The Challenge: Treating Thoracic Outlet Syndrome
Lois Ballog has been a swimmer all her life. By her junior year of high school, she needed surgery to repair several torn muscles in her right shoulder, the result of an old athletic injury and years of wear and tear in the swimming pool.
After her surgery, Lois’ shoulder felt better but she developed tingling, then numbness, in her right fingers. At first she thought little of it, but in the following months her symptoms worsened and affected her entire right hand. She had a difficult time with writing, completing her school work, driving, and other everyday activities.
Lois sought help from an orthopaedic hand specialist, who determined she either had carpal tunnel syndrome or thoracic outlet syndrome, also called TOS.
TOS is a disorder that induces compression of the artery, vein, or nerves in the upper chest region, which is referred to as the thoracic outlet. It is common among athletes—particularly swimmers, baseball players, and volleyball players—and other individuals who actively participate in repetitive overhead motion.
The Path to the UPMC Heart and Vascular Institute
Lois tried physical therapy to ease her symptoms, but when it didn’t help she was referred to Michael Singh, MD, FACS, RPVI, chief of Vascular Surgery at UPMC Shadyside. Dr. Singh evaluated Lois, and with the guidance of a series of tests, confirmed her diagnosis of neurogenic TOS.
With this condition, the brachial plexus – the bundle of nerves that controls movement and feeling in the arm and hand in the thoracic outlet – compresses and causes symptoms similar to what Lois experienced. Dr. Singh recommended a short course of focused physical therapy, which can help nearly two-thirds of patients with TOS and can eliminate the need for surgical intervention. After two months of therapy, it was clear that Lois would require surgery.
The Solution: Surgery
In October 2015, Lois underwent surgery with Dr. Singh and his team at UPMC Shadyside to relieve the compression on her brachial plexus. Lois felt immediate relief in her fingers and hand as soon as she awakened, and today has returned to her baseline with full feeling and normal function in her fingers and hand, as well as improved posture.
“This surgery not only gave me hope and a chance at a normal life, but I competed in my senior year of high school swimming,” says Lois.
She’s grateful to be living a life without pain and limitations, and is also very grateful for the care she received from UPMC, Dr. Singh, and his team.
“They were so understanding,” Lois says. “I was in pain, and they knew it, but they really put me at ease throughout the whole experience.”
Although she no longer swims competitively, Lois enjoys staying physically fit and hopes to run a marathon in the very near future. This fall, she will attend Waynesburg University, where she plans to study nursing.
Lois' treatment and results may not be representative of similar cases.
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