Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie.


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Old 07-10-2012, 12:22 AM #1
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Confused post rib resection problem

Hi everyone i am 5 month post op for my rib resection and still my arm turns blue and if my arm move slightly back or raise it i lose my pulse completely , still i have constant pain , does anyone have any sugestions if they are going through the same thing , also one note i for some reason pack on a lot of muscle very easy so i have rather large chest and arms which the surgeons have noted on their reports to wcb , any help would be apreciated
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Old 07-10-2012, 12:00 PM #2
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Did they remove the whole rib or leave a stump?
Has this been the same all along sine the surgery or was it OK and then got bad again?
Did they do anything with the scalene muscles - cut , move , re-sect them?

If you aren't sure you can get the surgical report, it should have all the details.

Did you have a very experienced surgeon?

Basically I'm wondering if it might be scar tissue & adhesions, or if not enough was looked at during the surgery.
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Old 07-10-2012, 01:00 PM #3
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i am having simliar problems 9 months post op. the 1st surgery was Transaxillary approach. I was told this approach leaves a small stump of rib. I have surgery scheduled for next week where they are using the supraclavicular approach. I will let you know how it goes.
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Old 07-10-2012, 01:45 PM #4
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the rib was completely removed and my arm only got warmer after the surgery other then that not much of a change other then that , i do get these new pains in my arm feels like some one is pinching me with a pair of pliers , no they did not remove any muscle but did cut some banding, also they have diagnosed me with multiple crush syndrome , now the are sending me for some type of gaglion nerve block what ever that is i have no idea what it is used for , as i have both vascular and nerve tos
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Old 07-10-2012, 02:26 PM #5
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Maybe a stellate ganglion block??

I read about that in the past on our RSD/CRPS forum.
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Old 07-10-2012, 02:39 PM #6
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Quote:
Originally Posted by rad351 View Post
Hi everyone i am 5 month post op for my rib resection and still my arm turns blue and if my arm move slightly back or raise it i lose my pulse completely , still i have constant pain , does anyone have any sugestions if they are going through the same thing , also one note i for some reason pack on a lot of muscle very easy so i have rather large chest and arms which the surgeons have noted on their reports to wcb , any help would be apreciated
I am very similar in terms of muscle mass (and I never really lifted weights). I had 1st rib resections but I still have some compression being caused by pec minor (this is steadily improving with physical and massage therapy). Are you in physical therapy and do they work on your pecs regularaly? It could even be that your scalenes have reattached somewhere after being clipped (this happens in 10-20% of rib resections without full scalenectomy). You may need a full scalenectomy and neurolysis to clean up scarring/adhesions if your problems persist.

I would recommend starting with your pecs and getting them worked on based on your description. There is a pec minor release surgery (tenotomy), but it is my opinion that this is unnecessary and has negative consequences in most cases.
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Old 07-11-2012, 01:19 PM #7
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i have seen a therapist for it but even during therapy i pack on muscle really crazy, i am built like a mma fighter, but i really getting tired of all the bs that the doctors put you through i had so many tests and each doctor runs the same test just because wcb does not forward on my results and why did they not remove my scalen muscle while they did the rib resection and the surgeon should have know this because in his report he noted my thoracic space was extremely tight and had trouble working in the area. also they had to use a machine called a spider because the asistent dr was not strong enough to help the vascular surgeon , and now they want to run another ct that will be my 3rd in less then a year not to mention a bone scan , and veinothgraphy , what they want me to glow in the dark
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Old 07-11-2012, 02:32 PM #8
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Rad,

A therapist that has you exercising in your state is the wrong therapist IMO. I chased my tail for years doing postural exercises only to get worse. I firmly believe Dr. Ando's approach is the best for chronic cases such as ours:

http://www.andoaston.com/staff
Quote:
As a Certified Functional Manual Therapist with nearly 30 years of experience, Dr. Ando's goal is to assist patients in achieving their pain and function goals without expensive surgery or the side effects of medications. To achieve this goal, he has fine-tuned a 5-Step Functional Approach.

STEP 1: True Source Evaluations. Finding the root problem is the 1st and most important Step. Our training as CFMTs allows us to look beyond just what is painful or what has been assessed by x-rays.

STEP 2: Skilled Joint Mobilization. Getting the joints to move is a critical step in regaining mobility and preparing the body to exercise successfully.

STEP 3: Skilled Muscle and Nerve Mobilization. Hands-on manual therapy to muscles and nerves decreases pain and completes the body's preparation for exercise.

STEP 4: Therapeutic Exercise. Neuromuscular re-education through individualized exercises is the 4th Step. Core strengthening in spine cases uses time-honored methods such as Pilates. All patients are trained in their home exercise program, receive them in writing or video format, and are encouraged to do them responsibly.

STEP 5: Body Control Training. Education and training in posture and body mechanics is the 5th and final Step. This allows patients to regain basic functions such as pain-free sitting, walking and lifting or, if a patient desires, more vigorous activities like gardening or sports. Patients that understand how to use their body safely and efficiently in functional activities have the best chance of maintaining their health and lifestyle of choice.

Our 5-Step Functional Approach reliably achieves patient pain and function goals when other treatment methods have failed. The particular order of the Steps and the cumulative skills needed to deliver each of the Steps is what sets our approach apart from others. The most debilitating and chronic cases have their best chance of pain resolvement and restoration of function when our thorough 5-Step Functional Approach is used.
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I found this PT list after talking to Dr. Ando about referrals elsewhere. This is where he studied and they have a certification process. They have a Center in Colorado and now in NYC. He recommended a PT in NYC: Dr. Greene who is on the list.

http://www.instituteofphysicalart.com/ipa/referral/list

http://www.instituteofphysicalart.com/#

I will also post this on the Sticky Thread.
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