Was on the fence about seeing another doc but felt something nagging still. It was simply that I felt we were missing something that until i felt this one piece was covered. My concern was my arteries. Had a apptmt but it got cancelled due to a ER on Doc's part - his sectry called me on Monday & asked I could make it there on Tues afternoon to see Dr Cassada - I took the apptmt.
Some of you may know & some of you do not but life has been turned upside down for me (again) after an accident over a year ago now. This event was the catalyst for continuing escalating problems. I had intermittent issues for TOS before this, but nothing like this. A year+ ago broke a rib over my heart - after colliding with the top of a fence. (long story) Had a lot of swelling up by my neck chest & shoulder much higher, than where I broke the rib at. Had hoped this would go away but it didn’t & over time a whole pathology has come about which has gotten only worse. This started me in seeing doc’s to try to get to the bottom of this whole mess for about 9 mo’s now with alot of conficting info & things to sort thru.
I found out one more piece of info making this trip to Knoxv’l. Am dead tired, but I have confirmation & at peace on what I must do now - scared sure, but I myself feel I no longer have the luxury of choice in the matter. Unless i find out a miracle way to remove this unstable cervical rib from my nerves & arteries.
Have my L.cervical rib moving when I move, & can feel it at times doing so, This extra rib isnt found in most people - most have only a 1st rib. I have felt it move - when my puppy dog stood on my chest which I cant tolerate for even a sec. He loves to do that and then put his paws around me for a hug but I have to avoid it anymore. One way I knew it was worse was I almost fainted it is so bad. Pain & pressure is mounting there. Was worried if it this extra rib was moving - yes it is & downwards. Not stable anymore.It is laying on & directly pressing on my main arteries on that side of base of my neck into the shoulder. One test that showed my artery as being clear with the rib right next to it,but the test was done with my arm by my side - problem is the cervical bone is moving around when I move & so is compressing. If I lift up my arm or hold it outwards - which the Doc in Knoxville said if the doc’s here knew what they were doing would have done the test with my arm in different positions. Have had massage & rough acupressure to that area for the last month, but the pressure has been greater I have wondered if this or coincidence. He said I am lucky I am alive. He's the FIRST doc to notice this as I stood in front of him & without my having to say a word, he said I can see your artery pulsing due to the cervical rib that has shifted downwards & is out of joint - it is resting directly on that artery.He lightly could feel it moving the rib outwards & down. He said whether he does it or someone else this rib MUST come out & NO LATER than one month take aspirin every day, high risk of a aneurysm - which I was worried about since last July, but the test gave me a false info. When I saw the TOS doc in St Louis he said only Neurological & risk of perm nerve damage but it was looking at the one study done by my side, which he too said should be with the arm up. Some doc’s rely on tests too much - they are not always accurate. Maybe it was not as apparent that day it is intermittent. Any doc could be wrong, but afterwards I cried as I feel he finally nailed EVERYTHING in being prepared for dealing with an aneurysm when he goes in. He noticed the right side too. We both agree the left is immediate 1st priority. He said the right has cartilage where the Cervical rib would be that is still taking up the space so compression there too but not the degree of swelling I have on my left.
He got that when I hit the fence, my arms hyperabducted backwards I said yes they did. He agrees with St Louis Doc that I tore the 2 muscle groups. Thinks I can leave the 1st rib, unlike ST Louis who wanted to remove both ribs. But both muscle groups will need to come out so both agree there he said if Ieave them & cant get the adhesions away by manipluation I then risk a 2nd surgery there.
The St Louis Doc has done 100 of these surgeries - Dr Cassada has done over 500 of these, he has lost count now. He says about a hr & ½ for the surgery be in about 3 days in the hosp & then another 3 to 4 more days there in the area b/4 traveling back. IF I am doing OK & the X ray looks good, can them ride by car going the 7 1/2 hr’s home we loose an hour in the time change. He was back patient himself & perhaps that is why he said doc's in general dont do enough feeling around before they make decisions.
