Thoracic Outlet Syndrome
Posted , 14 users are following.
Dr Hugh Gelabert
This vascular surgeon at UCLA is the first second and third choice of surgeon I would recommend for this condition. Well worth travelling for from anywhere
Best at diagnosis.
Best at explaining.
Best surgeon in the world.
Meticulous to the extreme.
High volume operator, but with very personal touch.
How do I know?
He operated on me twice for neurogenic TOS. Two weeks apart.
No complications. Amazing recovery.
I feel reborn.
I have my hand functions proving every day.
0 likes, 41 replies
ComedyOfEris lsurgeonpatient
Posted
I've been repeatedly diagnosed, but finally offered some solution in rib resection and partial scalenectomy but an experienced surgeon I trust very much. (I developed neurogenic and vascular TOS through chronic arm dislocation after a kayaking accident, yanking out my arm and causing a stretch injury in my brachial plexus and long thoracic nerve.)
Before my accident I was an avid climber and weight lifter. It's been 2 years of total disability, not able to live on my own, but I'm still Really worried about returning to overhead activities after surgery.
Do you find any troubles doing things over head? Can you hang from your arms still? Does your physiotherapist think you will be able to return to lifting heavy weights? What about pulling or rowing motions?
Hope your recovery is going well, and thanks again for sharing your experience.
jess87960 lsurgeonpatient
Posted
I'm asking because he's recently told me he still feels it regularly in his left arm, muscle weakness/pain and that nerve tingling, his hands shake often, he complains of headaches in the back base (like directly inferior to external occipital protuberance) which I've read are a symptom? I just wanted to know if in your opinion/experience if this was common? Like a ghost pain or result of nerve damage, an unsuccessful surgery? I wish he would talk to a doc about it but refuses, he has done a lot of drumming/manual labor since high school and I don't have every faith in the hospital or surgeon, though he says he was a great guy he sounds inexperienced...his family didn't have another option financially.
I was hoping to hear of any ways to lessen the pain he is still living with or if this is possibly more serious than he lets on, or maybe if you guys have had the same things happen? It's just been over 8 years and I would hope the full recovery would be done by now but I'm no expert, and if he needs another surgery to resolve this idk I would have to really talk him in to even getting it looked at again.
Thanks in advance!
lsurgeonpatient jess87960
Posted
Depending on the type of surgery your boyfriend had it is possible that he has developed TOS again.
Where do you live?
He needs to be examined by someone who knows how to diagnose TOS correctly (not many people do) - I was diagnosed by a physiotherapist after I already had 3 operations on each arm to release nerves.
A physiotherapist may be able to help him improve his posture.
He may need more extensive surgery than he had the first time. A surgeon who specialises in TOS (high volume operator) will know what needs to be done.
The constant pain of TOS is like living with an elephant sitting on one's shoulders - I would definitely recommend that he sees someone to have this treated. Chronic pain spoils one's life and makes one very misearble all the time. It also affects all the people around one.
jessica86653 lsurgeonpatient
Posted
Guest lsurgeonpatient
Posted
Hi, I am so happy to have found this site. I have been experiencing TOS symptoms since age 11 (I'm 47 now). In just the past year I finally have a diagnosis of veinous TOS after a four day stint in the ICU for a blood clot in my subclavian vein. Unfortunately, the attending physician was not familiar with TOS and after finding the clot decided to talk me into having a stent placed. Within 10 days the stent was crushed and my symptoms returned.
After much research, I have seen two great vascular surgeons one being Dr. Gelapert at UCLA. Both physicians recommend rib resection surgery but have opposing approaches to surgery. One does it via transaxillary and the other Dr. does the surgery via cutting above and below the clavicle.
Can anyone give me their opinion or experience with either approach so that I can make an informed decision?
Thanks so much!!
jessica86653 Guest
Posted
Hey Heidi! I'm so glad you found this article. I posted six months ago asking for advice and didn't receive a response but my mom ended up booking surgery with Dr. Gelabert and is doing fantastic. Her affected arm is now outperforming her other arm which will need the same operation in a couple of months. Definitely at least book a consultation with him, he is a phenomenal doctor that really cares about his patients and will honestly tell you whether or not the procedure is right for you . His method of going transaxillary poses less risk and there is also less scarring.
