Can you pay privately for couple visits and see Art and learn some of the basic mobilizing he teaches with the help of props? He starts mobilizing the very first day and also teaches the self mobilizing the very first day itself.
If you can have 2 or 3 sessions with him and James and purchase the props and work on it everyday and also work with your local PT on your WC would that work for you?
I had to do something similar for scar related issues after my scalenectomy in 2010, since I could only go to him once a month from Northern Cal and have 2 or 3 sessions with them each time I went there.

Hi all:

Sec- Sorry to hear about your pain but it does seem pretty early. Were you happy with Dr. Gelabart? If I were to consider surgery it would most likely be with him.

James is no longer at Ando and Aston but Heather is very Good. I have tried both Joyce Wilkinson and Lider Chan and have spoken with Leslie Rudinski on the phone. Art is the best. Joyce was ok but couldnt help me when I was so acute.I was disapointed with Lider as well.

Sea Pines: I hadnt heard of Jeff Loox- one of another forum members Junior Corey was looking for someone in the valley. What does he do? I am also looking for someone closer to me too- I want to start focusing on strengthening. I may go back to an old PT who has alot of Pilates machines and an Osteopath, massage etc- His name is Rick at Sportfit in SM. I'll let you all know. I am also going to try a chiropracter since my neck is the worst pain. Also I have bben thinking about starting a thread for all of us Southern Californians- to share Dr. info and eventually maybe a website-What do you think?

Sea Pines - I will find out about the Sherman Oaks guy and Leslie, and then see if my WC will accept either. I am not even sure how many sessions I have left.

Stos - Unfortunately, I can't afford to pay out of pocket for Ando at this time.

jkl - I love Dr. Gelabert. He did both of my surgeries and I feel he is a very competent and knowledgable in TOS. I also like his personality - I find him rather funny. I think it would be great to have a SoCal based link. There is so much in this area and difficult to keep track of it.

20yrs - A recumbent bike is also a great option - many of them have arm rests. I can't do the elliptical (even with out arms) because I need the support.

I have not given up all hope. I will continue to do what I can to get better - trust me, I'd much rather live without pain! But I am also making decisions for my future based on having TOS. Even if I do improve, I want to make sure I am taking care of myself in a way that won't create another recurrence (if possible).

fyi- this group of doctors up in Seattle seem to think the pec minor is often the cause of recurrence.

Stay optimistic and please follow-through on the pec minor testing. Let us know how it goes. best wishes -

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[Recurrent neurogenic thoracic outlet syndrome
Esteban Ambrad-Chalela, M.D., George I. Thomas, M.D., Kaj H. Johansen, M.D., Ph.D.*
Vascular Institute of the Northwest, 1600 E. Jefferson St., No. 101, Seattle, WA 98122, USA
Presented at the Annual Meeting of the North Pacific Surgical Association, Seattle, WA, November 8, 2002


Abstract

Background: Although 90% of patients with neurogenic thoracic outlet syndrome (NTOS) experience “excellent” or “good” results after
thoracic outlet decompression, recurrent symptoms may develop in certain patients.

Methods: This is a retrospective review of patients with NTOS who developed recurrent symptoms of upper extremity/shoulder/neck pain,
weakness and limitation of motion at least 3 months after initial relief of symptoms by surgical decompression. Diagnostic procedures and
outcomes of reoperative surgery were assessed.

Results: Among almost 500 patients undergoing initial successful thoracic outlet decompression for symptoms of NTOS during the last
decade, 17 redeveloped classic NTOS symptoms (3 of them bilaterally) at intervals from 3 to 80 months (mean 18 months) after the initial
operative procedure. Ultimate diagnoses included incomplete first-rib resection (n=1), compression of the brachial plexus by an ectopic
band (n=1), persistent brachial plexus compression by an intact first (n=2) or second (n=1) rib, brachial plexus compression by the
pectoralis minor tendon (n=13) and adherent residual scalene muscle (n=14). Anterior scalene muscle block was positive in 9 patients
later found to have recurrent symptoms from adherent residual scalene muscle. Among these 20 cases of osseous or musculotendinous
causes of recurrent NTOS, all had “excellent” or “good” results from repeat surgery to eliminate the underlying structural problem (removal
of intact or residual rib, pectoralis minor tenotomy, brachial plexus neurolysis, or a combination of these).

Conclusions: Complete excision of cervical or first ribs and subtotal excision (instead of simple division) of the scalene muscles will
decrease the incidence of recurrent NTOS. Pectoralis minor tenotomy should be considered part of complete thoracic outlet decompression.Anterior scalene muscle block accurately predicts outcome of reoperation for certain types of recurrent NTOS.]
http://www.ncbi.nlm.nih.gov/pubmed/15041500