My daughter had bilateral rib resection (removal) about a month ago by a
fantastic vascular surgeon in Tulsa. She is doing great; now in Physical
Therapy. Her left sided TOS was (we believe) from a scar tissue concern, and
the right sided TOS was (we think) from a tangled nerve/arteries.

Either way, simply removing the first rib on both sides has done WONDERS and she
is mostly recovered. The left side had been a problem for over a year and was
very serious. The right side was probably 9-10 months along before surgery and
had a "complication" just a few weeks before surgery, so it is recovering much
slower.

Her surgery was supposed to be 60-90 minutes long, but it took almost five
hours. She is very light weight (thin) and apparently did not want to give up
those ribs! So the doctor had a quite a time getting them removed. Entry was
under the arm pits and she has scars there that are now hardly even noticeable.

We visited her Pain Management doctor last week and he gave her samples and
prescription for Voltaren (Diclofenac) gel. Apparently the gel is fairly new.
He prescribed 5 large tubes ($32 a tube if insurance didn't cover it) for her
and we are waiting for Prior Authorization on them. She is not taking any other
meds at this time and that is a real blessing!

Bless her heart, she has really had a rough year! We are thankful that she is
having success and now we can concentrate on the more recent right side
incident. It is regrowing nerves and right after surgery it was very obvious -
she had bruising as the new nerves had increased circulation and it was not
painful, just looked worse than it was.

She still has problems with specific motions with the right hand. During PT,
using heat to loosen up the shoulder joints and arms is proving highly
beneficial. Without heat, her improvement is much more limited. She has just
two more PT visits in this round, and we will probably wait 2-3 weeks with the
new exercises and then request another round of PT.

One of the things the PT assistants have her do is "walk" up the wall (or door)
with her finger tips and see how high she can get. Then they put a piece of
tape where she gets the highest.

They also do the "genie" stretch, which is a new thing. It is taken from the "I
Dream of Genie" show, because the exercise starts with arms crossed like Genie
would do, and then stretches fromo one side to the other, slightly pulling on
the elbow. This really helped her range of motion come back quickly.

This week they added stretches with the yellow plastic tie things and some of
those are difficult because they are "balanced" resistance when she uses both
arms.

She has to concentrate on rotating her shoulders backwards and holding in the
scapulas so they don't "wing out" during exercises.

She is also doing a few stretches with light hand-held weights to work out the
stretching in many directions.

Is there a place on the internet that shows PT stretches and techniques? I
haven't found any. Maybe we need to organize some and take photos to show what
my daughter is doing. These are very simple and almost anybody can do them at
home. They are really making a difference in her recovery!

Debbie Dahl


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