The doctor indicated that physical therapy has the same chance of curing my issues as surgery. However, since I've been doing PT for almost 6 months, it is unlikely that PT alone will resolve my circulation and/or nerve issues. Therefore surgery is my only option.
The surgery involved an incision at my collar-bone and the removal/resection of my first rib. This will open up the thoracic outlet (the triangular opening between your first rib and collar-bone where your nerves and blood vessels thread through to go from your spine/neck to your arm). As long as no scar tissue blocks this opening or there isn't some other cause for my issue, opening this channel will allow more room for movement and normal circulation. Due to my mastectomy lymph node dissection, lymphendema is a distinct possibility. That is actually why the surgeon is proposing the supraclavicular incision -- to stay away from my lymph nodes. He was concerned about scarring, but since I'm a veritable roadmap of scars already, one more won't be a big deal.
Best case scenario: the surgery succeeds and with continued PT I'll regain all circulation and the nerves (and muscles) will be healed. After a two week (minimal) recovery period, I'll begin PT again to ensure the mechanics of my arm and shoulder use are appropriate. Then as long as scar tissue doesn't form in the first year or so, I'll be cured. I'll have another scar, but hopefully no more pain. The chances of this surgical outcome is in the 60-70 percent range for the circulation (not the nerves/muscles).
Moderate case scenario: the surgery will cure the circulation issue, but the nerve/muscle issues are permanent. This is still an improvement over my current state because improved circulation should stop any further damage from lack of blood supply. However, if the nerve and muscle issues aren't blood supply related, those issues can become worse or stay the same. I'll have a new scar, and have improved circulation, but I'll still have most of my current symptoms.
Worst case scenario: during surgery the nerves and/or blood vessels are nicked or injured. This could cause permanent damage as bad as paralysis or complete numbness. If only the blood vessel is nicked, grafting another blood vessel (or medical substitute) can restore circulation. I'll have a scar and new, worse, symptoms.
Of course, with me being me, there is a chance of some really odd consequence to this surgery. This kind of reaction cannot be foreseen and will undoubtably be difficult or even impossible to diagnose, locate, describe, or cure. I'm really hoping for a complete cure or even a partial one that will ease at least some of my pain. I'm praying, will you join me?
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