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

    Hi Kathy,

    I have a similar condition to TOS however mine is diagnosed as PSS (Paget- Schrotter Syndrome). At the beginning of May i had my first rib removed on my right side. I was in hospital for 2 days before i was sent home. I personally found the first week the worst part of my recovery. I am left handed so i found that i wasnt as affected with mobility and being independant as i have use of my right hand. I have had no physio but i was told by my specialsit and my sister (who is a physio) that initially i need to ensure that i have movement and rotation in my shoulder. Simply shoulder rolls forwards and backwards, slight elevation of my arm forwards and sideways. Also by bending forward and allowing my arm to naturally hang down helped alot. This is very pain ful at times but by doing litlte and often within 2 weeks i almost had full rotation in my shoulder again. I would avoid lifting anything for a good 5-6 weeks. From experience i simply lifted a carrier bag which was that bit too heavy and found myself in alot of pain. Going on short walks really helped by overall fitness. After seeing by surgeon 6 weeks after my operation he gave me the all clear to go back and start to exercise. This is where i got a personal trainer who specialsies in rehabiltation. Although expensive having a professional who can ensure that i am doing all exercises correctly and safely was the best money i have ever spent. It has now been 4 months since my operation and i am stronger than i was before my operation. Even though the pain is bad at first the best tihng i can say is to keep her shoulder moving.

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  • Posted

    Hi Kathy,

    How's everything going for your daughter now? I remember her having really bad chest pain a little while ago.

    I had my surgery done 2 day ago (15th). My surgeon used the supraclavicular approach so i have wound about 4cm long at the base of my neck, was this the same for her? Im extremely surprised by the low levels of pain. I came home yesterday and only take pain killers morning snd evening, mostly to make sure i can breathe deeply. The hospital physio gave me a triflow breathing thing to test lung capacity, which seems fine. Otherwise I can move my arm quite freely, can stretch out to the side, touch top of my head etc totally wondering if this is a calm before the storm but i feel great!

    Hope your daughter (monica is it?) Is doing well 😊

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    • Posted

      Hello Amerese

      Thanks for rememberingwink.

      So glad to hear your surgery is done and successful!

      Monica is doing really well. She just had another follow up Tuesday and things are good. She is feeling good but still goes for massages to help her relax her shoulder and behind her neck. This is where she carries her tension as well so that is part of the issue.

      Her chest pain left her at week 5 and the fact you are not experiencing it is awesome and hoping it stays that way. It sounds like your recovery is off to a really good start!!

      Her incision is about that size as well and it is healing nicely. Surgeon said it will take a full year before it is completely healed. Still a lovely shade of lavendersmile. It looks really good I think.

      If you have any concerns or questions with regards to what you feel along the way please email anytime.

      Take good care, rest lots!!


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    • Posted

      Hi Kathy,

      I'm so glad to hear Monica is doing so much better, sounded a bit rough for a while there for sure!!

      I think I've just been really lucky, perhaps because the found it before clots formed, and maybe they took less of the rib than in Monica's case. Or perhaps my surgeon is just really really good. Actually i find the lack of pain a little disturbing. Monica's incision was at the base of the neck too right? I was told to expect sharp pain between the shoulderblade, headaches and difficulty breathing, but honestly I've felt a lot worse after some gym sessions 😕. I've sent my clinical nurse an email just for peace of mind, not that I'm unhappy about it, it just seem very odd.

      I have a lovely square lavendar bruise also that I cant see disappearing anytime soon 😂. Has Monica ever had acupuncture or seen a sports physio who uses dry needling? I found that worked great for muscle tension and spasms in the past. Im lucky again in that i already feel like I have almost full range of motion, can raise my arms front and sides, wash and dry my hair, roll shoulders, turn my head etc.... just 3 days post op!! Could Monica do that then? I'm hoping it's not a result of nerve damage or internal swelling or something. It doesnt compute in my brain, I should hurt but I don't and that makes me worried lol. I the flipside I wish I could give my "problem," i.e low pain, to others who are recovering.

      Hopefully Monica can find a really good physio who can help her get that motion back. Was she very active prior to surgery? I think muscle memory could help. My nurse told me to try and get into physio within a week of surgery and both she and my Dr said to start with exercises immediately to expedite recovery... Im assuming everyone gets this advice.

      Anyway, hope everything goes really well for you both from here on out.😊

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    • Posted

      Hi amerese

      You are probably a rare find on these blogs here that have such positive recovery results!

      Monica's scar is nicely lined up with her collar bone, almost tucked in there. A good location. Her collar bone is now finally starting to show again. She is slim and so her collar bones stick out and well it's nice to see them showing on that side of her body againsmile.

      Monica is not physically active other then normal living, an athlete she is notsmile

      Her range of motion was good from the beginning as far as moving her arm but definitely not enough to wash her hair and such.

      The lacking part we found at her hospital was the lack of knowledge of this type of surgery with the nurses in her ward. And the lack of what to do when you get home from her surgeon.

      When we called his office they said to do nothing until they she saw the surgeon 10 days post op which was enough time for her body to completely stiffen up.

      Doing exercises right away may have helped her with a lot of after pain.

      Hindsight is so clearsmile

      Nonetheless, she got through it and is doing well. Her physiotherapist was not the best but her massage therapist amazing! I will mention the needling to her, I have never heard of this.

      Continued blessings to you through your recovery!


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    • Posted

      Ahh sounds like Monica's Dr used the same method as mine. And likewise i have a case of missing collar bone, was thinking of putting up reward signs 😉. There's a nice mustard and lavender bruise curtain covering where it once was lol. I'm not super fit but I do enjoy a weight training a couple of times a week to break up the monotony of office work... or well I guess i DID enjoy lol.

      Lukily for me I had a brilliant doctor who is very skilled with this particular condition. Before the op he gave me a bunch of info to read and told me to ask as many questions as came to mind, either if him or his nurse. He also gave me a copy of his own first rib resection cheat sheet describing what to expect both prior to and post op, and how to look after the arm (exercises, wound care etc). He stressed the importance of gently mobilising the arm straight away and trying to recover full range of motion within the first week. If only everyone here had that too!

      The day after the op his nurse visited me and told me how important it was to start with physio 1 wk after the op. She said the people that have the hardest time with the recovery are those who wait too long for physio. Thankfully I already had one lined up who is familiar with TOS but has never had a vascular case before and is excited to help me with rehab 😊

      So I guess you're right, experience of both Dr and support staff is key. Sounds like all is going well for you guys now (bless that massage therapist!). Dry needling is amazing on really tight muscles, works like a reset button. Is kind of a type of acupuncture but quicker, deeper and more isolated. I love it! Hopefully all continues well from here on out 👍.

      Thank you for your well wishes 😊

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  • Posted

    When I had mine it was almost like a frozen shoulder after. I would try to stretch it out a little every day but not too much with the swelling. I would try to put my arm up on the back of the couch and move a bit, but don't overdo it until the dr says so. It was a few weeks later before I could move around a lot more. Just be patient and I used lots of ice packs and gentle movements. I have to get the other side done in February so will be back at square one! It'll get better soon. It's quite a drastic procedure. I wasn't prepared for the amount of pain and discomfort. But it does get better!

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    • Posted

      A GREAT stretching exercise my surgeon told me to do is to stand an arms length away from a wall and try to "walk" your fingers up the wall (with your arm straight) until the pain gets too intense. I kept doing this daily and slowly but surly I gained flexibility in my shoulder and a greater range of motion in my arm all together. There was also something about seeing my progress that made it me feel like I was healing quicker. It gave me some sort of goal.

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