Originally Posted by MaryG

I met with Dr. Thompson this week. He was very friendly and thorough. I don't doubt that I am in good hands. It was a relief to finally have a diagnosis after 5 long years. Neurogenic thoracic outlet with pec involvement. I was scheduled for a scalene injection the next day. However, he said that since there was no doubt about my diagnosis, that I did not need to have this procedure done. He wants me to have 6 weeks of PT and I have a follow up appt with him May 29th. I asked him what the probability of surgery was. His response was that I will more than likely be having surgery. That my symptoms are pretty progressed. He also told me that with the nature of my job that I will be out on recovery for 2-3 months. While relieved to finally have a diagnosis, I am worried about surgery. I have never had surgery nor any hospital stays aside from having my children. My job is strenuous on my body. I move and lift patients. Also pushing carts constantly. Which worries me that after I go back to work that I am going to mess up the progress from surgery.

Originally Posted by MaryG

He didn't specifically say how he came to that conclusion. Would definitely be a good question to ask him at my next appt. My guess however, is that he came to conclusion from my list of symptoms and physical exam. I have tenderness/pain in area below and above my clavicle all the way to my shoulder. Plus I have pain in my shoulder anterior and posterior.

Originally Posted by MaryG

First, I want to say thank you for all the useful information I have found here. I find myself more optimistic since finding this board.
My Journey thus far... 5 years in the making
My symptoms started in May 2009 while performing ultrasounds. My hand would go completely numb within the first few minutes of the exam. This made doing exams extremely difficult, as I needed to utilized both hands for exams. I am right hand dominate and that was the hand going numb. I also was having terrible headaches that began at the base of my skull and had shooting pains to behind my right eye. Pain that went from my shoulder to the elbow to the pinkie side of wrist. I also had pain to the right of my spine between my shoulder blades. It was such a sharp pain at times that it hurt to breathe. I also had muscles knots (trigger points). I was having pain in my lower right back that radiated to my hip and knee. ( Which I had prior to new symptoms in the arm). I also was having trouble sleeping at night because I was constantly waking up with numbness in my arm. Hard to get comfortable to fall asleep. I not only did ultrasound, I also preformed X-rays and Cat scans. I had a 8 month old son and 8 year old daughter at home. My husband was deployed in Afghanistan. I was finding that my hand was going numb while feeding my son, drying my hair, driving and talking on the phone. Essentially any activity that my arm was abducted or elevated. I was advised to file work comp and go to my doctor. I first put on ultrasound restriction, however was able to preform CT and X-rays. I was sent to ortho doc. He thought that it was possibly TOS. I had C-spine X-rays and MRI, a shoulder MRI, Brachial Plexus MRI, and an EMG. I was started on PT for Thoracic Outlet. I did not find that PT was helping much. PT told me that my right clavicle sat higher than my left. She would try pushing downward on it. That hurt like crazy. She would tell me to breathe the whole time she was doing it. So painful. All my tests were negative except EMG showed the start of carpal tunnel syndrome. Ortho doc sent me for consult with cardio thoracic surgeon. I had a positive physical exam for TOS. The doc sent me for an ultrasound of my arm. That study was negative. My employer through work comp sent me to a work comp physician. The physician concluded that I should not be out on any restrictions because my job was not one of repetitive motion. (Which is not true) My employer was forcing me back to ultrasound and I asked them to please hold off to give PT a chance to help. I was still currently working in my other two positions. The cardio thoracic surgeon said that I didn't have tos because all of my exams were negative and that I didn't not have a cervical rib. I was at a loss. I was sent to head PT person (mind you that I was doing PT through the hospital at which I was employed). He said that trigger points was my problem. (Side note, I was young and had blind faith in doctors. Hindsight is that I should have done more research). Since I was reluctant to go back into ultrasound ( the pain and numbness were still in full force and I did not feel that it was good patient care to have a tech whose hand was not properly functioning), my director pulled me into the office. I was told that as of now I was placed from full time to prn status ( as needed with no guarantee of hours). I had the option to sign resignation papers with a severance package. I was angry and upset. Never have I been " let go" from a job. I take pride in my job and work ethic. I never call in and was always there. We could not afford not to have a paycheck or health care coverage and they knew that. So I signed the papers for the severance package which consisted of 4 months of full pay and healthcare coverage. (Hindsight I should of hired a lawyer) I felt defeated. No help for symptoms and thought that I was just going to have to live with it. My Pt ended with no relief. I went on job hunt and was able to obtain a weekend overnight position (that I still have) doing CT and X-ray. I just lived with pain and numbness for the next 4 1/2 years. I finally had enough and started the journey for an answer again. The symptoms have gotten worse over the years to a point that I have ringing in my ears, numbness in lips and tingling on right side of scalp and face, sharp pains around C7 on right side of neck that is tender. Headaches have gotten tremendously worse. I now get numbness in my right foot. I had a MRI of cervical and thoracic. It showed a minimal bulging at C5-6 C6-7. Was sent to spine doctor. She said that the symptoms were not caused from spine and referred me to a rheumatologist. After physical exam with rheumatologist, she said she was going to run labs and really didn't think it was a rheumatological issues. She said I had a positive physical exam for TOS at which point I explained the prior venture with this and how I was told that bc I didn't have an extra cervical rib and tests were negative that I didn't have tos. She said that it didn't have to be structural that it could be functional. She sent me for an EMG. I had that this week with results showing only mild carpal tunnel syndrome. I have been doing my research. For the first time in years I feel optimistic that I may have an answer. My husband and I decoded that going to a specialist is the right thing to do. I am tired and frustrated with being passed doctor to doctor. Expensive test after expensive test. I set up an appointment with DR. Thompson at Barnes in St. Louis. I read so many positive reviews on him from this board. Della was super nice. She asked for my symptoms and said it sounds like neurogenic TOS. I have my appt set up for April 9/10. I pray for some answers and a light at the end of this long exhausting tunnel.....
Sorry this was such a long post and than you for taking time to read. I appreciate any feedback.

