KY,

Just curious about a few things. What did Dr. D. have to say about the vein involvement shown on the MRA? Did he discuss any possible pec minor involvement (since the MRA showed issue with the axillary artery as well)?

I'm really happy for you that things are looking to turn out the way you were hoping. Good luck with your CT scan and keep us updated!

He did mention pec minor, but not that much. Dr. Donahue indicated that it could be a target for botox injection as well and worst case if surgery is needed, could be a minor target as well.

God knows he tries to be even in his presentation to patients to ensure that they don't get too high or low, but I read Dr Donahue to be pretty confident in his hypothesis that the abnormal scalene insertion is the major culprit. He also noted on his physical exam when pressing on my neck above the clavicle that "jeesh, you're really tight here."

KY

Well, new test result from Dr. Donahue at Mass General. He called today post CT Scan result. The findings were surprising to me. Originally, Dr Donahue had hypothesized that I had an abnormal scalene insertion. Nope. The finding:

* Elongated transverse process, on both sides, but more prominent on the right.
* Transverse process on the right seems to have fused with the first rib.

Dr Donahue suspects that this is putting the pressure on the scalene muscle which is compressing the subclavian artery and creating the symptoms.

On one hand, kind of a bummer. In reading these boards, this finding could potentially put me in a first rib removal down the road. On the other hand, it's good to finally know once and for all what the deal is after 2 years.

All that said, Dr Donahue doesn't even want to pursue the CT guided botox injection at this time. My symptoms have diminished dramatically since all the scalene stretching in April to the point where maybe I hit a 1 or 1.5 on a 1 to 10 pain scale. We're going to regroup in the fall and see where we are. Right now, surgery is not really an option. Things would have to reverse direction in a big way.

I really hope this all was a case of a) boney abnormility making me predisposed + b) excessive repetitive stress due to resistance training in the gym + c) creation of forward posture, tight anterior muscles...and now, I'm unwinding this due to stretching.

KY

Curious what led you initially to ATOS verus just regular TOS? How did you ultimately decide it was the first? What symptoms differentiate the two?

Nobody has told me specifically what I have actually. I labelled it ATOS since tests revealed that my subclavian artery is being compressed. That said, my symptoms are all neurological (pain in shoulder, upper arm), not arterial (cold hands, etc).

I'd actually gather that I'm more neurological. It's my understanding that the brachial plexus envelopes the subclavian artery, so if the artery is getting compressed, there's a good bet the nerves are as well and thus, the symptoms.

KY