After thoracic outlet surgery

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Hello, new here. My 27 year old daughter is just home from hospital after having her first rib removed 4 days ago.

My question is, when should she be starting to do small exercises. Her neck is stiff and she is lifting her shoulder, to in some way keep her incision area from moving. I want her to relax it but the pain is of course making it difficult. I am concerned if she keeps her shoulder and neck tight and in this same position she is going to have more difficulties to loosen it up.

Any experience in this?

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  • Posted

    Hey,

    I had my surgery October 27th, 2015 and I was in pain for a good three weeks. Your best bet is to get that info from the doctor who performed the surgery. I was moving my arm freely within few days of the surgery even though I had a constent pins and needles feeling in my arm for 6 weeks.

    Best,

    Eddie

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  • Posted

    Hi Kathy

    Best wishes to your daughter! I had mine removed about 3 weeks ago. The limiting factor in movement is the wound/scar - she should move gently as much as possible, without in any way feeling that the wound is pulling. It can take around 7-14 days for it to fully heal, and it also depends on the closure type. I had glue, which I think is the norm. A professional should sign off on her wound being fully healed to be on the safe side.

    Best thing for now is to walk a little, and frequently, allowing the arm to swing normally, with the shoulder relaxed - takes effort and focus, but the aim should be that no one would know which side had been operated on when she is walking... this gives a great mental focus.

    Once the wound is healed, it's vital she gets really good physical therapy (and maybe chiropractic) to get back her range of motion and to break down scar tissue. Try to find someone who will use a class 4 laser to aid this breakdown and repair. And also see if they can use a tool called a graston, used for stripping down the scar tissue. They'll also give her lots of exercises to do at home. After a couple of weeks, get walking, especially gentle hills, as much as allows.

    All the best!

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  • Posted

    Hi Kathy

    Dont worry, I did exactly as you describe, as your daughter with raising the shoulder as it seemed to protect me somewhat from the pain and the muscle spasm increased when trying to relax, so there wasn't much of a choice in it. Gradually it decreased over the first week post op and then two weeks post op I could relax my shoulder almost fully.  I am now four months post op on the right and three on the left and I do not have any movement issues of my arms anymore.  Physio and keeping moving is important but it takes a while to let yourself do it as it can scary testing out the pain levels for movement.

    Emotional support for your daughter may be more important than physical at the moment. She will gradually reflex with time but she has been through a lot and I found that sometimes the combination of lack of sleep and pain killers would make me tearful.

    I hope her recovery is speedy.  One day at at time is the best philosophy to adopt.

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    • Posted

      Hello Jules100201

      Thank you for your response! You are so right with regards to the emotional support! Lots of tender loving care goes very far.

      We will I am sure get instructions from her surgeon at her follow up and perhaps after a day or two she will start relaxing a little on her own as she healssmile

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  • Posted

    Hi, I had mine done just under two weeks ago. I'm 22. I was given an exercise leaflet two days after the rib removal, I couldn't move for atleast two days. I was hunched up and stiff as a board. I came out of hospital on the 5th day. I was advised to start doing the exercises immediately, to start to loosen things up. I've also got an appointment with my physiotherapist in a few days. Neck movements, shoulder, and hand exercises I've been doing everyday every hour of the day, and then every half hour 5 deep breathes. At first it was hard but the stiffness starts to go and you do loosen up abit. Start now with the exercises and also go to see your physiotherapist. It's vital to start exercising now so you won't stay stiff. With the pain just keep on top of the medication I was in pain for about a week then it started to go everyday is a new day and it'll get that little bit better. Hope she starts feeling okay soon. Hope this helps. smile

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    • Posted

      Thank you for your response Benny Jay!

      if you can, could you let me know what neck and shoulder movements you began with. Only if it's not too much trouble!

      She has to call her surgeon office tomorrow anyways so perhaps they will let her know then.

