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


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Old 09-30-2013, 01:58 PM #1
Haleyjane89 Haleyjane89 is offline
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Haleyjane89 Haleyjane89 is offline
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Default New here...5 weeks post-op

Hi everyone, my name is Haley and I'm new to the site but not new to TOS. I am just about 5 weeks post-op from a left first rib removal, scalene muscle removal and scar tissue/fibrous band removal as well. A little about me, In November 2012 I was in a car accident where I was rear-ended by a kid who was looking in his rear view mirror rather than looking forward. I was passenger in my car, my boyfriend was driving and was not injured at all. The next view days I was quite sore and decided to see the chiropractor. X-rays were taken and only showed that I had no curvature to my neck. I then noticed that my strength in my left arm was going away, my chiropractor then set me up with physical therapy the beginning of December. My physical therapist measured my grip strength the first day I saw him which showed that my left hand had a grip strength of ~16lbs and my right hand had a grip strength of ~64lbs. I then saw an orthopedic doctor who performed a EMG, MRI, and acupuncture (weekly). Both the EMG and MRI came back normal. I continued with the physical therapy and acupuncture for awhile. Neither of these were helping so my chiropractor set up an appointment with another orthopedic physician who specializes in shoulders to see if something was going on in my shoulder. X-ray of my should was done and it was normal. This physician recommended that I go to a neurologist. I was really scared to see a neurologist but luckily saw one of the best neurologists in my town, I saw him in March 2013. He truly listened to what I was saying, he performed second EMG to make sure I didn't have ulnar nerve entrapment, this second EMG came back normal as well. A second MRI did not have to be done (thank god!). I went to the vascular lab to have the "thoracic outlet screening" which when I put my left arm over my head my pulse went away. The neurologist diagnosed me with Thoracic Outlet Syndrome and recommended I see Dr. Greg Schultz a Vascular Surgeon at Sanford Health. I saw Dr. Schultz in April 2013, he recommended that I continue with physical therapy for 3 months than follow up with him and make a decision regarding surgery at that time. As you can guess the next three months nothing had improved, my strength in my left arm had no improvement which made it very difficult with working. When I had my follow-up with Dr. Schultz he recommended that I have a first rib resection, I agreed to start the paperwork for insurance clearance. My insurance company called me the beginning of August 2013 explaining that they would cover the procedure but that I should see a physician that is considered "In-network", I agreed to this and made an appointment to see Dr. Steven Feldhaus at Avera Heart Hospital. (I would rather have surgery at Avera than Sanford ). I saw Dr. Feldhaus mid-August and he was awesome, he spent about 45minutes with me explaining everything in regards to the surgery. He said he would recommend doing the surgery but he was concerned about my strength (grip) in my left arm. I felt really comfortable with him and Surgery was scheduled for August 29th. The surgery went well, he removed my left first rib, scalenes, and fibrous bands/scar tissue around my nerve. My incision is under my armpit, I also have an incision from a JP drain, and one from a chest tube. After surgery I didn't have my pain other than from that damn chest tube! I was on a dilaudid pain pump which helped and made me sleep most of the first day. I was told I would be in the hospital 3 days but I actually got out the afternoon the day after my surgery. I started physical therapy a week after surgery and have gone twice weekly. So fast forward to today, just about 5 weeks post-op....I still have quite a bit of pain (taking Norco every 4-6hrs), my pain includes nerve pain (shooting down my arm), aching, stabbing under my arm/shoulder. I have found it really difficult to sleep the last week since I can not get comfortable. My strength hasn't gotten any better and have dropped many things that I tried holding in my left hand. At therapy we measured my strength after surgery and left hand was 10lbs grip strength. My arm (mostly pinky & ring fingers) go numb when I try to work above my head. Driving is HORRIBLE, I can't wear my seatbelt, and cannot use my left arm to help steer the car, plus bumps are so painful! I also get to the point where I am almost having panic attacks in the car, especially when people get too close or traffic is too busy, anyone else get this anxious? I have no idea if I should consider my surgery a failure or not? or is it too early?
Tomorrow I go to Dr. Feldhaus for my follow-up appointment. My biggest concern is my future. I am 24 years old and I work as a Nurse on an Oncology/Transplant floor. My job is very physical and I often work over my head especially with IV bags. Before my surgery I had a hard time doing my job and often came home in so much pain. My manager told me I have to be able to lift 40lbs before I can come back to my job which I don't know if I will ever be able to do that. I'm wondering if there is any nurses out there and what they have done with their careers?
This is a very frustrating situation and my emotional state is getting worse everyday. Thank goodness I have an attorney to deal with the insurance company of the kid who hit me!

