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All TopicsForum: Surgery - Before, During, and After → Topic: Nerve entrapment

Topic: Nerve entrapment

Forum: Surgery - Before, During, and After — Surgical options and helpful tips for recovery and side effects.

Posted on: Nov 17, 2010 08:30AM

voraciousreader wrote:

My internist confirmed for me, a nerve entrapment, what I already knew I had (since I had one already, years ago, that required surgery on my other arm.  This one is  located an inch or two away from where my sentinel node biopsy was done 8 months ago.  The entrapment is palpable.  It feels like like a tight violin string in the fold of my armpit.  The pain begins in my shoulder and travels down the inside of my arm to my elbow.  He told me to call my breast surgeon and give him a heads up, for now.  He thinks anything could have caused it.  We discussed perhaps scar tissue from the sentinel node biopsy and he thought that was a possibility.  I'm resting the arm for now.  Anyone else have this problem?  A little background, I've had on the other arm, shoulder, elbow and pinky surgery.  Trying to figure out if more surgery is in my future. 

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Nov 17, 2010 02:07PM TenderIsOurMight wrote:

Good Morning,

I had a similar problem after mastectomy, Level I and II lymph node dissection and radiation for IDC. While I believe the initial problem was Mondor's Syndrome (a vein thrombosis at site of a traumatic vacuum biopsy which spread, involving more and more of the vein), the radiation scarred enough tissue to entrap the fibrotic vein and or nerve. I had a long, long palpable fibrotic band extending from my lower rib cage up to my clavicle bone, as well as smaller band down to my elbow. 

Heat, manual message, PT scar attempt break up and tincture of time did not offer relief. Due to the persistent pain I sought several surgical opinions, and eventually at reconstruction, the band was incised, allowing the fibrotic structure to be released at both ends, take the pressure off the clavicle and hence end the co-incident nerve pain.

The risk I ran with this attempt is that arteries, veins and nerves run in bundles. While no one though this was an artery, the question of whether this involved the nerve (long thoracic) was real. If you cut that, you loose innervation. Ultimately the decision/judgement (with my informed consent) rested in the best surgeon's hands I found and trusted. 

Your situation most likely will not devolve to my particular dilemma. I always suggest second and if needed, third opinions in difficult medical calls.

Good luck,

Tender 

It cannot be emphasized too strongly that treatment of each patient is a highly individualized matter. (FDA-approved labeling for warfarin (Coumadin) NDA 9-218/5-105)

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Nov 18, 2010 07:21AM voraciousreader wrote:

Tender -

Thanks for your reply.  I'm sorry to hear about the difficult time you had that resulted in surgery.  I hope you now have a complete recovery and no pain.

You have pretty much confirmed my thought that surgery is the route that must be taken.  Regarding my other arm, I was previously misdiagnosed for a year with "tennis elbow."  I finally went to another doctor who told me I had an ulnar nerve compression and the only way to correct the problem was with surgery.  I had the surgery and the recouperation, as I'm sure you're aware, is tough.  However, it was worth it because I felt so much better within days of the surgery.

Since this time it occurred on my "good" arm, I am very upset.  I need to remedy this arm's problem so I don't cause unnecessary damage to the other arm which is inherently weak, despite constant physical therapy.

I'm convinced there is scar tissue in the vicinity of the sentinel node biopsy. 

Thanks for all of your information regarding the anatomy.  I will keep it in mind when I meet, once again, with all my doctors.

I'd still like to hear if ANYONE had the same problem and was able to avoid surgery.  Anyone???  Thanks!

Doctor told me regarding my prognosis that I WASN'T on the Titanic! Hmmm...Really?....Okay! 2/10 Pure Mucinous Breast Cancer, Oncotype DX 15, Stage 1, Grade 1, 1.8 cm, 0/2 nodes, ER+ 90% PR+ 70% HER2- (+1)

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Nov 20, 2010 02:54PM kira wrote:

Reader, what you have sounds like axillary web syndrome (Tender had a variant of that=Mondor's syndrome). Axillary webs are thrombosed--clotted--lymph vessels due to the axillary surgery--the tight violin string bands can last for years--despite the articles in the medical literature that says that they are self-limited.

The webs can occur at any point, most commonly in the first month after surgery, but at any point in time.

Because axillary webs are a risk for lymphedema--you'll find a lot posts about the (frequently called cords) on that forum.

Here is a link to a page that describes axillary web syndrome:

www.stepup-speakout.org/Cordin...

Persistant cords tend to resolve with special PT manipulation and overhead stretching. Sometimes the cords do "pop", but intentional popping of the cords is considered risky, per Jodi Winicour PT--an expert on the syndrome.

Kira

Knowledge is the antidote to fear, Ralph Waldo Emerson

Dx 5/10/2008, IDC, 1cm, Stage Ib, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Nov 20, 2010 05:00PM voraciousreader wrote:

Kira - Thanks for all of the information!  That's EXACTLY what I have!  You can see my chord too!!! The doctors have advised me to rest the arm, massage it and wait a week or two and see if it improves before signing me up for some physical therapy.  I know the drill.  I just hope I won't be needing surgery like Tender.  I have a very poor track record when it comes to physical therapy.  I keep flunking physical therapy and getting surgery!  I'm pretty bionic from the waist up.  Besides all of my arm and hand surgeries and now recovering from breast cancer surgery, I also had a ruptured ectopic and a pneumothorax that required MAJOR lung surgery.  Wooo!  Enough is enough already! 

Just wondering if anyone else had this and DIDN'T require surgery?

Doctor told me regarding my prognosis that I WASN'T on the Titanic! Hmmm...Really?....Okay! 2/10 Pure Mucinous Breast Cancer, Oncotype DX 15, Stage 1, Grade 1, 1.8 cm, 0/2 nodes, ER+ 90% PR+ 70% HER2- (+1)

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Nov 21, 2010 09:18AM, edited Aug 20, 2013 06:14AM by kira

There are loads of threads about it on the lymphedema forum: I can't think of anyone who was treated with surgery.

I saw Jodi Winicour PT, of Klose Training, give an excellent lecture on it at the National Lymphedema Network Conference in Orlando in September, and she manipulates the cords and does special PT--the PT has to understand axillary web and be very careful as it increases the risk for lymphedema--primarily it's a lot of overhead stretching with the elbows straight.

If you go to the lymphedema forum, and search "cord" you'll find a ton of threads.

Hoping this goes away without any surgery.

Here's a really long thread on cording:

community.breastcancer.org/for...

Kira

Knowledge is the antidote to fear, Ralph Waldo Emerson

Dx 5/10/2008, IDC, 1cm, Stage Ib, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Dec 16, 2010 05:21PM voraciousreader wrote:

Just thought I post and let you know that I saw a physician today and he concurred that I had the axillary web syndrome.  However, that seems to be resolving.  I've been doing stretches and massage which really has helped.  So thanks for the help in that department.  The bad news is that I ALSO have a nerve entrapment AND a shoulder tear.  And, until now, that was my good arm. Surprised  I guess you could say I had a trifecta!

Doctor told me regarding my prognosis that I WASN'T on the Titanic! Hmmm...Really?....Okay! 2/10 Pure Mucinous Breast Cancer, Oncotype DX 15, Stage 1, Grade 1, 1.8 cm, 0/2 nodes, ER+ 90% PR+ 70% HER2- (+1)