Yu kin gɛt pen na yu nɛk, yu sholda, ɔ yu an ɔltɛm? Dis sik kin bi Thoracic Outlet Syndrome (TOS)!

Sɔntɛnde yu kin fil wan strenj pen ɔ swɛt we kin kɔmɔt na yu nɛk ɛn sholda dɛn dɔŋ yu an dɛn? Sɔntɛm dis pen kin bɔku we yu es wan wet ɔ es yu an ɔp. If yu gɛt sɔm kayn sik lɛk dis, de kɔz kin bi wan sik wae gɛt sɔm kayn kɔmplikɛt nem. Tide wi de tɔk bɔt dis kayn sik, dat na Thoracic Outlet Syndrome (TOS) . Pan ɔl we di nem kin mek yu fred smɔl we yu yɛri am, if dɛn tɛl yu bɔt am di rayt we, yu go ridyus bɔku prɔblɛm dɛn.

Wetin na di sik we dɛn kɔl Thoracic Outlet Syndrome?

Fɔ tɔk am simpul wan, Thoracic Outlet Syndrome (TOS) na wan kɔlekɛshɔn fɔ di sayn dɛm wae kin kam wae yu kɔmprεsh yu nerv ɔr blɔd vesel dɛm na yu lכw nεk εn כp chεst. כda nem fכ dis na "thoracic outlet."

Imajin se smɔl ples de, lɛk domɔt, bitwin yu nɛk ɛn yu chɛst. Dis na wetin dכkta dεn kכl "Thoracic Outlet." tru dis spεs pas imכtant nεv dεm we de go na yu an, εn di at dεm we de kכri bכdi to yu an εn vein dεm we de go bak blכd frכm yu an to yu at. di mכst imכtant pan dεm na di brachial plexus, we na wan nεtwכk fכ nεv dεm we de go na yu an, εn di sabklavian at εn vein.

nכmal wan, dis spεs we dεn kכl "thoracic outlet" big fכ dεn nεv dεm εn bכdi vεsεl dεm fכ pas tru witout nכ obstrכkshכn. כltu, sכmtεm dis spεs kin sכmtεm bikoz fכ sכm anatomical vεryushכn dεm na wi bכdi כ bikoz fכ injuri dεm na di nεk כ chεst. Na da tɛm de di prɔblɛm bigin. we dis spεs de sכm, di nεv dεm כ di blכd vesel dεm we de pas insay de bigin fכ prεs bay di bon dεm כ di mכsul dεm we de dכn. Dis prɛshɔn kin mek yu gɛt sɔm sayn dɛm lɛk pen ɛn swɛ na yu an, sholda, ɛn nɛk. Dɛn sayn ya nɔr kin gɛt ɛnitin fɔ du wit dɛnsɛf ɛn dɛn kin difrɛn, so sɔmtɛm i kin tek sɔm tɛm fɔ no dis as TOS kɔndishɔn.

Bɔt nɔ wɔri. Bɔrku pipul kin gɛt rεlif wit simpul tritmɛnt lεk fyzikal tεrapi εn pen kil. Bɔt if dɛn wan dɛn de nɔ ɛp ɔ if siriɔs blɔk de na di blɔd we de flɔ, i kin nid fɔ du ɔpreshɔn.

Yu tink se kayn TOS de?

Yɛs, dɔktɔ dɛn kin sheb TOS to tri men kayn, i kin dipen pan wetin de mek dis throbbing:

Nyurojɛnik TOS (Tos we kin kam bikɔs ɔf kɔmpreshɔn na di nerv) .

Dis na di kayn TOS we kɔmɔn pas ɔl . Na lɛk 95% pan ɔl di TOS pasɛnt dɛn gɛt dis kayn. wetin de apin ya na di ``Brachial plexus``, di nεtwכk fכ nεv dεm we de rכn frכm yu nεk tru yu armpit to yu an, de kכmprεs. Bɔrku tɛm, i kin apun pan pipul dɛm wae dɔn pas 30 ia. Ripit strɛs injuri - mɔ pan spɔt - ɛn sɔdɛn injuri na di nɛk, lɛk ``Whiplash`` frɔm motoka aksidɛnt, na di men tin we kin mek i apin.

