[Tocs]

Hi everyone,

I'll start off with a little paragraph about myself. I'm 22 years old and live in Sydney, Australia. I'm very active. I do a sport called crossfit, which involves gymnastics, olympic weightlifting and other metabolic conditioning aids like running, rowing etc. I compete in this sport against others when local competitions are held too. I kayak, wakeboard, kiteboard and scuba dive. Pretty much any water sport I can get my hands onto. I don't smoke or drink and eat a very clean diet 95% of the time.

In the middle of the night in mid June this year, my left arm swelled to about twice it's usual size. It was purple and quite sore. I went to emergency section of my local hospital in the middle of the night and waited a while to see the doctor. I was quickly admitted and hooked up to IV Heparin. I was put through a CT scan and ultrasound throughout the next couple of days. I was assigned a vascular surgeon from the hospital, Dr Gabrielle McMullin, whom is a local surgeon who services several local hospitals, as well as having a local clinic near the hospital I went to.

The surgeon diagnosed me with Venous Thorasic Outlet Syndrome or Paget-Schroetter Syndrome. The tests at the hospital came back 'inconclusive' for clots. I definitely did not have a cervical rib. My surgeon asked for the radiologists to look at the scans again because she was sure I had clots due to the size of my arm, but they wouldn't. I was released from hospital on high dose aspirin and a compression sleeve. I booked a followup appointment with the surgeon a couple days later.

A couple days later at the surgeons clinic, they found clots formed between my armpit and elbow on the left arm, during an ultrasound. Needless to say my surgeon was furious at the radiologists. She sent me to a private hospital that afternoon for thrombolysis. I was hooked up to the IV Heparin again and stayed for a few nights and was released.

A few days later I was back at the surgeon's clinic and I had another ultrasound. They found that the clots had reformed and were continuing to block the veins. I was put on clexane (blood thinner) twice daily and picked up a custom compression sleeve for my left arm. The surgeon told me that due to the high risk nature of clots, a PT would be unlikely to resolve the problem and it could reoccur down the track. The surgeon wanted to perform a rib-resection surgery as soon as possible.

I was a bit reluctant and booked in an appointment with a a highly qualified professional in sports medicine. He is both qualified in physiotherapy and medical surgery. My biggest fear was losing functionality of my arm, particularly with sport or exercise using my arms above my head. Also I need use of my arm as I'm in the Police too. He calmed me down considerably. Telling me that unless there was some sort of unforeseen complication, that I would have full use of my arm and make a full recovery.

5 days prior to surgery I had thrombolysis of the left arm again.

Last week on Wednesday 10 July 2013, I had the rib-resection and scalenectomy performed at St George Private Hospital in Sydney under Dr McMullin. It was supposed to take about 2 hours, but took 3.5 hours. I was taken to the Intensive Care Unit after surgery as a precaution. They had morphine ready for me when I woke up but I didn't need it. I was not in much pain at all. The surgeon made the incision just under my collarbone on my left side. She said that the armpit approach would be almost impossible due to my muscular body. Over the next couple of days I took about 3 doses of endone. I was moved to a coronary ward the day after surgery. The following day I was released from hospital. I was given a sling for my arm. I told to keep my compression sleeve on and take 300mg of aspirin daily.

The car trip home was fine. It is only about 20 minutes. That afternoon I went out for coffee with friends. I was cautious with my movements and kept my sling on but I did not experience much pain at all. That night I did have some discomfort with my left shoulder blade. I found it hard to get comfortable. I took some panadol (over the counter medication, very mild pain relief and anti-inflammatory). I had my family assist me in the shower, to wash my back and right arm. I was able to do the rest. I needed help dressing myself for the first few days too.

Over the next week my discomfort became less and less. I did not have to move as cautiously and I could use my left hand for small tasks or to pick up very light objects. I have become much more independent. I make sure not to lift my arm above shoulder height. After a week, the pain is non-existent.

Today I had a followup appointment with the surgeon. The end of the stitches were cut so that it can be left to dissolve and my dressing was taken off. It looks very clean and should heal nicely. The surgeon was happy with how the rib-resection went. She says that the she took out the subclavius muscle, as well as the scalenes and part of the rib. My arm is normal size now. The colour looks natural and the inside of my bicep/tricep area is soft, rather than hard as it was before surgery. My sling is now off and I just need to keep the compression sleeve on.

I have an ultrasound booked for next week and I'll start light PT then too. I am looking at getting back to work in another 2 weeks (3 weeks post op) on restricted duties. I may stretch that to 4 weeks post op If I don't feel comfortable with it. I'll see how PT goes.

I posted this thread because I saw so many threads about unfortunate experiences with tos and surgery. If I've left anything out or someone wants to ask any questions, please feel free. I'll update the thread with my progress over the coming weeks/months.

[SwissMiss]

Hello Tocs

I am glad your surgery went so well and that you posted this positive outcome. Had surgery for vascular TOS 4 weeks ago and I am doing fine so far. Started working this week although not full time yet.

Speedy recovery and greetings to Down Under

[OzKira]

Wow sounds like your surgery went well. I am so glad for you. Take it easy and slow to prevent scar tissue build up and problems down the track.

