Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie.


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Old 09-04-2007, 03:37 PM #11
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Thank you everyone!!

Tuesday: Dr. Sanders put me thru the usual 2 hour exam with the whole 20 month chronological history. I found Dr Sanders to be the easiest Vascular Surgeon to talk to. I had been to 5 total.
At the end of his exam he said he had good news for me. He doesn't believe I had TOS, but rather pec minor syndrome. I was sent for a chest & neck xrays and bloodwork preop.

Wednesday: Had a MAC test with a neurologist. All I know is that it came back abnormal, but that didn't change Dr. Sanders mind. It hurt like heck too!!!!! YIKES!! I am waiting on this report in the mail.

Thursday:11:00 am Had surgery at Rose Hospital. They did left side first..released the pec minor and cut an inch off it. Then on to the right side. The right pec minor was fused to the pec major and he had to cut it loose. Cut an inch off of it also. It was a total of 90 min surgery. I was released around 4 pm. Pain was minimal.

Friday: I tried to sleep on & off all day. DR Sanders called to check on me. He told me we are gonna be great phone buddies for the next few years. He also told me to try taking tylenol as my pain meds make me hyper. (vicoden & dilaudud)

Saturday: I was a little more miserable this day. In fact my hubby thought we should go sightseeing. Needless to say I wanted to choke him. I stayed in bed and told him go for it lol!!

Sunday we flew home and I am so glad to be home but wish Dr Sanders lived closer!!

I always knew my symptoms seemed different and lower than some of the usual TOS. (severe rib pain beside my breast) and lately even burning pain in my right nipple. I'm happy to say that pain is gone. I can actually touch my ribs and it's not sore. I have 3 inch incisions under my arms. He used stitches then glue. Will post more later. Ihtos
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Old 09-04-2007, 06:54 PM #12
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I am reading my surgical report and it says that they explored my axillary neurovascular bundle. "the ulnar, median, and pectoral nerves were identified and freed." It doesn't say anything about any nerve damage.

The most amazing thing is how i feel like my shoulders are back where they should be. I sit here in tears so greatful someone finally helped me. All the therapy, injections etc, would never have fixed my problem on the right side. I hope you can learn from me as I have from all of you.

The nurses spoke of Dr Sanders retiring soon. I do know another Doctor assisted in my surgery so maybe he's learning from Dr Sanders.
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Old 09-04-2007, 09:25 PM #13
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Default "cut an inch off it"?

How wide is the pec minor? If the surgeon cut off one inch of it, does this refer to width>? It sounds like the pec minor will still work. This sounds like a great solution.


ih--so glad to hear everything is going so well for you!
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Old 09-04-2007, 09:56 PM #14
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Fern, Dr Sanders website explains it better than I can. I know that when he did the block on my pec minor as a test......my symptoms improved dramatically. http://http://www.ecentral.com/members/rsanders/
"If following a pectoralis minor block there is significant improvement within a few minutes, we have been performing a very simple operation called pectoralis minor tenotomy. This operation is performed through a 3 inch incision in the arm pit. The pectoralis minor muscle is easily found and cut at its attachment to the shoulder blade (at the coracoid process). One inch of the muscle is then removed to prevent it's reattachment to the top of the nerves going to the arm. The incision is closed with buried stitches. The operation usually takes less than 30 minutes and can be performed as an outpatient and recently we have found that this procedure can be performed under local anesthesia, but with an anesthesiologist in attendance so that patients are asleep for a short time but are awake within a few minutes of the end of the operation. The procedure carries almost no risk of injury."


Hope this helps!
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Old 09-13-2007, 02:09 PM #15
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Default 2 weeks post op

It's been 2 weeks since my bilateral pec minor release surgery. I am doing good. Had quite a few sleepless nights due to not being able to get comfortable. The numbness I had in right arm for the last 18 months is gone. I get a few weird nerve feelings in that arm but its not painful. The rib pain is gone.
My incisions have bothered me more the last week than the first week. The tape came off and they are healing. Underarms get damp I guess, and I will finally be able to wear anti-perspirant again next week. For now I just use powder.
Will post again soon. Ihtos
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Old 09-13-2007, 09:55 PM #16
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Default Mac Test

I got the report in the mail of the MAC test Dr Sanders sent me for. It was done by a neurologist .

It was kind of like an EMG/NVC test but more painful. Definitely worth it as Johanna told me though ,because this is the first and only nerve test I had done in 20 months that showed something wrong!!

I also had forgot to tell you that my grip strength in dominant right hand was 25 and 50 in the left. Does anyone know what that means? I've lost muscle or what?

Anyway, my mac test ( short for medial antebrachial cutaneous ) showed the following summary.
In the Doctor's words...
"Distinct pathology over right upper extremity. Both direct cervical root stimulation measurements and indirect medial cutaneous nerve data suggest pathology over the LOWER BRACHIAL PLEXUS. The profile of today's study would suggest more of a proximal process, vis-a-vis full blown thoracic outlet syndrome. However, the possibility of pathology also focally over the pectoralis minor must be considered, based on this profile. On the left, there does appear to be some borderline pathology developing over the brachial plexus, and this will need clinical correlation. "

I hope this info can help anyone who needs it. This neurologist was shocked that my 2 previous tests done here at home ( emg/nvc ) were normal.

I went for this test the day before my surgery. Dr Sanders told me to tell him to only do my forearms. I anxiously told him that, because I had been warned by Johanna that it was painful. Well once he got started he told me there was no way he would only do my forearms. He was getting abnormal responses and felt he needed to be more thorough. I told him ok just put duct tape on my mouth and do whatever needs done. I am so glad I had it done!! Finally something on paper!!!!

I looked at my notes from the last 20 months and saw the ones I had taken on upper verses lower brachial plexus. My symptoms were mostly lower brachial.
c8-t1

More later, too much typing, armpits hurt. Ihtos
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Old 09-13-2007, 10:45 PM #17
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Default Ouch!

sorry you had to endure. interesting that he can tell the pec minor from other stuff. mine says nothign about pec minor...only TOS. I have no quotes on hand, though.
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Old 09-14-2007, 10:40 PM #18
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Ihtos- the way that the grip strength thing was explained to me was..... most everyone has one hand/arm stronger than the other...... the fact that your dominant side was 25lbs of pressure (i think thats how they measure it) weaker than your other side makes me think that you did lose some muscle mass. I think thats fairly normal though.
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Old 09-14-2007, 11:19 PM #19
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it could be lost muscle mass, but it may be that nerve compression started it or came along...as both will contribute to weakness. I think once the nerve is squeezed, you lose strength, then you stop using it cause it hurts, then you lose the muscle. viscous cycle!!!
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Old 09-15-2007, 03:42 PM #20
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Thanks for that info Dabbo.
Isn't that the truth Johanna? Vicious cycle!!
For the last 18 months I've been told not to raise arms above chest level, but Soc Security says I can still do the only job I have ever done.....for 29 years I was a Hairstylist. I am 5 ft tall. Tried working off a platform for a while then ended up having to quit working all together.

I guess I will have to ask Dr Sanders which muscles I need to work on and when to start. I never did find any physical therapists who were knowledgable about TOS in my area. The 2 I went to both made my symptoms worse. There is no way I am gonna let someone mess up what Dr Sanders just fixed.
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