TOS we kin kam bikɔs ɔf di venɔs kɔnjɛshɔn (Venous TOS) .

dis na di say we yu ``Subclavian vein`` de kam in. Dis na di men bכdi we de kכri dכti bכdi frכm di an bak to di at. I kin apin mɔ pan man dɛm , bɔku tɛm bitwin di ej dɛm fɔ 20 ɛn 30. Bɔku tɛm di sayn dɛm kin apia na di an we dɛn kin yuz mɔ (`dominant arm`).

TOS we di atεrial kכmpreshכn de kכz (Arterial TOS) .

Dis na di kayn TOS we nɔ bɔku pas ɔl . I kin afɛkt lɛk 1% pan ɔl di TOS pasɛnt dɛn. Bɔt na di tin we kin mek blɔd klɔt wantɛm wantɛm na di an pan pipul dɛn we nɔ rich 40 ia yet.Dis kayn TOS kin apin na yu sabklavian at, we na di men blɔd vesel we kin kɛr blɔd we gɛt ɔksijɛn frɔm yu at to yu an. Bɔku tɛm, na wan tin we dɛn bɔn wit we dɛn bɔn wit am, i kin kam wit am. wan egzampl na wan ekstra rib na di nεk (sεvikal rib). כlmost 70% pan di pipul dεm we gεt sεvikal rib na uman dεm, so dis kayn TOS de mכr pan uman dεm.

sכmtεm dכkta dεn kin kam togεda di tu tכp dεm fכ di venכs εn atεrial TOS εn kכl dεm "Vascular Thoracic Outlet Syndrome." Dɛn tu kayn ya kin nid ɔpreshɔn fɔ mek dɛn nɔ gɛt di sik ɛn fɔ mek dɛn nɔ gɛt prɔblɛm dɛn. Di kayn TOS wae gɛt fɔ du wit di nerve (Neurogenic TOS) kin ansa fayn fayn wan to fizik tritmɛnt ɛn ɛksesaiz, bɔt sɔm pipul dɛn kin nid ɔpreshɔn.

Aw dis sik kin kɔmɔn?

Di wan dɛn we de stɔdi bɔt dis bin tɔk se ɛvri ia:

• Nyurojɛnik TOS kin apin pan lɛk wan pan ɛvri 40,000 pipul dɛm.
• Venous TOS kin apin pan lɛk wan pan ɔl 1.25 milyɔn pipul dɛm.

Bɔt bikɔs i nɔ kin izi fɔ no dis sik kɔrɛkt wan, di rial nɔmba fɔ pipul dɛn we de sɔfa wit dis sik kin bɔku pasmak.

Wetin na di sayn dɛm fɔ TOS?

TOS simptom kin apin na wan say na yu ɔpa bɔdi (nɛk, ɔpa chɛst, sholda, an, ɔ finga). Yu kin gɛt tin dɛn lɛk:

• Pen: Dis pen kin bɔku we yu es yu an ɔp.
• Numbness ɔ wan "krayzi" filin.
• Numbness, fil se natin nɔ de na di an .
• An wikɛdnɛs.
• Swel ɔ ebi ebi na di an.
• di skin in kɔlɔ kin chenj (di skin kin tɔn pale ɔ blu).
• Fɔ fil kol we yu tɔch di skin.
• Finga wund dɛn kin tek lɔng tɛm fɔ wɛl.

Dɛn sayn ya kin difrɛn difrɛn wan fɔ di kayn TOS wae yu gɛt. Bikɔs di sayn dɛm de dipen pan wetin dɛn de kɔmprɛs (wan nerve ɔ blɔd vesel). Fɔ tɔk di kɔrɛkt tin, dɛn na dɛn wan ya:

• yu ``Brachial plexus'' na di say we yu an de gεt in muvmεnt εn sens. So, we dis nεtwכk fכ di nεv dεm de irita, tin dεm lεk pen εn sכmtin de apin.
• Yu sabklavian vein na di wan we de kɛr blɔd frɔm yu an bak to yu at. So, we dis vein blok, di blɔd na yu an nɔ kin ebul fɔ kɔmɔt fayn, we kin mek yu an swel ɛn fil ebi.
• Yu sabklavian at de gi yu blɔd we gɛt ɔksijɛn to yu an. So, we dis at de blok, di bכdi fכ fכlכ na yu an εn finga dεm de rεdכks. Dis kin mek yu an nɔ fil fayn, yu kin swɛla, yu kin fil pen, ɛn yu kin kol.

Aw TOS pen kin fil lɛk? Yu tink se dɛn kin kɔnfyus am wit angina?

