Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie.


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Old 02-10-2007, 08:13 PM #21
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Quote:
Originally Posted by olecyn View Post
O, Wait
You mean the NEO Vista 3D Imaging?
So, it's like Dr. Collins' here down at UCLA
Yes, it is being called "Neo Vista" They are in the process of upgrading their website.

Last edited by Jomar; 02-12-2007 at 05:06 PM. Reason: name/link removed
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Old 02-11-2007, 12:08 PM #22
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Default A quick note...

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Originally Posted by annhere View Post
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
I am the developer of this test, and would like to add a few points for informational purposes.

The examination has several technical differences from Dr. Collins' excellent test in LA.

The interpretation of the test is focused more on the anatomy that is described in decades of surgical literature. I have been told by a very well-respected prestigious university that my report on each patient is "like I read the surgical report". In other words, the focus of my examination addresses the presence or absence of all the anomalies the surgeons would look for BEFORE they go in and do any procedure. The purposes are:

1. To prevent surgery on those patients with a syndrome like TOS but without correctable anatomic or pathologic problems. Some studies in the medical literature have demonstrated that up to 30% of TOS patients do not have anatomic anomalies of the scalene muscles. Why do surgery on these patients?
2. To prepare the surgeon for what he or she might expect before they go in. There are numerous vascular anomalies as well, with arteries in a very superficial location that the surgeon would want to avoid.
3. To provide objective evidence of pathology in TOS patients struggling to convince their physicians or insurers to take the symptoms of TOS seriously
4. To enable the medical community to correlate the known anatomic anomalies in any single patient with the patient's symptoms. This will hopefully allow docs in the future to better understand why some clinical signs and symptoms occur in some patients and not in others, which patients do better with surgery and which do better with PT, and to allow minimal or less invasive surgery in those patients with certain minor anomalies, rather than a rib resection or more major procedure.

While some of these may not be at their full potential right now, the design of the examination is based on hundreds of papers in the literature, and on the experience I have with hundreds of patients to date. I am optimistic that i can continue to contribute to understanding of this condition.

I visited with Dr. Sanders, a very nice man, and observed surgery, clinical examination of patients, and a pec minor block. I got to spend about fifteen minutes demonstrating some of this new MRI to Dr. Sanders, and he asked me to teach him how to read the examination. I think it is admirable for any physician to want to learn new things, but radiologists spend five years learning in residency and more years in fellowship, which makes it nearly impossible for a non-radiologist to learn ANY MRI, much less a new technique with up to a thousand images, in fifteen minutes. I CAN tell you that there are several physicians in the SF Bay area that use my examination on a regular basis, and I consult with them regularly to try to help them learn little bits over months to years. So Dr. Sanders is likely unable to read this new test, but that does not in any way mean it is too complex. It HAS to be complex because TOS is by nature so complex. I think Dr. Sanders is just setting his personal bar rather high, high enough that I wouldn't expect anyone, even as knowledgable as Dr. Sanders, to be able to meet it. Bear in mind that there are numerous papers in peer-reviewed radiology journals that are widely-accepted by expert radiologists. I think that expert opinion carries a lot of credibility.

Since we all know how complex TOS is, we should all expect that the MRI would be complex, as well. I have worked very hard over several years to be comprehensive, yet concise and and organized in my reports.

The website explaining more about this test will be up within a week. I welcome any questions people might have about the examination, although I cannot answer specific medical questions.

Have a great Sunday!
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Old 02-11-2007, 12:23 PM #23
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Dr. Brantigan along with a radiologist at PSl has come up with a CT, (I think) that will show the pec minor if it is part of the cause. Sorry I can't recall what it is but you can call his office and ask.
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Old 02-11-2007, 01:17 PM #24
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SAWXRAY......

Thanks so much for the information....And for the record I feel lucky to have had this image test done...( not many people have had it yet)...I pushed my doctor to order it because I read it would give me the most information and allow to make the best choice. Peter Edglow will tell his patients...." If you really want to know what's going on in there get this test".....

This test allowed Dr. Avery to determine that I needed surgery becasue your scan/image told him (clearly) how small my narrowings were.... And that's the best part.....no guessing !!!

Thanks again for helping and keeping us TOS's informed, sometimes it get's a little bumpy....
Ann
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Old 02-11-2007, 01:20 PM #25
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I would like to learn more about this test, and where it is available. What was it like? Do a lot of doctors know about it? Thanks
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Old 02-11-2007, 01:23 PM #26
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Default Thank you for the comments

Thank you!

I am glad to contribute what I can, and certainly continue to learn the needs and concerns of those here. Many here know more than a lot of docs, and that kind of hard-working cooperative attitude is very inspiring. TOS is a big part of my life now, fortunately from the viewpoint of a caregiver rather than as a patient. I want to help make a difference, and am now luckily involved with some very good people like Dr. Avery, and Peter Edgelow.

Regards
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Old 02-11-2007, 03:34 PM #27
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Quote:
Originally Posted by bettertoser View Post
Dr. Brantigan along with a radiologist at PSl has come up with a CT, (I think) that will show the pec minor if it is part of the cause. Sorry I can't recall what it is but you can call his office and ask.
Even if the Pec minor muscle looks normal, it doesn't necessarily meant that the Pec Minor procedure wouldn't help. If the goal is to make more room in that area, that may be the easiest,least invasive way to do it with with the least amount of side effects.

Just my layman opinion...

Marabunta,
N. California
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Old 02-11-2007, 05:35 PM #28
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Default Re: Pec minor

Please also bear in mind that the balance of muscles around the shoulder girdle, ie the tension of the anterior vs posterior muscles, affects the position of the scapula and the clavicle, which may narrow the costoclavicular interval (the space between the rib and the clavicle). So relaxing the pec minor, which can be done in a number of ways, may widen the space and relieve compression on the brachial plexus.
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Old 02-12-2007, 01:33 AM #29
bettertoser bettertoser is offline
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Quote:
Originally Posted by marabunta View Post
Even if the Pec minor muscle looks normal, it doesn't necessarily meant that the Pec Minor procedure wouldn't help. If the goal is to make more room in that area, that may be the easiest,least invasive way to do it with with the least amount of side effects.

Just my layman opinion...

Marabunta,
N. California
I guess I would have to differ with what you say. The test clearly showed on my friend that her pec minor was causing the symptoms by pressure. If there isn't compression in an area for symptoms of TOS then any good doc wouldn't remove anything to make room for something that isn't an issue in the first place. No matter how easy or inexpensive it may be. That would never make sense. Anytime the body is opened it causes the chance for adhesions to form thus causing even more problems "in that area". Docs don't like trading one issue for another.
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Old 02-12-2007, 02:07 AM #30
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Default hmmmmmm

my symptoms have all come back since my surgery in July 2005...had my
MRI of brachial plexus today....hope scar tissue is not the culpret.....fingers crossed as all my sx are the same as pre surgery!!!!!!!!!!!!!!!!!!

I guess you get the point here...lol

take care all
love and hugs to all
Victoria (man can't even spell my own name right....guess it's bed time...or this damn arm isn't working properly...... hope it is the former!!)
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How poor are they who have not patience!
What wound did ever heal but by degrees.

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