It was my 5th surgery by Dr. Filler at UCLA when I got the Staph Infection so because of the infection the surgery was unsuccessful! Five surgeries at my left clavicle and one on my right total six surgeries, that is more than enough for me! It was originally suppose to be 1 surgery on each side total of 2. I don't plan on having any more TOS surgeries!
Jacque63

Jaquee- I am sorry you had such a bad experience with dr filler. I have not seen a lot of people have very good outcomes with him, and my experience with him was dissapointing. Have you ever tried to visit another surgeon? I had my surgeries with Dr AHn, adn I foudn him to be excellent, personable adn super smart. Dr Gelabert is also in LA and supposed to be very qualified.

Momz- the major questions about what type of surgery you will have is
1. Will you remove the rib or not??generally surgeons do two types of TOS surgeries:
rib resection with scalenectomy (they remove the first rib)
scalenectomy alone (they leave the rib and either cut ro remove the scalene muscles)

For a scalenectomy alone, a surgeon will almost always go supraclavicularly (incision near collar bone). If you are only getting a scalenectomy, be sure to ask if he is just cutting the scalene, removing part of it, or removing all of it...generally anterior and medial scalenes are included in this procedure.

For Rib resection with scalenectomy, some surgeons will come in supraclavicularly (by the collar bone)and some will come in at the axilla (under the arm pit). They cannot remove the entire rib supraclavicularly, but they can remove more of the scalene that way. You will find that each surgeon has his own preference.

Different surgeons also do different things with the cut scalene muscles...some like to disconnect whatever is attached to them then sew them back on to something (so that they reconnect where he wants them), others cut out a section of them and leave the rest to atrophy inside, others remove the entire muscle. There are different opinions on why one way is better than the other.

In the surgery that I had (same on both sides) they came in from the armpit, removed the entire rib, and cut as much of the anterior, middle, and scalene minimus muscles out as they could then left about 4" of each to atrophy. They found severe nerve swelling and scar tissue/fibrous bands on both sides, aand removes as much of the extra bands and scar tissue as they could.

My surgeon warned me that in 25% of his patients come back later and have a second procedure because the top 4" of scalene that he cannot remove either reattaches somewhere or was causing problems in the beginning that were not relieved. Other surgeons will do it differently.

Be sure to ask what exactly what he will do and why he likes to do it that way.

Also- for pain control...I have started taking effexor, which is an antideppressant. Unlike lyrica and neurontin it does not (supposedly) cause weight gain. It is in teh antidepressant class. I have been having a lot of luck with it for pain control, though it took several weeks to get to a stable dose.

I would also work hard on relaxation techniques- get an ipod and practice either hypnosis like states or focused relaxation with music...victoria can send you a DVD with several hypnosis and relaxation cd's burned onto it. Learn them before surgery so that you can use them after- I had my ipod glued to my ears in the hospital.

I second the idea to take someone with you for your surgery consult-and write down your questions in advance.



JOhanna