MUSCLE WASTING TAKES A WHILE.
BESIDES YOUR HANDS ARE VERY TONE FROM PLAYING ALL THESE YEARS.
YOU ARE NOT YOUR CHURCH FRIEND.

It's your decision to have the ulnar nerve redo or not.
I can hear your scared.
Just keep in mind what these TOS patients are trying to tell you, K?
All of us have or are going through the same obstacles as you.
The more pressure we put on ourselves the more stressed we get.
The stress creates our muscles to contract and press on the nerves.
So, WE ALL have to practice calm and take the time to make the right decisions for ourselves.
Keep on researching, listen to experts and you'll make the right decision for you.

Please see my post to Rogergayla. I am in so much pain, I can't copy it here...

My intent though is the same for you, in that, as a bunch of people on the internet, we can share our experience, give support to eachother, and try to understand eachother as we battle this very complicated, rare and for most doctors, misunderstood condition. (Syndrome actually, a set of symptoms.)

What we can't do is GUESS what a person should do.

We don't have the full picture - your job duties, the hours, how you developed TOS, if you have TOS for sure, how your orthopedic problems complicate the picture, IF the orthopedic elbow is even orthopedic or TOS just acting like it, what your finances are like, and on and on.

Only YOU have the GUT INSTINCT to decide what to do once you've listened and read all that you can.

NONE of us is rich enough to just fly off to Denver. We have programs, help for those who need for flying costs, ways to save on hotels, etc. If you post that you need help, I know people here can search old threads for help and ideas.

One tries to get to the nearest TOS top doc. Why? Because most docs don't know what they're talking about in relation to TOS.

Do you need elbow surgery? Like I already posted, I don't know what your MRI looks like - did you go over the image with the doctor, or have him draw out on paper what it is he's trying to accomplish with another surgery, and does that make sense to you? Did you ask him if FOR SURE this is an elbow problem, and not a nerve problem from the brachial plexus area? And WHY or WHAT facts he bases that on? And how exactly would that affect hand wasting??? I don't get the relationship there - can the doctor guarantee you that the elbow surgery will alleviate ANY of the hand problems???

You ask if you "can" do the surgery. Each of us has to take responsibility for our own treatment plan. It does get scary. It does get frustrating. I've lost everything. Don't you think I did not want to get to the point that I couldn't be a trial lawyer anymore, drive a sports car, lose my beach house, wear pajamas all day and live in horrific pain? As Olecyn says, we've all been there, or are there, or are about to be there...we're in the same boat.

You've got to do whatever it is you do for strength - do you have a faith? Or meditate? Pray? Or just do one of those plus / minus charts - what do you have to lose or gain by skipping a TOS consult and going straight to the elbow surgery? Be advised you can cause more nerve damage, you can cause RSD to get started (read up on that one, as many of us here have that, including me. Mine came from waiting for surgery for four years.)

If I could do anything over, it would be getting to Denver as fast as I could.

I had to wait, first cuz I didn't know about this site or that I had TOS, second cuz I am work comp and tried to fight for it and third I simply thought waiting wouldn't hurt. I was WRONG in my case. I would have stopped or slowed the nerve damage, I am sure of that now.

So do your chart, post for help on flying / staying in Denver - and btw, you only need to stay for one day's visit - EVERYTHING was done for me in one day. And what they say about copying your records and getting it to the doc ahead of time is true, then they just decide what they need to do the day you're there. I would recommend seeing TWO of the Denver docs that day. Also, if you have no insurance, let them know that, the docs are VERY compassionate people. They have dedicated their LIVES to this rare disease, and they risk lawsuits for these surgeries which they perform every week, all of the time - (as does the hospital. Important fact.)

Please keep coming back. Let us know what you're feeling, what you decide, and feel free to ask for specific help, such as the hotel costs, etc. That, we do know!!!

I hear you guys and I know you are trying to help. And you're right - I'm damn scared.

I am calling Dr. Sanders' office tomorrow to see if I can get an appointment. I'll try to fly out there for a day. I do have friends who live there, so I have a place to stay. I hear Frontier Airlines is relatively inexpensive.

Again, thank you everyone for helping me to see a path.

Sue

Best of luck -
It's a big step but in the long run you'll be better off seeing an expert and finding the truth instead of running around and wasting time going from doc to doc.

