Diagnosis?

[admin]

My boyfriend had a motorcycle accident and suffered tbpi to his left arm on March 16, 2006. An MRI was done on his upper extremity, left arm but it was inconclusive because of the amount of swelling, the MRI was not clear. We followed up with an EMG at the hospital last week, but the doctor that saw him did not even do it, he just did nerve conduction studies. He told my boyfriend, after pulling and yanking on his arm and basically physically examining him, that his nerves were avulsed. Now we were told by the ortho. surgeon that did the actual surgery, that his nerves were badly streched, but that they were not avulsed. Wouldn't an MRI now be warranted since one Dr. is saying one thing and the other says the total opposite? Being stretched and being avulsed is a pretty big difference, and at least before we had held out some hope that he would eventually have some use of his arm or feeling at least. Now we are told that there is no hope. He doesn't have insurance which is making things even more hopeless. We tried getting medicaid but got rejected, we are repealing it, but it takes forever and is of no help right now. Can't even get through to them on the phone. SSI takes years. The ortho. Dr. that we do see won't prescribe him any pain meds, he is just taking aspirin and he doesn't sleep for more than 3 or 4 hours a night, the pain awakens him. He says it feels like his arm is in a deep frier 24/7 and has on more than one occassion mentioned that he would rather be dead and is "worthless". His depression has deepened immensely since this other doctor told him the nerves were avulsed. We don't know what to do now, we are selling his truck since he can't work (he is a carpenter by trade) and that would give us some money to pay for an MRI, but I have a feeling that the ortho. doctor won't even prescribe it. We don't see him again until June 1 for another follow up. He only spends an average of 5 minutes with the doctor, the doctor barely utters a word but without insurance nobody else will see him. Would an MRI confirm the extent of the injury to the nerves?

[jpix]

sorry to hear about your boyfriend. you could get any diagnostic test in the world done but nothing will be 100% accurate. the only way is through exploratory surgery. i do know that of all the tests you can do the ct myleogram is pretty good at determining avulsions. we all know what your husband is going through and its normal. i to thought i would rather be dead and AM WORTHLESS. that will gradually go away over time. i hope you can get him the care he deserves. health insurance in this country is a huge problem. good luck and god bless.

[ptrefam]

Unfortunately jpix is right, none of the tests for bpi are conclusive. Without exploratory sugery it is nearly impossible to know for sure. It looks like he did have a surgery? I would believe that dr as he has been in there. If they were badly stretched that would give him a chance for some recovery, but keep in mind that it is long and slow. Sorry to hear about his accident. But, you have come to the right place for information. You will find wonderful people here who can probably give you more information than the drs. as these people have all been there and are living it.
Sue

[admin]

Thanks for your responses. Yes, he did have surgery, he had numerious fractures from the accident, broken clavial, ulna and radious and his left hand/fingers had multiple fractures. So the ortho. surgeon was in there and I would assume have checked out the extent of the nerve injury. He was the one who said they were badly stretched. This other doctor was not a part of the surgery, he was just the guy who was to give the follow up EMG, but he said there was no point in doing one since he believed the nerves were avulsed and he came to that conclusion by physically examining my boyfriend.

[cbe411]

Hey... sorry I am late here, I have been out of town! As far as tests to determine the extent of the bpi... nothing is conclusive, nothing! The best way to really diagnose the damage is to do an exploatory surgery... to physically go in there and see what exactly is going on. You said he did have surgery, but what exactly did he have done? I would try to get in touch with a doctor and see about charity cases, I believe that Mayo in MN works with them some. Get an attorney for SSD! It really will help. Yes it is a LONG S L O W process but get it started sooner than later!!!

Keep asking questions!! We are here to help!!

COurtney

[lizzyb]

I agree with everyone here...there is no test or combination of external tests that can conclusively diagnose the extent of damage to the nerves of the brachial plexus. A myelogram comes pretty close by showing up avulsed nerves, but even then, we have heard of some who have been mis-diagnosed.

The ONLY true test and diagnostic tool is exploratory surgery, even better with EMG's performed on the exposed nerves during the surgery.

It is vitally important to find out EXACTLY what surgery he had done. In my experience, it isn't a good idea to assume that the Dr looked at the nerves while he was operating on possibly other parts of the shoulder. It would be even better to get a written report if that is possible, then at least you could take this with you and show it to other surgeons if you decide to search for more and better treatment, which I hope you will do.

I am so sorry I can't help you with the SSI or getting treament at little or no cost as I live in the UK. All I DO know is that, thanks to some of the board of directors of UBPN, Brachial plexus injuries are now included in the list of recognised disabilities when calculating SSI. (Kath where are you ??) Hopefully, you will get a lot of useful tips from all the people from the U.S. who have unfortunately been in the same postition as yourselves.

Please keep in contact and let us know how you get on...

Lizzyf