marabunta,

Re: MRA/MRV/MRI test.......


Hi Just wondering,

What were the results? did Dr. Avery tell what the narrowing was at the clavicle ( the mm ) and what did he recommend? I'm under his care but haven't decided what to yet.....

Thanks for your help,
Ann

Ann,

I haven't seen Dr. Avery yet for a follow-up, my Primary, by chance, is pretty well-versed in TOS. I had PremiereScan fax the report directly to me and I'm interpreting it as best I can on my own before I go talk to the Docs.

This is a VERY detailed mapping of the brachial plexus, specific to diagnosing the "Real" cause for TOS symptoms. Its a good 3 full pages, with 10 listed impressions.
My wife is an RN, so she's able to help with all the anatomical terms. Still, I bought a "Color Atlas of Human Anatomy" for $20 at Barnes & Noble.

To answer your question, on the right it narrows to a minimum of 11mm and on the left to a minimum of 14. I have no idea what normal is?

Dr. W's impressions include numerous anomolies in both scalene triangles, many appear to be genetic and others have occurred over time.

He says no incidence of Cervical ribs, just mild to moderately enlargements of both C7 transverse processes. I'm now convinced different DRs have different definitions of cervical ribs, because I've had them pointed out to me on an x-ray more than once and had one vascular surgeon ready to cut 'em out after a 20 second review of my x-ray.

Most disturbing is an anomalous aortic arch, with several anomolies including a left dorsal scapular artery piercing the middle scalene muscle. Haven't studied enough to know what that means, it looks normal on the anatomy charts. An additional right transverse cervical artery coursing anterior to the anterior scalene. More stuff too...

Moderate right and mild left extrinsic compression of subclavian veins on hyperabduction.

I think I'm going to send it to Dr. Sanders in Denver,...hoping to evaluate for the "pectoralis minor tenotomy" as a stopgap measure before getting scalenectomies, etc. If I can hold out for another year or so my disability insurance gets much better.

As always, just taking it day-by-day at the moment and trying to stay upbeat and not let the pain, etc. get to me. The chest pain worries me more than anything, its a recent development, comes along with flares, and scares me to no end. I've had full heart workups recently, and EKGs while it was happening and I could barely speak, and everything looked normal.

But us TOSers know about Drs telling us everthing looks normal

Marabunta
No. California.

keep the information and sharing coming...
I hear Avery has lessened his practice.
Is it true?

Avery, Saunders, Brantigan, Annest, Filler....
Can we get them all in a room to agreee to disagreee with the best treatment.

Then we really can't since everyone's condition is different and they all have a different take on the surgery procedures

This is awesome! Thank you for sharing this with us. There is hope out there yet for people to be able to get the answers they need.

Peggy

marabunta,

Dr. Avery said that normal was 15-20mm, when he gave my report back he said mine were 6mm on the right and 7mm on left.....that explains why he wanted to do surgery asap....you might get lucky and be sent to Peter Edglowfor therapy, if you follow his program you will feel better, I've been in his program for about 6 months, but because of of small my narrowing is the therapy will never resolve my problem.....I have spoken to Dr. Sanders and he's thinks I shoud try the Pec procedure first ( of course, that's what he's selling ). And of course that's what I'll do before the other surgery. Good luck...I too am happy to have found Dr. Avery, he's very detailed and I do love details......

Ann

I think this is more true than any of us readily realize. TOS by definition is not an accepted disorder or disease, it is a "SYNDROME" and that is defined as a collection of symptoms and/or signs. There is ALWAYS an underlying disorder/disease. Since the brachial plexus area is so complex, there are many,many possible underlying disorders, many very difficult to readily identify. Many of us have more than one underlying disorder, some have exclusively different disorders, but we still match the collection of symptoms/signs called Thoracic Outlet Syndrome.

Medical imaging capability is growing exponentially, and I think "exploratory" surgery will become a relic of the past in the near future. Hopefully we'll rarely hear "We won't know until we get in there."

I am not in the industry, but I would highly advise anyone contemplating major surgery in an area as complex as the brachial plexus, get the best scans that you can, even if it means travelling for the scan. It will provide your surgeon with essential information. If there are any anomalies of nerve or vascular locations, your surgeon will know where to look to visualize these and avoid complications.

marabunta,

Just to give you a heads up....That amazing test we both had done that gave sooo much info is the same test that Dr. Sanders will tell you he doesn't put much merit into...In my last conversation with him, I brought up the test and what did he think.....and he said he felt they were too complicated and too difficult to read...Just thought you might want to know before you asked him to read it....Also I heard through this site that Dr. Avery is going to be doing the Pec procedure soon......Yippee for us. no traveling

Ann

That's interesting because I found it to be detailed yet concise. That's the reason, on Dr Avery's advice, I waited for Dr. W to be available instead of traveling elsewhere. I had heard that some of these specialized imaging reports can go on forever to the point of being ignored because it takes too long to read and comprehend them...but I really would have a hard time believing that's the case with this report.

TOS is such a complex animal, with symptoms for many coming from secondary disorders and not the original previously undiagnosed or symptomatic disorder.

For someone as experienced as Dr. Sanders, I wouldn't think the reports would be entirely necessary, and they've worked for so long without them. But in the case of multiple anatomical anomolies, which seem to be not so anomolous in TOSers, I think it pays to know what to expect and what they'll find before they go in there.

Did I miss the specific tests you mention?
Which tests did you have?

O, Wait
You mean the NEO Vista 3D Imaging?
So, it's like Dr. Collins' here down at UCLA