@merpreb Thanks for asking. I am breathing well. The only time I have shortness of breath is now from allergies and asthma, and if I stay on top of preventing that, I'm doing just fine, and I haven't had a relapse of the repeated chest infections since I got better control of my breathing.

There can be many causes of TOS, and my physical build contributes to my risk because I have a long neck....and my neck looks longer because the collar bones are attached lower on the front of my spine, so there is less room under them for the brachial plexus to pass with all the nerves and the blood supply in-between them and my rib cage. Some of the other risks are injuries like whiplashes, or repetitive stress like jobs with lots of arm movements. This can cause scar tissue in neck muscles like the scalenes, and the brachial plexus passes between the groups of anterior and posterior scalene muscles. Even high stress computer jobs, and poor posture contribute to the problem. I don't have an extra rib (cervical rib) in my neck. Emotional trauma is also a factor because as humans we tense our shoulders and neck in a guarded position and are not in good posture. Think about how a confident person's posture looks. that is where we should be and it's ergonomic. That is what you want to strive for to prevent TOS.

TOS is more common in spine injury patients, and I have had an injury and had surgery at Mayo to decompress my spinal cord. The scar tissue from surgeries also is a factor as tight fascia can restrict normal movement and ergonomics. If you have poor posture with shoulders and head in a forward position and round the back, it compresses the muscles on the front of the chest where these nerves and muscles pass. So it's complicated, and there are multiple points on compression in the neck and chest that can affect arteries, veins, and nerves, and even the blood supply to the brain. One of the tests is the doctor listens to my pulse at the base of my neck, and when I turn my head away from him, my pulse stops. When I look forward again it resumes. I had also lost shoulder and arm muscles that atrophied from spinal cord compression before I came to Mayo because all the local surgeons I saw would not help me.

The good news is that physical therapy and the myofascial release that I've mentioned helps a lot, and I am making good progress in my recovery and I am rebuilding muscle that was lost. I think that I will overcome this. It's actually common, and what makes TOS rare is finding doctors who understand the problem and know how to treat it. It is hardly covered in medical schools. That is why I came to Mayo. I needed spine surgery and also had TOS and needed to be somewhere that both issues were understood. I also had carpal tunnel surgery, and all these physical issues have overlapping neurological symptoms. I have had the imaging and nerve conduction studies, as well as Doppler imaging with blood pressure cuffs for my fingers confirming the changes to my circulation from TOS.

Here's my story. https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/