Let's say you get botox on some muscles and that relieves your symptoms. Would that then imply that you don't need the first rib removed? After all, the botox does not make the rib disappear. Plus if it's the scalenes we're talking about, their removal would reduce the chance of the first rib lifting and probably make it easier to push the first rib down.

Thoughts?

Very interesting. I can see what you mean. I wish that was an option for me. TOO LATE NOW. Like I say if my issues were NTOS than I think that I would steer clear of the op. If such a method did relieve symptoms than job done. Leave bits where nature intended them to be.

Chroma,

Have you seen this? Seems the results are good, if only short lasting.

http://www.paulchristomd.com/wp-cont...OSfulltext.pdf

And while on the topic of surgery / and avoiding the rib resection.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2966747/

Sanders (the supposed leading doc) suggests there is no difference in success (or failure) rates whether you remove it or not. I'd be more apt to keep it in if I could. Less changes of complications or a collapsed long.

Thanks. I hadn't seen those. I do get the shoulder pain so I still have some ntos problems.

There is so much to consider, hmmm sometimes i think cancer would be easier to fight.

Alot of the stuff you read of the net however when i mention it to the surgeons or professionals they completely dissmiss it

For instance when i had mentioned scar tissue forming after surgey to the surgeon he completely dissmissed it and said the way he removes the ribs is completely with all the meat and muscle around it , so scar tissue doesnt form?

Dunno how that works but yea

Agreed to a large part. It's also exponentially better known. It's scary and sad when the "expert" you see knows less about TOS than you. I would consider the Botox before surgery but I remember reading about risks paralyzing the phrenic nerve. But surgery has the same. Definitely has to be guided injection.

http://neurotalk.psychcentral.com/ar.../t-148263.html

Heparin could be interesting. $2K per side for actual Botox. Ouch.

How can surgeons be so dismissive???????? I really am losing any faith I had in the medical profession.
Of course there is a risk of scar tissue forming...... where the incisions are. That's some thick muscle to go through and that in its self can cause nerve issues. What they also choose to not mention is that the thoracic/chest region is incredibly sensitive and more prone to scar tissue thickening or keloid scarring.

I think any surgeon will tell you it's a complicated procedure to begin with. I mean literally it is well documented to only be about 30% successful long term. That means, without question, almost 2/3rd's will fail and leave patients worse off than where they were.

I realize many patients don't have a choice when proceeding, especially for vascular situations. It's just already a disadvantaged situation. One one hand I see a doctor's dilemma. What do you really want them to do?

• Drugs (Opiates)?
• More surgery?

Someone in another thread made a good point. In some cases Cancer is easier to fight. But TOS is ultimately something that never goes away. In best cases, it's managed. In worse cases, it's a slow agonizing "life sentence" of chronic pain and discomfort.

I'm looking into botox here in SoCal. If I get a current price estimate, I'll let you know.