Hi John, how did you like dr. Gelabart? i am going to see him and Dr. Ahn. Currently only dr. Ahn is covered by my insurance,but that may change soon.I dont think I have any venous or vascular symptoms,just neurogenic. Will Dr. Gelabrt do scalenectomy only? Thanks.

I like Dr. Gelabert a lot and would recommend him to others, in regards to the scalenectomy I'm not sure, you would have to discuss that with him. I can say that he seems to be on the conservative side.

SWEEEEEET!!

I asked Dr. Gelabert about this. Both Gelabert and Angle told me they always go for the transaxillary rib resection with partial scalenectomy as it is a more complete decompression than scalenectomy only. They do the full scalanectomy only if the patient experiences recurrence of symptoms down the road.

Dr. Ahn told me he used to follow this same approach but will now perform scalenectomy only, in some cases. I think Dr. Ahn would have to strongly believe that your problems are due to scalene hypertrophy only to take this approach. He said that even then, he may have to take the rib once he gets you open and sees everything that is going on. I recommend you undergo Ahn's angiogram/angioplasty test to see if you are truly a candidate for scalenectomy only. I was not a candidate as I failed the scalene block so I didn't bother going through with Ahn's angioplasty.

Dr. Angle convinced me to just lose the rib because we don't need it anyway and there was no real advantage to keeping it. Also, women here in LA get the lower ribs removed for cosmetic reasons all the time.

If you really don't want to lose the rib you could go to the neurosurgeons who treat this, Dr. Aaron Filler or Dr. Justin Brown. But, what do these guys do if they open you up and find out you need your rib removed, or have some other vascular complication? I heard Filler sends you back to Ahn for a second surgery. I guess Brown would send you over to a vascular surgeon at UCSD.

The only surgeons I felt comfortable with cutting me were Gelabert and Angle. My surgery was with Angle. Gelabert and Angle told me Ahn is a great surgeon but his bedside manor simply doesn't compare to the other two.

Thanks, I'm just gathering info. I havent seen any of them yet. I would not go to Dr. F for surgery but will probably see the other 3. Dr. G is not on my insurance (Blue Shield) but my insurance is changing in August to Blue Cross.I dont know about Dr. Angle, but I definately want to check him out based on your recommendation. I have been reading alot of research on scalenectomy only and it is gaining traction. Dr. Ellis, Sanders and Dr's in Europe ,Asia and Isreal are proponents of it. However I agree, i think the Dr. who does the surgery should be able to take the rib out if it becomes necessary. What do you mean by "I failed the scalene block" I do not want to go through the angiogram if I can help it. I am seeing Dr. J tomorrow and hope to go over some of this with him. Why do women get their ribs removed? It must be some beauty thing I havent heard of.

I am actually doing better the past couple of days .The shoulder brace and the neuropathy cream are helping me. Joyce said I was moving bettter too, so all this surgery talk might be premature for me anyway. We'll see. i am going to give it another month or so and then my PT coverage runs out.

I had the scalene block and my rib didn't drop nor did my symptoms improve even temporarily. Dr. Ando, my physical therapist couldn't adjust the 1st rib down either because of dysfunction of the multiple ribs below the 1st. In surgery, Dr. Angle verified that the thoracic inlet/outlet space was super tight but the scalenes were not hypertrophied. My rib needed to come out.

This is just my opinion (definitely run all of this by Dr. J). You should seek a positive result from the scalane block/botox (I didn't want to go through the angiogram either). You may even want to get an eval by Dr. Ando. It may be possible that you can avoid surgery by working with Joyce and/or Ando. Ando told me surgery is not necessary for TOS in most of the cases he sees. Ask Dr. Jordan about Ando. Ando says he refers many of his TOS patients to Jordan for botox.

Hopefully you don't need surgery at all!!!

http://www.plasticsurgeryspot.com/tu...c-surgery.html