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    • Posted

      That's no problem. Yes of course, I'll try to explain as best as I can.... Tilt your head to the left so your ear is nearly touching your shoulder, then same to the right (10 times) then look to the left so your chin is inline with the shoulder then same to the right (10 times). Shoulder ones: put your shoulders back so you are squeezing your back muscles together (10 times) shrug up (10 times). Roll shoulder forward (10 times) roll backwards (10 times) This next one you stand up raise your arm straight infront of you asif your going to shake someone's hand but go right up so its inline with your shoulder and then back down to your side (10 times) then put your arm out to the side asif your a bird going to fly all the way untill inline with your shoulder and back down to the side (10 times) I hope I've explained them okay. Anything else I can help with please ask, I understand how hard this all is.

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  • Posted

    One more thought...

    Someone mentioned deeper breathes, and it's a great point! Stand up, relax shoulder, gentle pull shoulders down and back just a little. Imagine opening up your rib cage. Breath in deep through nose for a count of 3-5. Hold breathe for 1-2. Breath out through pursed lips (making almost a whistling noise!) for 4-6, then repeat, keeping that great posture in place. Maybe hourly for a minute or two. Helps the lungs inflate properly, and improved oxygenation of the blood and therefore organs, which aids recovery a surprising amount!

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    • Posted

      PS. My frighteningly bad mixing up of breath and breathe is totally the fault of my meds and tiredness, not my fairly solid education 😁

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  • Posted

    Hi! I'm a 39 yr old female... I had surgery March 27, 2016. I didn't move from the couch for a few days either aside from going to the bathroom, etc.  I'm still healing. It will take awhile. For me, I felt immediate relief and as time passes, I continue to do my exercises, the pain has pretty much gone completely (except if I sleep on it wrong). The numbness is still prominent but not as bad as it was. I have also had stretches of days where I feel NORMAL again. My advice: YES, she should start to stretch herself out. No lifing. I was in school again after 5 days. I couldn't wear my backpack, had to switch to a bag on my right side (I had left cervical rib removed). I have chronic pain anyway because i have Psoriatic Arthritis. In this way, I'm used to pushing through the pain. One exercise that my surgeon gave me, and I passed on to another on these boards, is to use your (her) fingers to walk up a wall. This helps with mobility and range of motion. It will also help stretch her out and she can do this a little at a time at her own pace. It is actually fun to watch how much progress you make. It's a confidence builder to help adjust. Hehe I left my bandage on until I saw my surgeon... this wasn't necessary and in fact, as long as the incision is closed she shouldn't be concerned about moving it. It hurt for quite some time on touch for me, longer than I expected. Sometimes if I'm wearing my seatbelt for too long, it will begin to be sore also. I'm a fan of epson salt baths as well. Another tool is lidocaine patches, or Tiger Balm patches (these work best but are super stinky). I'm sure she's still on pain meds but for switching off I'm a fan of Tramadol for pain (non narcotic) and Lyrica for the nerve pain and numbness. Hope this helps.

    Here is a link to another board on here started... http://patient.info/forums/discuss/thoracic-outlet-syndrome-532273?page=0#2301264

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  • Posted

    -Is she taking something for muscle spasm, Valuim works great a lot surgeons overlook it.

    -she on a coarse of steroids? ( helps the nerves settle)

    - some people want you in a sling I found it kept my shoulder shrugging... I did wear it sometimes to prevent my from picking things up

    - honestly first 16 weeks is a about getting your range or motion so stretching either active or passive....take the pain meds 30 mins before if you need to, double the dose of you have too (fear of addiction will prevent people from taking and doctors from prescribing meds) if your pain is triggering you to take the meds it's ok

    - the trick is not overdoing it and causing more SCAR TISSUE from developing from lifting to much ect.

    -she should be gently stretching her neck, if you don't move it skin and stitch's ( skin is elastic and meant to be pliable you don't have to be afraid to move tear them, they are stitched deep under the skin and probably glued superficial...not moving it will make the scar harder and more noticable later) not saying go crazy gentle stretching it shouldn't hurt

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    • Posted

      She is probably in a emotional/psycological rollercoaster if she doesn't feelbetter yet and in crazy pain. My pain wasn't that bad post op but everyone is different

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