I know I'm not a doctor, but...
 

I saw the vascular surgeon today (referred from neuro) and she didn’t perform any tests or examination; just asked me a bunch of questions. I was diagnosed with TOS but she thinks its neuro because it couldn’t be arterial – I still have all my fingers – or venous - my arm hasn’t swelled 5x its normal size. So I would have to have the worst case symptoms to be positive? There is no such thing as having some or slight symptoms?

She said she could remove my large cervical rib (her words were: “This is a fun surgery”) but cannot guarantee that my rib is what is actually causing problems. So I follow up after I see ortho and have my EMG and try PT (from someone who is familiar with TOS, I made sure of that). Ok, fair enough. Nothing wrong with being conservative but I just feel like she didn’t do enough to check to see if I had vascular problems.

There's a test using doppler sonography where they look at if and how your blood flow changes when you put your arms in various positions. I would go see another md until you find one who will order it - if not to give you peace of mind.

Did she test your reflexes? I would go see a neurologist. You may need surgery, but I would want to know why and not that "it's fun." Some surgeons just like to cut, and that's the only solution they see. Just on the limited info you just gave, that's what it sounds like this md is to me - someone who just likes to cut.

I agree completely that the doppler in different positions is very important. when I was diagnosed, I lost blood flow as soon as I moved my arm into any position. Now after 5 months of twice weekly pt and doing exercises daily, it is normal in all positions but up over my head.

I'm in the Navy so I don't get a choice about what Dr I see. I had my neurologist text my reflexes and performed some other tests. I did lose my radial pulse performing the Adson maneuver. My hand numbness seems to be subjective but I can tell you my pinky weakness is objective - I play the cello and have problems with that finger. I hope the ortho is more helpful.

I am supposed to be moving overseas in January and I don’t want to leave the US without some kind of resolution. I work with an occupational health Dr who at least prescribed me something stronger than motrin (vascular Dr didn’t seem to care that I was in pain). He also told me that if it was him he would have his extra rib removed but after the comment the vascular surgeon made I do not feel comfortable with her operating on me. I am just extremely frustrated! I know, preaching to the choir :)

Have you done a search on cello and RSI?
https://www.google.com/search?q=play...&bpcl=35277026

Unfortunately it may be making things worse if you practice/play quite often.

Do you have 2 c ribs, or only 1, and if 1 is it on the side that would be more compromised when playing?

translation
 

"fun surgery" = extremely difficult.

don't let anyone operate on you who hasn't done this hundreds of times.

my 2cents

Can you share what exercises you do daily?