[colleen]

Originally Posted by colleen

I called Dr. Kline's (LSU) office today in my search for someone who has a clue. His office told me that he has retired, but they are referring TOS patients to Dr. Daniel Kim (Houston Baylor). Dr. Kim was trained by Dr. Kline.
http://www.bcm.edu/neurosurgery/?PMID=7782

This was a great relief to find someone who had been trained in TOS. I meet with him next week. Hopefully this information will be helpful to others.

Well, I thought I'd follow up since I posted Dr. Kim as another Houston doctor.

Things I liked:

• He clearly had experience with TOS, although I'm not sure I'd consider him a TOS expert.
• He definately worked with Dr. Kline doing the post-surgical TOS follow-up studies.
• Provided surgical outcome expectations - 60% feel some improvement, 5% feel they shouldn't have had the surgery.
• Said if I had surgery it would be a joint surgery between him and a vascular surgeon & referred me to see a surgeon he has worked with before.

Things I didn't like:

• My appt was scheduled for 9am. I didn't see him till 11:30.
• Rushed appointment - didn't get to ask all the questions I had.
• Said I had neurological and vascular TOS. Didn't suggest any testing to determine which was the dominant issue.
• Gave me the "if you can live with the pain...." speech.
• Never indicated if there might be risks to NOT having the surgery (annurisms? nerve damage?). I mean if my artery is being obstructed, isn't that bad? Should I suck up the reduced circulation to my arm and just deal with it? Is that good for you? Do I really have arterial TOS??? I don't even know what I have.
• Never looked at my c-spine MRI's. Said everyone has bad disks, focus on the TOS and if we need to we'll worry about the disk later.
• I asked if there was any other pt or another pt that I could go to that might help and told him I didn't think my pt knew how to treat TOS. Dr said it looked like I already tried that and it didn't work (I had 6 sessions with a PT that was doing things that I'm reading you should NOT do for TOS).
• The vascular surgeon he referred me to seemed a little wishy-washy. She wanted to redo my doppler study (sorry, but if my pulse cuts off for the first one, it's going to cut off in the 2nd.... just because it wasn't done by Baylor people doesn't mean it wasn't done ok.... I mean how likely are you to have a false-positive doppler scan where it shows your pulse was cutting off but it really wasn't???). Then after that she became more wishy-washy saying "Well, if Dr. Kim wants to do the surgery without any further testing then .... well, I'll talk to Dr. Kim and we'll call you back to schedule any further testing". ----- it's been 2 weeks... no word.

That last 2 bullets are the key ones. I had a phone conversation with Dr. Sanders yesterday. He said that the bad disk in my neck should definately be further investiagated. My MRI showed the c5-6 disk to have moderate central and right side disk protrusion and bone spurring into the right neural foramen causing moderate right foraminal compromise. Dr. Sanders said that this could be causing a good portion of the symptoms of neck/shoulder pain as well as some of the neurological symptoms of tingling in my arm. Dr Sanders also said I definately have not had enough PT and from what it sounded like, not the right kind of PT. He said that therabands shouldn't be used, that they can make the symptoms worse (my pt was using therabands).

Dr. Sanders did give me the name of a Neurologist in the North Houston Area. His name is Lee Pollack. I've seen that name somewhere, but I'm not sure where. Dr. Sanders said that he receives surgical referals from Dr. Pollack and feels that Dr. Pollack would be able to connect me with the proper therapy/treatment. Then if that doesn't help after 3-4 months, then call Dr. Sanders back again......which at that point I guess I'd be more of a surgical candidate.

I was VERY happy with the phone consultation Dr. Sanders provided. I was so upset prior to this that I was ready to hop a plane somewhere just to have someone be able to definatively tell me what is wrong with me and to what degree.

I'll follow up with a review of Dr. Pollack after I see him (unfortunately not for another month). All the doctor reviews people provided here have helped so much. I hope this can help someone else who feels like I do.... completely frustrated, confused, angry, depressed, and everwhere in between.

[Lisa48]

Just wanted to post that while I do not have TOS I do have the exact same trouble with my C4 to C7 discs. What that does mean is that it is causing the neck/shoulder pain I am having and the tingling numbness down my arm. I have tried PT, but when it gets to the point of that weird tingling, that usually suggests some nerve damage of some sort. I was referred to Dr. Kim who is a neurosurgeon by my neurologist, Dr. Nammour. I believe that when you finally make it to a neurosurgeon, it is all about surgery usually. Unless you elect to not go that route and risk severe nerve damage. I came equipped with my MRI's on disk and Dr. Kim's office had my neurologist's notes when I arrived. I think I only waited about a half hour to see Dr. Kim. While he was somewhat hurried in his approach, he and his associates did spend a moderate amount of time with me and my husband explaining the procedure, the expected outcome and the risks involved. Dr. Kim elected to do minimally invasive surgery where he would clean up the bone spurs and protrusions rather than perform disc replacement. I am very grateful that this is an option because disc replacement is definitely super invasive surgery and takes a longer recovery time. Dr. Kim informed me that what we are trying to accomplish from this surgery is to prevent any damage from getting worse. It will be icing on the cake to clear up the symptoms or pain or damage. But that is not to say it is not usually successful in the 90 percentiles. He hopes to buy me at least another 5 to 10 years before disc replacement is needed. I guess I will see how it goes and post after I go through the procedure next week!

