TOS in the UK.

chroma · 12-30-2011, 05:11 PM

Quote:

Originally Posted by debbietellez

i'm having my surgery at medway hospital on 16th of jan, i've read quite abit about what to expect the recovery to be like the american information seems very dramatic which worried however both my consultant and nurse have said to ignore the usa advice as they tend to exagerate things somewhat! Both consultants have said it is a straight forward op with very little after care needed and will be able to return to my full time office based job after 1 week following surgery. I believe i am just having a scalenectomy no rib resection but just recently been having alot of pain in my shoulder blades. Has anyone else been put off surgery after reading american info? Debx

I don't think American patients here on these boards are exaggerating their post-op experiences. If you're able to go back to work after one week, it is definitely due to you having just the scalenectomy with no rib resection, as opposed to you not being American.

I am curious why American doctors seem to favor the rib resection to start with. Seems like scalenectomy is the right place to start.

debbietellez · 12-30-2011, 06:04 PM

Quote:

Originally Posted by chroma

I don't think American patients here on these boards are exaggerating their post-op experiences. If you're able to go back to work after one week, it is definitely due to you having just the scalenectomy with no rib resection, as opposed to you not being American.

I am curious why American doctors seem to favor the rib resection to start with. Seems like scalenectomy is the right place to start.

you're probably right as it appears to be a much simpler op but i'm wondering if my doc is underplaying it at all!! i just hope the scalectomy works because if not then they'll do the rib resection with more time off work. I'm very frustrated by the whole thing tbh and am in alot of pain today, i have had many different tests over the past 18 months and have had to take time off work when this could have been sorted out sooner. My consultant said tos right at the beginning but due to the nature of the surgery i needed other tests to confirm his diagnosis now 18 months later at my pre op assessment he said the surgery is straightforward and a relatively easy recovery and able to drive after 48hours. All this is great i just wish it had been taken of sooner. Sorry for the rant xx

343v343 · 12-30-2011, 07:02 PM

Quote:

Originally Posted by chroma

I am curious why American doctors seem to favor the rib resection to start with. Seems like scalenectomy is the right place to start.

Many call it a more 'complete' decompression. However Sanders / Annest in Denver, prefer Scalenectomy alone. According to their research, the statistical outcome is the same long term regardless of procedure.

http://www.ecentral.com/members/rsanders/

Quote:

it was observed that the failure rate for scalenectomy with rib resection or without rib resection was the same. This has led us to use scalenectomy without rib resection as our operation of choice. However, when during the operation we observe the nerves to the arm being pressed by the first rib, we will remove the rib during that operation.

chroma · 12-30-2011, 07:04 PM

No problem re: the rant. We all need to let off a little steam every now and then.

Keep in mind that after the scalenectomy, conservative approaches like chiro and PT might work better than before due to various reasons like more space, less muscle tension (the muscle is gone, hehe) and I would think that pushing/adjusting the first rib down would be easier. So if you still have symptoms after the surgery, I would restart the conservative approach first before getting the big rib operation.

Just my two cents. Hmm, what's that in the UK? Pence?

343v343 · 12-30-2011, 07:08 PM

Quote:

Both consultants have said it is a straight forward op with very little after care needed and will be able to return to my full time office based job after 1 week following surgery.

Seems a tad bit optimistic, if not downright unrealistic. But I'm hoping that is the case for you. I'd be surprised if you returned to full capacity after a month, let alone a week.

SD38 · 01-01-2012, 03:49 AM

Quote:

Originally Posted by debbietellez

i'm having my surgery at medway hospital on 16th of jan, i've read quite abit about what to expect the recovery to be like the american information seems very dramatic which worried however both my consultant and nurse have said to ignore the usa advice as they tend to exagerate things somewhat! Both consultants have said it is a straight forward op with very little after care needed and will be able to return to my full time office based job after 1 week following surgery. I believe i am just having a scalenectomy no rib resection but just recently been having alot of pain in my shoulder blades. Has anyone else been put off surgery after reading american info? Debx

I can't comment on the recovery for a scalenectomy op but if it includes a first rib resection then BE PREPARED!!!!!! It carries a BIG ouch factor...... I'm still recovering now, post 4 months.