TOS kin mek yu gɛt pen na yu nɛk, ɔp chɛst, yu sholda, ɛn yu an. Dis kin bi dɔl pen, lɛk pen we de mek yu fil pen, ɛn i kin wɔs we yu muv yu an.

Sɔm pipul dɛn kin kɔnfyus TOS pen wit angina , we na wan at prɔblɛm. Angina na chɛst pen we di at mɔsul nɔ de gɛt inof ɔksijɛn. Bɔt impɔtant tin dɛn de we difrɛn bitwin dɛn tu tin ya:

• TOS pen nɔ kin kam ɔr kin wɔs wit aw yu de waka. Bɔt, angina pen kin apin. Angina kin kam wit ɔda sayn dɛm lɛk fɔ blo shɔt, at bit kwik kwik wan, ɛn diziz.
• TOS pen kin bכku we dεn es di an we dεn afekt. Dis nɔ kin apin wit angina.

Impɔtant: Nɔ kɔnfyus TOS wit at atak ɔ strok!

Dis na sɔntin we yu fɔ mɛmba . Sɔm pan di sayn dɛm fɔ TOS kin tan lɛk di wan dɛm wae kin gɛt siriɔs sik lɛk at atak ɛn strok, wae kin nid fɔ gɛt mɛrɛsin kwik kwik wan. Fɔ ɛgzampul:

• Chɛst pen , mɔ if i kam wantɛm wantɛm ɛn we yu nɔ bin de ɛkspɛkt, kin bi sayn fɔ se yu gɛt at atak. Bɔt we pɔsin gɛt at atak, ɔda tin dɛn kin apin lɛk we i nɔ de blo fayn, we i de fil pen na in bɛlɛ, we i de swet, ɛn we i de fil se i de fred fɔ day.
• If yu wik na wan say na di bɔdi, dat kin bi sayn fɔ se yu nɔ ebul fɔ waka. Bɔt paralayz kin gɛt ɔda sayn dɛn bak, lɛk we i nɔ de tɔk fayn, wan ɔ ɔl tu say na in fes kin drɔp, ɛn i nɔ kin si wantɛm wantɛm.

If yu gɛt sayn dɛn we de sho se yu gɛt at atak ɔ strok, go to dɔktɔ wantɛm wantɛm. Dis na imejensi we kin mek pɔsin in layf de pan denja. If yu delay fɔ di tritmɛnt, dat kin mek yu day.

Wetin na di tin dɛn we kin mek pɔsin gɛt TOS?

Dɔktɔ dɛn kin sheb di tin dɛn we kin mek pɔsin gɛt TOS to tri men grup dɛn:

Di tin dɛn we kin mek pɔsin bɔn pikin

Dis na sɔm pan di chenj dɛm wae kin de na yu bɔdi wae dɛn bɔn yu. fכ egzampl, dεn kin bכn yu wit εkstra rib (a `sεvikal rib`) na yu nεk. Dis de nia, ɛn sɔntɛm i ivin kɔnɛkt to, di fɔs rib. Ɔ yu kin gɛt tin dɛn we nɔ fayn na yu rib, yu nɛk mɔsul, ɔ yu ligamɛnt. dis chenj dεm kin mek prεshכn pan di nεv dεm כ di bכdi vεsul dεm na di `thoracic outlet`.

Bikɔs ɔf aksidɛnt (Traumatic) .

Dis na injury dɛn we kin apin wantɛm wantɛm na yu nɛk ɛn ɔp chɛst. Injury frɔm motoka aksidɛnt, mɔ whiplash, na wan fayn ɛgzampul fɔ dis. Imajin, if yu de rayd tri-wil motoka ɛn yu gɛt aksidɛnt ɛn yu nɛk snɛp wantɛm wantɛm, dis kin apin.

Bikɔs ɔf di aktiviti dɛn we de go bifo (Functional) .

dis min se we yu du di sem tin bak εn כva, di tin dεm na di "thoracic outlet" kin dεm. Dis na kɔmɔn tin we kin mek dis apin to atlet dɛn (espɛshali kriket pipul dɛn - bɔla, batsman, ɛn swima) bikɔs di an dɛn kin muv kwik kwik wan. Wan ɔda ɛgzampul na di we aw dɛn kin es tin dɛn ɔp di ed ɔltɛm we dɛn de du sɔm wok dɛn. Ivin pɔsin we de wok bifo kɔmpyuta ɔl di de wit bad pozishɔn kin de pan denja.

