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


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Old 07-28-2014, 02:33 PM #1
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Default Thoracic Outlet Decompression Surgery Recovery

I was diagnosed with vascular TOS a few months ago after I had a blood clot and will be getting the surgery (to remove the first rib and some scalene muscle) at NYU on Aug 18. My surgeon informed me that I would need a week of bed rest and he expects full range of motion in my left arm in 6 weeks with physical therapy 3/4 times a week.

I have a fairly demanding job in advertising and planned on taking a week off post surgery, working from home for one week, and then heading to the office after 2 full weeks.

I'm 24 years old and in good health. I have mild shoulder pain now, but the surgery is a preventative measure to prevent blood clots in the future. Could anyone provide realistic expectations for recovery based on previous experience?

*I've been reading this forum for a few weeks - thank you to everyone and all of their advice!
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Old 07-28-2014, 03:31 PM #2
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Welcome jj430.

Someone will be along to help.
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Old 07-28-2014, 03:58 PM #3
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Get the best vascular surgeon that you can find, they will be moving a lot of delicate stuff around when they remove a rib and scalenes..
Don't feel locked into the surgery just because the date is set already. If you find a TOS doc or highly skilled vascular guy you can always reschedule.

I'm guessing you have seen the sticky threads for docs and such..

Unless you are seeing the very best , a second opinion is always suggested..

Are they removing the whole rib vs leaving stump? ( a stump can be problematic)

Don't jump back to work too soon let your body tell you when it is ready.. Some take longer to recover.
Sometimes the skill of the surgeon makes a difference in this part.
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Old 07-29-2014, 07:03 PM #4
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I had rib resection and scalenectomy for neurogenic TOS with some vascular involvement. It was a VERY difficult recovery. It took a full two months before I felt back to the condition I was before surgery.

One week of bed rest and one week of working from home seem wildly optimistic. I agree that you need to get yourself to the most experienced person you can find for a second opinion.

Good luck,
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Old 07-30-2014, 12:24 AM #5
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http://surgerydept.wustl.edu/TOS_Patients_Venous.aspx

The bottom of this web page indicates 4-6 weeks.

Who is your doctor? I would suggest a second opinion as well. Though it does seem that surgery is most likely a necessity to prevent further blood clots.
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Old 07-30-2014, 10:25 AM #6
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Thanks for the feedback - my doctor is Mark Adelman, he's the Head of Vascular at NYU Medical and was my second opinion.

He's said all of his patients who have had this surgery have had no issues with recovery and given my age I should move forward. Another reason is because I am on 20mg of Xarelto (daily) and he does not want me to continue on blood thinners for such an extended period of time.

In regards to Physical Therapy, I have been having trouble finding someone experienced in NYC. Most PTs are unfamiliar with the condition and want to do general stretches based on the areas of pain.
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Old 07-30-2014, 10:52 AM #7
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Quote:
Originally Posted by jj430 View Post
I was diagnosed with vascular TOS a few months ago after I had a blood clot and will be getting the surgery (to remove the first rib and some scalene muscle) at NYU on Aug 18. My surgeon informed me that I would need a week of bed rest and he expects full range of motion in my left arm in 6 weeks with physical therapy 3/4 times a week.

I have a fairly demanding job in advertising and planned on taking a week off post surgery, working from home for one week, and then heading to the office after 2 full weeks.

I'm 24 years old and in good health. I have mild shoulder pain now, but the surgery is a preventative measure to prevent blood clots in the future. Could anyone provide realistic expectations for recovery based on previous experience?

*I've been reading this forum for a few weeks - thank you to everyone and all of their advice!
It is possible ,but can be little tough. I went to work (in medical office)after 3 weeks. They put you in weird position during the surgery and I had back pain because of it for 3 weeks. It was difficult to sit for 3 weeks in an hour you want to lay down and relax plus pain from the surgery. You will have to be on meds, but it is not impossible. Yana you can call me **
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Old 07-30-2014, 11:08 PM #8
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Quote:
Originally Posted by YanaO View Post
It is possible ,but can be little tough. I went to work (in medical office)after 3 weeks. They put you in weird position during the surgery and I had back pain because of it for 3 weeks. It was difficult to sit for 3 weeks in an hour you want to lay down and relax plus pain from the surgery. You will have to be on meds, but it is not impossible. Yana you can call me **
Yes, its hard to function on pain meds n plus the fact u dont get much sleep. At least I didn't u cant sleep on the surgery side cuz to painful. Unless u can sleep ur back I cant. I had a lot of pain for least 2 mos. ( bone pain) from having 2 ribs removed. Then 1 mo of soreness. My Dr warned me that it was going to be very painful, and he said the pain meds won't even touch the pain! I also had a lot of scar tissue removed.
Its not a surgery to be taken lightly. But do get a second opinion from another expert surgeon.
Best of Luck!
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Old 07-31-2014, 07:27 AM #9
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I had first rib and cervical rib resection, scalene removal, and subclavian artery aneurysm repair done by Dr. Thompson in St. Louis in 2012. (I was 35 at the time). I did not have any complications and was in good health otherwise. I was in the hospital for 5 days and then had to stay in St. Louis for 2 more days for monitoring. After that week, I was off work 3 more full weeks and then went half-time for one week and then back full-time. I don't think I could have done it any faster (I have a stationary job but one that does not require constant typing thankfully). Unlike some other posters, my pain was well controlled with my prescribed pain meds, but the meds made me even more tired than I already was from the surgery. I also did PT 3 times a week at first, and I was always worn out after that. I just needed a lot of rest and sleep. It's important not to push it too much in those early weeks. I wish you all the best moving forward!
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Old 08-02-2014, 10:06 AM #10
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Quote:
Originally Posted by Jo*mar View Post
Are they removing the whole rib vs leaving stump? ( a stump can be problematic)
I keep seeing posts about ribs growing back. What is the percentage of people who have rib re-growth?

It also seems that some issues such as scar tissue growth can be a problem regardless of the type of surgery that is performed.

I tried to look for the stats for rib re-growth but I'm really not good at looking up such medical information.
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