United Brachial Plexus Network, Inc.

Hello,

Rick went back to his PM & R doctor this week. I have some questions, but don't know if they are in relation to his BPI or if it's due to his auto accident.

He's had a tendency to lean his neck since his accident. It leans to the right and his left arm is his injured arm. His PT had worked with him in therapy with his neck positioning. He said it was due to the BPI. Since Rick had surgery on Jan. 13th, he's just now getting back to therapy. His neck is the same as it was before the accident, leaning terribly to the side.

Is this something most people with BPI experience? The muscle wall in the neck is so very tight and tender. Rick's PM & R doc has prescribed a specially-compounded ointment that contains lidocaine, ketoprofen, and baclofen. He said we could also try Botox? Have any of you heard of this before? The Botox thing I'm really leary of....

I appreciate your input and thoughts!

On a sidenote, Rick's follow up went well. He's still got a pinhole on his incision on his bicep that's not yet healed six weeks out from surgery. He's started therapy back now.

He thought the pain would have gone away or lessened and was somewhat disheartened about that. I'm hoping that getting back to therapy will help to work him toward the goal of getting movement back. It's hard sometimes to continue to be encouraging - almost like it's easy for me to stay positive because I'm not going through it all firsthand.

Sorry for the babbling....hope it makes sense!
Kim
Wife of LTBPI

Hi- I feel I lean my head a bit away from my impacted right side. I also have tender feeling muscles on the impacted side, and headaches on the left. My thought is that it is due to the loss of muscle tone on the impacted side, and the body trying to balance itself with fewer functioning muscles. I also lose my balance to the left at times.


> Hello,
>
> Rick went back to his PM & R doctor this week. I
> have some questions, but don't know if they are in
> relation to his BPI or if it's due to his auto
> accident.
>
> He's had a tendency to lean his neck since his
> accident. It leans to the right and his left arm is
> his injured arm. His PT had worked with him in
> therapy with his neck positioning. He said it was
> due to the BPI. Since Rick had surgery on Jan. 13th,
> he's just now getting back to therapy. His neck is
> the same as it was before the accident, leaning
> terribly to the side.
>
> Is this something most people with BPI experience?
> The muscle wall in the neck is so very tight and
> d tender. Rick's PM & R doc has prescribed a
> specially-compounded ointment that contains
> lidocaine, ketoprofen, and baclofen. He said we
> could also try Botox? Have any of you heard of this
> before? The Botox thing I'm really leary of....
>
> I appreciate your input and thoughts!
>
> On a sidenote, Rick's follow up went well. He's
> still got a pinhole on his incision on his bicep
> that's not yet healed six weeks out from surgery.
> He's started therapy back now.
>
> He thought the pain would have gone away or lessened
> and was somewhat disheartened about that. I'm hoping
> that getting back to therapy will help to work him
> toward the goal of getting movement back. It's hard
> sometimes to continue to be encouraging - almost like
> it's easy for me to stay positive because I'm not
> going through it all firsthand.
>
> Sorry for the babbling....hope it makes sense!
> Kim
> Wife of LTBPI

Well my parents have taken me back in since my accident. I was injured badly and havent returned to work. Its kinda hard to be a grown man and living under my parents roof but I love them and cant possibly repay what they've done.

That said, my mother drove me nuts for a long time after. I also injured my neck with a laceration but I leaned my head a lot. I just wanted to be comfortable and she wouldn't stop saying try to straighten your neck. Its not gonna stay that way forever! I took time, kept myself comfortable, streched and recovered at my pace and hold it straight most all the time now. If it doesnt stay straight all the time, who cares? Thats surely not my biggest problem or concern.

It took time to get swelling to go down. Collarbone was outta shape, cuts healing, and tendons and muscles to stretch back out. It it doesn't bother him, don't worry about it. My 2 cents.

Kim, The "leaning neck" is something my son went through. He had alot of swelling and tenderness, it was horrible. It was like that for a long time and until most of the swelling went down PT couldnt do much. After though, they worked with him alot and its ok now. But it took a long while.

Did Rick have a TBI from his accident? Dustin had this and early on always leaned his head away from the side of the brain injury. The drs said that they found this with most patients that had a brain injury, though they don't know why. We were incouraged to try to have him hold it straight because long periods of him leaning it would let the muscles and tendons tighten and shrink which would eventually mean it would stay that way. Now that he is basically recovered from all but the BPI I notice that his neck still leans slightly but if you weren't looking for it you would never notice. Don't want to scare you but just passing on what they told us.
Sue

Funny thing, I also had to move in with my parents and though they are fantastic and mom brings me all the hot chocolate I can drink, it's just not my home. Can't wait to have my own place again.
That said, I have trouble turning my neck towards my injured arm and it cracks like a bag of pop rocks when I do. I think this is do to fractures I had in my c2 and c3. Had to wear a collar for two straight months which was torture.
I know with my dad's healing ankles between injury, swelling, and nerve damage the muscles cramp and seize around the nerves. Could this be part of that? I could see that's why they would recommend botox as it would paralyze the muscles and force them to relax (note I am not speaking from experience with botox)

My fiance also has the same issue. His head leans away from his affected arm. Our therapist told us that it is because of the muscles. Because he doesn't have the muscle capability to hold his arm up into socket, he uses accessory muscle to compensate for that. The neck and some back muscles that were not affected by the injury are contracted much of the time to try to lift up that arm into socket. It is kind of like when you are trying to carry something very heavy in one hand, and your body leans the opposite way to help your arm with its weight. You tend to lean your head and body to the opposite side. The only thing that was recommended to him to help relieve this was therapy. The therapist stood behind him in front of a mirror and tried to straighten out his neck and have him hold it while watching his head to visualize it straightened. Helped a bit, but was a little painful so he didn't do it as much. Just lives with the crooked necked. The only thing to worry about is scoliosis because of the curvature it creates in the spine.

Kelly

Heard it all before!

It is not going to "stay that way". While it is somewhat true that it can lead to tightened muscles and tendons, those are not permanent conditions that can't be slowly corrected as the "injured" person sees fit. Permanent spinal curvature? I have dealt with this and self corrected over the last year and a half. The important thing is that they do what makes them most comfortable and endure the least pain. It seems somewhat superficial to me to worry about anything visual or cosmetic after all else we have to worry about.

Having someone constantly comment about it, no matter how much they care, just makes you feel self conscious and worse. I still do it occasionally if it helps me. I don't want to be bothered about it.

Sorry! Just a pet peeve.

Yes, Rick did suffer a skull fracture, inner ear fracture and TBI from his accident. He had a open jaw fracture as well as facial fractures and was in a cervical collar for four days until he was able to have surgery.

I think I do recall something being said when Rick was in ICU about this happening with someone with his injuries.

When he was first rehabbing, it really bothered him about his head. Over the course of the last six months he was able to get it loosened up and able to keep it straight. However, since he had to quit therapy after his nerve graft in early January, the lean has become progressively worse.

It sounds like it could be from a combination of all his injuries.