Can surgery do anything yet?

[admin]

Hello there,

I realize this will come as the "n"th question on the same old theme, but I cannot help myself. My fiancee was in a motorcycle accident in 2005 and sustained a brachial plexus injury. I don't know all the medical details, but the gist is that the ER doctor simply called it a "stinger" with no further details, he was sent home and expected to recover. When his arm continued to be numb, we urged him to go to a doctor. This is the moment when our healthcare system failed us, as he was recommended an MRI but the nurse actually forgot to schedule him for one. Eventually, the test was performed 8 months after the accident and ever since then, he's done some physio and now is scheduled in for surgery: nerve transfer to the rotator (I think) and deltoid (for sure). 1.5 yrs after the accident, he is in no pain, he can lift his arm about almost 90 degrees, can bend his elbow by bringing his arm towards him, in a horizontal-almost manner, but cannot do the same if the hand is above the elbow level. He can also rotate his hand palm up almost completely (net being a very flexible person, I cannot really assess how well he does that). Again, no pain, just stiff neck once in a while and massages help. My concern is that it's been so long that the muscles might have atrophied. There is obvious decay of the deltoid, but he says the muscle spasms after strenuous activities to it, such as playing pool, or going to the gym. My questions, and concern is: how much will surgery really help? I see he's improving, but how much more progress can be expected after so long? I am so nervous and excited in the same time. I love him to pieces and I want him to recover. I understand from the posts I've read so far that you wonderful people are happily married and have found ways to lead fulfilling lives, but I might be a bit selfish and still want him to recover 100% (or close to...I'm a perfectionist, but I'm trying to be reasonable too). Also, is there anything I can do? I'm away with school, but I've already arranged to be in town the day of the surgery and I'll take time from school to help him with anything, but I don't know what that might be. Can anyone help with any advice or info? What shall I expect?

Once again, I'm sorry if I come across as selfish and not understanding and I thank you for taking the time to reply.

CA

[ptrefam]

What the Drs. told us is that as long as the muscle is not dead (no impulse) you should get some improvement. How much is hard to say as everyone is different. When Dustin hit the 6 mo post accident they went in to see if any nerve transfers were needed, as they felt this was the best time frame for this. All nerves were intact and firing although some were not so strong. They felt changing what he had would slow the recovery time. I have read here where it can take quite a while even after the surgery to then see improvement. They also told us that he would never be 100% so,just be happy with any improvement he gets. I know that Amy and some others are still getting improvements 19 years post BPI. And this gives me such hope. Best of luck with his surgery and recovery.
Sue

[admin]

Thank you, Sue,

I forgot to mention that the EMG showed strong firing in all nerves, less so in the deltoid nerves. So I guess I'll have to cling on to the idea that his deltoid seems to want to work and help him with the recovery process.

CA

[EllenB]

Hey -

One thing you might want to consider is the little battery operated zapper-thingie (somebody help me out here). It sends a charge to the muscle that makes it contract, and can help keep the muscle from atrophying until the nerve wakes up or a transferred one grows out to it. No more wine for me tonight.

Take care,

Ellen

[ptrefam]

LOL Ellen,
We had an EMS and now he uses an EMPI. Empi does low rate for longer about 4-8 hours a day. Ems was like 15 minutes on each muscle we were trying.
Sue

[srhykerd]

It's a neuromuscular stimulator that delivers the little jolt of electricity. EMPI is the supplier company.

[admin]

how'd you get a e stim unit for yourself? My OT/hand therapist brings it 2x a week only. When I asked about my own to use more often he said he never heard of that - people can burn themselves. Should I have been more persistent? -kaz

[ptrefam]

We've had 2 different kinds. Don't remember the first name but the second is the EMPI. They should be able to show you how to use it. Then they just sent it home with us. They did have to have a script from the Dr. to do that.
Sue

[admin]

That's very interesting: I knew about it and I even suggested it to him, but his physiotherapist pushed for only exercises. I will try and put my faith in her and believe she knew what she was doing.
I'll also suggest it to his surgeon. Maybe he'll write a referral for such a device after the surgery.

Thank you all for this idea.

[srhykerd]

We've had 2 EMPI units also. The first one I simply asked the neurosurgeon for a script and took it to the PT and he got one for us and showed us how to use it properly. The 2nd EMPI unit was given to us at the Mayo Clinic after Mel had her surgery. Our first neurosurgeon said the benefits of this unit are debatable and some doctors don't believe they offer any benefit but the Mayo Clinic uses them and they say they definitely do see improvements with people who use them. Mel uses hers 3-4 times a day.