hi, shellie, and thanks so much for your response. i can't believe i figured out how to cut and paste that thing onto the forum but for you, i did it! wow. pretty amazing if you knew what a computer illiterate i was, you'd laugh.
yes, being back in the office environment must be kinda surreal. i hope you don't have to be sent out driving on field assignments too soon, but i know that's a big part of your job as a social worker... and it's coming.
here's my thing - i'm rooting for you to be able to handle this and i know you want to be right back where you are, or you wouldn't be there. i know that you've probably missed your colleagues and your cases, the families they represent (especially the children). am i right? and they have been missing you too, shellie - like crazy. you do good work and it feeds your soul.
is there any way you can reduce your hours and go back into this gradually (like work 6-hour instead of 8-hour days, at first)? you did say you are returning weeks ahead of schedule. any flexibility there? or perhaps you could ACTUALLY take the breaks the state allots you each morning and afternoon... how about that? lie down, close your eyes, do some very gentle stretches and some deep breathing exercises... and a pillow or other props you can bring from home are always a good idea. you know what works best for you.
if the outfit you work for is large enough to have an IT dep't, get them involved. your computer monitor height, desk height, chair, chair arms (or lack thereof - may just be preferable), mouse, keyboard, etc... all that stuff needs to be looked at/upgraded ergonomically with your TOS first and foremost in everyone's minds. shelley just posted last night about a new mouseless (?) keyboard, good for those of us who don't use dragon naturally speaking. voice-activated software is another device that has helped many to heal. and bottom line, to stay that way!
a good OT needs to be called in to look at your work station and also your car, i would think, shellie. (maybe you get an rx for this from your doc, i'm not sure...) there are lots of things which can be done to accommodate your limitations. i know we are a proud lot... we don't like to think of TOS as a disability per se, but believe me - i've had it for many, many years - it will turn into a very grave condition if you do not take the steps to protect yourself while you are young and healthy. there's a lot of cool stuff out there - avail yourself of it, i say!
look at the awareness you have as a gift. use every resource available to you to make this work - IT, OT, common sense and everything in between. and be gentle to yourself, above all. you don't need to explain a lot to many people. you have a neurovascular entrapment disorder. you've just had surgery for it; that's gonna hopefully correct part of the problem. but you're still a TOS'er. if they still give you a blank look, i like di's explanation for dummies: 'kinda like carpal tunnel.... only higher up!' usually shuts them up.
you already know to limit your typing, but hopefully you will read and lurk on the forum, because we will be thinking about you, shellie. you are a valued member of our group. pipe back in when ya can - you are missed!
as far as PT goes, that may be a tough one if your surgeon is against it. but maybe you could look into some bodywork, like feldenkrais, hellerwork, alexander technique, bowen work or muscle activation technique. many of these practitioners have national networks and active websites which can make finding one in your area a lot easier.
it is very hard to find a PT who knows how to work with a TOS'er... let alone one who recently had a rib resection. personally, i agree with your instincts. i believe it to be an important part of rehab. talk to the neuro and see what she says. i'm going to try to find some material i came across recently that listed the number of hours' training in certain modalities you will need to be looking for, if you do decide to search for a PT - only 10% practicing in the U.S. today have the right kind of training. so your surgeon's reluctance could actually be a blessing in disguise, shellie. no strengthening just yet. your intrinsic muscles need rebalancing first. but i won't pretend to know what his thinking is there.
just take everything very slowly for right now. stress is the enemy. tension has to be tamed somehow. stay hydrated and remember how loved and cared for you are. tickle those little ones. you are still very fragile and this takes time. TOS surgery is a hard recovery and can take up to a year or two to fully get over and back to square one basics. nerves heal at their own pace, the regrowth rate is extremely slow and they may be giving you some fairly bizarre sx as they travel down that long cell pathway from the brachial plexus to your fingertips. it can feel like 2 steps forward, 1 step back. a lot!
you rest easy. take courage in the fact that you are doing so well this close out to your operation. being able to enjoy time away at the beach with your friends must have been very precious to you; cherish that. thank you for writing and it is wonderful to hear you are recovering so well, michelle. slowly but surely. just be careful with that job - i know how much you love it but don't go overboard, and please do remember to ask for help when you need it. this takes time. just put one foot in front of the other and the kingdom will again be yours!