United Brachial Plexus Network, Inc.

Hi all!! I'm so glad I found this sight- DH sustained a BPI 4 weeks ago in a dirt bike accident and I feel like we are really in unknown territory and floundering. Just a short rundown on him, then my questions....
After the accident, he had no movement in his arm at all, since then, things are starting to come back. He doesn't have much movement when standing up, but when laying down he his has quite a bit of movement in his bicep and tricep and can hold his arm straight out in front of him by himself once I get it into that position.

We've been through 3 doctors, and finally found once that recasted his hand (also broken) so we could get the EMG- the dr. said that the test didn't seem to indicate any tears (can't be absolutely sure), but instead was probably bruised and/or stretched. At this point, they have advised us to wait, see him again in 3 weeks, possibly get another EMG and give him somemore time to heal. At 3 months if movement is still limited he would start talking nerve graft.

So, here are my questions....
Right now we are seeing an orthepedic surgeon. While we appreciate him in that he finally got the ball rolling on testing- is this the right person to be working with?? Should we be seeing a neurologist?

At out last appointment, DH's pain wasn't bad at all (OK, it's always been bad, but not laying in bed screaming bad). In the last 4 days it has gone though the roof (ie-laying in bed screaming). They have advised him to just take ibuprofen and ice it. I don't know if we want to cut ties with this Dr. since we've finally found someone who is more proactive, but there has to be some other kind of pain management for this, right?

Finally- his pain sensation....he's always gotten some stabbing pain through his forearm and into this thumb, this is what is escalating and so painful. Even the lightest touch to his hand is painful (ie funny skin sensation) Sound like pain others of you have experienced??

Anyway, if you're still reading, thanks. I know I'll have a million more questions as we travel this road.

Amanda

Sorry to hear about your husband's accident. Hopefully a stretch injury is all he has.

I think a neurologist would be helpful to assist in his recovery. And I can tell you, and others here will too, NSAIDS will not cut the pain. Period. Nerve pain is different than inflammation of say a muscle, and there will be continueing discomfort. He would need an opiate, like vicadin for example, and something for the nerve pain itself, like neurontin. Some people get sick on both of these, so you're going to have to test them. There are other meds in both these areas, perhaps others can name a few to try. Ice might work while the tissue is chilled as it slows down all impulses, but once it's removed and regains normal temperature, you're generally back where you were. Well unless of course you would get over-zealous on the ice and cause the tissue to freeze and burn. You don't want to do that.

The pain he is getting when there is light touch, as in from clothing or a gentle stroke, is called

Allodynia: Pain from stimuli which are not normally painful. The pain may occur other than in the area stimulated. Allodynia means other pain.

Cutaneous allodynia: Pain resulting from an innocuous stimulus to normal skin or scalp. The stimulus that triggers allodynia is not normally painful. The pain can be provoked by combing or brushing the hair, shaving, showering, wearing glasses or earrings. The pressure of a single strand of hair reportedly can feel like a jab with a white-hot knife. Cutaneous allodynia is believed due to a transient increase in the responsiveness of central pain neurons that process information arising from the skin.

I have that with the ice on the neck area, feels like it is burning. As well, after the accident and I suffered whiplash and a shoulder injury, any pressure on the area felt like it was being chewed on you might say. Hard to describe it. Good luck to you and your husband. BTW, has he had an MRI on the brachial area, or any of the injury sites?

Thanks so much for the info Wendy. DH does have some vicadin the emergency room gave him right after the accident (before we knew about the BPI- just for general discomfort) He didn't like the nausea that accompandied it, but that might be better than the sheer pain he's got now, at least until we figure out another plan. He did have CT scans done of his shoulder arm and hand the night of the accident, ubt no MRI- can that give more conclusive info on the extent of the injury than the EMG? I think we will try to consult a neurologist about this. While we did appreciate that this dr. finally got the ball rolling, I'm not sure his expertise is going to serve us the best in the long run. Anyway- thanks so much for the info!

Try to get him something for the neurogenic pain he is having, either Neurontin (gabapentine) or Lyrica (pregabalin). There are other meds like Amytryptalin or Nortryptaline that work well at night too.
Good luck,
Marieke (31, LOBPI)

If the vicadin makes him ill, he shouldn't take it. Could get a really bad reaction from it. Reactions like that are for a reason, you generally don't build up a tolerance with drugs. They just pick the worst time to cause a system collapse.

But there is other things like toradol, ultram just for two. No a CT scan is good, and the EMG will show if there are nerve problems. Unless there is absolutely zero signal in a nerve, from point A to B, hard to say if there is or isn't a tear to a nerve. However, since your hubby is having shooting pain like he is, I would guess the nerve is entrapped or damaged somehow. And you would need a neurosurgeon to release it.

I am so glad you found this site too!! First off sorry to hear of your husbands injury. You will find a wealth of knowlege and support from the people here who have/are living it also. I think we all felt floundering and this will make that much easier. EMG and MRI are good, but not 100% accurate on a BPI. Unfortunately nothing is 100% accurate without going in to see. As your dr stated it seems early to worry about that especially with him already seeing improvements. We were told that a natural healing would give the best return if possible. Nerve graphs should be done by 6 mos post accident if needed so you are well within that. My son, Dustin, can also do many more movements when laying down or in water, taking the gravity out. It is important to keep doing ROM and light strengthening exercises. Small improvements are good. You don't mention if he is seeing a PT or OT. They would be able to set up an exersice plan for him working on the particular muscles that he needs. As far as drs I would say seek out a BPI specialist. Most ortho or neuro's have some ideas of this area but if it came to surgery I would definetaly see a BPI specialist even if just for a 2nd opinion. As for pain I don't have a clue as Dustin seems to be in the minority here(where I hope he stays), he is pain free.
Good Luck,
Sue

sorry for your situation,, i have tried everything from aspirin to morphine..None really kill my neuropathy. I finally settled on a cocktail of LYRICA, AMITRIPTYLINE, OXYCONTIN.. I tried nerve blocks in the spine they did not work well. Noneof the current mediacl tech seemed to help.. I found a healer, a cuz who practices HEALING TOUCH, he did more to help in an hour than modern medicine did in 6 yrs. It has been a real miracle for me. I went from not able to do anything to becoming more active. It is now the most important pat of my health regime. I have had 3 back surg. 2 hand and somewhere around 21 epiderrals. 10 was th e low end of my pain scale.24/7 never leaving. it i sstill there but no where near as bad.H. touch helps you recover an d unblock the energy paths in the body. The same energy the neurologists measure they call it something else is all. Painless, inexpensive and halpful. google it! best wishes marley

In my case, "Tegretol" 100 mg, one in morning and one in the night, was adviced... It helped reduce my pain.

The tablet name might change in other countries/manufactureres. The ingredient is: carbamazepine

-Raghu

I also am new. Only been 1 1/2 months.
Doc told me today, that since I am trying to stay away from opiates, to keep up the Ultram. I am having bood
in my urine, not sure if Plavix or Percocet with Tylenol
So rtyng to slow down with those.
God bless and prayers for both of you.
Rhonda

Hi...

The best relief Matt has received before the lidocaine was a hot tub, if you have one available try it out. We were told if ice helps heat will worsen the pain and the if heat helps don't ice it.

Best of luck