enjoy reading this thread...

Do you-all feel Dr Pearl is cognizant of the need for post op therapy long term? And what is his protocol?
I see from your posts he responds to texts?
Is he cut and dry as in always removing ribs, scalenes?
I would be frightened also if I was presented with a sympathectomy via pre op nurse.

Happy to hear a couple of you are doing good.

It's been 7 months since my daughter's surgery! In some ways, it seems so much longer and in other ways, not so long.

She is still doing great. She has had some muscle soreness and spasms right under her rib cage that started last month. They are getting better, but it's just strange that they are continuing even now. She has been using the heating pad, sometimes taking muscle relaxers and such. She is working hard on posture when she has to sit for a long period of time. All and all her symptoms are gone.

Hope everyone is having a great week. I will update more later.

Well, I went back to see Dr. P today because my symptoms started coming back towards the end of April with all of the batting practice I had been throwing since January. In a nutshell, I have to go back to physical therapy and now I am on muscle relaxers and anti inflammatory medication. He thinks it could be scar tissue buildup or it could be something with my pectoralis minor muscle. I'm just going to play it by ear and see if the PT works. He said if it doesn't work by the time I come back and see him at the end of September then he will go back in and clean up the scar tissue. If my pec minor muscle is involved then he said he would release it and that would help. So, the journey continues.

Oh TOSmother, I have those same spasms/cramps and they aren't very painful but they sure are annoying.

I'm so sorry to hear that cltbaseball. I was hoping you were one of Dr. P's success stories. It kind of depresses me to hear that --- I really hope my symptoms don't EVER come back. I will cry if they do. Life is a good deal better for me these days. I still have a number of TOS symptoms and still have a lot of limitations, but a lot of problems in the meck and face are mostly gone. The remaining symptoms I still have are better than before. I make sure not to use my left arm that much and definately don't raise it up more than 90degrees ---- I hope protecting my left arm like this means I will avoid a return of symptoms. My life is better and if the rest of my life was like this, I would be happy.

On a seperate note, I still have nerve entrapment on the left side in particular. I think it has to do with my pec major, serratus anterior, and clavicle. Learned some interesting things from Dr. Ando --- If I have my arm at my side and then slowly raise it up, I sart to get neural tension before I even get to 90degrees --- therefore, the nerves are still trapped somewhere and don't move freely like they should. My right side is better. I think my collarbone is too far back and my sterno-clavicular joint subluxes posteriorly. The bundle of nerves that pass under it (just distal of midline) might be getting irritated. Otherwise, nerves are still getting trapped by corocoid process, or pec major, or at the elbow, or something. I did notice that if I work my serratus anterior muscles (especially certain spots), I am able to raise my arm higher before getting neural tension --- also, the symptoms in my arm improve.
Lately, I have been thinking about prolotherapy to the sterno-clavicular joint to stabilize it.

Also, has anyone had cubittal tunnel surgery and has it helped?

There were clearly multiple compression points in my case. I have a feeling that the remaining major compression point is near the clavicle or the axilla.

Please keep us updated cltbaseball -- I hope Dr. P is able to help you.

Forgot to mention that if I raise my shoulder straight up and then try to slowly raise arm up, I am able to raise past 90degrees without nerve tension. Perhaps that is why my left shoulder has been higher than the right since I've had TOS --- my body is trying to protect against more nerve compression --- body is guarding against it.

Anyways, that is one of the reasons I think it might have to do with the clavicle.

http://www.ncbi.nlm.nih.gov/pubmed/23343034
http://www.youtube.com/watch?v=ivG6P7u0lBw
http://www.youtube.com/results?q=pos...-8&sa=N&tab=w1

Also, can we use ultra sound to see if there are nerve lesions near the axilla, or other places? Anyone had this?

http://radiographics.rsna.org/conten...expansion.html

Another link for sc joint TOS.

"Interventions consisted of manual therapy, therapeutic exercise, and the trial of two orthoses. After 12 treatment sessions, the patient's symptoms resolved and she improved by 10 points on the Upper Extremity Functional Index. She had no reproduction of symptoms with the thoracic outlet special tests. She maintained a static hold for 90 sec at 90° shoulder flexion, 90° shoulder abduction, and full shoulder flexion without symptoms. The outcomes describe a successful intervention for a patient with bilateral TOS secondary to idiopathic bilateral anterior SC joint subluxation. This case suggests that SC joint dysfunction should be considered as a cause of TOS and should be screened during the initial examination."

http://www.ncbi.nlm.nih.gov/pubmed/23343034

http://www.stltoday.com/sports/baseb...16e632d22.html

Thanks for this email. I've been waiting to hear about him. I've had two TOS surgeries, and might have a third one. But, u r not the same after these surgeries. After two surgeries, and dealing with this for 20yrs, my symptoms are worse. I think he might have to shut it down. I haven't been able to play any sports or do anything else I love to do.

Thanks for the update.

Here is my monthly update on my daughter. Still doing great aside from the pesky side cramps/spasms! Not sure what to do about those or how long we can expect them to last. Painful, but she can live with them. Here is hoping that next month they are gone!

Hope everyone else is doing well.

Take care!