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DRSD.FundraiserforBrii TOS/LTN Injury/Serratus Anterior Palsy hasn't added a story.
Brianna’s journey started 14 years ago with constant pain at bilateral shoulders/scapulars, neck and chest. However specialists considered Brianna ‘too young’ to have anything seriously wrong with her. Brii was not taken seriously for these years, she was misdiagnosed and her complaints of pain and feeling generally unwell were ignored. This was extreme patient neglect that Brii experienced, when she should have had the support and guidance from specialists involved in her care. Many school days were held in bed due to the lack of investigations and diagnostics performed on her, leaving her with nothing but her pain. Over the course of these 14 years, Brianna put all her effort into becoming a Registered Nurse. She wanted to be a patient advocate, something she had not witnessed with her specialists. However, her pain was growing daily and Brii was having many shifts filled with pain that she could not explain.
Although Thoracic Outlet Syndrome was not yet diagnosed, Brii started to experience severe bilateral chest pain- Chest X-Rays showed multiple rib fractures in the 1st, 2nd, 3rd and 4th ribs, bilaterally. The cause of these rib fractures were unknown. Bilateral 1st rib fractures were healing abnormally with lucent lesions, sclerosis and pseudoarthrosis. The right 1st rib was a non-union fracture with pseudoarthrosis in the shape of a football. The left first rib was connected to an extra rib, also known as a cervical rib at C7 via a thick fibrous sheath. However, even though scans were showing anomalies (abnormalities) in her body, doctors had no idea what exactly to do.
After pain became so severe, it started to effect Brii’s life in more ways than one. She was seen by an immunologist who noticed a raised area at the side of her neck. This visible, raised area was the extra (cervical) rib protruding out. The immunologist performed an Adson Test and noted that when her arms were raised, Brii’s radial pulses would disappear. Brii was then referred to her first Vascular surgeon who performed further diagnostics and confirmed that indeed, Brii’s radial pulses completely flat lined when her arms were raised. She was finally diagnosed with a most severe case of bilateral Thoracic Outlet Syndrome.
Surgery was performed immediately following diagnosis, 2 surgeries and 2 weeks apart from each other:
1. March 13th, 2017: Right Scalenectomy (removal of scalene muscles in the neck) and removal of multiple fibrous bands
2. March 27th, 2017: Left Cervical Rib Resection + First Rib Resection + removal of multiple fibrous bands and sheath + Scalenectomy
Post-op recovery was to be 6 weeks and then return back to work as an ICU Nurse.
Unfortunately, Brii was left with paralysis of the left arm due to a long thoracic nerve injury. This was noted via an EMG of the long thoracic nerve. This injury was due to the L) side surgery having been performed and caused serratus anterior palsy. A paralysis of the main muscle used to lift the scapular, resulting in arms being able to raise upwards. It took many months for Bri to convince her surgeon that something was very wrong. Brii was unable to return to work, having only the ability to mobilise her right arm.
On November 1st, 2017, Brii was admitted to hospital for a Left Pec Major Tendon Transfer surgery. A major surgery, splitting the pec major muscle and wrapping half around to the scapular bone. This took 1 year to recover from, however during her recovery from this major surgery, she continued to experience severe pain on her R) supraclavicular fossa. Still, Brii was too sick to return back to work.
Due to having had now 3 major surgeries in a space of 8 months, no specialist, including her original vascular surgeon, believed Brii was in such pain. The pain tracked from the right supraclavicular fossa, up the side of her neck, into her right side of jaw and to the occipital nerve region at the back of her head. Brii became bed ridden. What this pain was, was a complete blood circulatory occlusion at the Brachial Plexus (effecting the T1 nerve), Subclavian Vein and Subclavian Artery. Surgery was needed immediately.
Finally, with the help of a new vascular surgeon, Brii was able to forget the pain by having a 4th surgery on July 20th, 2018- consisting of a Right First Rib Resection, Subclavian muscle resection, multiple fibrous band removal and large mass removed from her upper thoracic region. All of this was completely occluding blood flow on the right side, hence all her pain.
As mentioned, Brii was only to have 6 weeks off work as an ICU nurse and it is now coming up to two years post 4 surgeries.
We are only now making progress with the help of a new team of professionals; Head Coach and Exercise Physiologist, whom I am in contact with and strongly believe that with the help of her team, she will accomplish a full recovery with the hopes of no further surgery.
Unfortunately, rehabilitation for someone like Brii is costly, requires a lot of time,effort and energy on a daily basis. For Brii to get well and return to work eventually, she must continue daily rehabilitation with her Exercise Physiologist and Team. This is an exhausting and long term process but with its benefits of making a full recovery. The rehabilitation Brii needs is very specialised to her specific case and due to her unique situation, a case study is currently being produced on Brii’s TOS specifically.
We are asking for your assistance in helping to pay for Brii’s weekly rehabilitation expenses. We appreciate any support you can give us, so Brii can continue rehabilitation sessions. In regards to her current rehabilitation, our short term plan is to get her to a position where she can work one day a week, in order to get back into the workforce. Currently, Brii needs to gain more strength to cope with any form of work. She has been on a long journey and still has a long road ahead of her, however we have successfully found a Team that will support and guide Brii through this journey and we hope you can be part of it also.
Thankyou.
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