I woke up to a knock on my door. A mix of vascular surgeons and residents walked into my hospital room to explain the surgical procedures they would be performing in less than an hour. My right arm lay next to me, completely limp and propped up on two pillows, a mix of purple and dark red, swollen from my shoulder down to my hand. It was still early in the morning; the sun hadn’t risen yet, and I was too tired to listen or care what the team of doctors was saying. The only words that mattered were the last things one of the surgeons said before leaving the room: “You’ll probably be out for the season.”

The previous 48 hours had been hectic. Two days earlier, aside from some mild unexplained soreness, my right arm (the one I pitch with for Palo Alto High School’s Varsity baseball team) felt great. I went through my extensive warmup routine, played catch and even pitched two innings in a scrimmage. After practice, I looked down at my right arm. It was unusually bright red and swollen. Although concerning, my arm wasn’t in much pain, and I assumed some ice and rest would help return it to its normal color. 

However, when the color had not resolved the next morning, I finally went to the emergency room and got diagnosed with an injury I’d never heard of before: Venous Thoracic Outlet Syndrome (TOS).

TOS is an extremely rare condition, primarily affecting athletes who use repetitive overhead arm motions, like baseball pitchers or swimmers, affecting nerves or blood vessels in the shoulder and upper chest. Stanford doctor and Chief of Vascular Surgery Jason Lee said that the condition occurs when the affected vein doesn’t have enough room between the patient’s first rib and clavicle, leading to a blood clot.

My first hospital visit lasted two days and involved two separate procedures in a 12-hour span to break up the clot using blood-thinning medications, which I’d likely remain on until the end of May.

In early March, I also underwent a rib resection, which involves removing part of my first rib that was compressing my subclavian vein. Lee, who performed the surgery, said the procedure would decompress the shoulder area and prevent future blood clots.

“The goal of that operation is to create more space so that in the future, the vein is not compressed, or the body isn’t put at risk anymore,” Lee said.  “It allows the athlete to get back to their usual activities.” 

Lee said that while 80 to 90% of patients undergo successful treatment through completely removing the blood clot and reopening the vein, there are still patients who have complications and need additional treatment. Sometimes their veins never return to their full pre-injury function. At a follow-up appointment three weeks after my rib resection, doctors determined that my subclavian vein had collapsed again. I underwent two more procedures in a span of a month in an attempt to balloon my vein back open.

I was devastated. After four surgeries, I wondered if I could do the same activities I did pre-injury, and if I would ever be able to throw a baseball again. 

However, after conversations with doctors and going through physical therapy to regain my strength and mobility after my surgeries, I realized that everyone’s recovery process is unique. Although mine might take longer than most others and will likely heal differently, my body will find a way to adapt and live with a compromised subclavian vein.

“Blood flow in the body is an amazing thing,” Lee said. “When something is narrowed or blocked, the body on its own will find what are called collaterals, or detours, where then the body heals itself to allow the patient to compensate for some blockages that might be there.”

In the past, I’d taken my health for granted. Missing my last season of competitive baseball that I poured so much time and effort into made enduring my injury physically and mentally difficult.  However, it has allowed me to engage in other activities, like coaching Little League baseball in East Palo Alto. I’ve been able to make peace with the fact that while my arm may not heal perfectly, I can still achieve a positive recovery and return to playing the sport I love.