Question about TOS surgery
 

A few weeks ago I noticed my left arm felt funny and so I looked down at my hand and my fingers were purple. I went to the clinic on campus at my college who sent me to the ER. The ER then set up an appointment to see a vascular surgeon. I had tests done and they showed that in my left arm, my pulse diminishes when I move it in certain positions.

He told me I need physical therapy or possibly surgery to remove my top rib. I was just wondering after the surgery what happens? Do you stay in the hospital for a few days? Do I wear a cast to immobilize my shoulder? Just wondering everything in general that goes on.
Thanks!

Hello and welcome,
sorry you are having possible TOS troubles.

First thing most of us suggest is to make sure you get expert second & third opinions about surgery.

There are specific tests they can do to check for serious vascular problems, it sounds like you might have that instead of the more hard to diagnose & treat nerve pain.

Usually a clear cut case of vascular compression has the best results with surgery.
Scar tissue regrowth can happen if you are prone to it.


Did anything change in your life to make this show up?
Car accident, sports injury, posture changes, new job, new hobby?

Do you have any arm, hand or neck pain or other symptoms?

If you don't have a serious case of vascular compression {a possibility blood clots forming}, make sure you learn about posture & awareness, go to the best PT expert you can find, maybe even an expert chiropractor.

I'll find the testing thread and post the link to it for you.

also look thru our sticky threads above the posts on the main TOS forum page.

Hi! I've had similar symptoms since I injured my left shoulder and lower brachial plexus. I was diagnosed with a 60% compression of the artery and vein leading to my left arm in the Fall 2008. I saw my shoulder shoulder doctor when my arm was purple, shrivelled, hurt really bad and was about 20 degrees colder than the other arm. I was sent directly to the hospital (next building) to get vascular studies done as they suspected a blood clot. Even the technician was concerned as she hadn't seen an arm look like that before so she spent extra time and ran extra tests (it was a slow day for them so she could spend the extra time).

Post-surgery:
I have had surgery on the right side to remove an abnormal first rib for neurogenic and vascular TOS. I was not put in a sling or brace. PT was started around 2 months post-op to regain the strength. I think other doctors start the PT sooner. After surgery, each surgeon will have his or her own guidelines/protocol. They do attempt conservative treatment first as surgery is a last result and not everyone fares well with surgery.

For me, the surgery results have been great and I'm glad I did the surgery. Even though I had great results, I'm still scared at the thought of possibly going through it again. I do realize it's a possiblity given the compression on the artery and vein and the fact that I have a cervical rib on that side (didn't have this on the right side). If the compression worsens, I could develop a clot.

What area of the country are you in? I believe there is a list of doctors at the top of this forum. I'd recommend reading old posts to see peoples experiences from surgery. If yours is more vascular in nature (sounds like it), people tend to fair better after surgery. I know someone who had a 9 inch blood clot who had to have her 1st rib removed. She spent a week in the hospital while the clot was dissolved, had surgery once the clot dissolved and was released 2 to 3 days later. She was back to work in two weeks and has had no return of symptoms (surgery was about 4 years ago).

Here's a post about various kinds of TOS testing -
http://neurotalk.psychcentral.com/post580952-11.html

Jo*Mar-
It randomly showed up one day. I was sitting in class when I noticed it. I am a freshman in college and am not doing any extra activities to harm it recently, but 2 years ago I was in a car wreck that made my neck super sore and I also played basketball all throughout school and had a few bad falls landing on my head/shoulder. Do you think it may be the cause of it?

When my fingers were purple it was only for the day, the next morning it was gone. But after everyonce in awhile my elbow felt funny.

In the last week or so I have had trouble sleeping at night, I wake up with a pain in my elbow. I think I am sleeping on it wrong. Also a few times I have had a throbbing pain in my shoulder.

Sheri TOS-
I am in the USA in Ohio.
Thanks for the info on your surgery. Hope all is well!

Welcome to NT

You're getting good advice. There's lots of info here so take your time to digest some of the TOS stuff. You may find something to ease your discomfort.

I do hope it turns out not to be TOS or something worse. I hope you get good recovery and don't need TOS management. It's very difficult to deal with and even harder to get good treatment. Be wise and be careful who you let work on you. It's bad now but it can be made worse.

Ah school...lets look at it..

if you are doing a lot of leaning over or sideways and reading/writing, computer/desk??
not very ergonomic postures ?

all of those can aggravate things
as well as the previous car wreck & sports falls.

Have you considered expert chiropractic care/evaluation?
Upper cervical- its the c1/c2 that helps keep the whole body in balance or not.
http://www.upcspine.com/self.htm

I happened to find a very well rounded chiro that has been the most helpful for me. Also advanced PT's have been very helpful for me too.
Much more so than any dr, but I didn'/don't have the high pain like some have ended up with. Long term meds or surgery isn't needed.

I had to pad & wrap my elbow for awhile to keep it from the pressure/rubbing on the bed. that was one of the bad times for me.
i am a light sleeper and got hardly any sleep at that time.
Luckily it only was bad for a few weeks and PT was helping overall too.

My mom actually set up an appointment with a chiropractor for this Friday. Then on Monday I have an appointment with another vascular surgeon.

Thanks for all the info!

hi, i had a fall where i landed on back upper back - 6 months later and symptoms started (pain, strange feelings in my hand), was working in an office - posture not great.....makes things 10 times worse.

According to my pain consultant, my symptoms are more vascular than nerve related - he says the way i sleep indicates that im more vascular.....the only way i can sleep is with my right arm propped up off the bed slightly - i usually do this by bunching my quilt up under my arm so that it raises it off the bed and i place my arm in a sling like position - arm resting across my chest. Sounds tricky but that really is the only way i have been ableto sleep for the last nearly 5 years!

My TOS is on the more mild side in comparison to some... i can still work (not in office job, with kids in a school now) but have to watch my posture and be careful in avoiding aggrevating activities......

good luck!

I was reading the testing Jo*Mar posted and I do have one issue with my thyroid but it is just that I have excessive sweating sometimes.
Do you think this has anything to do with it?