I have had issues with my hands since April. They get red, bluish and ice cold. The issues with my hands have not resolved themselves independently or with medical help. I went back to the hand surgeon. Hated having to wait 1 1/2 hours which puts me in a bad mood. One of the tests he did was Adson's test which is used to assess for the presence of Thoracic Outlet Syndrome at the scalene triangle. I tested positive in both arms although more-so in the left hand. The color changes and coldness are not as strong as they were in the past. But now I feel my right hand is more swollen than it had been, not horrible but enough for me to notice. I also have a heaviness in my left writs and forearm. The hand surgeon wants me to go for physical therapy for 4 weeks and then go back. (I have been going for TENS, heat and massage for a month and I can't do that and PT at the same time due to insurance). He also took x-rays which looked good on my left shoulder. He said there were other tests that would show more info (MRA, angio... CAT scan) but didn't want to perform yet. I told him I do not want to put off testing until issues get much worse which I did with my neck. Never a dull moment. My ROM is pretty good once the day gets going. First thing in the am I am very tight, but after a few hours and exercises I am looser and better. Went back to the 2 pound weights in my Left hand and 5 pounds in my Right hand. I feel they are still so weak. I want all of the pain and discomfort to stop and feel good in order to participate in life to the fullest. There are days that I wake up in pain like prior to surgery but those are few and far apart. But it scares me when it happens. Have a Painless Day.
I would like some suggestions on exercises and how to proceed with the medical aspect. DO I continue with hand surgeon or go to a vascular surgeon. I will be going back to work in September and would like to further address these issues before going back to work. HELP PLEASE!

12/9/2010 ACDF C5-6 C6-7 with plate, screws,
BMP & bone fragment filled cages
2/14/2011 trying to go back to work as a teacher
2/17/2011 starting PT
wearing bone stimulator 4 hours a day
DDD, arthritis, herniated disks, pinched nerves
3 months saw a little bit of bone growth (YEAH)
4/15/2011 Home Tens Unit
6/2011 end plate growth no more bone stimulator
pretty good ROM
still working on the strength
some issues with knots and spasms
Hands turning red and bluish and cold
8/2011 Hand surgeon feels I have TOS ( 2nd visit since 4/2011)

With the fusion & TOS as complicating factors - I would make sure to get a very advanced PT person, lots of letters behind their name.

And someone that has tx'd TOS and Spinal rehab clients before.

Do you feel the weights are helping you or not?
many w/TOS don't do to well with weights or resistance bands or the hand bikes.

I did ok with them after the worst of my RSI/TOS was resolved.

Thank you for your response. Back in April when symptoms first appeared I thought about TOS or RSD. No diagnosis then. Now I just need to find out which type of TOS? I also need to decide if I want to push for some of the more invasive testing to determine that. The hand surgeon gave em 1 recommendation for PT. I am not sure if I should get a recommendation from the vascular surgeon that I went to or the OSS that performed the ACDF? I will probably call the OSS and ask him. I have alot of faith in him.
Thanks again for the relpy.

Well it has been quite a few interesting weeks since I last posted. On 9/2/11 I had a test that was a doppler of the blood flood with my arms at rest and above my head. I saw the EKG type print outs and they seemed very different. The doctor wasn't able to see them and then me because he was called for emergency surgery. Unfortunately later in the day I was rear-ended. The accident wasn't horrible, but because of my ACDF C5-6 C6-7 I was really scared. The x rays showed the fusion was stable. I was however in horrible distress with significant whiplash. 2 weeks later I started PT. I am better than I was in the beginning but still having muscle spasms in my neck and shoulders. My lower back is also an issue a slight slippage was seen by either L 5 or L6 (yes I do have an L6). I go back to OSS on Tuesday and will request an MRI since I am not sure how long these issues should last after the accident. Still having issues with the TOS. The PT is working on that but being very gentle due to all of the other issues. Life is never dull. Just have to keep plugging along. Each day with sunshine is a good day.

Well it has been about a month since I last posted. Still trying to recover from the car accident. Getting better but still having headaches, muscle spams and issues. Went to the Rheumatoid Arthritis Dr and he ordered an MRI of my knee to see why it is buckling. (knee or lower back) Well after reading the MRI I think it is mainly arthritis, a small still and some swelling / edema. Not sure what it means and what it do about it. I also made an appointment with the head of Vascular Surgery at LIJ Hospital. I still have 3 more weeks to wait for the appointment, The other choice was going into NYC to someone at Mount Sinai. My hands are really an issue: red or blue, ice cold swollen and at times I feel they are numb. I have 2 toes on my left foot that go numb and now the toes at times are beat red and hot while other times they are cold. Who knows what the cause. I have been told I have TOS combined and Raynauds. Who really know what is happening. All I know is I feel much older than my age and just want my life back and to be able to rake leaves and shovel snow if I want to. Very tired of taking meds and having headaches.

