Pec Minor Release
 

Hi, I am back home after having bilateral pec minor release with Dr Sanders. I wish I could type the whole story but it will have to wait till I can type longer. I just really want to say.......Wow my rib pain that has been so awful is gone:). My right side pec minor was fused to the pec major. Dr Sanders fixed that. I will report again later :hug: IHTOS

Hi ihtos i am glad to hear your back i have been wondering how every thing turned out for you and best of all i am happy that your rib pain is gone. Can't wait to hear the rest of your story i have been posting about my self since i got home. Take care and i hope you are not suffering to much.:hug::) See you on line bye for now

Welcome Home!
 

thank you so much for posting, i was beginning to worry about you IHTOS!!!

that is wonderful that you were able to avoid having to have a scalenectomy and just get by with the more minor procedure... i can never remember the name of it so i'll just say pec minor release, for now-:D

hey, is there someone there with you who could maybe post for you? that way you wouldn't have to type at the keyboard and you could still fill us in on all the details while they're still fresh in your mind.

just a thought, ITOS. i have them occasionally. very, very, rarely...:rolleyes:

(no comments from the peanut gallery...;))

so happy for you, that your awful rib pain is gone. it is not often that we get to hear about an "instant" surgical success like this! very exciting, and i thank you so much for telling us about it because it brings hope to so many of us, it truly does. that being said, i don't want to sound like i'm minimizing your TOS, and all the normal rules apply. please take it very, very easy - rest up, ice the most painful areas (if that helps you), use lots of pillows, stay on top of your meds and breathing exercises, gentle ROM, etc. any plans for PT and/or feldenkrais in the future for you, when you are ready i mean?:)

dr. sanders is great. this just goes to show what a fine surgeon he is, and that he won't automatically perform the more drastic procedure on a TOS'er if your individual case doesn't call for it.

alison
"Be Brave"

so great to hear from you :)
- but take it easy and give yourselves plenty of time to heal.

rib pain gone---that's terrific news ihtos! I hope you continue to take good care of yourself and fill us in when you are up to it.

ihots- great news...warm thoughts and *hugs*

i am also doing well, though overdid it way too much yesterday, and my mommy left this AM so I am on my own now.

can't type much, but thinking of you :)

YAY. I am happy to see ya posting and hear that you are getting some relief. :hug:

Hi Ihtos
 

Thanks for keeping us posted. I'm so glad to hear about the reduction in your pain level!

Great to hear such positive news ihtos! Did Dr Sanders say anything about the condition of the nerve cords beneath the pec minor - the brachial plexus has formed into 3 cords, the lateral, medial and radial (I believe) at that point.
The damage can be pretty mild to severe. If he hasn't, this should be in your surgical report. Don't forget to ask his office for a copy - pretty fascinating, if a bit weird to read all that was done to your unconscious person. :eek:

Can't imagine both sides done at once - it's much easier than rib resection, but still plenty painful having both pec major and minor cut! Hope you have adequate post-op meds. Rest up and feel better!

beth :hug:

Hi
 

Glad to hear pain levels down!! :Dancing-Chilli:

take care and take it easy!!!!

love and hugs,
Victoria:hug:

Thank you everyone!! :grouphug:

Tuesday: Dr. Sanders put me thru the usual 2 hour exam with the whole 20 month chronological history. I found Dr Sanders to be the easiest Vascular Surgeon to talk to. I had been to 5 total.
At the end of his exam he said he had good news for me. He doesn't believe I had TOS, but rather pec minor syndrome. I was sent for a chest & neck xrays and bloodwork preop.

Wednesday: Had a MAC test with a neurologist. All I know is that it came back abnormal, but that didn't change Dr. Sanders mind. It hurt like heck too!!!!! YIKES!! I am waiting on this report in the mail.

Thursday:11:00 am Had surgery at Rose Hospital. They did left side first..released the pec minor and cut an inch off it. Then on to the right side. The right pec minor was fused to the pec major and he had to cut it loose. Cut an inch off of it also. It was a total of 90 min surgery. I was released around 4 pm. Pain was minimal.

