the worst

Hope526 · 02-25-2015, 12:39 AM

Quote:

Originally Posted by SD72

Hi Bobby
I am new here as well. Almost 2 weeks post rib resection surgery with Dr.Donahue. I have been dealing with TOS for 2 years, I had seen 3 neurologists, 2 thoracic surgeons, rheumatologist and Dr.Donahue was the only doc to quickly diagnose compression through ct scan last June. It showed the compression of the arteries. I had PT and chiro for months and botox shots to no avail. I saw one PT that did massage/fascial manipulation and that did help short term but stiff posture or stretching would bring back the pain and nerves. I am optimistic the surgery will help. I have pretty good range of motion but a lot of numbness still in my arm and hand. He said it should subside in the next couple of months but nerves are slow to recover. He found a lot of scar tissue that pt/botox would not have helped with. Dr.Donahue is very attentive and gives you all of the time for a thorough exam (well over an hour for initial exam). He offers all options and does not jump into surgery hastily. It did take some time to see him and a couple of months for the surgery. I am highly impressed with him and his team.
I do sympathize with you . I am a hands on technician and it is hard not being able to do all that you used to do. If you find relief with the message grasp onto that as Daesin eluded to any relief is appreciated greatly. I hope any of this helps. I am really relieved to have found this forum to realize there are alot of others that are going through the same issues.

Hi SD72,
I noticed that you mentioned you had a CT that showed compression of your arteries. What kind of CT did they do? Did they scan you with your arms above your head and at your side?

SD72 · 02-26-2015, 09:55 AM

Quote:

Originally Posted by Hope526

Hi SD72,
I noticed that you mentioned you had a CT that showed compression of your arteries. What kind of CT did they do? Did they scan you with your arms above your head and at your side?

It was a CTA scan of the Neck and Chest with intravenous contrast at MGH.
My hands were by my side. I have seen the images and you can see compression of the arteries.

Bobby78 · 03-25-2015, 10:30 PM

Yeah so things got a little better with stretching, doing nothing, and some light back workouts. Not acceptable, but anyways. I think I hindered myself trying to get back to "normalcy" too soon. Normalcy is defined as enjoying my life.

Anyways, my question, how do you know if arterial or venous involvement is the problem? Differentiating from neurogenic?

Jomar · 03-26-2015, 12:15 AM

[The first structure compromised in these compression syndromes is the subclavian artery (five percent of all cases).
This great vessel leaves the thorax by arching over the first rib from behind the scalenus anticus muscle and in front of the scalenus medius muscle.

This egress of the artery through the interscalene triangle places it at high risk for compression by the scalenes whenever there is muscular hypertrophy. Compression of the subclavian artery gives rise to ischemia, decreased peripheral pulses, coolness, pallor, and possible cyanosis of the upper extremity.

Running directly beside the subclavian artery, with the exception of passage anterior to the scalenus anticus muscle, is the subclavian vein. Due to the vein’s escape from inter-muscular passage, venous compression syndromes are much less common (one percent), but involve swelling in the hands whenever the vein is involved.

The third component of the neurovascular bundle, the brachial plexus, also follows the same course as the subclavian artery through the interscalene triangle, only slightly more posterior and lateral. It is the most frequently involved structure in TOS (95 percent of all cases) and produces paresthesias, anesthesias, pain, weakness, and atrophy in the upper extremity as a result of its compression.

Finally, the great lymph channels also pass through Sibson’s fascia, following the course of the neurovascular bundle, but are rarely compressed.
] http://spinetalk.conforums.com/index...num=1153540139

Chart of symptoms and causes -
http://tos-syndrome.com/newpage12.htm

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