Not One, But Two?

After calling the new surgeon’s office every day, the doctor’s office actually called me and let me know they had an appointment for me! I was super excited to finally get the call, but nervous at the same time. This meant that I was one step closer to getting this rib removed. On one hand, I was pumped to be rid of it, but on the other, I’ve never been so nervous! By this time, I had done my research. I knew prior to going to my appointment the things I wanted to ask. I read the major complications of such a procedure were the risk of stroke and the risk of the surgeon nicking my lung causing me to have a chest tube.

The day had finally arrived for me to go to the office visit. My husband and 5 year old daughter accompanied me to the office visit. We get to the hospital, once we actually figure out where the office is located, we go into the office where we are the only ones. I go up to the secretary who tells me that the surgeon got called to do an emergency surgery. She goes on to say that it could be several hours before he would be back in the office. I explain to her that we just traveled 2 1/2 hours to get there and that we would just wait on him, she understood and we sat down to wait. Luckily, my 5 year old is exceptionally well behaved and had brought her iPad along for the car ride. The secretary also turned some cartoons on for her to watch as well. It was about 2 1/2 hours of waiting before the nurse came to tell me he was finishing up surgery and shouldn’t be much longer. At this time, she puts us in an exam room where we wait another 30 minutes or so.

The surgeon enters the room and introduces himself. He’s already read through my chart and reviewed my CTA results. He tries to pull up my CTA imaging on the computer in the room, but it doesn’t load. He then takes us into his personal office and shows us the imaging. He points out my right cervical rib and shows me where it’s touching my subclavian artery. He points out a lot of scar tissue and shows me that the rib is actually attached to my artery. He tells me how rare it is to have one cervical rib. Then says, “but guess what?” He proceeds to tell me that I have not only a cervical rib on the right, but I have another cervical rib on the left side! He then tells me that I’m a rarity. He jokes with my husband asking him if he knew he was married to such a rarity. My husband laughs and says, “she’s rare alright!”

We go back into the exam room, where we start discussing the procedure itself. He says that the left cervical rib isn’t very big at this time and doesn’t require surgery, but it will need to be monitored. The right rib has to come out now and he thinks he will have to take out my first rib as well. He says he is going to use a supraclavicular approach. Mayo clinic describes this approach as one that your surgeon makes an incision just under your neck to expose your brachial plexus region. Your surgeon then looks for signs of trauma or muscles contributing to compression near your first (uppermost) rib. It goes on to say your first rib may be removed if necessary to relieve compression.

*Cervical ribs are also called, “extra ribs” as they are not part of the 24 ribs that we normally have.

During all my research I had done, prior to this appointment, I had read this Mayo Clinic website multiple times. I proceed to ask him my concerns regarding the surgery, what is the likelihood of having a stroke, what is the likelihood of requiring a chest tube and what if my subclavian artery were to rupture during the procedure? He says a stroke is of concern, but the hospital was actually known for their stroke-care. I had actually read this myself, while researching the hospital. He said I was at increased for a chest tube post-operatively because of my size. He said without much fat, he doesn’t have much room for error. He says if he were to nick my lung, he would stick a chest tube in and I would be in the hospital a little longer than originally planned. Furthermore, he says he’s very comfortable around arteries and veins and that if there would be a rupture or anything else happen that he was more than capable of repairing it. As I said before, he had been a vascular surgeon for many years so I was certain he was more than capable of doing exactly what he said.

Once all of my questions were answered, he said he will see me next week for the procedure. He says that I have to stay overnight, at least one night. But, assuming there were no complications, that I would likely be up and ready to go home the morning after my surgery. He gave me paperwork to stop and get my pre-op lab work drawn before next week. I go over to the registration department to get registered for my labs. To explain just how nervous I am for all that I’ve just been told, she asks me for my social security number and I cannot think of the numbers! I’m usually an on my toes thinker and can usually just spout things right out without much thought, but my brain was just on overload. I mean, really, I can’t even think of my own social security number? The lady then asks for my license number, which I can provide only as I have my drivers license on me. I get my labs drawn and get my nervous self back home, to Kentucky.

References:

Thoracic outlet syndrome. (2016, August 27). Retrieved February 25, 2019, from https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/diagnosis-treatment/drc-20353994

(n.d.). Retrieved February 25, 2019, from https://www.bing.com/images/search?view=detailV2&ccid=GZrP4nti&id=BA52509BCE17AADB0B4F5BF782AE29FDFD26AE96&thid=OIP.GZrP4nti1GXj_4N7zWwuzwHaDK&mediaurl=http://revolutionhealthcentre.com/wp-content/uploads/2017/06/cervical-rib-1030×439.jpg&exph=439&expw=1030&q=cervical rib image&simid=608018053202971133&selectedIndex=94&ajaxhist=0

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