First rib resection due to DVT
Posted , 8 users are following.
Hello to you all,
I need advice from good people here J
Here is my story.
I am a health 27 male.
Last year, after training for a half-marathon I experienced some pain in my shoulder area. At the time I ignored the symptoms and continued with the training.
This continued till one night my arm went purple and very swollen. I went to A&E and was diagnosed with subclavian DVT. They put me on Warfarin and sent me home. The next few months I continued with taking Warfarin and my arm improved pretty much to normal appearance within 2-3 months. After they checked all the blood work I did (and all was ok), they sent me to do MRI scan with the dye injected.
After that I saw a vascular team once and they said I have significant narrowing of the subclavian veins only when I raised my hands. Both arteries look fine. This is the case on both sides. After that they offered me a surgery, but didn't really push for it. They said it is surgery (first rib resection on both sides) or I would need to down my training and to be careful with any future intense physical activity + to keep taking warfarin.
I must say I don't have any pain or any other significant symptoms. Sometimes when I run (I still do), I feel some pain in my shoulder area but it's not too bad. (3 or 4 out of 10).
Reading all the experiences on this forum, I found that most people do the surgery because of the pain or other symptoms. I didn't have any symptoms apart from DVT and I have very occasional pain in shoulder area.
What are you thoughts on this? I am mostly afraid that I would feel much worse after the surgery than now. But on the other hand I don't want to risk getting another clot or bleeding due to taking warfarin.
Any good surgeons dealing with vascular TOS in UK?
0 likes, 22 replies
Simurgh
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a26543 Simurgh
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The good news is I have a restored full pulse on that arm now. No pain like before or numbness. My hand used to always be cold and now it's warm. It did work but wow....what a recovery! Can't wait to feel normal agin.
Simurgh a26543
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Thank you so much for sharing your experience. I really hope you will be getting better soon and active. I am sure you will!
May I aks you in which hospital did you have the surgery, and if you know the doctor's name? I am being seen in St Georges Hospital. They have quite a good team there.
a26543 Simurgh
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Simurgh a26543
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I dont have the problem with the artery but veins. My arm doesn't lose pulse. Surgeon recommended the surgery but said it isnt imperative or urgent.
I am still making my mind. Its a difficult descision as I dont have any pain, but I need to stay on blood thinners till I decide.
a26543 Simurgh
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Simurgh a26543
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a26543 Simurgh
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a26543
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eddie25439 a26543
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I see that you had this surgery done about ten months ago, mine was almost six months ago and I still randomly (once a week) feel a sharp shooting pain from chest area down to my elbow (where they went in for the angioplasty), sometimes the pain is just in the chest area, and sometimes in a random area so I was wondering if your pain was the same and if it was did subside with time?
Best,
Jules100201 Simurgh
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Simurgh Jules100201
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Thank you very much for your post. Much appreciated! Could you tell me who was the surgeon who did the surgery? UCH is very close to the place I work and I can maybe seek to ask for the opinion.
Basically I had two suregons seeing me. First one was in Royal London Hospital and they suggested a surgery. I was a bit reluctant as they said they don't do too much of those (maybe up to 10 per year). Then I reach to Dr Ian Loftus who I found to have a specific interest in TOS and he himself did over 100 of TOS surgeries. He suggested I don't do anything at the moment as my collateral veins have a bit unusual pattern and there is some risk to damage them if they do rib resection. Also my vein is patent and the stress is only in certain positions.
I myself didn't had a lot of problems. Sometimes when I run more than often I get some tingling in my shoulder area and some pain, but it usually goes away in a day or two.
I am still on Xalerto and thanks God it works great for me. Since I begin to take it (almost 2 years ago) I had zero issues with it. I didn't like Warfarin.
So yeah.. for me it's a bit of a waiting game. There is no concensious on the treatment. I do understand the most important thing is to have someone experienced to deal with it.
Jules100201 Simurgh
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sand.county Simurgh
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Simurgh sand.county
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I was diagnosed almost 2.5 years ago. I have gone back and forth should I do the surgery. At the end I decided not to do the surgery for time being.
I don't have any major sympthoms. My arm feels fine 95% of time. I do run quite often, but I don't lift weights. I do excercise withouth lifting from time to time.
Having said all that, I stayed on blood thinners all this time. I switched from Warfarin to Xalerto and that was great for me. No side-effects at all, I can eat whatever I want and generally feel better on it.
My hematologist is fine with me taking xalerto long term. I understand the risk associated with it (bleeding + there is no quick anti-dote for xalerto).
Anyhow for me the decision was not to do the surgery as there is non-zero chance I would be worse after the surgery (nerve damage, vein damage, etc..)
My advice is to try not to stress too much over it. Belive me, I KNOW that's not easy. Chances are you are going to be fine either you decide to do the surgery or stay on blood thinners. I recommend you get the second opionon from vascular surgeon and also do venogram. That will tell wheter you have TOS or not. Also it will tell if your artery is fine. If artery is compressed that is the most serious problem.
"Excellent news" for you is that you don't have pain that is assocated with nTOS. People tend to have much more problems with nerves compared to veins.
Take it easy - day by day, week by week. It will be fine.
Let me know if you have more Qs..
victoria93724 sand.county
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How are things going now sand. county? I am also a runner and am very active. I suffered a DVT in subclavian vein in April 2015, and am still on thinners. My shoulder/neck pain started to worsen when I started getting into triathlons, and eventually ended up with a subclavian DVT while travelling. I have been on Xarelto since ( they took me off after 4 mths but I ended up with small clots while travelling again so they put me back on it ). Basically the discussion of surgery has been ongoing and I decided to have it done on Jan 11, 2017 so it's coming up! I'm super nervous, and hoping I'm making the right choice as I want to continue to be active. The pain I experience is bearable, but it does affect my daily life as I feel that it holds me back. Also, I am an optometrist and am doing alot of overhead motion through the day. I have only been practicing 4 years, and want to have a long career, so the doctors felt this was the best option. I'm just wondering your progress.
Thanks, Victoria
Victoria