Blast from the past to the present -

[Harrison]

Jill,

Wow...what an ordeal you've been through. I am glad you are on the other side resting comfortably! I'll write again soon here or by PM.

[Harrison]

Jill,

I reread your most recent topic again. How are you? Good Lord, you’ve been through the proverbial meat grinder! Sorry to be crass – you get my drift. I only went through the veg-o-matic (old farts like me who grew up in the 60s remember….)

I had a very specific question. OK, more than one…when you feel up to it:

• Were the muscles removed because they were “fibrotic?”
• Was the fibrosis causing ischemic compression?
• What was the cause of the fibrosis? Was any of the tissue sent to the immunohistopathology lab for testing?
• Did you "peg out" the spirometer?
• What meds are you taking?

The traveling must have been brutal. I hope you are home safe and resting peacefully!

[cavalier]

Typing one handed - answering your ?'s -

1 & 2 are BIG YES to both.

3 - Yes they were sent to the lab the testing was not completed when I left the hospital & they were testing the bone as well so they d/n want to give me up the bone just yet I had asked for it My extra cervical rib. I imagine this will be disclosed to me upon my return follow up Doc & hospital is in Knoxville I am in Memphis they are over 6 1/2 hr's away 7 if you stop each way so ... I dont go back til Sept 25th & Cant drive til AFTER then which is already hard after only one week. both muscles wer torn is the guess when I hit the fence last July in 08 & hyerabducted backwards & broke my 5th rib over my heart & thats when I was raised up significantly higher on my L shoulder line & it never went away. I am now even again.

4- NO I have difficulty & I got worsening of my actyeletisis -spelling I got water in the L lung & it is still a battle I now wheeze when I lay from the L lung & never did b/4 I have a call into my doc who did the surgery for oxygen to help expand this lung and continue with the spirometer. I still have alot of chest tightnesss & some pain there but the big pressure above is gone That the subclavian artery was getting tremendous pressure on that & the nerves is relieved, just sore sometimes nerves healing still etc.

5- My normal vits includ Vit E MSM. Percocet is VERY little amt. I asked for lower than the 10's I was being given i have 7's when I was in the hospital & started backing them down - I cut the 7's in 1/2 ALSO my choice & take only 3.5 that way & even then sparingly!

I normally take only one at nite as I get sore laying down best position is to sleep on my back which is hard to do all nite long for me, sometimes I take a 2nd 1/2 of a pill at nite middle of the nite when the 1st wears off & I wake up. some nites I have tried nothing & have had days all day long with nothing. Last nite 10 days out fropm my surgery at bed time I took NONE got me thru 6 hr's sleep IF I over do it I may take a 1/2 of one during the day but this I try to not do. One week out now IF I am careful no typing with it & not using it for alot other thn writing then i just take no pain meds other than one 81 mg aspirin for clots - he wants me to stay on that.

I am ltd to what I can pick up weight wise to 5 lbs & I noticed certain poisitions leasning forward or beding ovedr alot in a days time tweak me up so avoiding for now & I m doing OK getting stronger I had a fairly active day hub took me out for a 3 hr drive we looked at houses & stopped a cpuple of places & I made dinner a homemade meatloaf & managed to slowly use my hand to cut carrots

Laundry is harder need help as too bulky & heavy to pick up espec. wet for now. & aarms up etc in pulling them out.

YES I remember Veggy matic

I have a scar by my neckline & it adds to my 2 front & back scars & my R hand scars - I dont like it as this shows but considering the anuersym we do what we must I consider myself lucky that I came thru b/4 the artery burst it was flat with a big balloon & I was a time bomb Angels worked OT for now to keep me here.

Met a man yesterday who asked me as I wear a sling so as not to be bumped & if I am walking around for long for support for now - he had a artery repair his aorta few mo's back so it happens more than we think - justr mine had compression not due to plaque etc, My Mom had this extra bone we think as I looked like she did she died of a anuersym only 4 yr's older than I am now - I say she was y angel I kept feeling I was at risk in this process & kept feeling a niggling voice - sometimes I was ,islead & assured by docs iun the end this warning proved to be true - proving we know our own skin better than they often do.

