My name is Lynda and I am writing to learn more about how to help my son recover from his first rib resection surgery.

Blake is a very healthy 24 year old that was diagnosed with TOS on Aug 3rd after having a blood clot in his left arm and enumerable pulmonary emboli. He had surgery at Stanford Hospital on Aug 31st. The surgeon removed the left first rib and the scalene muscles and said it was a textbook surgery and all went very well. But the past week has been a roller coaster. He has been in constant pain. Originally the pain was in his back just behind his left shoulder blade. Now it is in his left shoulder and arm. He is on constant pain meds and muscle relaxers and even takes ativan from time to time to help him relax. Ice seems to help with the swelling too.

I honestly thought that he would begin improving by now but he is still just as bad as a week ago. He starts physical therapy today and doesn't have a followup with the surgeon until next week. I feel like he needs to be seen by the surgeon sooner. Am I just being a worried mum or is this constant pain something he will have to live with for a while.

Any advice would be greatly appreciated.
Cheers,
Lynda

Many swear by sleeping in a recliner or many many pillows to prop /support the areas.

Extreme discomfort is pretty normal for a week or 2, but a call to the dr asking about better pain relief for this time wouldn't hurt.

Pain makes you tense up and that is not a good thing during recovery, or ever really..
when a muscle/s is/are constantly tensed up blood flow is restricted - blood flow carries in the good stuff as well as carries out the bad stuff.
So you want to have the flow moving.

What does he rate his pain level at? 0 none -10 highest - dr will want to know that most likely. daily avg + highest /lowest
http://www.tipna.org/info/documents/...ePainScale.htm

Sending you good thought for your son recovery! I just meet with my surgeon last week (im pre surgery waiting on authorization) but same as Jo said... My Dr said the pain most likely will be worse for weeks after, as the nerves are swollen and need time to heal. Is he still in the hospital? Please keep us posted and let him know we are thinking good thoughts for him!

Im sorry .... he is not in hospital.... I originaly thought it said Aug 30... sorry

I must need more coffee.... he is only 1 week post op.... Im on the retard side today and shall stop posting.

Hi Lynda I am a mom that my daughter had surgery back in 1997 from a 95 injury, She was 16 at the time of the injury.
I don't know what the worse surgery you every had but there is so much tramua from the poking, prodding, pulling. To remove the rib large mechanic size cutters are used. THey have to pull every nerve and identify it as to not cut them.

They do end up being truamatized, and flare. The blood clot was the vascular end of it, after the space was open with the rib gone, then the scalense muscle in the neck had to be seperated, and likely a bypass of the affected arties or veins around the scalense area.
I bet it feels like a butcher knife in the area above the wing...there is a nerve that runs along there that is a painful trigger. It is inflamed and the muscles around it try to make a splint to protect it. Right were the nerve inserts into that muscle. THose muscles are the Hanger if you picture one for the wings to sit in.
Some times ICE right on that spot, and some gentle pressure, or a tennis ball pressing in may help.

The surgery is like someone sticking there hand with a wrench in it into the neck and pulled, cut, covered and sewed up.
So a week is when you feel the worst really.

I also agree, I bought a used recliner for $50 for my daughter, (sanitize it for bedbugs now a days). Ice, we used frozen bags of peas, make sure to mark not to eat.
Pillows in the arm pits or small rolled towels.
Keep up on the medication, do not wait until the pain is there, take it on time! better then playing catch up. Make things in reach, oh, and many times a baby boppy for the waist is great support while in that recliner.

But realistically, it could take a month to calm down the nerves and body from the surgery, and 6 months to a year to feel what the results are.
I find it particulary odd how many blot clot cases are being diagnosed and treated that we meet on the forum.

Traditionally it is only about 5% of True TOS, not disputed TOS diagnosed which is about 95%. I wonder why the increase?
But over the years we have had many young people on here.
Welcome, and feel free to pick our brains or look for a hug.
di
OH, Toradol is a great anti inflamatory that is non narcotic so doc's do not argue the use. The shot is better...if your son is in the worst type of tooth ache pain almost in tears with the pain, a "shot" of toradol will help.
I am able to manage with my PCP providing my shots in huge flare ups. Better then pills.

Hi and welcome

I hope your son is recovering and his results are good.

You're getting great advice here.

I used 3" balloons for my armpits. Portable too

I pray he recovers Godspeed. My heart goes out to you and him.

Lynda: He is really early in his recovery. If you don't mind me asking, was it Merritt or Lee who performed the surgery? or someone else?

I hope he starts to feel better real soon.

Hello. I am writing because my daughter was diagonosed with thoracic outlet syndrome after a swollen right arm resulted from clots forming in her shoulder due to the compression on the subclavican vein. After dissolving the clots, (she has been on coumeden for 4 months) her vascular surgeon informed us that she needs to have the first rib removed. Since then, we have received conflicting advice on whether she really needs to have the surgery or not, and who is better qualified to do it - a vascualar or orthopedic surgeon. Needless to say we are both very confused. She lives in Atlanta and we don't know how to go about finding the best doctor there to do this procedure. Since most of you have probably done tons of research on this, any advice you can give would be greatly appreciated. Thanks.

Hello,
I'm very sorry to hear about your daughters current diagnoses. I also had TOS(paget-schroetter syndrome) clot removal surgery and 1st rib resection all within a 2 month period. I personally would recommend having the rib removal surgery but only by a Vascular Surgeon who is familiar with TOS and has performed a rib removal at least 20 times or so. Also keep in mind that some doctors are trained to go in directly above the Clavicle while others are trained to remove the rib from making the incision below the arm-pit( my doc went above the clavicle and it turned out fine). As far fetched as it might be Stanford has a great staff (Dr. Jason Lee) and would be ideal if you could make it out here.
Once the rib was removed I had some lymphatic fluid swelling in my shoulder which resulted in referred pain in my back but all in all I'm glad I had the surgery. It has really helped put my mind at ease knowing that I'm not going to cause another clot next time I reach up high or extend my arm out. Here is a verse that helped me .Deuteronomy 31:6

I wish you the best of luck and will keep you in my prayers.