welcome, sorry for the reasons you've found us but sure glad you're here. yes, the thoracic guy sounds like a surgeon alright. won't be much interested in you, either, no doubt, since in all likelihood (and let's keep our fingers crossed it's not TOS in the first place, man!) you're not a surgical candidate. TOS surgery SHOULD be a last resort, unless your sx are (acutely) vascular or you have that rare case of true neuro TOS.

so your best bet really is what your heart is already telling you and you have some excellent ideas. alexander technique, craniosacral massage and myofascial release, etc. be aware that the WRONG kind of PT can not only NOT help a TOS'er but can actually do more damage, james, so you must be very careful. olecyn will tell you, her personal search took her i think 5 years to find the right guy, but she has, and is very happy with him and he is right there in your area... so ask her about her "doc of PT"---

as far as a PCP goes, you don't really need one. what you do need is a neuro who specializes in TOS (again, i'm presupposing that dx in your case but just bear with me for the sake of argument here...). i'm going to second what johannakat has suggested and recommend dr. sheldon jordan for you. while i realize there are some drawbacks in that he is located in LA county and does not accept private insurance, james, the fact that he is a pain management dr., a neuro, AND a TOS specialist may give you something to consider... at least as far as getting the dx confirmed goes. for dr. j. is an excellent diagnostician and can perform scalene blocks as well as do botox injections and other therapeutic measures for you down the line if you've an interest in that. or perhaps he could recommend someone in OC to tx you, better still... not exactly non-invasive, some of the things i mention here but still, a far cry from surgery and in reading between the lines of your post i sense that you are suffering so i just wanted to give you some options, that is all.

you also could look into purchasing voice-activated software (dragon naturally speaking is the program for PC users, less than $100 all-in, i think - there's another one for MAC users). sign up for the sorehand list out of ucsf.edu and you will get tons of ideas about ergonomics and gain access to its archives as well (there was some interesting material recently about the difference between playing the piano and computer keyboarding in terms of aggravating RSI which would be right up your alley...).

also, if insurance coverage is an issue (it is for me sometimes) or you do decide to go for posture or bodywork because that seems a better way to address your issues right now, then maybe look into some of the low-cost or free classes offered through the national MS foundation - you do not have to have MS to participate in the national MS society 'being active' program, and by signing up for the 'better living' catalogue i'm told you can get a heads up as to upcoming events and MS programs within your own community. as you know, the national MS foundation is nationwide and extremely well-funded, with lots of public awareness. great programs. so take advantage of that, james.

you really touched on an important aspect when you said how important it is to talk things through. i think emotional support is key. it can be one of the hardest things for a TOS'er to find, sadly, even among medical professionals - there is so much controversy, political nonsense, litigation, etc. and it does such a great disservice to the patient. we just want to get better.

the answers lie within, james. stay close; we need you here! we can help each other by giving information and support. you have the right attitude. and you are very fortunate to live in a part of the country where there are some good treating professionals. hopefully members here can help you find ones you are comfortable with.

i wish you the best of luck. hope you join us! i can tell you've already earned your seat; so pull up a chair, kid...

alison