A Medical Mystery

Gina Hammer knew something wasn’t right when she began to unexpectedly drop things and lose function in her right arm. This and other unusual symptoms would eventually bring the Hawaii resident to The Johns Hopkins Hospital in pursuit of relief.

Gina had grown accustomed to intermittent pain in her shoulder blade/thoracic spine region, pain that eventually began to manifest in her elbow. Given her history as an avid tennis player, she was initially diagnosed with tennis elbow and treated with a regimen of physical therapy and cortisone shots, which seemed to help ease the discomfort.

However, over time, her symptoms became more concerning. “I started to randomly drop my tennis racket and even dishes,” she explains. “I felt a coolness, weakness and heaviness in my arms.” She underwent a battery of medical tests and studies, none of which showed anything physically wrong.

“My arm would bend at the elbow involuntarily any time I exercised. I physically could not straighten it,” recalled Gina, who began to realize tennis elbow was not the culprit. “I needed help. I couldn’t even push my daughter in her stroller without intense pain radiating into my right shoulder.” Perhaps most alarming, Gina, physically fit and athletic, began to have trouble catching her breath when she ran or played tennis.

A Physician Referral to Johns Hopkins Begins a Road to Recovery

With her latest and scariest symptoms unfolding, Gina went back to her local doctor, who was concerned about a possible blood clot and suspected there was something more. He diagnosed Gina with thoracic outlet syndrome (TOS), a condition that arises when blood vessels and nerves become compressed between the collar bone and first rib. Knowing the complexities of treating TOS, Gina’s physician in Hawaii referred her to Johns Hopkins Medicine, which is nationally known as a center of excellence for TOS treatment. At Johns Hopkins, Gina connected with Ying Wei Lum, M.D., a vascular surgeon and expert in the treatment of TOS.

Lum quickly confirmed her diagnosis and scheduled her for surgery in November 2014. “I was impressed by Dr. Lum’s willingness to accommodate,” Gina remembered. “He recognized the great distance we were traveling for treatment, so he and his team made every effort to simplify the process. He spoke to us in easy-to-understand terms, and his responsiveness was second to none. I knew if I emailed him with a question or concern, he would respond right away.”

During the procedure, Lum made a discreet incision through Gina’s armpit (known as a transaxillary approach) to surgically remove her first rib, immediately decompressing the blood vessels and nerves to relieve pain and restore normal function. When she awoke from surgery, Gina noted that her whole arm, which previously was always cold due to restricted blood flow, was warm, and that her hand already had started to feel normal again.
Gina now lives in Washington state with her family. After giving up tennis completely during the ordeal, she can now play again. “Although I get occasional hand cramps, I am thrilled to have my life back and to be able to do pretty much everything I want to again. I truly don’t know what would have happened to me if I hadn’t met Dr. Lum and had this surgery.”