Friday: I tried to sleep on & off all day. DR Sanders called to check on me. He told me we are gonna be great phone buddies for the next few years. He also told me to try taking tylenol as my pain meds make me hyper. (vicoden & dilaudud)

Saturday: I was a little more miserable this day. In fact my hubby thought we should go sightseeing. Needless to say I wanted to choke him. :mad: I stayed in bed and told him go for it lol!!

Sunday we flew home and I am so glad to be home but wish Dr Sanders lived closer!!

I always knew my symptoms seemed different and lower than some of the usual TOS. (severe rib pain beside my breast) and lately even burning pain in my right nipple. I'm happy to say that pain is gone. I can actually touch my ribs and it's not sore. I have 3 inch incisions under my arms. He used stitches then glue. Will post more later. Ihtos

I am reading my surgical report and it says that they explored my axillary neurovascular bundle. "the ulnar, median, and pectoral nerves were identified and freed." It doesn't say anything about any nerve damage.

The most amazing thing is how i feel like my shoulders are back where they should be. I sit here in tears so greatful someone finally helped me. All the therapy, injections etc, would never have fixed my problem on the right side. I hope you can learn from me as I have from all of you.

The nurses spoke of Dr Sanders retiring soon. I do know another Doctor assisted in my surgery so maybe he's learning from Dr Sanders. :confused:

"cut an inch off it"?
 

How wide is the pec minor? If the surgeon cut off one inch of it, does this refer to width>? It sounds like the pec minor will still work. This sounds like a great solution.


ih--so glad to hear everything is going so well for you!

Fern, Dr Sanders website explains it better than I can. I know that when he did the block on my pec minor as a test......my symptoms improved dramatically. http://http://www.ecentral.com/members/rsanders/
"If following a pectoralis minor block there is significant improvement within a few minutes, we have been performing a very simple operation called pectoralis minor tenotomy. This operation is performed through a 3 inch incision in the arm pit. The pectoralis minor muscle is easily found and cut at its attachment to the shoulder blade (at the coracoid process). One inch of the muscle is then removed to prevent it's reattachment to the top of the nerves going to the arm. The incision is closed with buried stitches. The operation usually takes less than 30 minutes and can be performed as an outpatient and recently we have found that this procedure can be performed under local anesthesia, but with an anesthesiologist in attendance so that patients are asleep for a short time but are awake within a few minutes of the end of the operation. The procedure carries almost no risk of injury."


Hope this helps!

2 weeks post op
 

It's been 2 weeks since my bilateral pec minor release surgery. I am doing good. Had quite a few sleepless nights due to not being able to get comfortable. The numbness I had in right arm for the last 18 months is gone. I get a few weird nerve feelings in that arm but its not painful. The rib pain is gone.
My incisions have bothered me more the last week than the first week. The tape came off and they are healing. Underarms get damp I guess, and I will finally be able to wear anti-perspirant again next week. For now I just use powder.
Will post again soon. :grouphug: Ihtos

Mac Test
 

I got the report in the mail of the MAC test Dr Sanders sent me for. It was done by a neurologist .

It was kind of like an EMG/NVC test but more painful. Definitely worth it as Johanna told me though ,because this is the first and only nerve test I had done in 20 months that showed something wrong!! :D

I also had forgot to tell you that my grip strength in dominant right hand was 25 and 50 in the left. Does anyone know what that means? I've lost muscle or what?

Anyway, my mac test ( short for medial antebrachial cutaneous ) showed the following summary.
In the Doctor's words...
"Distinct pathology over right upper extremity. Both direct cervical root stimulation measurements and indirect medial cutaneous nerve data suggest pathology over the LOWER BRACHIAL PLEXUS. The profile of today's study would suggest more of a proximal process, vis-a-vis full blown thoracic outlet syndrome. However, the possibility of pathology also focally over the pectoralis minor must be considered, based on this profile. On the left, there does appear to be some borderline pathology developing over the brachial plexus, and this will need clinical correlation. "

I hope this info can help anyone who needs it. This neurologist was shocked that my 2 previous tests done here at home ( emg/nvc ) were normal.