Pan ɔl we dɛn kin bɔn sɔm pipul dɛn wit di tin dɛn we kin mek dɛn gɛt TOS, dɛn nɔ kin gɛt ɛni sayn te dɛn gɛt aksidɛnt wantɛm wantɛm na dɛn nɛk ɔ dɛn kin du di sem kayn wok ɔltɛm ɛn i kin pwɛl.

Udat de pan ay risk fɔ gɛt TOS?

Yu kin gɛt ay risk fɔ gɛt TOS if yu:

• If yu de ple spɔt dɛn we kin mek yu muv yu an ɔ sholda bɔku tɛm. Ɛgzampul dɛn: kriket, swimin, gɔlf, volibol.
• If yu de du weitliftin.
• If yu kin kɛr ebi ebi bag dɛn na yu sholda bɔku tɛm ɔ es tin dɛn ɔp yu ed. (e.g., pipul dɛn we de wok na di kɔnstrɔkshɔn industri, pipul dɛn we de lod guds)
• If yu dɔn gɛt injuri na yu nɛk ɔ bak, fɔ ɛgzampul `(Whiplash)`.
• If yu gɛt tumor ɔ big limf no dɛm na di ɔpa chɛst ɔ armpit.
• If di we aw yu sidɔm ɔ tinap nɔ fayn. (Fɔ ɛgzampul: pipul dɛn we de wok na kɔmpyuta wit dɛn bak bɛn ɔl di de)

TOS na siriɔs kɔndishɔn? Wetin na di prɔblɛm dɛn we kin apin?

If dɛn nɔ trit am, Thoracic Outlet Syndrome kin mek yu gɛt siriɔs prɔblɛm dɛn. Sɔm pan dɛn na:

• di bכdi de kכlכt na di armpit εn di vein dεm we de kכl am (`Axillo-subclavian vein thrombosis`).
• swel we de kɔntinyu fɔ swel ɛn pen na di an, mɔ pan di wan dɛn we gɛt venɔs TOS (`Venous TOS`).
• Tisu day (`Gangrene`).
• Ischemic ulcers kin apin na di finga dεm bikoz fכ di bכdi fכ fכlכ dכn.
• Di nerv dɛn we de pwɛl ɔltɛm.
• Pulmonary embolism – Dis na wan sik we rili denja.

So, yu si, i nɔ fayn fɔ jɔs tink se dis na jɔs smɔl prɔblɛm. E fayn fɔ no ɛn trit am kwik kwik wan.

Aw yu go no fɔ tru if yu gɛt TOS? (Diagnosis) .

Dɔktɔ go chɛk yu ɛn aks yu bɔt yu mɛdikal istri fɔ no if yu gɛt TOS. We yu de du di fyzikal ɛgzam, yu dɔktɔ go aks yu fɔ du sɔm tɛst dɛn fɔ mek yu muv. Fɔ ɛgzampul:

• `Upper limb tension test` (na test fכ si if di כp limb de afekt)
• `Elevεt arm strεs tεst`

We dɛn de du dɛn tɛst ya, yu dɔktɔ go aks yu fɔ du simpul tin lɛk fɔ es yu an ɔp, tɔn yu ed, ɛn shek yu an. Dɔn i go luk us muvmɛnt de mek pɔsin fil pen ɔ ɔda sayn dɛn. De rizulyt kin ɛp fɔ no di sik.

Apat frɔm dat, yu dɔktɔ kin ɔda fɔ mek dɛn du lab tɛst ɛn imej tɛst fɔ no if yu gɛt TOS ɛn fɔ no ɔda tin dɛn we de mek yu gɛt di sik.

Us ɔda tɛst dɛn yu kin du?

Yu kin nid fɔ du wan ɔ mɔ pan dɛn tɛst ya:

• Blɔd tɛst dɛn .
• Chɛst X -ray.
• Wan CT skan fɔ di chɛst ɛn/ɔ di spayna .
• EMG tεst (`Electromyography (EMG)`) – Dis de chεk di aktiviti fכ di mכsul dεm εn nεv dεm.
• Magnɛtik rɛsɔnans angiografi (MRA) fɔ yu blɔd vesel dɛn.
• Magnɛtik rɛsɔnans imej (MRI) fɔ di chɛst ɛn/ɔ di spayna .
• nεv kכndukshכn stכdi – dis de mכsu di spid we di mεsej dεm de travul tru di nεv dεm.