Originally Posted by MaryG

First, I want to say thank you for all the useful information I have found here. I find myself more optimistic since finding this board.
My Journey thus far... 5 years in the making
My symptoms started in May 2009 while performing ultrasounds. My hand would go completely numb within the first few minutes of the exam. This made doing exams extremely difficult, as I needed to utilized both hands for exams. I am right hand dominate and that was the hand going numb. I also was having terrible headaches that began at the base of my skull and had shooting pains to behind my right eye. Pain that went from my shoulder to the elbow to the pinkie side of wrist. I also had pain to the right of my spine between my shoulder blades. It was such a sharp pain at times that it hurt to breathe. I also had muscles knots (trigger points). I was having pain in my lower right back that radiated to my hip and knee. ( Which I had prior to new symptoms in the arm). I also was having trouble sleeping at night because I was constantly waking up with numbness in my arm. Hard to get comfortable to fall asleep. I not only did ultrasound, I also preformed X-rays and Cat scans. I had a 8 month old son and 8 year old daughter at home. My husband was deployed in Afghanistan. I was finding that my hand was going numb while feeding my son, drying my hair, driving and talking on the phone. Essentially any activity that my arm was abducted or elevated. I was advised to file work comp and go to my doctor. I first put on ultrasound restriction, however was able to preform CT and X-rays. I was sent to ortho doc. He thought that it was possibly TOS. I had C-spine X-rays and MRI, a shoulder MRI, Brachial Plexus MRI, and an EMG. I was started on PT for Thoracic Outlet. I did not find that PT was helping much. PT told me that my right clavicle sat higher than my left. She would try pushing downward on it. That hurt like crazy. She would tell me to breathe the whole time she was doing it. So painful. All my tests were negative except EMG showed the start of carpal tunnel syndrome. Ortho doc sent me for consult with cardio thoracic surgeon. I had a positive physical exam for TOS. The doc sent me for an ultrasound of my arm. That study was negative. My employer through work comp sent me to a work comp physician. The physician concluded that I should not be out on any restrictions because my job was not one of repetitive motion. (Which is not true) My employer was forcing me back to ultrasound and I asked them to please hold off to give PT a chance to help. I was still currently working in my other two positions. The cardio thoracic surgeon said that I didn't have tos because all of my exams were negative and that I didn't not have a cervical rib. I was at a loss. I was sent to head PT person (mind you that I was doing PT through the hospital at which I was employed). He said that trigger points was my problem. (Side note, I was young and had blind faith in doctors. Hindsight is that I should have done more research). Since I was reluctant to go back into ultrasound ( the pain and numbness were still in full force and I did not feel that it was good patient care to have a tech whose hand was not properly functioning), my director pulled me into the office. I was told that as of now I was placed from full time to prn status ( as needed with no guarantee of hours). I had the option to sign resignation papers with a severance package. I was angry and upset. Never have I been " let go" from a job. I take pride in my job and work ethic. I never call in and was always there. We could not afford not to have a paycheck or health care coverage and they knew that. So I signed the papers for the severance package which consisted of 4 months of full pay and healthcare coverage. (Hindsight I should of hired a lawyer) I felt defeated. No help for symptoms and thought that I was just going to have to live with it. My Pt ended with no relief. I went on job hunt and was able to obtain a weekend overnight position (that I still have) doing CT and X-ray. I just lived with pain and numbness for the next 4 1/2 years. I finally had enough and started the journey for an answer again. The symptoms have gotten worse over the years to a point that I have ringing in my ears, numbness in lips and tingling on right side of scalp and face, sharp pains around C7 on right side of neck that is tender. Headaches have gotten tremendously worse. I now get numbness in my right foot. I had a MRI of cervical and thoracic. It showed a minimal bulging at C5-6 C6-7. Was sent to spine doctor. She said that the symptoms were not caused from spine and referred me to a rheumatologist. After physical exam with rheumatologist, she said she was going to run labs and really didn't think it was a rheumatological issues. She said I had a positive physical exam for TOS at which point I explained the prior venture with this and how I was told that bc I didn't have an extra cervical rib and tests were negative that I didn't have tos. She said that it didn't have to be structural that it could be functional. She sent me for an EMG. I had that this week with results showing only mild carpal tunnel syndrome. I have been doing my research. For the first time in years I feel optimistic that I may have an answer. My husband and I decoded that going to a specialist is the right thing to do. I am tired and frustrated with being passed doctor to doctor. Expensive test after expensive test. I set up an appointment with DR. Thompson at Barnes in St. Louis. I read so many positive reviews on him from this board. Della was super nice. She asked for my symptoms and said it sounds like neurogenic TOS. I have my appt set up for April 9/10. I pray for some answers and a light at the end of this long exhausting tunnel.....
Sorry this was such a long post and than you for taking time to read. I appreciate any feedback.