Thanks for listening!
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Old 09-30-2013, 09:04 PM #2
20YrsTOS 20YrsTOS is offline
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Quote:
Originally Posted by Haleyjane89 View Post
Hi everyone, my name is Haley and I'm new to the site but not new to TOS. I am just about 5 weeks post-op from a left first rib removal, scalene muscle removal and scar tissue/fibrous band removal as well. A little about me, In November 2012 I was in a car accident where I was rear-ended by a kid who was looking in his rear view mirror rather than looking forward. I was passenger in my car, my boyfriend was driving and was not injured at all. The next view days I was quite sore and decided to see the chiropractor. X-rays were taken and only showed that I had no curvature to my neck. I then noticed that my strength in my left arm was going away, my chiropractor then set me up with physical therapy the beginning of December. My physical therapist measured my grip strength the first day I saw him which showed that my left hand had a grip strength of ~16lbs and my right hand had a grip strength of ~64lbs. I then saw an orthopedic doctor who performed a EMG, MRI, and acupuncture (weekly). Both the EMG and MRI came back normal. I continued with the physical therapy and acupuncture for awhile. Neither of these were helping so my chiropractor set up an appointment with another orthopedic physician who specializes in shoulders to see if something was going on in my shoulder. X-ray of my should was done and it was normal. This physician recommended that I go to a neurologist. I was really scared to see a neurologist but luckily saw one of the best neurologists in my town, I saw him in March 2013. He truly listened to what I was saying, he performed second EMG to make sure I didn't have ulnar nerve entrapment, this second EMG came back normal as well. A second MRI did not have to be done (thank god!). I went to the vascular lab to have the "thoracic outlet screening" which when I put my left arm over my head my pulse went away. The neurologist diagnosed me with Thoracic Outlet Syndrome and recommended I see Dr. Greg Schultz a Vascular Surgeon at Sanford Health. I saw Dr. Schultz in April 2013, he recommended that I continue with physical therapy for 3 months than follow up with him and make a decision regarding surgery at that time. As you can guess the next three months nothing had improved, my strength in my left arm had no improvement which made it very difficult with working. When I had my follow-up with Dr. Schultz he recommended that I have a first rib resection, I agreed to start the paperwork for insurance clearance. My insurance company called me the beginning of August 2013 explaining that they would cover the procedure but that I should see a physician that is considered "In-network", I agreed to this and made an appointment to see Dr. Steven Feldhaus at Avera Heart Hospital. (I would rather have surgery at Avera than Sanford ). I saw Dr. Feldhaus mid-August and he was awesome, he spent about 45minutes with me explaining everything in regards to the surgery. He said he would recommend doing the surgery but he was concerned about my strength (grip) in my left arm. I felt really comfortable with him and Surgery was scheduled for August 29th. The surgery went well, he removed my left first rib, scalenes, and fibrous bands/scar tissue around my nerve. My incision is under my armpit, I also have an incision from a JP drain, and one from a chest tube. After surgery I didn't have my pain other than from that damn chest tube! I was on a dilaudid pain pump which helped and made me sleep most of the first day. I was told I would be in the hospital 3 days but I actually got out the afternoon the day after my surgery. I started physical therapy a week after surgery and have gone twice weekly. So fast forward to today, just about 5 weeks post-op....I still have quite a bit of pain (taking Norco every 4-6hrs), my pain includes nerve pain (shooting down my arm), aching, stabbing under my arm/shoulder. I have found it really difficult to sleep the last week since I can not get comfortable. My strength hasn't gotten any better and have dropped many things that I tried holding in my left hand. At therapy we measured my strength after surgery and left hand was 10lbs grip strength. My arm (mostly pinky & ring fingers) go numb when I try to work above my head. Driving is HORRIBLE, I can't wear my seatbelt, and cannot use my left arm to help steer the car, plus bumps are so painful! I also get to the point where I am almost having panic attacks in the car, especially when people get too close or traffic is too busy, anyone else get this anxious? I have no idea if I should consider my surgery a failure or not? or is it too early?
Tomorrow I go to Dr. Feldhaus for my follow-up appointment. My biggest concern is my future. I am 24 years old and I work as a Nurse on an Oncology/Transplant floor. My job is very physical and I often work over my head especially with IV bags. Before my surgery I had a hard time doing my job and often came home in so much pain. My manager told me I have to be able to lift 40lbs before I can come back to my job which I don't know if I will ever be able to do that. I'm wondering if there is any nurses out there and what they have done with their careers?
This is a very frustrating situation and my emotional state is getting worse everyday. Thank goodness I have an attorney to deal with the insurance company of the kid who hit me!

