Hospital Bureaucracy

[chris ruggles]

Hi everyone, my name is Chris Ruggles. I had a severe motorcycle accident on 2/2/03 that injured c5,c6,c7, and c8 of the bp in my right shoulder. Both forearms were totally shattered which left me with little use of my left arm( 2 metal plates,1 six inch screw) and due to the bpi, none of the right(3 metal plates). I have some feeling in the tricep, but it is really hypersensative. I am noticing a little return here, but nothing much in the deltoid or bicep. I have no active movement in the hand or elbow, and very little in the shoulder. I have a lot of pain in the shoulder and I think I might have a wingged scapula. The shoulder is subluxed and I keep my arm in a sling most of the time, otherwise it gets a dark purple color due to the poor circulation. I had exploritory surgery at the Mayo Clinic in Rochester,MN. on Aug 15 2003 where they tested the nerves directly through an incision on the right side of my neck. Dr. Shin and Dr. Spinner found no need to go on with the nerve graph because all the nerves stimulated worked all the way down the arm. I have been going to the Veterans Administration Medical center in Kansas City, but they don't know anything about the brachial plexus. I used to be a search and rescue swimmer in the U.S. Navy and I have been trying to get a referal from the VA to go back to Mayo Clinic for months, but they don't want to risk spending the money and getting no results. Can anyone give me some advice?

p.s. Has anyone heard of a surgery where a muscle and tendon are taken from the leg and graphed in the arm? Thanks.

[EllenB]

Hi Chris,

I'm so sorry to hear about your accident, but I couldn't be more pleased that you chose Mayo. My teenage son John had all five avulsed a bit over 2 years ago, and had surgery at Mayo both Feb & Apr '03. And yes, he had the "Double Doi" procedure where, in each surgery, a gracilis muscle/tendon was transferred from his inner thigh into his arm - to power both the arm & his hand. About six months out of each surgery he had muscle response, which of course has gotten stronger over time & with therapy. He can now bend his arm & make/release a grip. But best of all, his pain is almost completely gone - from massive daily dosages to around one/week as needed. And I think the reduced pain is directly related to him now having arm movement.

The gracilis, btw, is a great donor muscle since unless you ride horses (i.e. need to grip with your legs) you won't even miss it.

But what I don't understand is that since Mayo saw nerve response all the way down your arm, why things aren't cooking by now, two years later. Any idea?

What kind of results does the VA require in order to approve the referral? I know Bishop/Shin/Spinner track their results carefully, I've read medical papers by them with that kind of detail - so would that suffice? If so, I'm sure they can provide it.

Good luck & keep us posted.

Ellen

[chris ruggles]

Hi, Ellen. Thanks for the good news. I'm glad to hear that your son is doing better. As far as the nerves in my arm, I'm not sure why I'm not getting more response. I did have an emg done last sept. that showed a little nerve action in the tri's, bi's, and deltiod, which compared to all the other emg's that showed nothing, it was an improvement. But I still don't understand why it is taking so long.
With the VA, I really don't know what else to do. I'll talk with my therapist there and see what else can be done. Thanks for your help. My email is all4speed77@yahoo.com if you would like to chat.
Chris

[EllenB]

Hi Chris -

I've sent you an email -

Ellen