Dɛn tɛst ya kin ɛp di dɔktɔ fɔ no:

• chεk fכ di abnכmaliti dεm we dεn bכn wit (e.g., wan sεvikal rib).
• Chek aw blɔd de flɔ tru yu at ɛn vein dɛn.
• Rul ɔut ɔda tin dɛm wae kin de kɔz dɛn sik ya.
• Luk aw yu mɔsul ɛn yu nerv dɛn de wok.
• Fɛn ɔl di say we di prɛshɔn de.

Wetin na di tritmɛnt dɛm fɔ TOS?

Di tritmɛnt fɔ TOS kin difrɛn difrɛn wan bay di kayn TOS we yu gɛt ɛn di sayn dɛm we yu gɛt. Di men gol fɔ tritmɛnt na fɔ ridyus di sayn dɛm ɛn fɔ mek dɛn nɔ gɛt prɔblɛm dɛn we kin apin. Yu dɔktɔ go disayd us tritmɛnt go fayn fɔ yu.

Na sɔm tritmɛnt dɛn we pɔsin kin gɛt:

• Fyzikal tεrapi: Dis na di fכs layn fכ tritmεnt fכ nyurojεnik TOS. Wan dɔktɔ we de mɛn yu bɔdi kin ɛp yu fɔ mek yu ebul fɔ muv mɔ na yu nɛk ɛn yu sholda, fɔ mek yu mɔsul dɛn strɔng, ɛn fɔ mek yu tinap fayn. Dis na big rilif fɔ bɔku pipul dɛn we gɛt nyurojɛnik TOS.
• Di tin dɛn we de mek yu nɔ fil pen: Yu dɔktɔ kin gi yu mɛrɛsin fɔ mek yu fil pen, lɛk NSAID (non-steroidal anti-inflammatory drugs), we yu kin bay na di famasi.
• Mɛrɛsin dɛn we de mek blɔd nɔ klin ɔ sɔlv am:Pipul dεm we gεt atεrial כ venus TOS kin εp bay `thrombolytic therapy` (blכd klot-disכlv tritmεnt). Dis involv fɔ gi mɛrɛsin tru wan IV layn ɔ kateta fɔ sɔlv di blɔd we dɔn de ɛn fɔ mek nyu wan dɛn nɔ fɔm. Yu dɔktɔ kin gi yu bak `anticoagulant mɛrɛsin`.
• Ɔpreshɔn: Bɔku pipul dɛn we gɛt TOS we de kɔmprɛs di at ɔ vein dɛn nid ɔpreshɔn. Sɔm pipul dɛm wae gɛt TOS wae de kɔmprɛs dɛn nerv kin nid ɔpreshɔn bak if ɔda tritmɛnt nɔr ɛp. Di dɔktɔ dɛn we de du ɔpreshɔn kin yuz difrɛn we dɛn fɔ du ɔpreshɔn dipen pan di kayn TOS ɛn di kayn bɔdi we yu gɛt. Fɔ ɛgzampul, di ɔpreshɔn we dɛn kin du fɔ pul di kɔmpreshɔn, kin pul di bon ɔ tisu we nɔ nɔmal we de mek di kɔmpreshɔn. Ɔda ɔpreshɔn dɛn kin mek di blɔd flɔ fayn bay we dɛn kin mek di strɔkchɔral prɔblɛm dɛn we de na di blɔd vesel dɛn bak. Yu dɔktɔ go ɛksplen to yu if yu nid fɔ gɛt ɔpreshɔn, aw dɛn kin du am, ɛn wetin kin apin to yu.

Yu tink se TOS go bɛtɛ fɔ insɛf ?

Nɔ, nɔ wet fɔ mek di sayn dɛn we de sho se di sik bɛtɛ fɔ dɛnsɛf. If yu gɛt sayn dɛn fɔ TOS , go to dɔktɔ wantɛm wantɛm. Pan ɔl we simpul tin lɛk fɔ trit yu bɔdi kin ɛp fɔ pul di sik, sɔm pipul dɛn kin nid ɔpreshɔn ɔ ɔda tritmɛnt fɔ mek dɛn nɔ gɛt siriɔs prɔblɛm. Yu dɔktɔ go tɛl yu us tritmɛnt plan we bɛtɛ fɔ yu.

Yu tink se dɛn kin mek dɛn nɔ gɛt TOS?