Thanks for listening!
Hello and welcome to the forum. Thanks for sharing your story. We all on here are facing the same issues u are going through, and some are worse. I've been dealing with TOS for 20yrs plus. Heading for my third surgery in Dec. So I know how difficult it is, but don't let this syndrome overwhelm u. I pray that GOD will give u strength and peace through this. No that u are not alone. U have to put everything in his hands, and he will get through it. Everything u r facing, I'm going through right now, with even more. First, go back to the doctor and get all your questions answered. Trust me, there are so many suggestions and ideas out here, but should at least get more than 1 or 2 opinions. This is a difficult syndrome to figure out, and so many doctors have told me that. I'm thankful u shared your story, and know that I'm praying for u. Don't wait too long to get this resolved, because the longer u wait, the worse u it can get. U are young, and u have so much to do and offer. Also, do your own research on TOS, it helps.

Please keep us updated on your situation.

Take care and GOD bless u.
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Old 09-30-2013, 09:45 PM #3
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I would say give it more time.
Be as cautious as possible to avoid any jerks or quick moves.

I hope PT isn't focusing on much strengthening so soon?
Some places use a set plan for PT , and that is not good for TOS.
You can still have TOS even after surgery. Sometimes surgery is a 100% fix, but sometimes not.. some have lingering issues..
Seems like PT post op should be gentle, passive & pain relieving therapy at first.
But I haven't had surgery so maybe the others will chime in on their PT post op experiences.

You might think about other employment that would still use your nursing skills, but less hands on heavy work..
Why take a chance on making things worse in the future?

Seek out the best PTs that you can find, if things aren't improving after 2 weeks or so, move on to someone else. Move on sooner if things get worse right away..
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Old 09-30-2013, 11:58 PM #4
Sheri_TOS Sheri_TOS is offline
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Haley,

My 1st bout with TOS arose from a car accident, too. I had surgery 21 months after the accident. For me, surgery dramatically helped but from my own experience, I can say that 5 weeks is way too early to be considering the surgery a failure. It took me a good year to make a good recovery but a good two to three years to regain the use of the hand because I had significant nerve damage (positive EMG/NCV).

