I was officially diagnosed with ATOS by a vascular surgeon(Dr. Lum) at Johns Hopkins(we live in KY). I saw him at the beginning of December, then flew back on Dec. 30th for a scalene block and MRI. The surgeon emailed me the next day to say I was a good candidate for surgery. He will be doing a scalenectomy and 1st rib removal(L side). In the mean time, I saw a thoracic surgeon here in KY, he confirmed the ATOS diagnosis, and said he would do a first rib removal, when I asked about the scalenectomy, he said "Well, some of the scalene naturally gets cut during the procedure." Sooo, here are my questions that I need all of you wise people to help me figure out: 1) Is that right about the scalenectomy? Are these two surgeons talking about basically the same procedure, but just wording it differently? 2) It would obviously be more convenient to have the surgery here. We have a 6 year old and don't want to have to be away from him for that long. On the other hand, it IS Johns Hopkins, and I really liked Dr. Lum. The thoracic surgeon here was fine, older, seemed to know what he was talking about.

As ya'll can see, I'm a mess. I'm just grateful someone finally figured out what was going on with me. Now, I don't want my pain-addled brain to make the wrong decision. Help please?!

As we all know, TOS surgery is a major procedure. Given that, I would not let geographic location (and the associated financial and logistical factors) play any role in deciding what surgeon to choose. You need to go to the surgeon who you think will give you the best outcome and whom you feel most comfortable with.

Dr Dean Donahue at MGH seems to have a positive following here on the board, and several have reported good outcomes from his procedures.
If it were me -- I would consult with Dr Donahue as well, and then decide among the 3 doctors.

Don't rush your decision...and good luck with it...

I second what cyclist said. And add, choose a very experienced surgeon - it is a complicated surgery. You don't want to come out worse. That was the advice I received over and over (not via this forum). Ask how many the surgeon has done and what his outcomes have been. Require specifics, not vague answers or estimates. Ask, are there any other approaches short of surgery that can be considered and if not, why not.

Bristol, I just had the same surgery last month. They remove two scalene muscles and first rib on the left side. My doctor called the surgery, "First Rib Resection". Which included both the scalene and first rib. I know I'm not u, but I would get some clarification.

FYI-The surgery was about 3 hours and half. Very, very painful. I'm still having a lot of pain from the two incisions, but he told me it's going to be about 1 and half for a full recovery. Make sure u have a lot of pillows when u get home. U will need some assistance, and pain medicine. I had to stop my pain medicine, made me sick. I'm only taking Tylenol.

Please as more questions, and make sure they know what they are doing. This was my third TOS surgery. If I can answer any more questions, please let me know.

GOD bless, and I'm praying for your healing and recovery.

Thank you, I hope you get to feeling better soon.

Hello from a fellow Louisville area resident, I recently had this surgery (VTOS) done in St Louis by Dr Thompson, very pleased with the results.

Who was the surgeon in Louisville?

RW

Hello!! The thoracic surgeon here is Dr. Bowling. He is with Jewish Hospital. Did you have the rib removal with scalenectomy?

Yes I had the first rib removed, scalenes, and a portion of my subclavian vein replaced. Very pleased with the outcome.

That's great, did you ever contemplate having it done here at home?

No, I wanted it done by someone who specialized in TOS. I looked around Louisville and no one fit that requirement.