P.S I don't want to downplay a scalenectomy op as I know that too can complicate issues in the neck....... any surgery in this region carries probs. Whatever is performed, be sure to stretch gently afterwards and take the recovery nice and slow. It doesn't do to go rushing back into normal activities to please others. Along with surgery comes scar tissue damage if care is not taken!

SD38 · 01-01-2012, 04:09 AM

Quote:

Originally Posted by Clematis

klm207, I am not sure what tests are needed. In my case the most helpful tests were functional dopler ultrasound of my artery and x-ray.

The dopler study showed arterial compression and the x-ray image showed an extra cervical rib or a far too long transverse process that that was fused to my first rib. Interestingly, the extra ribs had not been mentioned in the MRI scan report. The surgeon said this is very typical and therefore the x-ray is always needed. She also mentioned that my first ribs were a bit abnormal shape which is linked to TOS. In the operation an extra scalene muscle (!) was found and removed too.

I also went through a venogram (that showed compression of my vein under pectoralis minor), then the MRIs I mentioned (did not show anything) and some nerve conduction studies (were fine).

SD38, oh gosh you had TOS for 6 years before you got diagnosis! Have you been able to work during that time?

debbietellez, the American info both made me scared and gave me strength. Because I lost my ability to work from the beginning of the symptoms I had to take a risk and go through the surgery.

I've managed to continue working but over the last few years my hours have reduced dramatically, I'm now part time: 3 hours/day. I've also had to adapt and make alot of life style changes to help me cope with the symptoms. I work hard on things like trying to reinforce good posture and limit working with my arms as much as possible.... if its not needed I don't volunteer it. There are many things I just can't attempt anymore. Heavy lifting is an absolute no no and even to try and do a gentle job/exercises causes issues for me! I'm managing just, but at least I can still earn alittle which helps with my self esteem, I just hope it stays that way??? FINGERS CROSSED!
It's been pretty tough at times, I just have to be very aware of signals that my body send out and know when to quit and rest up. I'm more at a mental struggle at the moment due to not being as physically active as I used to be..... VERY FRUSTRATING...... I miss jogging

.

Joanna81 · 01-05-2012, 07:05 AM

I was dx with a sub cervical rib about 27 months ago after I found a hard lump in my neck. I was lucky the consultant knew about it as he knew before the xray confirmed.
I was having fairly minimal symptoms. I was told to come back if it bothered me. Which it got really bad after the birth of my daughter. I tried physio and acupuncture the physio made it worse.
The left was removed in September 11 and the right us to be removed in a couple if weeks.
I am still taking pain meds from the left side, it didn't go smoothly I has complications post op. He thinks the pain should go within a few months.
I think I will need physio though.
I am hoping the next op will go better than the first.
Good luck, it is a difficult journey.

SD38 · 01-05-2012, 10:58 AM

Quote:

Originally Posted by Joanna81

I was dx with a sub cervical rib about 27 months ago after I found a hard lump in my neck. I was lucky the consultant knew about it as he knew before the xray confirmed.
I was having fairly minimal symptoms. I was told to come back if it bothered me. Which it got really bad after the birth of my daughter. I tried physio and acupuncture the physio made it worse.
The left was removed in September 11 and the right us to be removed in a couple if weeks.
I am still taking pain meds from the left side, it didn't go smoothly I has complications post op. He thinks the pain should go within a few months.
I think I will need physio though.
I am hoping the next op will go better than the first.
Good luck, it is a difficult journey.

I hear you...... I'm still tender in places from my op and chose to pospone my 2nd which was to be performed just before Xmas. I need more sufficient recovery time and to see better results from the previous op before I go ahead and agree to the 2nd. The thoughts of having the other side done fills me with absolute dread. I have another consultation with my surgeon on the 19th Jan so I will keep you all posted as to the outcome.
KEEP STRONG, TOS people.

Joanna81 · 01-06-2012, 07:47 AM

The thought of a second surgery fills me with dread! But although I am still in pain it is better than it was pre op where I had practically no use of my arm.
I will admit when I saw my surgeon it was pre flair up of pain...
I wanted to get them over and done with so I can get on with recovering.
Did your first surgery go smoothly? I was in hospital for 9 days then back in 2 days later for 6 days

i really hope it goes better this time, he said such complications are very rare...

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