I went for this test the day before my surgery. Dr Sanders told me to tell him to only do my forearms. I anxiously told him that, because I had been warned by Johanna that it was painful. Well once he got started he told me there was no way he would only do my forearms. He was getting abnormal responses and felt he needed to be more thorough. I told him ok just put duct tape on my mouth and do whatever needs done. I am so glad I had it done!! Finally something on paper!!!!

I looked at my notes from the last 20 months and saw the ones I had taken on upper verses lower brachial plexus. My symptoms were mostly lower brachial.
c8-t1

More later, too much typing, armpits hurt. :grouphug: Ihtos

Ouch!
 

:hug:sorry you had to endure. interesting that he can tell the pec minor from other stuff. mine says nothign about pec minor...only TOS. I have no quotes on hand, though.

Ihtos- the way that the grip strength thing was explained to me was..... most everyone has one hand/arm stronger than the other...... the fact that your dominant side was 25lbs of pressure (i think thats how they measure it) weaker than your other side makes me think that you did lose some muscle mass. I think thats fairly normal though.

it could be lost muscle mass, but it may be that nerve compression started it or came along...as both will contribute to weakness. I think once the nerve is squeezed, you lose strength, then you stop using it cause it hurts, then you lose the muscle. viscous cycle!!!

Thanks for that info Dabbo.
Isn't that the truth Johanna? Vicious cycle!!
For the last 18 months I've been told not to raise arms above chest level, but Soc Security says I can still do the only job I have ever done...:confused:..for 29 years I was a Hairstylist. I am 5 ft tall. Tried working off a platform for a while then ended up having to quit working all together.

I guess I will have to ask Dr Sanders which muscles I need to work on and when to start. I never did find any physical therapists who were knowledgable about TOS in my area. The 2 I went to both made my symptoms worse. There is no way I am gonna let someone mess up what Dr Sanders just fixed. :eek:

Social Sec.'s first decision on me was a joke. Then at my appeals hearing, despite the fact that I had to stop lifting a paper cup of water (hand overuse) and couldn't get up easily out of my chair to walk, the dr. there said I could stand 8 hours and sit for 4, etc. (Don't react to these comments, btw. Let your attorney handle it.)

You must appeal or have another hearing until the full extent of the disability in your case is properly described and acknowledged. Even though I usually (before TOS) could have done an SS hearing in my sleep, I HAD to hire an SS atty. to properly question the SS "experts" and present all of the med reports that I did obtain along the way.

I don't know what your SS status is, but it is so important to stress the neurological aspects of TOS in tiredness, memory, decision-making, etc. Again, I don't knwo your status, but just in general, I don't want anyone to give up.

Best wishes.

3 weeks post op
 

Well its been 3 weeks and I am doing better each week.

I forgot to mention previously that I had been having TMJ syndrome since this all began. I can't believe it but it seems to be gone. :D I don't know how it was connected, if it was due to the nerve being compressed, or if it was from clenching from being in pain. I can again drink cold liquids, eat ice cream and crunchy carrots without moaning in pain.

Biceps are still sore by every afternoon but I am learning to expect it and take tylenol and do my stretches. I also lay down for at least an hour just to get the weight of my arms hanging down off my shoulders. This seems to help.

I know that mentioning Doctors on here can sometimes cause controversy but I don't care!! Someone finally helped me and I am gonna tell it to whoever wants to read it or listen. How can we learn from each other if we don't?

http://http://www.cartage.org.lb/en/themes/Sciences/LifeScience/GeneralBiology/Physiology/Humanbody/Muscle%20Menu/The%20Shoulder/Pectoralisminor/Pectoralisminor.html

Dr Sanders you ROCK!!!!!!!!!!!!!

Hi,
 

I am so glad that the surgeries done what you needed done. I think Dr. S is one of the best Drs. I have ever met. He will be your phone buddy. He did my first TOS surgery in 2000 and in 2003, I think it was or 4 he did the other side where he took out 3 inches of muscle to releive my chest pain. It did the job. The first surgery was removing a rib and it did the job also. I know I have to watch what I do but man did he work wonders on me. As far as phone buddy, he called me in Oct. of last year to check on me. We also talked after Bill passed away in Nov. He is a very caring Dr. and like you said he does rock.

