's good. My arms are feeling better but I still have numbness and tingling when I raise my arms up. I'm hoping this is just one of those things that takes time to fix but between the disparaging blood pressures in my arms, the tingling/numbness when raising up my arms, and the crazy muscle spasms, I'm left wondering if perhaps this surgery wasn't as successful as it could have been if they had released the left pec minor and removed the scalenes instead of letting them just kinda hang out.

I'm sorry you're having such complications with your surgeon/the PT being ordered. Your hospital experience also sounds horrible. My parents are rather passive and wouldn't have been much help advocating if it were me in that situation!

Thank you for posting all of this, though! It's been very helpful to read through your surgery process!

Having some shortness of breath that's getting worse over the past few days, new pain behind my sternum and some wheezing. I can't breath at all if I lay down flat. It's looking like my doctor's office is sending me to the ER to be worked up for pulmonary embolism... just waiting for a call back now.

Ended up getting in with the doctor yesterday. Found some weird findings... my pulse ox was down at 92 though I was feeling better than I was the day before and my pulse ox is usually 100 as I live at sea level. When it was bad, it was around 87.
After doing an x-ray to rule out pneumonia, listening to my lungs to rule out a collapsed lung, and a CT scan to rule out pulmonary embolism I was diagnosed with anxiety and given a script for Ativan. I challenged the doctor on this because A. I do have an anxiety disorder so it's not like I don't know the feeling and I wasn't anxious- just couldn't breath! Also, being anxious can cause you to hyperventilate or feel like you can't breath... but it doesn't actually cause your pulse ox to go down. He then said that what's probably going on is that everything is tight and swollen so the phrenic nerve is probably being irritated causing difficulty breathing but he still wants me to talk the Ativan since it works as a muscle relaxant too. Whatever. What's a few more damn pills?