I am in Melbourne but there is another aussie who is only a few days post op with another Dr and doing well also.

Take care
Tracie

[Nicktheslick]

Originally Posted by Tocs

Hi everyone,

I'll start off with a little paragraph about myself. I'm 22 years old and live in Sydney, Australia. I'm very active. I do a sport called crossfit, which involves gymnastics, olympic weightlifting and other metabolic conditioning aids like running, rowing etc. I compete in this sport against others when local competitions are held too. I kayak, wakeboard, kiteboard and scuba dive. Pretty much any water sport I can get my hands onto. I don't smoke or drink and eat a very clean diet 95% of the time.

In the middle of the night in mid June this year, my left arm swelled to about twice it's usual size. It was purple and quite sore. I went to emergency section of my local hospital in the middle of the night and waited a while to see the doctor. I was quickly admitted and hooked up to IV Heparin. I was put through a CT scan and ultrasound throughout the next couple of days. I was assigned a vascular surgeon from the hospital, Dr Gabrielle McMullin, whom is a local surgeon who services several local hospitals, as well as having a local clinic near the hospital I went to.

The surgeon diagnosed me with Venous Thorasic Outlet Syndrome or Paget-Schroetter Syndrome. The tests at the hospital came back 'inconclusive' for clots. I definitely did not have a cervical rib. My surgeon asked for the radiologists to look at the scans again because she was sure I had clots due to the size of my arm, but they wouldn't. I was released from hospital on high dose aspirin and a compression sleeve. I booked a followup appointment with the surgeon a couple days later.

A couple days later at the surgeons clinic, they found clots formed between my armpit and elbow on the left arm, during an ultrasound. Needless to say my surgeon was furious at the radiologists. She sent me to a private hospital that afternoon for thrombolysis. I was hooked up to the IV Heparin again and stayed for a few nights and was released.

A few days later I was back at the surgeon's clinic and I had another ultrasound. They found that the clots had reformed and were continuing to block the veins. I was put on clexane (blood thinner) twice daily and picked up a custom compression sleeve for my left arm. The surgeon told me that due to the high risk nature of clots, a PT would be unlikely to resolve the problem and it could reoccur down the track. The surgeon wanted to perform a rib-resection surgery as soon as possible.

I was a bit reluctant and booked in an appointment with a a highly qualified professional in sports medicine. He is both qualified in physiotherapy and medical surgery. My biggest fear was losing functionality of my arm, particularly with sport or exercise using my arms above my head. Also I need use of my arm as I'm in the Police too. He calmed me down considerably. Telling me that unless there was some sort of unforeseen complication, that I would have full use of my arm and make a full recovery.

5 days prior to surgery I had thrombolysis of the left arm again.

Last week on Wednesday 10 July 2013, I had the rib-resection and scalenectomy performed at St George Private Hospital in Sydney under Dr McMullin. It was supposed to take about 2 hours, but took 3.5 hours. I was taken to the Intensive Care Unit after surgery as a precaution. They had morphine ready for me when I woke up but I didn't need it. I was not in much pain at all. The surgeon made the incision just under my collarbone on my left side. She said that the armpit approach would be almost impossible due to my muscular body. Over the next couple of days I took about 3 doses of endone. I was moved to a coronary ward the day after surgery. The following day I was released from hospital. I was given a sling for my arm. I told to keep my compression sleeve on and take 300mg of aspirin daily.

The car trip home was fine. It is only about 20 minutes. That afternoon I went out for coffee with friends. I was cautious with my movements and kept my sling on but I did not experience much pain at all. That night I did have some discomfort with my left shoulder blade. I found it hard to get comfortable. I took some panadol (over the counter medication, very mild pain relief and anti-inflammatory). I had my family assist me in the shower, to wash my back and right arm. I was able to do the rest. I needed help dressing myself for the first few days too.

Over the next week my discomfort became less and less. I did not have to move as cautiously and I could use my left hand for small tasks or to pick up very light objects. I have become much more independent. I make sure not to lift my arm above shoulder height. After a week, the pain is non-existent.

Today I had a followup appointment with the surgeon. The end of the stitches were cut so that it can be left to dissolve and my dressing was taken off. It looks very clean and should heal nicely. The surgeon was happy with how the rib-resection went. She says that the she took out the subclavius muscle, as well as the scalenes and part of the rib. My arm is normal size now. The colour looks natural and the inside of my bicep/tricep area is soft, rather than hard as it was before surgery. My sling is now off and I just need to keep the compression sleeve on.

I have an ultrasound booked for next week and I'll start light PT then too. I am looking at getting back to work in another 2 weeks (3 weeks post op) on restricted duties. I may stretch that to 4 weeks post op If I don't feel comfortable with it. I'll see how PT goes.

I posthis thread because I saw so many threads about unfortunate experiences with tos and surgery. If I've left anything out or someone wants to ask any questions, please feel free. I'll update the thread with my progress over the coming weeks/months.

I was just diagnosed I have a very active 24-year-old male who also eats healthy and has no previous medical history. I would love to hear how you're doing now after the surgery because it is the most thing I am worried about you I will be able to work out with a healthy normal lifestyle without any problems.