Guest jessica86653
Posted
Thanks so much for your reply! I have had my consult with Dr. Gelabert and have surgery schedulded for Oct. I just wanted to make sure I was on the right track as the other surgeon I saw had a completely different approach. Just wanted to get both sides before proceeding
lsurgeonpatient Guest
Posted
I'm so pleased that you have seen Dr Gelabert and are scheduled for surgery with him! I had my TOS also diagnosed late in life (my early 50's after having the very first symptom in my late teens). I researched all the surgeons in the world who do TOS surgery and chose Dr Gelabert. I travelled from Europe to be treated by him.
Dr Gelabert is not only a superb surgeon, he is caring and compassionate.
He operated on me twice and I have never looked back. I had both sides operated on sequentially - via the trans axillary approach. I also had Pec. minor tenotomies ( a small cut on the front of the chest near to the shoulder) at the same time. My scars are hardly visible!
My two operations were in March 2014 - The nerve recovery is a slow process (around 3 years), but the relief is almost instant. I was back at work, and fully functional after a short time. I am however still taking Nuerontin 3 times a day and expect to do so for another 6 months. This helps with the nerve irritabilty while recovery takes place.
I hope it goes really well for you.
paul15196 lsurgeonpatient
Posted
kim06648 lsurgeonpatient
Posted
Hi Everyone;
I may not be on the correct discussion board here - I feel like i have all the sx but was told by a vascular surgeon after a normal arterial ultrasound that there is no was I can have TOS. There was no exam or history taken, but he did mention that I am older and not an althete, therefore I do not meet the 'typical' criteria for diagnosis. My question is - was anyone else diagnosed based off of an arterial ultrasound? This Dr. claims that if the arteries aren't compressed, it follows that the nerves are not compressed either. Thanks for any input you can give.
lsurgeonpatient kim06648
Posted
Hi Kim,
I also had my diagnosis refuted by a vascualr surgeon as well despite muscle wasting and on ultrasound examination showing disappearing pulses with my arms in the "hands up postion" and even with visible veins over the front of my shoulder (all signs of TOS). I then had an MRAngiogram with my arms in the stress position - and this confirmed TOS.
Someone who can't or won't make a daignosis of TOS is obviously not someone who feels comfortable operating to treat it.
I suggest you get a second opinion from someone else.
Find someone who has a high caseload (operates a signficant number of patients with TOS every year) and have another examination. That way you are sure to get the best result from diagnosis and surgery - if you need it.
Good luck.
kim06648 lsurgeonpatient
Posted
Thanks so much for your input. I went to a top Dr. at Stanford who supposedly works with TOS patients and has performed many operations. We drove 10 hours to get there only to find the dx turned down based on one test....he didn't even do a history or look at my aching shoulder. Anyway, his claim is that there can't be nTOS without arterial TOS, because the compression that blocks the nerve also blocks the artery. Have you ever heard of this before? Because I thought that by far the highest number of cases are nTOS. Thanks for your support - I found a guy at UCLA and we'll see what he says!
bowler01 lsurgeonpatient
Posted
bowler01
Posted
jayglo lsurgeonpatient
Posted
Hello, I realise it's been a while since you posted, but I'm just keen to pick your brain a bit ... You have obviously experienced TOS for some time and will understand it better than most ... I have had the right side done (5 weeks ago) ... I presented originally in july 2016 with all the usual symptoms including severe anterior chest pain, pain radiating down the right arm, tightness in various muscles in the back, blue discolouration of the right hand etc ... However, I have also had weird cramps in the muscles of the back and am having similar weird cramps in the muscles on the left now too ... Did you also get muscle cramp / spasm as part of the TOS ? It's very odd and unsettling - so when I activate the muscles for whatever reason, there is a very slight delay then this intense slow cramp develops which almost catches my breath it is so intense
Although I don't have any other symptoms on the left (other than severe cramping) I'm guessing I am affected on the left side too ...
I would be interested to hear your experience - to see if you too have experienced this weird cramping sensation too - and if so does it settle?
Thanks so much