If risk of aneurysm, whihc I e then no way around it as I had read up on this to know then surgerbelieve is real, so I agree with his findings then this must be considered. The longer I wait the riskier it is. He is on vac. next week but his surgery schedule is already booked til the 19th of Aug. I called home afterwards - we both felt do it on the 19th - Called them back & booked the 19th for the surgery. I knew if Arterial I had to put urgency to this. He said this has gone on for too long & you really need to do this in a month’s time at the latest whether it is him or someone else. He said think about it, but he said dont ignore this. Seen 3 TOS Specialist doc’s now, & phne with Dr Sanders, besides a few other specialities & ALL agree I need TOS surgery. I cant change this compression of the arteries & nerves with the bone laying on this. He said PT nothing can change that. Has to come out but so will these 2 muscles groups too (did blocks to both muscle groups & defintely affected.) I have to do my right side affected too so will see but once I get recovered with my left, unless I get lucky & that abates. If I can use my R less maybe by getting my L back. This doc I feel got all of the details down & drew everything out but also really looked at me in being even more observant, has a quick keen eye. Felt he picked up a bit more than the last other doc’s visit without having to spend as much time. Feel it indicates being very sharp & nimble on his feet to have such a good grasp, that others had yet to pick up. I feel this is the one not sure exactly why but I originally felt maybe my doc. Each doc I gleaned a bit, but also put in a lot of learning & living with this as well, told me even more, so when this guy nailed it WITHOUT my having to tell him & he got the whole picture - I finally felt he has a handle on ALL of it. Cried when I called to Hub to tell him - as I have felt this for so long now - had said all along my arteries are at risk it is the one right up by my neck. Had a conclusive test that showed 2 arteries in my hands as being blocked, I kept saying before this you need to trace this up higher source is up by my neck. Bawled my eyes out as I had felt my Mom kicking my butt trying to warn me not to ignore this, that this was emergent & to not have history repeat itself. She didn’t want this to happen to me l felt, as we think (she died 4 yr’s older than I am now) of a aneursym. You see doc’s & get passed around for a bit - but I c/n shake this. I have come this far & am still here
Want to let you know I CANT use either arm for a min. of 3 wk’s after the surgery & very strict - which matches what I read in order to keep down the risk of scar tissue as when you use your right arm it still moves muscles around on your left. The St Louis doc was going to have me use my left arm lightly after the surgery. Am aware of one side makes movement for the other side - with both sides being messed up, I can feel that as opposed to when things were normal. 3 wk’s I cant use e-ml or do any typing and for now I am just going to take it easy. For those 3 wk’s minimum post-op I cant do any housework or even make my own meals nothing ! Not even using my R. hand - That’s going to be HARD. Last July I showed Hub my artery jumping & saying this is just not right - my artery is trapped I said this is messing up my BP & yet when I tried to tell Doc’s they d/n listen. This is not a common pathology & most doc’s have no idea what is going on. These doc's can read a Cervical MRI but the spine doc's dont seem to know as much about TOS yet both can affect the neck. It takes a good deal of sorting out when you have abnormal Cerivcal MRI but will address the most pressing 1st. You need a good Vascular Cardio Thoracic Doc, one who knows Thoracic Outlet Syndrome as well. This doc said for sure the compressed artery affects the sympathetic system & explained it all, but basically I already had the idea.I had kept saying mechanically this is why my BP is up down & normal & is unregulated & nothing med’s wise could control it.
Angels have been busy working OT to keep me here.
Now it is time for me to do my part to see if I can have a bit more time here still. J Got no sleep prior to leaving & up in Knoxville,deep pain from the arteries in to my hands just wont let me sleep. Could not use my left hand at all in driving & my right was white hurts like crazy. Don’t know how I did it. Hub had just taken off & did all of the driving last week for ST Louis. & needed to get caught up on work, which I need the insurance for. Insurance does not like to pay for this surgery it is expensive & risky so say a prayer that goes off without any delays as I need to have this done unfortunately.
At high risk for an aneurysm and needs to have surgery to remove a rib that is pressing against an artery ASAP. Of course, then tell me the first date they can get her in for this surgery is Wednesday August 19th. Will be in the hospital through Friday or Saturday, and then has to stay in the Knoxville area for a few days after that.
Once released, be back at home just watching the dust bunnies collect. It will be hard doing nothing.
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