In 2017, Karen English began experiencing pain related to Thoracic Outlet Syndrome (TOS). After nearly a year of medical consultations, she was referred to the Division of Thoracic Surgery to meet with Dean Donahue, MD, the director of the TOS Program.
When Gabby Harrison, 22, tagged a runner out during a softball game, the last thing she anticipated was an injury to her elbow that would result in a four-year medical journey. In 2016, the then-18-year-old collegiate softball player received treatment for the torn ligaments in her damaged elbow from that play.
During recovery, she began to experience potent signs of nerve damage including numbness and tingling in her pinky and ring fingers on her left hand, which were at first attributed to the elbow injury. But when the symptoms progressed in the weeks following treatment, Gabby became concerned that the problem went beyond her sport injury.
First Signs of Thoracic Outlet Syndrome
During a workout session at her gym, when the safety bar on the squat machine touched her neck, Gabby’s symptoms instantly intensified. In addition to the numbness, Gabby quickly lost function in two fingers on her left hand. Shortly after, they curled into her palm, forming a permanent claw. The pain, which had been previously isolated to her elbow, advanced into her neck and shoulders.
People did not believe that I was having pain. I would show them my hand and they would say ‘just open your hand’ and I really could not.
Simple tasks such as washing her hair and lifting her arms up to shoulder height were next to impossible. But for Gabby, an otherwise healthy athlete, the impact her condition had on her ability to play was the hardest outcome to accept. She continued to participate in practices and games, but she experienced a significant loss of strength to the point where she could no longer squeeze her gloved hand around a ball.
When the symptoms did not subside after a few weeks, Gabby and her mother, a registered nurse, searched for an explanation and matched them with thoracic outlet syndrome (TOS)—a condition that neither she nor her mother had ever heard of before.
“My mom and I brought this condition up with other physicians and peers, and they said ‘no, that can’t be it’ and that my pain was just part of my elbow’s healing process,” said Gabby. “People did not believe that I was having pain. I would show them my hand and they would say ‘just open your hand’ and I really could not.”
Seeking Treatment for TOS
Gabby visited Massachusetts General Hospital in 2019 to meet with Kelly McInnis, DO, sports medicine physiatrist in the Department of Orthopaedics, who recognized her symptoms as TOS. Dr. McInnis referred Gabby to Dean Donahue, MD, thoracic surgeon and director of the TOS Program in the Division of Thoracic Surgery.
“No doctor had ever sat and talked with me for that long to get to the bottom of what I was experiencing,” said Gabby of the amount of time she spent with Dr. Donahue during her first appointment discussing her symptoms, the moment they first appeared and how they progressed.
In August 2019, on her 21st birthday, Gabby underwent her first rib removal surgery to treat her TOS. On the day of her surgery, she recalls her care team making jokes to lighten the mood and keep her spirits up. “The anesthesiologists, nurses, really everyone made me feel super comfortable and safe,” she said.
She also recalls Dr. Donahue waiting for her outside of the operating room to reassure her that she would have full support from his team to manage any pain following surgery—a fear that she had expressed in her preceding consultations.
Within 24 hours after her surgery, Gabby experienced significant pain relief and regained the function of her hand.
Out of the Dugout
A year later in January 2020, during her senior year of college, Gabby reclaimed her spot on the softball field. She has since graduated college and is now participating in a summer league. While it was, at first, a slow start to catch up with the rest of her teammates, she now considers herself almost fully recovered, regaining more muscle strength every day and feeling like it is “night and day” from where she first started her recovery. In fact, she recently hit a home run—the very first since before her injury.
“I want to share my story because there is not a lot of information out there about TOS and it was hard to even figure out what my condition was in the beginning,” she said. “But when I met Dr. Donahue, I knew he was the right person to perform my surgery. He made me feel comfortable and it was a perfect fit. Today, I can do everything and more.”
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We provide comprehensive evaluation and treatment for patients with all forms of TOS.
Thoracic Outlet Syndrome (TOS) can be extremely difficult to diagnose and treat. Symptoms vary but may include may include pain and tingling in the arm, neck, shoulder, upper chest and back.