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


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Old 02-25-2014, 05:44 AM #1
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Been on and off reading this board since 2008 but rarely post. Quick history - 34 yo female. Had 1st rib resection with Dr. Gelabert in 4/2009 after 10 years of chronic pain. Symptoms returned 11/2012 and have been struggling to get treatment through workers' compensation. After a year of tests and unsuccessful PT and acupuncture, finally had surgery approved and got scalenectomy 2 weeks ago, on 2/11.

Turned out scar tissue built up and attached itself to my subclavian artery and scalene, pulling the artery up an inch from it's desired location. While Dr. G admitted this probably sucked for me - apparently it is was pretty cool for him, as a surgeon, to see. He found an extra scalene in my first surgery, I guess I am just anatomically fascinating... :-/

I know recovery on rib was rough but I appreciate the body's inability to remember pain because this has really sucked. Was in hospital 3 nights post-surgery trying to moderate pain - and discovering an allergy to dilaudid. I went to ER 6 days post-surgery convinced my incision was infected as it was swollen and red. Dr. G believed this was the normal healing (and irritation from the dressing tape) as my pain level hadn't changed much. I got antibiotics just to be safe. It's been slowly getting better and today I am finally able to go more than 4 hours between doses of oxy.

I'm noticing less tingling/pain on the ulnar nerve but my radial nerve is super flared up since surgery. Anytime I reach for something, I get this electric current down into my thumb - I'm hoping this will go away. Still a lot of scapular, neck and shoulder pain. Mostly worse than pre-surgery but I assume that has to do with the new trauma. I see Dr. G for follow-up on Wednesday.

No real point in posting this except to share 2nd surgery outcomes. And because I am trying to will myself recovered so maybe this adds to my strength. I will try to keep you updated - especially because I haven't seen a ton of 2nd surgery posts on here. Fingers crossed that this is the beginning of the end (again).
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Old 02-25-2014, 08:46 AM #2
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Originally Posted by sec161 View Post
Been on and off reading this board since 2008 but rarely post. Quick history - 34 yo female. Had 1st rib resection with Dr. Gelabert in 4/2009 after 10 years of chronic pain. Symptoms returned 11/2012 and have been struggling to get treatment through workers' compensation. After a year of tests and unsuccessful PT and acupuncture, finally had surgery approved and got scalenectomy 2 weeks ago, on 2/11.
Sorry to hear you needed follow-up surgery. Why doesn't Dr. Gelabert do the 1st rib resection and scalenectomy together?
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Old 02-25-2014, 03:35 PM #3
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Sorry to hear you needed follow-up surgery. Why doesn't Dr. Gelabert do the 1st rib resection and scalenectomy together?
Dr. Gelabert prefers the transaxillary approach to removing the first rib - which doesn't allow for a full scalenectomy. The recurrence of symptoms after resection is only about 10-15% so it usually isn't an issue. I just happened to be in that 10-15%...
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Old 02-25-2014, 06:48 PM #4
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Originally Posted by sec161 View Post
Been on and off reading this board since 2008 but rarely post. Quick history - 34 yo female. Had 1st rib resection with Dr. Gelabert in 4/2009 after 10 years of chronic pain. Symptoms returned 11/2012 and have been struggling to get treatment through workers' compensation. After a year of tests and unsuccessful PT and acupuncture, finally had surgery approved and got scalenectomy 2 weeks ago, on 2/11.

Turned out scar tissue built up and attached itself to my subclavian artery and scalene, pulling the artery up an inch from it's desired location. While Dr. G admitted this probably sucked for me - apparently it is was pretty cool for him, as a surgeon, to see. He found an extra scalene in my first surgery, I guess I am just anatomically fascinating... :-/

I know recovery on rib was rough but I appreciate the body's inability to remember pain because this has really sucked. Was in hospital 3 nights post-surgery trying to moderate pain - and discovering an allergy to dilaudid. I went to ER 6 days post-surgery convinced my incision was infected as it was swollen and red. Dr. G believed this was the normal healing (and irritation from the dressing tape) as my pain level hadn't changed much. I got antibiotics just to be safe. It's been slowly getting better and today I am finally able to go more than 4 hours between doses of oxy.

I'm noticing less tingling/pain on the ulnar nerve but my radial nerve is super flared up since surgery. Anytime I reach for something, I get this electric current down into my thumb - I'm hoping this will go away. Still a lot of scapular, neck and shoulder pain. Mostly worse than pre-surgery but I assume that has to do with the new trauma. I see Dr. G for follow-up on Wednesday.

No real point in posting this except to share 2nd surgery outcomes. And because I am trying to will myself recovered so maybe this adds to my strength. I will try to keep you updated - especially because I haven't seen a ton of 2nd surgery posts on here. Fingers crossed that this is the beginning of the end (again).

good luck with your recovery and definately keep us posted. If I ever do surgery it most likely will be with dr. G too.
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Old 02-26-2014, 09:07 AM #5
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Wow. That is rough and good for you to be so positive for your recovery, Thats half the battle. I had a bilateral rib resections and on one my subclavian was out of place afterwards, put back after the scalenectomy also. It has been 25 years of uber care for those nerves, ulnar--- and for me "funny bone" pain that was/is anything but. I have to watch out for the stress on my arms always, and occasionally nerves just gets bent out of shape. Still, recovery was hardest right after the surgery and during the first year. Take your time with recovery! Best best wishes and prayers for you!
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Old 02-27-2014, 12:59 PM #6
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Saw Dr. Gelabert yesterday. He isn't happy with the speed of my recovery but not discouraged either. I still have a pretty good bruise from my IV so I clearly don't heal that quickly anyway... Will start PT as soon as workers' comp approves it, in the meantime I have some shoulder exercises to prevent frozen shoulder.

I'm still in a good amount of pain and very limited on daily activities. For example, driving is really rough so I try not to do much; even riding in the car is pretty painful. My impression is that I am having a harder time than most - but that is about how things go for me, especially health wise. Note my new allergy to dilaudid, there's always something Will update next week and will hopefully be MUCH better.
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Old 03-06-2014, 06:47 AM #7
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How is it going? I am thinking of having the scalenectomy instead of the rib resection next. I have has the pec minor release.
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Old 04-02-2014, 05:16 PM #8
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7 weeks out now, finally started PT last week (thanks to workers' comp for the delay). My surgical pain is pretty much gone but my original TOS pain isn't any better and now I am having pain in my radial nerve in addition to my ulnar - so that sucks.

I'm seeing Lider Chan in LA for PT - he thinks a lot of my issues come from an immobilized AC joint. Not to mention every muscle from my neck to my arm on front & back is super tight. Hopefully, we can make it better as it seems the surgery didn't make the difference I expected.
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