Your Symptom Checklist — Why This Matters

Before we dive into any exercises, I want you to stop and take stock of where you are right now.

I know that might feel like an unnecessary step. You're in pain, you want to get moving, and filling out a checklist doesn't feel like progress. I get it. But this baseline is one of the most important things you'll do in the entire program — and my own experience is exactly why I know that.

The story behind the checklist

When my subclavian vein clot was diagnosed in 2011, I had obvious, measurable symptoms: a visibly swollen arm, a bluish tint to my skin, and imaging that confirmed a four-inch clot. The diagnosis was clear.

Five years later, living in Boulder and experimenting with a new handstand-heavy workout routine, I started developing pain and swelling in my right inner elbow. My mind went immediately to blood clots — understandably, given my history. I had recently treated a patient with the exact same complaint who turned out to have a medial elbow clot. The fear was real.

But after a thorough physical examination with a colleague, the culprit wasn't vascular at all. It was ulnar nerve tension — the peripheral nervous system, not the vascular system. My colleague explained it this way:

"The nervous system is like a garden hose. The hose is your nerves, and the grass, trees, bushes, and yard furniture are your muscular, vascular, skeletal, and lymphatic systems. With your recent overhead activity, the hose wasn't moving freely through the complexities of the yard — it became tensioned and compressed, limiting its ability to water the grass."

What resolved my symptoms wasn't a procedure or a medication. It was understanding what was actually happening in my body. That clarity settled my nervous system, I temporarily modified my activity, added some light exercise — and the symptoms resolved completely.

Why I'm telling you this

TOS symptoms are notoriously difficult to interpret. Pain, tingling, swelling, weakness, and color changes can all have overlapping causes. Neurogenic TOS — the most common form, and what this program primarily addresses — can even mimic vascular symptoms, as my own story illustrates.

This is why tracking your symptoms carefully matters so much. Not just the pain levels, but the patterns. What time of day are your symptoms worst? What positions or activities trigger them? What makes them better? These details tell a story that a single clinic visit often can't capture.

My surgeon once described the vascular system to me this way: "Imagine your veins as a detailed network of roads. The subclavian vein is the major highway. When it closes, your body builds collateral routes — side roads that gradually take on the traffic." That kind of mental model changed how I understood my own recovery.

I want you to build that same kind of understanding about your symptoms.

How to use this checklist

Rate each symptom on a scale of 0–10 based on how you've felt over the past week — not just today. TOS fluctuates, and a single bad day can skew your perception. The week-long view is more accurate.

Then keep it. At the end of every phase, you'll re-rate these same symptoms and compare. Watching those numbers move — even slowly — is one of the most powerful motivators in a long recovery process.

As you move through this program, I want to challenge you to do one thing: look for patterns. Not just in your pain levels, but in the environmental and lifestyle factors surrounding them. Sleep, stress, posture, activity load, screen time — all of it is data. The more clearly you can see the pattern, the more control you have over it.

That shift — from feeling at the mercy of your symptoms to understanding them — is where real recovery begins.