Astern, Beth, ...
Can any of you who've had the pec minor release let us know how you are doing now that some time has passed. Was it worth it to you? Do you have any problems that have occured or long term relief? Any insights you can share for those of us deciding on the surgery (in addn to the value of the block)?

Hi fern, my procedure was done early April of '05.

I can no longer pick up things away from my body. I'd be afraid to pick up a child.

I find that my rt. bicep tends to 'flip over' when I use my arm in a certain position (flossing my back teeth for example), this is VERY painful, like a cramped foot would be!

I'm also experiencing my sternalis muscles and biceps overcompensating for the lost pec minor stablization (per my PT), so now I'm getting tearing sensations in the sternum and arms.

On the plus side, I have fewer trigger points and a less-sensitive collarbone area. My scalenes spasm less often, but still give me problems.

It's not a complete fix by any means - merely a trade-off for pain/problems. I would highly suggest having the pec minor nerve block done first, to see if you get any relief. This is what I did, although in my situation the clock was ticking for my health insurance - I had literally 2 weeks before it was canceled, so I opted to have the pec minor release done bi-laterally. Had my insurance not been canceled, I'd have tried the blocks until they ceased to give me relief.

Hope this helps you,
Anne

Thank you so much Anne for your input. I had the block in Denver but it was a test to see if the muscle was affected and how I might feel after the release. Are you saying that there is a block that gives longer lasting relief--like botox or something? I don't want to have surgery if I'm going to trade one set of symptoms for another.

No, I'm not really aware how 'long' a block is supposed to work. I was told, in my case, that it may last a week to a few months. It lasted a month or so for me. I know because the side I had the block done on tolerated the pec minor release (and scalenectomy) very well, until it wore off... then it was angry! The side done without the block didn't tolerate the release very nicely - bruised, burning and angry from surgery onward.

If you aren't ready to trade sets of symptoms, I'd suggest that you not do it. It shows you may have enough functionality to manage the symptoms "as-is".


Anne

Anne-just to clarify, because I'd like to try a block. Is the one you had not what Dr Sanders uses to diagnose? If not, what is it? Do you get it from a pain dr? do you know what is injected? With all the post surgery issues, I think it makes sense to try everything out there even if the quality of life sucks in the meantime. I'm not comfortable "managing" as you say but things like repeat surgeries and RSD really concern me.

I have no idea what Dr. Sanders uses to diagnose TOS.

I assume all "nerve blocks" are done the same - I think Beth or some others here may be able to pinpoint what it is you are needing to know, ie: what meds are injected and where. My pec minors were injected about center-muscle.

Nerve block are similar in nature, and in some people can last a few weeks to a month, in others can last two hours...just depends. You can do trigger point injections (a lidocaine or marcaine injection into a knotted muscle) or botox into the same places... trigger points i think the goal is to relax the muscle by making it not hurt any more. Botox relaxes the muscle by not allowing it to contract.

The trigger point injection of lidocaine or a botox injection will do similar things to a nerve block (relax the muscle) but will generally last longer than a nerve block. I haven't done trigger points myself, only botox, but I think People get trigger point injections every few weeks, botox can go 6 weeks to 6 months, though I haven't heard of 6 months from anyone except the doc. I expect those people aren't hanging around here.

poeple get either type of injection in scalene, trapezius, and pec minor muscles depending on what is spasmed.

Dr. Agnew injected me bilaterally 3 weeks ago.
I was the BIGGEST baby
Trading one pain for another.
After it was done and over
I had maybe 5 hours of NO pain, NO sciatica, NO leg & foot stiffness, NO tingling & numbeness in the toes.
However, the headaches and cervicle pain was still there.

After it wore off, I had a flare like an angry PUMA for weeks.

My 10 minute computer timer just went off...wish I could stay and read and share

Dr Sanders has updated his page to include quite a bit about the pec minor problem and procedure. It's interesting, although the literature described the problem, there was NOTHING out there about anyone doing pec minor procedures when I was dx'd and sent to Denver to have it done in Oct 2004.
When Dr. Annest said he had never done the procedure before, I was really surprised. Turns out, I may have been the very FIRST patient to have had it done---if I'd know that then, I'd have been MUCH more nervous!!!

Dr S. says either novicaine or xylocaine is used in the block.

Although my shoulder blade initially felt MORE unstable/like it was winging more, and was uncomfortable/somewhat more painful for about 12 months I'd estimate, the shoulder blade is better now, less overall pain than before the surgery. The unstable feeling is gone as well, guess other muscles have adapted. What has NOT changed is the pain below the collarbone, that's been with me from day one of my injury, and I think always will be, dang it!
It's present on the left side as well. NOT a good place to be touched!!

Here's the link to Dr. Sander's page:

http://www.ecentral.com/members/rsanders/