United Brachial Plexus Network, Inc.

Hi, I was recently to see our Dr. for my son's injury. Michael had a nerve graph at the age of 6 months. The doctor told me,we should see some bicep movement by the age of 2. Michael will be 2 next month, he still has no bicep movement. Now they are telling me they moved the age limit to 3. That there is still hope. I'm wondering if I should seek a third opinion or just wait and see what happens. Any Ideas?

Thanks
mylittemj's mom

Javier had nerve grafts at 10 months. We were told that any return he would get could take up to 18 months to show and would continue progressing for atleast 3 years. He will be 2 in May and is 13 months post op. We just had the OT and specialist confirm bicep, and even that is with gravity(on his back).

I would probably get a second opinion, but you might hear the same thing. Have you asked the surgeon why they changed it to 3 years?

Good luck, Marlyn

I thionk you should definitely get a nother opinion. Does he have a strong tricep?/

I think you should think about getting an EMG done to see if there's innervation. They can do a surface EMG that's less invasive than a needle one. Why wait and worry for another year. A test on just biceps will take about a minute.

My little one had nerve grafts (4) at 4months. We were told to wait for bicep until 2 years POST OP. We had the emg done during her second surgery (at 11 mo)and the grafts took but she still no dicernable bicep function. It really depends on the injury. We were just in Philly for a third surgery and the ot's were trying to figure out how to grade her because she is starting from negative positions on most things. ooopps, off track... At almost four and only after having Dr. Kozin fix her severe internal rotation are we able to see some tiny amount of bicep. What joy it brings to her and my heart that she can (still using mostly gravity) flex her muscles! Definitely get a second opinion, but in our case it took over three years to see anything.

Hello! It's been a while since I posted. I was lurking again and read your post and wanted to share our bit with you.
My daughter Tara has a LOBPI. She had the nerve graft and the secondary surgery. Her injury was on the severe side. At 2 years old we still did not see any bicep or tricep progress(among other things), it was like we hit this plateau in therapy for a few months. BTW we have gone to therapy 2-3 times a week since birth. Tara turned 4 in January and she is just now showing trace bicep and tricep movement. The doctors at Children's in Seattle & Texas are amazed to say the least - she was never supposed to come this far. The doc at Seattle Children's told me he was speechless and would have argued that the bicep would have never come just a few months earlier.
She does not have use of the muscles yet - but they are fluttering and getting signals. We don't do anything fancy but we are consistant in therapy and our PT/OT has BPI experience prior to us coming along. Most important is that Tara loves it and wants to go. If I call in sick cause I don't feel like going Tara calls her grandma and complains about what a horrible mom I am for not letting her go to PT. She believes that present therapy is important not only for right now but for when she is an adult too.

There is still many things Tara can't do, but there are many more things she can. As a stubborn red-head, she insisted she wanted to learn to swing on the big kid swings. She told her PT and they did therapy based on that. We now have a play system in our back yard that she swings on everyday without fear of falling. She climbs the rock wall and a hundred other things with a left arm that is barely an assist arm. She can take her own dishes to the sink, ride a bike, give the best hugs in the world. She knows her lefty is different and it's smaller with limited feeling - but that her lefty is not what defines her.

The one thing her dad and I have learned in the last 4+ years is that the doctors don't know everything about your child's capabilities. We were told the same thing "You should see something within x amount of time" Well, we didn't see much to talk about in the first 2 years of either surgery. I hope you took the doctors telling you there should be movement by 2 as a guideline and not a cut off for improvement.
As for opinions - go with your mommy heart and follow it. If you have any doubts find another doctor, just remember they are learning too.

Feel free to ask me anything I am happy to share.

Brenda Scamehorn (mom to Tara)
Burlington WA

His tricep is limited, he can only lift it midway. Why? does that make a difference?

Thanks for the responses from everyone.

Have a Happy Easter!

My daughter Julia had absolutly zero bicep until 28 mths and Dr Nath kept telling us it was there and I was beginning to disbelieve him but after a higher dose of botox into the tricep she one day only a week after botox took a cheerio and put it to her mouth just like that. Before that I must have asked her to do it a thousand times, with no movement at all, not even gravity assisted. she is doing well now but still very weak. good luck !