United Brachial Plexus Network, Inc.

Hello,

This is my first time posting to this site. I am 20 years old, and I have LOBPI. I recently became re-interested in finding out possibilities for increasing my range of motion. I have had two previous surgeries. The first, a bicep extension, was successful initially, however, over time the muscle began re-contract. I had a similar procedure done 7 years later, but it was a complete failure. The doctor feared that an extension would leave my arm completely paralyzed and suggested that I leave things the way they are.

Recently in my search I stumbled upon a Dr. Nath, whom I have noticed, is very popular on several of the message boards on this site. I have been corresponding with him for the past few weeks via telephone and e-mail. I have also sent him a video. In our conversations he suggested his Mod Quad procedure. I have viewed the video demonstration of the procedure he has online, but I am still a little reluctant to believe that it is that simple. As my two previous surgeries did not exactly help, I am not exactly sure if I want to go through another one.

I guess what I would really like to know is if there are any adults or people close to my age who have had experience with Dr. Nath, and/or any of his procedures, would you be willing to share? Is he a good doctor? How successful was your surgery, and did you gain any motion? What were your Results? I am not completely limited in my movements. I am mostly unable to extend my arm, and supinate.

Before I close, I would also like to say that it is truly amazing that websites and message boards such as this do exist. As I have never actually met another person with a BPI, I was so moved when I found this site to know that there are people that share my experience.

Appreciatively,

Cody

Cody,
Welcome to the boards! I started a big long story and somehow lost it. So, here I go if you didn't get the first one. I am 34 yrs.old from Montana and have LOBPI. I had the mod quad surgery with Dr. Nath about 2.5 years ago. I always like to remind people that everyones injury is different and the outcomes may be different as well. My surgery turned out to be a great success. My arm was shrinking and paryzing. I had the surgery and regained two inches in length back and my degrees or range of motion became better as well. The extention in my arm also improved however the suppination just a small amount, which was better than none. The surgery itself really wasn't that bad. I had anticipated it to be a lot worse. I could remove my *pillow* as I called it and do my physical therapy with no problems at all. Dr.Nath is a great doctor and his staff as well. I did the same thing, sent in a video and talked via e mails and phone. It did seem at the time to be a bit unnerving, but for myself it was truly worth it. I have also talked to others who have had the mod quad and they feel as if it did not do a lot for them. The doctors here told me there wasn't anything I could do for my arm also. So, I found UBPN and it has been the most wonderful thing ever. I went to the camp this summer and met so many people whom I could relate to for the first time in my life. It was definitely a great experience and I would recommend it to anyone with an injury. If you have any more questions feel free to e mail me. I have pictures of the pillow and all kinds of things.
Take care
OH by the way where are you from?
Hope this helped you out a little.

I had the Mod Quad with Dr. Nath just one year ago - I am LOBPI and only injured at the C5 (deltoid) which is why the Mod Quad was perfect for me. Actually the surgery is quite simple - mine took only 45 minutes and he moved 5 muscles, 2 tendons and unpinched a nerve. I had great results because the deltoid couldn't fight against all those contractures and I have doubled and tripled my ranges of motion in all directions. I am not overhead but hope to be with some time. The most important thing to remember is you must keep up with the stretches basically for the rest of your life so the contractures don't reform - if you don't move the arm they will reform. Even once a day will keep them legnthened. I had several doctors warn me not to do this and now I fax them my new results whenever I get remeasured. It is not just muscle weakness you must overcome though, it is also having the other muscles relearn their tasks and not interfer with the deltoid and muscles trying to lift up - lots of new neural pathways have to be built and it takes a lot of time and effort. I would do it again in a heartbeat. Also, now my shoulders are dead even - before one was a bit scrunched up and so after legnthening the muscles the arm is longer too. Feel free to call if you like (503) 880-4682
Suzy

Hey,

Thanks for responding. I am from Memphis Tennessee, but right now I am in college here in Boston. I am glad to here that the surgery in has been successful for you. I was wondering, are you able to touch your face? I guess more specifically what I am asking is are you able to do dumbell curls and things like that to work your bicep?

Hi Suzy,

My regular doctor has also told me that Mod Quad is not worth it, but the more I follow this message board, the less I believe him. I know you said that you just had the surgery a year ago, but what do you think will be your long term results? I mean do you think that the results that you have experienced thus far will last, provided that you keep up with the stretches and things like that? Also, are you going to have to have more surgery's in the future.

hey there!
can you let me know link to dr Naths online video of the mod quad procedure?? cheers

Sorry it took so long to get back to you. The link to Dr. Naths brachial plexus sight is http://www.drnathbrachialplexus.com/index.php

I had several doctors tell me the Mod Quad would make me worse - but relied upon Dr. Nath to tell me if I was a good candidate. The key question to ask other doctors is 1) have they ever seen a brachial plexus adult before? 2) Can they tell you why you can't lift your arm? The answer was always no to both questions for me.
And yes I can touch my face and could before but couldn't touch my head which I can do now. I have doubled and tripled my lift ability - front,side, back. Yes I can do bicep curls and could before because I did not have C7 involvement so my arm is straight, not bent. But my goal is to stregnthen the tricip, not bicep which is already stronger and part of the problem. As for range of motion I went stretched to 180* overhead so just working on the stregnth and coordination to catch up. I think I am on the 5 year plan. I still stretch 3 times a day and work out 40 minutes every other day (just my arm). Some of the issue is building new nueral pathways in ROM that the arm has never seen. For instance, my arm would respond when moving up to about 90* but then go dead when lifted up higher. It took 8 months of working with pullies to get a responce above 90* - yes, 8 months because the arm never worked in this upper range -hence, my 5 year plan. It seems I get height first, then function. So I can reach a top shelf but it may take a while longer to actually be able to get a towel from the high shelf. I think I will be overhead someday - now at 114* (from 45* presurgery)out in front and 112* to the side (from 25*). But you seriosly have to believe in building new neural pathways because like I said it took 8 months to get any response from the arm over 90* for me. Suzy Call if you like (503) 880-4682

I personally visited Dr. Nath and he recommended the Mod Quad surgery for me. However, like you, it sounds like its too good to be true. Have checked with several doctors back home in India and the Middle East and they were all against it. I also went to the Boston Children's Hospital and the doctor there was against it too. Accordign to him, my deltoid is very very weak and hence, the surgery would not help me. In his opinion, even if I do notice an improvement, it would probably be because of the rigorous physical therapy regimen that I would follow after the surgery and not because of the surgery itself. Not sure what to do...

Sorry but that doctors explaination kind of pisses me off. The point of the surgery is to free up the arm so the deltoid has a better chance at moving the arm with greater range of motion. So of course the deltoid is weak - it is fighting against the other larger groups of muscles which are pining the arm in place. So yes there is lots of rehab afterwards - the arm has to learn to move in new and higher positions.

And FYI, pre-surgery I could lift my arm in front only 22* and 3 days post surgery I was at 79* with no rehab or intervention beyond freeing the arm up. I am now at 114*. So again, I would ask if that doctor has ever seen and adult with OBPI and have they any experience with a patient post mod quad. If not - watch the warnings fly! Suzy

My doctor here also told me I was taking a huge risk and it wasn't going to be worth it. I always state everything with...*I know all injuries are different* so keep that in mind. However, if I had to do it all over again I would in a heart beat. I know some who have had the mod quad done and it didn't seem to work out as well for them. I guess it depends on you individually and what risks you want to take.
Best of luck.