Hey Everyone

[gimpyfireman2010]

I have been surfing this board for the past week and figured it was time to post.

On May 19 I was cut off by a transport truck on my motorcycle. I broke my right dominant arm in 6 places and had plates put in to hold it together. 8 weeks post accident my bone is healed but I am now realizing I have a Brachial Plexus injury. I can move my shoulder and with physio am now able to move my fingers about 50%.

After reading many of the stories here it seems my mobility in my hand is better than most. At this time I can't flex at the elbow or get any movement in my bicep. I assume the reason I can't seem to find stories of people recovering without surgery is because when they get better they stop posting? Anyone here recover without surgery? How long before movement returned? I work as a firefighter and the thought of losing my beloved profession scares the hell out of me.

Thanks in advance for any comments.

I'm in chat everyday but its dead!

[Christopher]

Some folks have recovered without surgery, but it is fewer than we'd like. I highly recommend getting a qualified BPI specialist to check you out and help determine what you're up against (surgery or not and why). Understand that most neurologists and other specialists (no matter who excellent they are in their field) have no real idea or experience in handling BPI cases. I'll throw in my 2 cents since I spent every penny I had finding the best specialists and interviewing everyone in between. Get yourself in somewhere good soon. Don't waste time. Some specialists have wait lists for months before you can see them.

I went to the Mayo Clinic in Minnesota. No one in the southern California area (or west coast in my opinion) was qualified to give me the best treatment available. The docs at the Mayo are very advanced, yet still very conservative. They prefer not to operate if possible (which is rare considering they are surgeons and that's what they do). They are truly interested in the best possible outcome for each individual situation. That's my 2 cents.

Best of Luck!
Christopher

mayo appointment page:
http://www.mayoclinic.org/brachial-plex ... ments.html

[gimpyfireman2010]

Great advice thanks!

Other comments appreciated.

[AngelaW]

Christopher pretty much nailed it on the head. The mayo clinic team is amazing and are among the few doctors who specailize in brachial plexus injuries. There are certain tests (emg, possibly with a lumbar puncture) that need to be done to determine if what you have is a b.p. injury, and if so, how bad the injury is. It is important to get checked out soon because if surgery is needed, the best results are within about a 6 month window from the time of the injury.
Nerves take a long time to heal (one millimeter a month I think) so it can take years to see how much you will recover, with or without surgery.
There are a few on the board who have had nearly full recoveries without surgeries but it is rare. Consider yourself very lucky to be able to use yor fingers as they are the most dificult for doctors to try to fix.
I am curious about your arm flexion.......do you know if the muscles, especially your bicep are completely intact? I ask this because you mentioned you broke a lot of bones. I broke the upper part of my arm badly and the bone pretty much shredded the muscle when it broke through and that was the main reason why I can't bend my arm.........is it possible that that has happened to you?

good luck

[gimpyfireman2010]

Thanks Angela.
My bones were broken in my forearm below the bicep. As far as I know other than being flabby my bicep is fine. I have an MRI Aug 5 and am awaiting an appt with a nerve specialist here in Toronto. This board really helps! Being able to speak with others having similar experiences is a great resource.

[BaldPlumber]

Hi

I managed to compress/stretch/crush C7-C8 during a shoulder dislocation on July 4th last year. I know that there are people here with great knowledge on the anatomical side of things, but unfortunately I am not one of them, so all I can tell you about are my personal observations. Whether they are a perfect fit to a C7-C8 injury, I have no idea.

Immediately following the accident, I had no triceps, no wrist movement, no finger movement of any kind, I could not extend my forearm which didn't actually matter because my upper arm could only move about 15 degrees in any direction.

I was referred to our UK specialists in London for examination at about the 10 week post accident mark. Although the consultants are specialist nerve and orthopaedic surgeons, they are loathe to open you up at the first opportunity, but did seem happy enough to talk about what surgeries were possible at a later date if needed. Here in the UK at least, they adopt an initial wait and see approach. On the standard tests they do, I managed to score zero for just about everything.

