Are You At Risk For Thoracic Outlet Syndrome?

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NY Mets pitcher Matt Harvey is set to undergo season-ending surgery for Thoracic Outlet Syndrome (TOS). It might not be a condition you've heard of, but if you work at a desk or have a job that requires overhead lifting, it could already affect you. Below Lina Wiley shares her story.

In early 2015, 21-year-old University of Central Florida student Lina Wiley woke up with intense shoulder pain. She thought perhaps she had overdone it at the gym the night before. However, the pain persisted throughout the day and veins in her shoulder became more pronounced, turning bright red, then purple. A trip to the emergency room uncovered a blood clot.

I met with several doctors and felt like none of them really knew what was wrong me, says Lina. Then he was referred to Dr. Farid Gharagozloo, MD, a thoracic surgeon at AdventHealth.

I met Dr. Gharagozloo and within five minutes he diagnosed me with thoracic outlet syndrome. He explained how a rib was pinching my vein causing a blood clot. It was such a relief to understand what was going on.

Thoracic outlet syndrome (TOS) occurs when blood vessels or nerves in the space between your collarbone and first rib (thoracic outlet) become compressed. It causes pain in your shoulders and neck and numbness in your fingers. If left untreated, it can cause blood clotting, such as in Lina's case, and damage to the nerves/blood vessels.

Some people are born with a deformity in the first rib that causes it to clamp down on the nerves and blood vessels passing through the area. Other common causes include poor posture (slouching, looking down at video games or smartphones frequently, or carrying too heavy bags); physical trauma from a car accident; job- or sports-related activities (such as tennis, volleyball, baseball, swimming, and weightlifting) that require repetitive motions of the arm and shoulder; anatomical defects (having an extra rib), and pregnancy. It can affect you, regardless of your age or gender.

Most people improve with physical therapy and pain relief. When that doesn't work, surgery is the next option.

Lina's relief came in the form of minimally invasive, robotic surgery.

This is a very complex surgery to execute and cannot be done without a robot, explains Dr. Gharagozloo. The bone I needed to reach is one-inch deep into the chest, so a special robotic device was used to reach and see the rib that needed to be removed.

The surgery was successful and Lina is happily back in school.

It is a mission of mine to spread the word about Thoracic Outlet Syndrome eight percent of the population has this condition, but its often overlooked, says Dr. Gharagozloo. Most patients are young women who don't receive the help they need. They can end up taking strong pain medications, which don't offer a long-term solution.

Dr. Gharagozloo urges anyone with persistent arm pain to seek medical care to determine if they have TOS. A magnetic resonance angiogram (MRA) or magnetic resonance venography (MRV), two non-invasive, painless medical tests help physicians diagnose and treat TOS by providing clear images of blood or nerve blockage, and more importantly, help predict success with robotic surgery therapy.

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