First Rib Resection - understanding side effects after surgery
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In October 2015, I underwent a first rib resection after being diagnosed with Venous Thoracic Outlet Syndrome (Subclavian Compression v. Nueral Compression). My case was fairly urgent as the blood flow was limited to roughly 10% thru my subclavian vein. I was very lucky as I did not experience any typical symptoms such as a swollen arm due to clotting. I originally went to the doctors because I had a pain in my lower abdomin, which I thought was pneumonia coming on. I tested positive for D-Dimer (results around 2.0+), therefore my doctor immediately sent to get a CT Scan to rule out a blood clot. I did not have a blood clot, but this is when they did discover the unusually narrow vein. The doctor advised I see a Thoracic specialist.
The surgery went well. I was in the hospital for 2 nights. Recovery took about 4-6 weeks before I could go back to work full-time. I underwent PT for about 2 months, starting 1 month after surgery.
However, since October I have experienced a number of side effects including:
1. Horner's Syndrome. My right pupil (side of surgery) is still noticably constricted.
2. Numb arm due to damage of the long thoracic nerve, a constant roller coaster of sharp, acute pain and soreness near my right breast bone (I had my right first rib taken out). I want to understand if the pains I am feeling 6 months later are a normal part of nerve regeneration and if anyone has a similar experience, how long they last? The pain seems to come on and off all day. Some pains (acute/shooting) mainly in the mid-section of my right arm. The under side of my arm is still numb to touch.
3. Another pain I experience is near my second rib, where it attachs to the breastbone. A lower position then where my first rib was taken out, so I find this strange, the irriation would be lasting this long.
4. About 2 months ago, I started getting sharp pains in my upper lung (is the best way to describe it). When I drink cold water or other beverages it sends a sharp pain to the area. It is very strange.
5. Stuffy nose at night. Since surgery I can not breathe through my nose fully. It feels stuffy and not clear.
I have been to a few typical follow up appointments but my surgeon has not been able to identify a detailed reason for these pains besides a side effect of surgery. I understand my body underwent an intrusive surgery and needs time to heal, but I often get worried now something else is wrong, since the pains come on so suddenly and sharp, six months later.
We do not know the reason for the development of the VTOS. One of my surgeons suggested it happened when I was young, as the network of blood vessels around the vein were enlarged and carried much of the blood not flowing through my subclavian vein. The main surgeon thinks it may have happened within in the last 5 years. Typically trauma or excessive overhead movement causes VTOS, however neither of these applied to my case.
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deedee65 Ski2016
Posted
It's been almost 8 years since I had my right side cervical rib removed. My main Thoracic nerve was damaged during surgery as all the nerves and main artery was disturbed whilst disentangling from around the bone to remove it. At first I had completely lost the use of my arm but after several days it slowly returned and then I had the pain around the right shoulder blade, which has never gone away. It takes the nerves around 2 years to settle and I had regular nerve testing in that time and after 2 -3 years was told the main nerve was damaged and it would never be the same again and that I had to learn to live with the pain.
7-8 years on and I still have problems. My right arm often feels pain; I feel every single movement in my shoulder blade. My hand often feels still with a cold sensation running down my arm through my thumb. If I get cold, I hunch my shoulders and then this adds to the pain and discomfort and then I get muscle contractions in my neck which often run up the back of my head behind my ears.
Life is different now. I feel fatigued all the time, I work full time and by the time I get home I'm too exhausted to have any life. Doing most manual things exhausts me as the discomfort and pain set in. I can still do all the things I used to do but consequences of doing them set in.
I have become a couch potato.
I sit at a computer all day for work, which doesn’t help but it's what I do. When I think about what else I could do for work, there isn't really much else that doesn’t require the use of my arm, so I just do it.
Every time I get sick, it affects my right arm shoulder. I have recently had problems with displaced cartilage in my jaw and it's really added another layer on top of my existing troubles on the right side.
At 52 I don’t see it getting any better. When it gets to the point when I can’t manage the constant pain and discomfort and I have given up on having a life, I will do something about it before it totally takes away my ability to live with quality.
Constant pain is gruelling and disheartening. Without quality what’s the point of quantity?
If I knew then what I knew now I would have thought harder about having the surgery and who was doing it. I had my surgery in Sussex and I think I was one of the last patients that the surgeon performed this operation on before he retired. Do your homework before agreeing to have this operation. Check the surgeon’s experience. Be aware of all the possible complications before consenting. This is major invasive surgery that can affect you for the rest of your life. But then again you get lucky and it solves your pre-existing medical aches and pains.
jennifer30214 deedee65
Posted
Hi deedee65,
I hope you don't mind answering some question I have. I am sorry to hear all that you have gone though. My daughter had rib resection surgery in March 2018, had her rib and scalene muscle removed. Her healing and physical therapy went well and she worked her strength back up to her normal, but when the doctor went back in a month later for a follow up to check on the vein, he found that the scar tissue was ecluding (blocking) the flow of the vein. Did you experienced any of that? If yes, did you have to have anything done to correct it? If yes, was it succesfull? Do you know if there is there any therapies that can be done to scar tissue? Any help much appreciated, Thank you
charity58288 Ski2016
Posted
I just had thoracic outlet surgery 7 days ago - comprised of first rib removal, scalene muscle release & scar tissue removal, and pectoralis minor release at arm pit - due to chronic nerve pains throughout right arm/ shoulder for a year, chronic joint pains mimicking carpal tunnel syndrome & tennis elbow, as well as circulation/numbness issues in that right arm. No surgical complications noted - surgeon said I had major nerve entrapment (duh!). Nerve pains are now gone!!! (yay)
I do seem to have constant numbness at my thumb and first finger now (mostly thumb), as well as a small area of my shoulder (already improving). Major post-op pain was in my upper back directly behind the surgical area, which feels like stabbing when I cough or take a very deep breath... improving a bit now, and constant aching/ tension in all the muscles of the upper right quadrant of my back & into the right shoulder - I'm guessing this may just be readjustment to the different tension on everything since multiple muscles were cut away... not to mention I have scoliosis and it looks more obvious to me now on the right side with my shoulder dropping more. I did have that excruciating muscle tearing pain at armpit just after surgery if I tried to reach for something, but that seemed to heal quickly already... or I've just been a lot more careful about reaching out with that arm.
Good news is that I finally had my first normal poo post-op today! lol