TOS nɔ kin ebul fɔ stɔp ɔltɛm. Bikɔs bɔku pan di tin dɛm wae kin mek pɔrsin gɛt am nɔr kin ebul fɔ kɔntrol am (e.g., jɛnɛtik tin dɛm), sɔm tin dɛm de wae yu kin du fɔ ridyus yu risk:

• If yu de ple spɔt we yu nid fɔ muv yu an ɔltɛm, tɔk to yu kɔch ɔ trena bɔt ɛksesaiz dɛn we go mek di mɔsul dɛn we de rawnd yu sholda dɛn strɔng.
• If yu wok nid fɔ es wet ɔ wok ova ed, tɔk to dɔktɔ bɔt ɛksesaiz dɛn we go mek yu nɔ gɛt bɔku prɔblɛm.
• Mek yu kɔntinyu fɔ tinap di rayt we. Kip yu bak stret we yu sidɔm, tinap, ɛn wok.
• Nɔ de na di sem pozishɔn ɔltɛm. Grap ɛn waka rawnd wan tɛm insay di awa, ɛn strɛch yu bɔdi smɔl.

If yu gɛt TOS, wetin yu fɔ ɛkspɛkt? / Aw yu go tek kia ɔf yusɛf?

Di luk fɔ pɔsin we gɛt TOS kin difrɛn difrɛn wan bay di kayn TOS we i gɛt. Yu dɔktɔ go ebul fɔ tɛl yu bɔt aw yu de si tin.

If yu gɛt TOS, fala wetin yu dɔktɔ tɛl yu bɔt aw fɔ kia fɔ yusɛf. Yu dɔktɔ kin tɛl yu tin dɛn lɛk:

• Ridyus ɔ stɔp fɔ kɛr ebi ebi bag dɛn oba yu sholda ɛn es tin dɛn ɔp yu ed as yu ebul.
• Wok wit pɔsin we de mɛn yu bɔdi. Du di ɛgzampul dɛn we i de gi yu.
• Du ɛksɛsayz dɛn we yu kin du na os fɔ mek yu mɔsul dɛn strɔng ɛn fɔ mek yu tinap fayn.
• Limit ɔ avɔyd sɔm muvmɛnt dɛm wae de mek yu gɛt mɔr sik.Chenj di tin dɛn we yu de du ɛvride.

Ustɛm yu fɔ go to dɔktɔ? / Kwɛshɔn dɛn fɔ aks di dɔktɔ

If yu gɛt nyu sik ɔr if yu sik chenj, tɔk to yu dɔktɔ. I go tɛl yu aw ɔltɛm yu fɔ go to yu dɔktɔ ɛn if yu nid fɔ du ɛni tɛst.

If dɛn jɔs dɔn no se yu gɛt Thoracic Outlet Syndrome, na sɔm kwɛstyɔn dɛn ya yu kin aks yu dɔktɔ:

• Us kayn Thoracic Outlet Syndrome a gɛt?
• Wetin na di rizin fɔ dis?
• Us tritmɛnt dɛn yu kin advays? Ustɛm dɛn fɔ du dɛn?
• Aw wi go no if di tritmɛnt dɔn wok fayn?
• Wetin na di prɔblɛm dɛn we kin apin we pɔsin gɛt tritmɛnt?
• Us chenj dɛn a nid fɔ mek pan di nɔmal tin dɛn we a kin du ɔ di abit dɛn we a kin du ɛvride?
• Wetin a kin du na os fɔ ridyus di sayn dɛm?
• Wetin na di we aw a de si tin?

Tin dɛn fɔ mɛmba frɔm dis atikul (Take-Home Message)

Thoracic Outlet Syndrome (TOS) kin ambɔg yu nɔrmal layf. I kin mek yu at pwɛl we yu gɛt fɔ blo smɔl pan yu spɔt ɔ wok. Bɔt peshɛnt. If yu tek kia ɔf yusɛf wit fizik tritmɛnt ɔ ɔda tritmɛnt, yu kin gɛt yu trɛnk bak ɛn de wɛl as tɛm de go.

De tin wae impɔtant pas ɔl na fɔ go to dɔktɔ if yu gɛt sɔm kayn sik, pas fɔ ignore dɛm. If yu no di tritmɛnt kwik kwik wan, dat kin mek i izi fɔ tek di tritmɛnt ɛn i kin mek yu nɔ gɛt prɔblɛm dɛn.

If yu gɛt ɛni kwɛstyɔn bɔt yu sik, tritmɛnt plan, ɔ aw yu go si, tɔk to yu dɔktɔ.

` Thoracic Outlet Syndrome, TOS, nek pen, an pen, sholda pen, numbness, nerve comppression