GRACILIS MUSCLE TRANSFER

[PatE]

Hey Everyone. I'd love to hear about your experience having the gracilis free muscle transfer. I'll be traveling to Mayo Clinic, Rochester at the end of June for this procedure. I realize improvements may not be seen for a number of months. I'm mostly wondering what it's like the first month or so post surgery - Pain level, recovery time, returning work, etc. Thanks for your comments.

[suzannesteam]

My 17 year old son had his 1st muscle transfer 16 Feb 2011 and the 2nd one 25 April 2011. His C5,6,7,8,T1 are avulsed. We opted for two separate operations due to not knowing what the recovery was going to be for the legs. Glad we didn't combine both. Donor leg is very sore first couple days after surgery and then very tendor for a few weeks after, slow walking, avoiding stairs, kept elevated whenever possible plus a full leg ace wrap to help prevent swelling by the donor wound. He was in St Mary's (Mayo, Rochester, MN) for 5 days and missed following week of school. Second surgery was more physically demanding due to the nerve transfer from the ribs to the new gracilis transfer. The chest area is very sore, especially when coughing, sneezing, moving and armpit if compromised due to the skin graft location. So depending on if your having a single or double muscle transfer will depend on your recovery. Ryan's advice is this, "Strength is in the Mind", so basically if you have the mind strength to endure some discomfort for a greater gain then your recovery should go well. Good Luck! Ryan's team at the Mayo was Dr. Bishop, Dr. Shin & Dr. Spinner.

[PatE]

Thank you suzannesteam. So sorry for the trauma your son has experienced but it sounds like he has a positive attitude and he'll be in my prayers for continued improvement. It is truly amazing what one can accomplish when put up to the challenge. I too was 17 at the time of a car accident resulting in the avulsion. This type of surgery just wasn't available back then (1979). I have been very fortunate throughout the years to not have chronic pain. Surgery is scheduled for June 29th (gracilis transfer with donor nerves from behind the ribs). I wanted to try to take an online college course that starts the day I should return home so your reply is very helpful. It's also very encouraging that I won't have to use all of my vacation time from work for medical reasons.

[PatE]

Hi suzannesteam. I was wondering if your son has the same discomfort in his armpit area as I do. My gracilis transfer was performed June 2011. So, one year post-surgery, it still feels like there is a lot of healing to go. The intercostal nerve (from the lung) was used to fire the muscle. When I breathe in deep, the muscle contracts bending the elbow. When blowing out on exhale, the muscle is relaxed for release of the elbow. It's hard to describe the sensation, but in the front, maybe the pec area, feels really tight especially when I stand up and my arm drops to my side. Some of the numbness has gone away from the surgery. Originally, I was numb from the armpit to mid-chest. My understanding is that should reduce to a patch, but who knows how long. Thanks for you previous reply.

[billvxii]

Hi Pat, I'm behind you by about a year. I had my surgery in June of this year. Still in casts for stabilization. Pain is bearable with light drugs. I have morphine and OxyC but only using Gabapentine (2400mg daily). I am not expecting movement until Dec or so but would like to follow your successes to know what I have coming.

[PatE]

Hey Bill. Wow, you are pretty banged up. The one thing I think all of us on this forum have learned is patience. Surgery and nerve recovery is a long, slow process. It will seem like there is no improvement for awhile and then all of a sudden you'll see a new movement or less pain. So I am now 13 months post-surgery of the gracilis transfer. Just from my last post a few weeks ago, I've had a new therapist who did different stretches that resulted in the pain and tightness in the pec to have significant improvement. I'm really amazed, that just in a few weeks, my arm now is much more relaxed since the gracilis muscle is not as tight as a rope. The therapist also did soft tissue modalities on my neck and right shoulder blade. That was so jacked up that there was no way I could completely relax the bicep. My understanding is that it is 18-24 months until full benefits of the transfer. Best wishes for a speedy recovery.

[billvxii]

Banged up is a real understatement! If you want to go to http://bikerdown.blogspot.com. There you can see banged up.
I was out for twenty days and then spent another seven weeks in rehab and then to Mayo for consult back for muscle and nerve transfer and cast. So much fun!!
I am going back to get second cast off in a couple of weeks so then I guess the PT starts. I could probably use the exercise so it will be good to move on to another phase!!
Can't wait!

[suzannesteam]

This is Ryan's reply: "I've had alot of discomfort with the armpit, which is now 16 months post op for the second gracilis transfer and intercostal nerves; it used to be really sensitive but it wore off about 8 months post op. Now at 16 months post op it feels normal."

If you have any more questions, email us! Ryan will be glad to answer, he's just not on this forum daily, teenager you know, will get back to you sooner! best mom.

[PatE]

Thanks for Ryan's reply. It is encouraging to know that time will heal. I am now 13 mos post-op so my patience will be tested again. lol