Get other opinions even if you pay cash. I've had this for 4.5 years and my life & career have been destroyed. I have paid for private consults and over 20 physicians agree on my diagnoses, but finding one to tackle it has been hard because my case is very complex. TOS cases aren't always uniquely neurogenic, arterial or vascular and may have a combination of symptoms. Weights aren't usually good because muscle tension and fibrosis tend to exist, and it becomes a cycle of posturing problems. Discomfort makes you assume unnatural positions, which further aggravates it. Get any tests you can out of the way and find the most experienced surgeon possible. Then ask for contact info of former patients with the same diagnosis who have had good outcomes to ask about it. I had one horrid surgery to stabilize my scapula and am praying for the scalenectomy and rib resection. Scary as hell, yes, but not as scary as watching your life dissolve while you rot waiting for insurers to pay up. You aren't alone, though. Be aggressive and seek solutions. read every journal and text you can get your hands on. Educate yourself. Watch for RSD and CRS. note: Raynaud's -type symptoms can occur with TOS (phenomena and syndrome are not the same). Imaging doesn't always show anything positive. Scalene blocks might give insight. Botox may help temporarily. EMG testing. Imaging with contrast. Venogram. Ultrasound. Evoked potentials. Hand Blanches? Volumetric studies of the hands. Temperatures of each digit. Photograph changes in good light. The fact it's in your toes, too, sounds more like Raynaud's Syndrome. look up R. Sanders - Denver / R. Thompson - st louis / R. Braun (San diego) / J. Brown (san diego) / Collier? / Gelabert -UCLA / Warner / Best of luck. I'll need some, too. If you get depressed, get help. Pain is a killer

I hope that I did not make my case too horrible. I am frustrated, but still going through with the daily grind. I am just frustrated that since the cervical surgery, I felt so much better than I had in years. No debilitating headaches and I was able to function and feel well. I am taking it one step at a time with referrals and doctor visits. Going to the head of Vascular Surgery at Long Island Jewish Hospital. Highly recommended. If this doesn't seem to go in the right direction then my next step would b e into NYC to Mount Sinai.
Yes, I would agree that one part of the body hurts the other parts tend to overcompensation or change position which in turn aggravates another part of the body. I am sure that is what is happening to me. I need to learn the proper positioning for standing, sitting in front of the computer, driving and sleeping so that I don't aggravate any part of my body. Another factor is probably arthritis throughout my body. It is well documentation in my neck and right knee from MRI's. I am thinking about asking the OSS to MRI my lower back and include my hips and the Rheumatoid Arthritis to get the other knee. Just want to know how bad it is and try and figure out a way to hold the progression of it so it doesn't get any worse
THe OSS actually mentioned RSD and CRS. Right now I don't seem to have the pain that is usually associated with these yet. Not sure what the difference is between TOS phenomena and TOS syndrome.
Hoping the Vascular Dr. orders some of the tests that you mentioned in addition to an MRA of the shoulder. Time will tell.
Good luck to you also. Everyday is a new day. I'm loving the sunshine today even though it is only in the 50's.

[QUOTE=frenchfri1003;794879]I have had issues with my hands since April. They get red, bluish and ice cold. The issues with my hands have not resolved themselves independently or with medical help. I went back to the hand surgeon. Hated having to wait 1 1/2 hours which puts me in a bad mood. One of the tests he did was Adson's test which is used to assess for the presence of Thoracic Outlet Syndrome at the scalene triangle. I tested positive in both arms although more-so in the left hand. The color changes and coldness are not as strong as they were in the past. But now I feel my right hand is more swollen than it had been, not horrible but enough for me to notice. I also have a heaviness in my left writs and forearm. The hand surgeon wants me to go for physical therapy for 4 weeks and then go back. (I have been going for TENS, heat and massage for a month and I can't do that and PT at the same time due to insurance). He also took x-rays which looked good on my left shoulder. He said there were other tests that would show more info (MRA, angio... CAT scan) but didn't want to perform yet. I told him I do not want to put off testing until issues get much worse which I did with my neck. Never a dull moment. My ROM is pretty good once the day gets going. First thing in the am I am very tight, but after a few hours and exercises I am looser and better. Went back to the 2 pound weights in my Left hand and 5 pounds in my Right hand. I feel they are still so weak. I want all of the pain and discomfort to stop and feel good in order to participate in life to the fullest. There are days that I wake up in pain like prior to surgery but those are few and far apart. But it scares me when it happens. Have a Painless Day.
I would like some suggestions on exercises and how to proceed with the medical aspect. DO I continue with hand surgeon or go to a vascular surgeon. I will be going back to work in September and would like to further address these issues before going back to work. HELP PLEASE!

12/9/2010 ACDF C5-6 C6-7 with plate, screws,
BMP & bone fragment filled cages
2/14/2011 trying to go back to work as a teacher
2/17/2011 starting PT
wearing bone stimulator 4 hours a day
DDD, arthritis, herniated disks, pinched nerves
3 months saw a little bit of bone growth (YEAH)
4/15/2011 Home Tens Unit
6/2011 end plate growth no more bone stimulator
pretty good ROM
still working on the strength
some issues with knots and spasms

Hi Gail,

I'm having the same thing... isn't it weird how all this stuff pops up AFTER our fusions? Wish I knew then. I'm not diagnosed yet, but my PT and MT have both confirmed all symptoms with a recommendation to my neuro (who I see in 2 weeks) to test for TOS.

Please keep me posted on how things go with you. You seem to be experiencing things just a little bit ahead of me. Ugh.

I hope you find a great PT that can treat all, I have found a good one that is knowledgeable on both fusions and tos, but it took some searching for sure.

Good luck with it all... keep in touch.
Cathie

I think we will both be evaluated around the same time for the TOS. I go to the vascular surgeon on the 13th. i have spoken to all 3 PT's at the location where I am being treated. I have shown them the physical symptoms at various times. They all feel it is TOS due to positional situations, posture although there can be some Raynauds mixed in there too in order to complicate matters. I am trying to document all of the physical changes and my physical condition or position along with the room or outside temperature. My symptoms come and go regardless of the temperature. It affects my hands and toes/feet. I do have arthritis (more advanced than I thought) in my knees, neck and probably hands too. My hands swell at times (more often in the am) where I can't put on my rings. My symptoms seemed to be aggravated after the car accident. Are your symptoms any worse after you fall. How are you feeling?

I hope that we both get some answers and a possible remedy to our situation. Keep me posted.

Gail