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Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie. |
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05-30-2012, 07:12 PM | #11 | ||
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Thank you so much for the info everyone, I really appreciate it and it helps a lot. I feel better now that most of the surgeons specializing in TOS in NYC are vascular surgeons. I do plan to get several opinions. The neurosurgeon who found my cervical ribs is having me do a lower trunk selective block (to my brachial plexus I'm assuming) but at first I thought I was getting a scalene block to help confirm the diagnosis. However, regardless of the outcome I know I want to get the opinions of experienced vascular surgeons rather than going by what this neurosurgeon says since I am pretty sure he does not have much experience operating on TOS patients.
About the surgical approach, I have just been reading conflicting information about which one may be more likely to cause complications so I was wondering the approach that might be more commonly used with a higher success rate and fewer, if any complications. |
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05-30-2012, 07:15 PM | #12 | ||
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"Thanks for this!" says: | Catalinagarciac (07-14-2012), jkl626 (05-30-2012) |
07-14-2012, 12:01 PM | #13 | ||
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I live in Colombia, i am 25 years old and have TOS Symptoms since february 2012. I have cervical ribs in both sides, but I'm only symptomatic in the right side as the right cervical rib is bigger. My Symptoms include reynauds syndrome (white hand, reactive to temperature changes and position changes), pain and lack of strength In the righ arm and hand. I had a nerve block 4 days ago with the purpose of confirming mi diagnosis (neurological TOS) and my hand and arm improved in a 65 percent and the pain is completeley gone, which, according to my vascular surgeon means that I need surgery (because the diagnosis is confirmed). As you I was also not so sure of getting surgery with a vascular surgeon, taking into account my TOS is not vascular, but neurological (only nerve compression). It s relieving to read your case! I has never seen one so similar to mine!
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"Thanks for this!" says: | parbie (07-14-2012) |
07-14-2012, 12:25 PM | #14 | ||
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07-14-2012, 01:29 PM | #15 | ||
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It was a Stellate nerve block, performed as a Diagnosis procedure For neurogenic TOS ( if it stops your symptoms it means that the nerve it's what is giving you trouble). I am not allowed to post links, but in google you can find complete information in this procedure.
The effect of the block is not permanent. I am waiting to see for how long does it lasts. (the dr said it could last for weeks or months). But take into account that it is not a solution, as the nerve is still Suffering of compression. Do you have white hands also when exposing to cold? Have you been diagnosed with Reynauds phenomenon?. Are you getting sugery? Is a vascular surgeon performing it? have you had physical therapy? My surgeon is wants to perform surgery without trying first PT. Tks!!!! Quote:
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07-14-2012, 08:46 PM | #16 | ||
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07-14-2012, 08:49 PM | #17 | ||
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Last edited by Jomar; 07-18-2012 at 10:50 PM. Reason: per req. |
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07-15-2012, 01:59 PM | #18 | ||
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How do I find specialized PT for TOS? how long should I try PT before having surgery? my surgery is programmed for the 28th of July. Thank you!
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07-15-2012, 04:06 PM | #19 | ||
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I have been having good luck with PT but it took several months,pt's chiros etc to find a good one. And still I have pain when I use my arm, so I may be looking into some more injections and ultimately surgery if I find I cannot go back to work and live my life normally.I do not have any vascular symptoms. In general, I have read that people with cervical ribs are good candidates for surgery, because it is a verifiable diagnosis. Also if you have bad vascular symptoms,surgery is usually suggested. I have had the Stellate Block(it is the same as a sympathetic nerve block). it helped my arm and hand symptoms for a week. But did nothing for my shoulder pain. Parbie, Dr. Jordan told me that there have been no studies done on the BP nerve block as a diagnosis,but if it worked then it would pretty much be a diagnostic. He would also do Pulsed radiofrequency on the nerves to amke the pain relief last. Many studies have been done on the Scalene Block that have proven to be the best diagnostic test for TOS. Dr. Jordan is the original Dr. to use Ultrasound and has published studies on it. |
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07-15-2012, 08:58 PM | #20 | ||
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Catalina, if you can't find anything on the list on this forum, maybe you could try to google Pt's in your area who have experience with techniques that have helped others on the forum, like myofascial release, active release technique and call them to see if they have any experience that may help you. Also, if your surgery is in 2 weeks, and you have never done pt before, it probably isn't long enough to really know whether it helped or not. Maybe you can try it for 4 to 6 weeks (that's what surgeons I have spoken to have recommended) before going through with the surgery.
J, I think the bp block is diagnostic too but other surgeons have just said they don't use it because it is not specific enough, to really see the source. They think that injecting numbing meds in any area of the body doesn't necessarily indicate where exactly the pain may be coming from. That's why the scalene block was used more, because it is more specific. But many of the surgeons I spoke to just don't find it as useful anymore, because now they are saying it is also not specific enough, including Annest and Brantigan in Denver. Last edited by Jomar; 07-18-2012 at 10:49 PM. Reason: name removed per req. |
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