Lisa

"My MRI showed the c5-6 disk to have moderate central and right side disk protrusion and bone spurring into the right neural foramen causing moderate right foraminal compromise. Dr. Sanders said that this could be causing a good portion of the symptoms of neck/shoulder pain as well as some of the neurological symptoms of tingling in my arm. Dr Sanders also said I definately have not had enough PT and from what it sounded like, not the right kind of PT. He said that therabands shouldn't be used, that they can make the symptoms worse (my pt was using therabands)."

Originally Posted by colleen

Well, I thought I'd follow up since I posted Dr. Kim as another Houston doctor.

Things I liked:

• He clearly had experience with TOS, although I'm not sure I'd consider him a TOS expert.
• He definately worked with Dr. Kline doing the post-surgical TOS follow-up studies.
• Provided surgical outcome expectations - 60% feel some improvement, 5% feel they shouldn't have had the surgery.
• Said if I had surgery it would be a joint surgery between him and a vascular surgeon & referred me to see a surgeon he has worked with before.

Things I didn't like:

• My appt was scheduled for 9am. I didn't see him till 11:30.
• Rushed appointment - didn't get to ask all the questions I had.
• Said I had neurological and vascular TOS. Didn't suggest any testing to determine which was the dominant issue.
• Gave me the "if you can live with the pain...." speech.
• Never indicated if there might be risks to NOT having the surgery (annurisms? nerve damage?). I mean if my artery is being obstructed, isn't that bad? Should I suck up the reduced circulation to my arm and just deal with it? Is that good for you? Do I really have arterial TOS??? I don't even know what I have.
• Never looked at my c-spine MRI's. Said everyone has bad disks, focus on the TOS and if we need to we'll worry about the disk later.
• I asked if there was any other pt or another pt that I could go to that might help and told him I didn't think my pt knew how to treat TOS. Dr said it looked like I already tried that and it didn't work (I had 6 sessions with a PT that was doing things that I'm reading you should NOT do for TOS).
• The vascular surgeon he referred me to seemed a little wishy-washy. She wanted to redo my doppler study (sorry, but if my pulse cuts off for the first one, it's going to cut off in the 2nd.... just because it wasn't done by Baylor people doesn't mean it wasn't done ok.... I mean how likely are you to have a false-positive doppler scan where it shows your pulse was cutting off but it really wasn't???). Then after that she became more wishy-washy saying "Well, if Dr. Kim wants to do the surgery without any further testing then .... well, I'll talk to Dr. Kim and we'll call you back to schedule any further testing". ----- it's been 2 weeks... no word.

That last 2 bullets are the key ones. I had a phone conversation with Dr. Sanders yesterday. He said that the bad disk in my neck should definately be further investiagated. My MRI showed the c5-6 disk to have moderate central and right side disk protrusion and bone spurring into the right neural foramen causing moderate right foraminal compromise. Dr. Sanders said that this could be causing a good portion of the symptoms of neck/shoulder pain as well as some of the neurological symptoms of tingling in my arm. Dr Sanders also said I definately have not had enough PT and from what it sounded like, not the right kind of PT. He said that therabands shouldn't be used, that they can make the symptoms worse (my pt was using therabands).

Dr. Sanders did give me the name of a Neurologist in the North Houston Area. His name is Lee Pollack. I've seen that name somewhere, but I'm not sure where. Dr. Sanders said that he receives surgical referals from Dr. Pollack and feels that Dr. Pollack would be able to connect me with the proper therapy/treatment. Then if that doesn't help after 3-4 months, then call Dr. Sanders back again......which at that point I guess I'd be more of a surgical candidate.

I was VERY happy with the phone consultation Dr. Sanders provided. I was so upset prior to this that I was ready to hop a plane somewhere just to have someone be able to definatively tell me what is wrong with me and to what degree.

I'll follow up with a review of Dr. Pollack after I see him (unfortunately not for another month). All the doctor reviews people provided here have helped so much. I hope this can help someone else who feels like I do.... completely frustrated, confused, angry, depressed, and everwhere in between.

[mspennyloafer]

http://www.uggen.net/mike/writing/conditions/TOS.htm

http://www.uggen.net/mike//treatment.htm
Michael Uggen, Licensed Massage Practitioner. Washington State Massage License Number MA 16912
Nationally Certified – NCBTMB
Member – AMTA


i have NOT been here but this guys website and writings are very appealing, if you're the WA (?) area..i would definitely check him out.

Not for PT, but more massage/bodywork