United Brachial Plexus Network, Inc.

November 22 Gracilis transfer at Mayo! Im nervous but SUPER excited!! I will post more as it gets closer!! Any advise?

COurtney

Courtney,
What exactly are you getting done (transfer to where, and what is the best expected outcome)? Have you ever had any of your intercostal nerves grafted for other function, ie. biceps? And will they be innervating your gracilus transfer with intercostals or other nerves?

Once I know more, then we can compare notes and see what might be similar to what I've had done.

You're a bold woman! I'll try to answer any questions you can throwat me. Rock on!!!

Chris

Hey Chris... lets see if I can answer some of these questions... I have NOT had anything done with intercostals... and for this op, they are NOT going to use them wither. I was told it would limit my overhead motion... not that my arm can do it itself but I LOVE to sleep on my tummy with my hands under my pillow! They are going to use the...hmmmm. the nerve that supplies the upper trap, Im drawing blank, it not quite 6 am... the gracilis is for biceps. I was told 90% success rate... and that I have a great chance of having a pretty strong functional biceps down that road as I have a twinge of biceps... I have only lost an inch in bulk in my arm in 5 1/2 years, so they are intergued by that for sure!

I Just looked it up... spinal accessory nerve is what they are going to use, not intercostals.

I Have hand function but really it is pretty useless without biceps! There really isnt much that you do by your side thats for sure! Sitting its great but damn I cant sit everywhere! hahaha

Thanks CHris!

What about recovery time and what not? How long will I need to be off work? Not too long, I sit there, might as well make money while sitting right?!

Would love to chat more, when we can find time, maybe I can call you or something..

Courtney

Court, I know its been a long time coming for you, this 2nd surgery. I know youve pounded away trying to find out all you can and from one opinion to another. Im glad its finally working out and I wish you all the luck in the world !! 90 % on the bi-ceps, that sounds pretty good. Geezzz...November 22nd ? Thats when James had his accident, 3 years ago !

Id like to chat it up with you when you get a chance. I know youre working now, but whenever you have time is fine. Ill e mail ya !

Hey Court! Do you know how long you will be at the Mayo for this surgery? Maybe I can come down and see you. Not the best time for visitors but let me know! It would be awesome to see you again.
Talk to you soon,
Amy 19 ROBPI from MN

Amy I will probably be there about a week! It is the week of Thanksgiving, actually surgery is the day before so I told my mom we have to get a hotel with a kitchen so she can cook for me! haha You can tell where my concerns are! Would be great to see you if ya got a chance... if not its cool too! My mom is going to havea GREAT room so if ya even needed to stay he night, the offer is there too! Hell we are all family arnet we!? Thanks for thinking of me girly!!

Courtney

Courtney,
Okay, sounds good. I imagine they'll be harvesting a sural nerve from your calf as well, to cover the distance from the accessory nerve to the transfered gracilus. I was walking at around 4-5 days after surgery, and I had both legs opened for both surals and one gracilus.

I think that's great that they're using your accessory nerve, the intercostals leave a pretty nasty scar and I hate not being able to lift my arm more than shoulder level. My shoulder is so scarred up now, that I can't move my arm higher than that if I wanted to. My accessory was damaged in my accident, so it wasn't available for use, it's come back a bit now, but mostly only causes problems. My trapezius binds up into a large lumping knot really easily when I activate it and has to be forced back down with good hand, I've thought of getting a botox injection in it to give it a rest for a while and see how that goes.

The only thing you might not like, is the patch of skin that they'll place from your inner thigh/groin area above your arm pit. I'm sure your not hairy like a man, so it might not look so weird. They need to do that as a way of determining if the muscle is still healthy and getting blood after surgery. A microphone will be placed over the patch of skin a couple times a day and you'll be able to hear the blood coursing through the veins underneath. This patch of skin can be removed at a later date. They took off mine, but wouldn't give it back to me! I wanted to make a coin purse or something out of it, so they just threw it away! My flesh, you think I'd get a say on what happens to it. They said afterward, if I said it was against my religion, they would have kept it for me... oh well!

Did they mention if they were going to leave a bend in your arm? They tied in the gracilus muscle so my arm wouldn't straighten out all the way. The purpose for this is so it is not as difficult to start flexing it upward. It's supposed to straighten out to about a 30 degree angle max. This is the only thing that continually bothers me. I've even had them go back in and try and straighten it more, with not much luck.

I've emailed you my phone number, give me a buzz with any questions, or post them here for the next victim to read! Joking... (there are no victims, only volunteers)


Chris

ps I'm curious too about your lack of loss in arm size??? My injured arm is about a fourth of the size of my healthy arm, maybe even smaller. It's one thing that I'm still trying to get used to, not too sure if I will...

Courtney,
As you know Mel had the gracilis transfer along with all the nerve transfers. They used her left thigh gracilis and her right sural nerve along with her intercostal nerves and spinal accessory nerve. She had her surgery on a Wednesday and was discharged from the hospital on Monday. The first 2 days post op she was in ICU in an 80 degree temperature room. She had 2 male nurses and they were sweating up a storm! She joked about how she hoped their deodorant was working! She was then transferred to a private room. She does have the patch of skin near her right shoulder where they listened for blood flow every hour with the doppler. No hair grew there as of yet and her surgery was in May. The skin definitely looks different than the surrounding skin but it's not too bad. I think the thing that bothered her the most was the drains that htey had to put in during surgery and kept in for about 3 days post op. She hated when they took them out. But they do it quickly so it doesn;t last long. All of her incisions are healing up nicely. They did attach the gracilis muscle in her arm so it will never go completely straight. It never goes passed a 30 degree angle. She can't just let it fall down either. And of course since they used her intercostal nerves, she will never be able to bring her arm up passed her shoulder. Even with all of these "restrictions" she is very happy she had the surgery. We go to Mayo tomorrow for a follow up visit with the Docs. Pray that everything goes well. We will be thinking of you at surgery time! Best of luck to you! Sue

Sue,
Good detail on the recoup that Mel went through. I totally forgot about that heated ICU room, how I hated that! I kept on pulling aff all my clothes, because I was sweating so much. FYI Courtney, they keep you in there for a few days to keep your veins dilated so the transfered muscle gets as much blood as possible.

Sue, how long did it take before Mel could walk? I can't remember exactly, so my answer of 4-5 days is a guess my sister came up with.

Any other questions Courtney, please ask away!

Chris

Congratulations on the surgery date!! My only advice to you is try to keep relaxed before you go in. It's very stressful but if your like me I was so excited once minute and yet scared to death the next. Just stay focused and positive. I hope you get the results you are looking for.
*HUGS*
Rachel ( MT)