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By Rachel Kagno
It was anything but a normal Sunday for 18-year-old MIT student Grant Fuhr. The computer science student and varsity swimmer from Des Moines had just returned to his college dorm from swim practice when he felt an unusual pain in his chest.
“It was so random,” Fuhr recalled. “Every time I took a breath, I felt pain in my chest. I couldn’t sleep at all.”
The next day, he went to student health services, where he was told he had a virus and needed rest. After spending the rest of the week in bed and feeling a little better, Fuhr decided it was time to get back in the pool.
“My arm instantly started to hurt and became purple and swollen. At this point, I knew something was terribly wrong, but I had four mid-term exams that week…I had to get through them.”
What happened next is a bit of a blur.
“Everything happened quickly,” said Fuhr. “One minute I was taking a test, the next I was being whisked away to Newton-Wellesley Hospital. I tried my best to remain calm, stick with my faith and tell myself everything would turn out alright.”
At Newton-Wellesley’s pediatric emergency department, Fuhr met vascular surgeon Christopher Kwolek, MD, who “explained everything that was about to happen, with a calm and reassuring voice. I felt like I was in good hands.”
Dr. Kwolek told Fuhr he likely had thoracic outlet syndrome, or TOS, a condition often seen in high performing athletes, but also found in people who use their arms in a repetitive motion. It’s exactly the kind of motion that can lead to the compression of nerves or blood vessels in the thoracic outlet, an area bounded by the base of the neck and first rib.
In the operating room, Dr. Kwolek inserted a catheter to dissolve the blood clot in his right arm. Afterwards, Fuhr was transported to the ICU, where he spent the night.
Mom on the move
During all of this, Fuhr had been talking on the phone daily with his mom, Michelle Fuhr. After hearing from MIT Medical that her son had a virus, she did some research online. Concerned by what she learned, she decided to text her neighbor, who also happened to be Grant’s pediatrician.
“Something didn’t feel right to me, so after I described Grant’s symptoms, my neighbor confirmed what I already knew: he most likely had thoracic outlet syndrome and needed to go to the ER immediately.”
Fuhr had never heard of TOS before his diagnosis. Swimming had always been a huge part of his life, ever since his first summer league swim team at age 5. By the time he entered his freshman year at MIT, he had been lifting his arms over his head in a repetitive motion for years – exactly the kind of long-term overuse that creates thoracic outlet syndrome. It finally had caught up with him.
Michelle and Glenn Fuhr arrived from Des Moines at 1 a.m., several hours after their son’s procedure. They were weary from their trip but relieved to find that the nurses were keeping a close eye on him.
“The ICU nurses were amazing,” Mrs. Fuhr said. “One nurse stayed up late talking with Grant, reassuring him. Then she offered us a bed near Grant that was not being used. It was the middle of the night and to have to leave our son and go to a hotel would have been stressful. She was so kind to let us stay.”
The next day Fuhr was back in the OR, where Dr. Kwolek performed a balloon angioplasty (to help open narrowed arteries) and removed the catheter. By day three, Grant felt minimal pain, which could largely be controlled with Tylenol.
After being seen and evaluated by Dr. Kwolek, Fuhr was ready to go home to Iowa for Thanksgiving. But he still had a long road ahead of him.
Over the next few months, Dr. Kwolek performed two more procedures to remove Fuhr’s right and left top ribs, which were rubbing his collarbone and pinching his vein. In a rib resection, the surgeon widens the thoracic outlet by removing an extra rib and often the muscles attached to it. Surgery may also involve removing scar tissue caused by the repetitive use of an arm or shoulder that may be compressing adjacent nerves and muscles.
After a physically and emotionally challenging few months, Fuhr is back at MIT, looking forward to getting started with physical therapy and eventually returning to the varsity team and competitive swimming.
As for his prognosis? According to Dr. Kwolek, with hard work and perseverance, Fuhr should be back in the water soon. “Most patients return to their previous lifestyle without difficulty,” he said.
Swimming is definitely on Fuhr’s mind. “Will I be mentally tough enough? Will my body be ready? Will I have any other health complications? Will I still have the same passion? I think these thoughts are only natural but that won’t stop me from trying.”
Thoracic outlet syndrome is a group of disorders that occur when blood vessels or nerves in the space between the collarbone and first rib are compressed. This can cause pain in the shoulders, neck and arms, as well as numbness in the fingers. The condition is common among athletes who participate in sports that require repetitive motions of the arm and shoulder, such as baseball, swimming, volleyball, and other sports-related activities. Treatment for thoracic outlet syndrome usually involves surgery, physical therapy and pain relief measures. See your doctor if you consistently experience any signs or symptoms.
For more information about vascular services at Newton-Wellesley Hospital, visit: https://www.nwh.org/surgery/surgical-specialties/vascular-surgery/vascular-surgery
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