[hamisa]

Hi everyone!

I saw a Vascular Surgeon today and he diagnosed me right away with TOS.. He said mixed but mostly neurogenic TOS. Originally they told me my appt would be 45mins long and I assumed I was getting a the duplex study but the appt was barely 15 mins long. He asked me a few questions and raised my arm and pulled it back a little while checkng my pulse. He asked me how my arm felt in this position when I told him it hurts, feels heavy and feels like someone is pouring cold water inside my arm he said "Yup you have TOS". He didnt review the info from the referring doc and didnt review my nerve study... he just asked me if I had one done and what did it show.

He told me to go back to my Physiatrist, start PT, get a scalene block and see him back in 3 months. Is this normal for a TOS diagnosis? I was expecting something more indepth...

[Jomar]

If he read thru your history before the appt, he could be fairly sure if it is detailed with the prior surgeries and symptoms...

Usually more testing is done/ needed if a workers comp claim / other injury claim, or some other reason for solid proof, or a hard to dx /mulitiple dxs..

[Nellyzen]

What he did recommend as far as PT? Something specific or whatever the PT feels like should be done?

[hamisa]

Thanks for the replies... it didn't seem like he read any history...

He didn't specify any PT.. he wants me to be go back to the Physiatrist and have him handle the PT...

[chroma]

If he has seen TOS before, and given your symptoms, your description and probably your pulse disappearing when he raised your arm, he probably got it right. And given that MDs don't do PT, adjustments or neuromuscular massage, it makes sense that he moved you onto the next step.

I wouldn't worry about this experience. Your next focus is finding a good PT.

[Eight]

That sound like my visit to the first two vascular surgeons I went to. You must go to a vascular surgeon that specializes in tos, not just one that can do first rib resections.

The problem is that many vascular surgeons spend their days treating varicose veins. You have to do pt for at least six months before you are a candidate for surgery. After six months of pt, then consider surgery. It is my understanding that my upcoming surgery will be the worst pain I have ever experienced in my life - in exchange for that I have a good chance of getting my life back.

[hamisa]

Thanks for all the replies! This doctor does specialize in TOS and supposedly has the top vascular lab for TOS testing in the Seattle area. I guess thats why I assumed I would have more indepth testing. He seemed very knowledgable about TOS and even asked about the some of the symptoms I forgot to mention. After 7 years and 3 worthless surgeries I just dont want to make any more mistakes... I told him Im not interested in another surgery and he said what I have going for me is that my scalenes have never been worked on before and that might help but whats going against me is this is a 7yr old untreated injury.

[Eight]

Oh, then in that case, it sound like he will do surgery if you are not magically cured by the pt in three months. You could call his nurse to ask what his next step would be if the pt doesn't cure it.