Best - Jill

[cavalier]

My concern is the overlap of someone having Cervical issues / TOS issues they really do mirror one another so it can be someone can have the wrong surgery or maybe not the most pressing surgery especially if they have cervical findings on MRI.

Am posting this for a bit more info on TOS -

Subject: 3 points good explanation for what happened to me. perhaps it can help someone else.

Thoracic Outlet Syndrome

What is Thoracic Outlet Syndrome?
Thoracic outlet syndrome is caused by compression of the artery, vein or nerve in the thoracic outlet (the area just above the collar bone, between the neck and the chest.) 1- *Sometimes the compression is caused by an anomalous (extra) rib or abnormal bony anatomy after a clavicle (collar bone) fracture or shoulder surgery, or sometimes it is caused by enlargement of the scalene muscles of the neck. Many people with TOS have a history of whiplash trauma (motor vehicle accident, fall or assault) or repetitive activity of the arms (word processing or filing), particularly overhead activities (lifting).* I had a couple of MVA’s & a fall when I broke my 5th rib July of 08. plus the extra rib, along with many yr’s of painting, typing & lifting grooming etc.

Symptoms are dependent on which structure (artery, vein or nerve) is compromised.

Nuerogenic (nerve related) TOS is the most common (over 90% of patients) and is often the most difficult to diagnose and treat effectively. Patients have burning pain in the shoulder and chest wall area and/or shooting pain (a "pins and needles" sensation) in the arm from the compression of the nerves of the brachial plexus. Pain can severely limit the movement of the arm. Hand weakness can also develop over time.

Venous (vein related) TOS involves compression of the subclavian vein draining the arm. It can produce arm swelling, fullness in the armpit and engorgement or prominence of the superficial veins of the chest and shoulder region. Sometimes compression can cause venous thrombosis (blood clot in the vein) which leads to permanent venous damage.

2- *Arterial (artery related) TOS is the least common type of TOS and involves compression of the subclavian artery which supplies blood to the arm. It most often causes subclavian artery aneurysms, which can result in emboli (blockage of small hand arteries from a blood clot that breaks loose from the aneurysm). Patients may develop numb, cool or blue fingertips. Less commonly, subclavian artery compression results in arm pain or weakness with the use of the arm.* (This is what I had along with nuerogenic see above the arterial problem for me included all of this even the last statement of arm pain & weakness with use of the arm. I also had the venous issue as a side affect of the artery compression see above, as I had the armpit issue & prominence of the veins in the chest towards the latter part. I was very compressed in the words of my surgeon.)

How is Thoracic Outlet Syndrome Diagnosed?

TOS is often suggested by symptoms and physical examination. X-rays can show an anomalous rib or bony abnormality. Nerve testing is sometimes performed to assess nerve damage. Venous TOS is diagnosed by positional venogram. During this exam, contrast is injected through an intravenous line in the arm and used to outline the vein while the arm is moved above the head to maximize compression on the vein. Arterial TOS is diagnosed by angiography. This test involves inserting a catheter into the femoral artery in the groin, guiding this up to the subclavian artery supplying the arm and then injecting contrast to outline this vessel to detect any aneurysm or blockage.

How is Thoracic Outlet Syndrome Treated?

The cornerstone of treatment for neurogenic TOS is specific physical therapy beginning with breathing exercises and attention to posture. Transcutaneous electrical nerve stimulation (TENS) is often helpful. 3- *Surgery may be indicated in severe refractory cases and involve removal of the unusually large scalene (neck) muscles, scar tissue around the nerves, and any bony abnormalities. Although in carefully selected patients the initial surgical outcome is excellent, symptoms return within a year in as many as 25% of patients, presumably because of scarring around the nerves.*

Arterial and venous TOS are usually treated with surgery, which involves removing the scalene muscles and first rib. Often angiographic techniques are employed in conjunction with surgery to dissolve blood clots or angioplasty (stretch) or stent the involved vein or artery. Prognosis is excellent in most cases.

From - http://www.camsf.com/vasc_thoracic_outlet.html

It just figures that I stumbled across this now, rather than sooner this would have helped me out A LOT. IT nailed everything, but also echoes what my surgeon who I said yes too did. It was written very well I thought. I came across this looking for a question I had on recovery

Jill