I did have nerve conduction tests shortly afterwards which showed evidence of nerve regeneration, which I was delighted with.

As I understand it, your own body destroys the nerves downstream of the the injury within a few seconds of it happening. It then starts the process of preparing for regeneration, which takes a while. When this is complete the nerves can start to rebuild at an approximate rate of 1mm per day or about 1 inch per month. This is obviously frighteningly slow, but it seems nothing can be done to speed things up.

In my case I think that some of my nerves were just a bit shocked and recovered fairly quickly, my fingers in particular were able to move about a bit, well just sort of waggle really, but not straighten.

Anyway, my triceps returned at about the 5 month period, my wrist followed about 4 months later and I have recently got my finger extension back. I still have a little bit to go on my thumb which has not regained full range of movement and my fingers have very little strength but are rapidly regaining it.

I had my last appointment in London a couple of weeks ago and have now been discharged. My consultant said that I have had a complete functional recovery and could expect to be back to full strength in about a year or so.

Like you, I was searching the internet for information and found very little apart from this site and the UK forum. Even on these forums it was terrifying that there were very few, if any, 'good news' stories, as all I really wanted to hear was that I would eventually get better.

I know that everyone's injuries are different, but I thought I would try and reassure you that some of these injuries are not necessarily permanent, but of course many are.

For what it's worth, these are the basics that I've picked up from my experience, the forums and of course, google:-

• Nerve avulsions are the most serious form of a BP injury
  Problems with the shoulder seem to give people the most long-term difficulty, i.e. loss of rotator cuff etc
  Surgical intervention, whilst often successful, cannot mirror or match original function
  Regeneration of simple stretch/compression injuries can be halted by scar tissue
  The term spontaneous recovery is very misleading and a bit disappointing
  Seeing the un-innervated muscles in you arm is possibly the most depressing sight in the world
  Seeing your unused muscles gradually shrinking is the second most depressing sight
  Everything takes ages and you have to be patient

Anyway, I hope that helps and apologies for any inaccuracies about the medical stuff, about which I know virtually nothing.

Mike

[hilltopfwb]

First I want to say I am sorry that you were involved in an accident like this. It sounds very much like my situation with an 88 year old woman not seeing me when she pulled out on her vehicle.

2nd - I couldn't agree more with what Christopher said. I almost waited too late "hoping" my arm would recuperate on its own. It never did and I with less than a month to spare had the nerve transfer surgery. Dr. Li at Wake Forest University did the surgery. He has strings attached to the Mayo Clinic. I went to the Mayo Clinic later for the opportunity to see if anything else could be done as I continued to recover and they are GReat and Conservative. I can assure you if you do not NEED surgery, they will not do surgery.

Don't hesitate hoping, going there will give you answers and will give you peace of mind.

Good luck and keep us posted. Please remember, most folks have never heard of a Traumatic Brachial Plexus injury, and a large percentage of doctors are not well versed in dealing with it. Go on to the Mayo or somewhere equivalent.

Keep on keeping on!

[gimpyfireman2010]

Mayo definitely seems like the place to go! Another friend suggested HSS in NY...anyone have experience there?

[Christopher]

Mayo definitely seems like the place to go! Another friend suggested HSS in NY...anyone have experience there?

I interviewed with Dr Wolfe at Hospital for Special Surgery. He came highly recommended from a close family friend who is a top shoulder surgeon at Columbia University. I found him very agreeable, insightful, and honest. He ended up recommending that I head to the Mayo because he couldn't offer all the surgical possibilities that they could for the level of my injury. I would happily have him work on me if my injury wasn't as serious as it was. Good luck.

Remember, time is of the essence! Don't wast it by seeing local doctors that will only prolong you from getting adequate attention from someone that really knows what to look for and how to deal with it.

Dr Wolfe:
http://www.hss.edu/physicians_wolfe-scott.asp

[gimpyfireman2010]

Mike,

Thanks SO MUCH for posting...So nice to hear a positive non surgical recovery story.

Also, thanks to everyone else so far!!!