I wondered about him retiring. I know he is training another Dr. and I hope this one can do as well as Dr. S does. I still need my left TOS surgery but at this point, I am living with it ok. Again it's just not doing the things that get the TOS flared now.

As far as PT. I was blessed with good PT'ers before and after TOS. I hope you will be able to find one that does know TOS and do the right thing to help you with your rehab.

Hang in and feel better soon.

Ada

4 weeks post op
 

Hi,
I've had some post surgical armpit cysts that turned out to be sweat glands blocked. Right side only. They are going away finally. Dr Sanders had me on antibiotics tho just in case. He said I need to now start some kind of strength training for my right arm. I'm not sure if I want to try Physical Therapy again or look online and do it myself. :confused: I'm gonna tread very carefully on this. I'm nervous about making myself worse.

Other than that, I am doing good.

Ada, good to hear from you again. Hope you are doing well! :hug:

have you looked for a PT'er who is training in feldenkrais or alexander somewhere near you?
that might be a gentle way to start.

Please see my post to you on another thread...it's about lymph glands, etc. under Johanna's 2nd surgery. God bless.

Yes Johanna I looked into the Feldenkrais last year after my initial dignosis of TOS. Its in a bad area of a downtown city about 40 miles from me. I'm gonna hold off for now till this WHATEVER it is......cesspool :D clears up in right armpit. :lookaround:

OK, maybe you coudl look for lymphatic massage...that woudl be a place to start...also just pumping your hands..bending them up and back out can help the circulation in your arm. Make sure you are doing something to keep range of motion...just go as far as you can several times a day focusing on trying to get some blood pumping.

a good PT might still be able to help you work that out, mine does with some gentle massage and ultrasound to warm up the stuff and massage to move it around. The main drain to the lymph is at the base of your neck, very close to the BP...you can also pump your head...by bringing chin to side of chest to help that drain work more effieciently.

almost 6 weeks post op
 

Hello, My underarm cysts are now gone. :D Thank goodness, I was scared about that. I have had some scapula pain over the weekend. Knowing the pec minor can cause some scapular instability, I decided to seek help.
I think I have found a Phys Therapist who can help me. We will see.

My daughter gave me the inspiration to get started. She is 5 weeks pregnant. My first grandchild is due in June. I am so excited!! I want to be able to hold the baby. Whichever way it turns out, I am sure the grandbaby is gonna know Grandma loves him or her. :D

Congratualtions, Grammy!!!!
 

hey, good for you :)

i am sure you will be ready for that baby!!!!

Congratulations on the Grandchild !!
 

:Wave-Hello: ihtos,

I sure hope you can hold that baby.

I, like you, am having a grandchild next year and sure hope you and I
will be well enough, strong enough to hold these babies.
it is so exciting and well, I'm really looking forward to it :Dancing-Chilli::Dancing-Chilli:
I have a 4 year old grandson I've never held. It is so sad :Sigh:
Mine is due in April :Excited:
Again, congratulations on your first grandchild -- Hope

8 weeeks post op
 

Hi everyone, just checking in. I am doing therapy 3 times a week. It started out to be for arm strengthening but he is working on my scapula first. It's been very sore for last couple of weeks. Ultrasound & massage have helped so much. :D
I actually wore a bra this week for the first time in a year. My rib pain was so severe I couldnt stand any elastic around my chest at all before. I was approved for breast reduction 5 days before I went to see Dr Sanders. That only took 3 months to get approved UGH! I may do that at some point but not ready to go back under the knife again so soon.
Dr Sanders has called me 3 times since surgery. Nice follow-up! His office is also in touch with my therapist.
Experiencing a little bit of thumb swelling the last week near the base. The pain shoots up thru my wrist. I've got an appointment with my Ortho Nov 8, but it's probably more tendonitis. I seem to be prone to that. Or maybe its from using my hand more now? Take Care Everyone!! :grouphug:

Did your surgeon say anything more about the pec minor and pec major being fused? Is there any way to treat that other than surgery?

Thanks!