I talked to Dr. Sanders yesterday - what a nice guy! He's pretty sure I have pec minor syndrome. I'm seeing him on February 25!! He says I still may need the ulnar nerve redo, but we'll talk about that when I see him. I won't have any surgery this time, but will schedule it for later. I'm so excited - thanks for giving me a push, everyone!


sue

PP:

You are a piano player. I'm willing to bet you have bad posture while playing/practicing ala computer posture...i.e. hunched/rounded shoulders. Pec Minor Syndrome is a tight (shortened) Pec Minor which rounds the shoulders and compresses the BP. If so...STOP THAT! Get out some posture manuals and learn what to do to REVERSE that.

Some tips....

Get a foam roller. ($15-25)
Lie on it with your butt at one end and your head on the other. Let your shoulders roll back OFF the foam roller. This will OPEN your chest and reverse any rounding IF that is a contributing factor. If you can get some relief from that...you have your first CLUE. Not saying complete relief...SOME. Report back

Humorme,

I've made changes in my playing to get my shoulders as far back as possible. I now use a keyboard as often as possible, and set it at a height which allows me to stand to play with my body as straight as possible. I'm also very aware of my posture at all times.

I've used a foam roller for over a year now and it does feel good!

My PT has tried to physically push my shoulders back when I'm lying on my back, and it just doesn't happen, the muscle is that tight. In fact, when I lie on my back the right shoulder doesn't touch the surface from the shoulder to the bottom of the scapula.

I "had" that....I still have to work to get more "backwards" but....you have to do MORE. Stretch...is helping the Pec Minor....STRENGTENING the back muscles (i.e. rhomboids and mid traps) will allow the shoulders to be HELD back. If the back is weak (and it is probably as is typical of this syndrome...i.e. pec minor) it needs to be strengthened to pull back against the draw forward of the pec minor. At the moment the pec minor is taking full control ...you have to reverse that and tell the back to take over control and NOT allow the pec minor to win that battle. It takes A LOT of time and work...daily...but if you keep at it, you WILL eventually see the results and FEEL the results. Posture is a start...but your "default" position is still pec minor in control and rhomboids/mid-traps giving in. You will NOT see results overnight. It will take at least 6-9 months of strengthening exercises on an almost daily basis to start to notice the improvement. I've been at it almost 2 years now and I still have a few more inches to get but my back is much more in command and pec minor is giving up. The PT has seen the change and is ****** because she didn't take a before shot.

be Very Careful With Strengthening Excercises. I Also Have Poor Posture, And Was Told By My Surgeon Not To Obsess Over That. Right Now You Need To Find A Doc Who Knows Tos. Worry About Eerything Else Bit By Bit In Your Healing Journey.
Don't Strengthen Now At The Expense Of Your L;ong Term Well Being.

If I had not strengthened my back muscles, I'd be worse off. It was KEY to my recovery and/or progress and/or reduction of flare ups and pain.

The above said, I have always maintained that one listen to one's own body for indications of what is or is not appropriate. If one doesn't at least TRY, one will never know. And sometimes trying requires a LOT of effort (time/patience). As I said in another post...I did not see/feel improvement for at least 6-9 months. I had to trust the process and what was told and my own education about the body's mechanics. It makes perfect sense that merely standing straight is not sufficient IF the shoulders are rounded forward and held there by tight pec minors. It makes perfect sense if the opposing back (rhomboids/mid-traps) muscles are disinclined to hold the shoulders back because they are weakened by the short pec minors. The body becomes used to this position and in time compresses everything in the vicinity. Open the area up...reverse the compression...pull the shoulders back and KEEP them held back and voila...less/no compression!

I agree, not everyone may be able to tolerate the work necessary...but to not even try IMHO is a set up for disaster. The simple act of lying on a foam roller as suggested earlier should be helpful...if that can't be tolerated, one can lie on the floor and try to let the shoulder drape back...work up to a rolled up towel and progress from there. Progression is key. I did it with towel, then roller then roller with weights and then they gym with cable rows and the like which strengthened the back muscles while lying on the roller stretched the pec minors to allow them to lengthen so that the stronger back could then hold them in the corrected (held back) position.

This does not apply to everyone but it applies to many and I will not give up repeating this very important thing. There were MANY days I thought this was all pointless. There were MANY days I had the 2 steps back and couldn't see the 1 step forward. The progression sped up in the past 6 months because one has to just PERSEVERE. To give up was NOT an option for me.

Please do NOT discourage people from trying. I do NOT believe that the doctors are NOT recommending efforts like the above at least to TRY to see if they can be tolerated. Baby steps. I know my doctor promised nothing but did say it would take a LOT of dedication and hard work. Same with the PT. Both said many have given up and they both were disillusioned by their lack of persistence. Both are pleased with my sticktoitness and have used it with others to encourage them to keep at it. The PT has even named a maneuver after me because of something I found that helped me that she agreed would help others "get it."