Talk with your doctor and have your concerns addressed. My surgery was 9 years ago.
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Old 10-07-2013, 11:34 AM #5
16rhonda 16rhonda is offline
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hi haley
sounds like u need to communicate w ur Dr. More or his assist. Everyones different but most people need 2 mos to recover from this surgery wand still need to take activity very slow after that. U really cant. Say whether or not its a failure til 1 yr postop. U need to to ur stretching ex 3x day for 1 yr. No strenuous activity! I recently had my 2nd surgery its. depressing but u have to keep the faith! It will get better. My doc saids Avg. is 80% better no one gets 100%
Good Luck w ur recovery.
Quote:
Originally Posted by Haleyjane89 View Post
Hi everyone, my name is Haley and I'm new to the site but not new to TOS. I am just about 5 weeks post-op from a left first rib removal, scalene muscle removal and scar tissue/fibrous band removal as well. A little about me, In November 2012 I was in a car accident where I was rear-ended by a kid who was looking in his rear view mirror rather than looking forward. I was passenger in my car, my boyfriend was driving and was not injured at all. The next view days I was quite sore and decided to see the chiropractor. X-rays were taken and only showed that I had no curvature to my neck. I then noticed that my strength in my left arm was going away, my chiropractor then set me up with physical therapy the beginning of December. My physical therapist measured my grip strength the first day I saw him which showed that my left hand had a grip strength of ~16lbs and my right hand had a grip strength of ~64lbs. I then saw an orthopedic doctor who performed a EMG, MRI, and acupuncture (weekly). Both the EMG and MRI came back normal. I continued with the physical therapy and acupuncture for awhile. Neither of these were helping so my chiropractor set up an appointment with another orthopedic physician who specializes in shoulders to see if something was going on in my shoulder. X-ray of my should was done and it was normal. This physician recommended that I go to a neurologist. I was really scared to see a neurologist but luckily saw one of the best neurologists in my town, I saw him in March 2013. He truly listened to what I was saying, he performed second EMG to make sure I didn't have ulnar nerve entrapment, this second EMG came back normal as well. A second MRI did not have to be done (thank god!). I went to the vascular lab to have the "thoracic outlet screening" which when I put my left arm over my head my pulse went away. The neurologist diagnosed me with Thoracic Outlet Syndrome and recommended I see Dr. Greg Schultz a Vascular Surgeon at Sanford Health. I saw Dr. Schultz in April 2013, he recommended that I continue with physical therapy for 3 months than follow up with him and make a decision regarding surgery at that time. As you can guess the next three months nothing had improved, my strength in my left arm had no improvement which made it very difficult with working. When I had my follow-up with Dr. Schultz he recommended that I have a first rib resection, I agreed to start the paperwork for insurance clearance. My insurance company called me the beginning of August 2013 explaining that they would cover the procedure but that I should see a physician that is considered "In-network", I agreed to this and made an appointment to see Dr. Steven Feldhaus at Avera Heart Hospital. (I would rather have surgery at Avera than Sanford ). I saw Dr. Feldhaus mid-August and he was awesome, he spent about 45minutes with me explaining everything in regards to the surgery. He said he would recommend doing the surgery but he was concerned about my strength (grip) in my left arm. I felt really comfortable with him and Surgery was scheduled for August 29th. The surgery went well, he removed my left first rib, scalenes, and fibrous bands/scar tissue around my nerve. My incision is under my armpit, I also have an incision from a JP drain, and one from a chest tube. After surgery I didn't have my pain other than from that damn chest tube! I was on a dilaudid pain pump which helped and made me sleep most of the first day. I was told I would be in the hospital 3 days but I actually got out the afternoon the day after my surgery. I started physical therapy a week after surgery and have gone twice weekly. So fast forward to today, just about 5 weeks post-op....I still have quite a bit of pain (taking Norco every 4-6hrs), my pain includes nerve pain (shooting down my arm), aching, stabbing under my arm/shoulder. I have found it really difficult to sleep the last week since I can not get comfortable. My strength hasn't gotten any better and have dropped many things that I tried holding in my left hand. At therapy we measured my strength after surgery and left hand was 10lbs grip strength. My arm (mostly pinky & ring fingers) go numb when I try to work above my head. Driving is HORRIBLE, I can't wear my seatbelt, and cannot use my left arm to help steer the car, plus bumps are so painful! I also get to the point where I am almost having panic attacks in the car, especially when people get too close or traffic is too busy, anyone else get this anxious? I have no idea if I should consider my surgery a failure or not? or is it too early?
Tomorrow I go to Dr. Feldhaus for my follow-up appointment. My biggest concern is my future. I am 24 years old and I work as a Nurse on an Oncology/Transplant floor. My job is very physical and I often work over my head especially with IV bags. Before my surgery I had a hard time doing my job and often came home in so much pain. My manager told me I have to be able to lift 40lbs before I can come back to my job which I don't know if I will ever be able to do that. I'm wondering if there is any nurses out there and what they have done with their careers?
This is a very frustrating situation and my emotional state is getting worse everyday. Thank goodness I have an attorney to deal with the insurance company of the kid who hit me!

Thanks for listening!
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