Repeat Question,..Maybe.?

Treatments, Rehabilitation, and Recovery
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catchatrain
Posts: 49
Joined: Sat Mar 11, 2006 2:33 pm

Repeat Question,..Maybe.?

Post by catchatrain »

Hi everyone,

Hope everybody is hanging in there. All right here it is. I am as confused as can be about know. I tried to get the only doc. in Ga. that knows about TBPI to give me a list of all the test that were needed to get an idea of the extent of injury.

Well that worked so good I thought I would get a second opinion.( My first request fell on deaf ears... ).Anyway....What do you all think.? Know that I have a job and money coming in,at least at the moment,I figured I would get all the test done that I could while I have the money. I see it as being dificult knowing that I have no one here that knows how to read the test . I figure if I can at least get quality testing done maybe I can send it somewhere to get it reviewed you know. Anyway I think I have asked this before , but know that I can do it myself screw em ya know. Maybe I could get Christopher to review it. Or any of you guys for that mater. I'm trying to keep up and learn,but I'm flat on my own doing it. These forums are my docs ...Thanks . I learn quick but alot I still don't grasp. Even with Greys Anatomy it still isn't sinking in quit yet. Thanks in
EllenB
Posts: 604
Joined: Sun Jan 12, 2003 1:22 pm

Re: Repeat Question,..Maybe.?

Post by EllenB »

Hey Marshall,

The main test I know of is the EMG (nerve conductivity test). That was the first way we knew all of John's nerves were avulsed, because the signals just weren't getting through. I would think the doctor conducting the test would write up his/her conclusions for you.

John also had another test that involved dye in his spinal column but I can't remember the name of it. It's been almost four years and I am menopausal...so I forget a LOT more than I remember these days. TMI huh?

Good luck,

Ellen
catchatrain
Posts: 49
Joined: Sat Mar 11, 2006 2:33 pm

Re: Repeat Question,..Maybe.?

Post by catchatrain »

Hi Ellen,

Hah not really.I think I'm getting that way sometime...lol. Yeah thats what I'm looking for. I know some but not the names. Thanks though, I'm adding it to my list. I think MRI's are needed to , but I'm waiting on some more replies to see what I need.Thanks a bunch.....Marshall
ptrefam
Posts: 674
Joined: Fri Jan 06, 2006 5:19 pm

Re: Repeat Question,..Maybe.?

Post by ptrefam »

Dustin had EMG's and MRI's with contrast. I have heard about the one with the dye in the spine but he never had it.
Sue
User avatar
marieke
Posts: 1627
Joined: Fri Apr 01, 2005 6:00 pm
Injury Description, Date, extent, surgical intervention etc: LOBPI
no external rotation against gravity, can only go to 90 degree fwd flexion, no hand-to-mouth
1 surgery at age 14 (latissimus dorsi transfer). In 2004, at age 28 I was struck with Transverse Myelitis which paralyzed me from the chest down. I recovered movement to my right leg, but need a KAFO to walk on my left leg. I became an RN in 2008.
Location: Montreal, Qc, Canada
Contact:

Re: Repeat Question,..Maybe.?

Post by marieke »

That's what "contrast" means, the MRI with the dye.
Marieke (LOBPI)
Marieke Dufresne RN
34, LOBPI
http://nurse-to-be08.blogspot.com
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Christopher
Posts: 845
Joined: Wed Jun 18, 2003 10:09 pm
Injury Description, Date, extent, surgical intervention etc: Date of Injury: 12/15/02

Level of Injury:
-dominant side C5, C6, & C7 avulsed. C8 & T1 stretched & crushed

BPI Related Surgeries:
-2 Intercostal nerves grafted to Biceps muscle,
-Free-Gracilis muscle transfer to Biceps Region innervated with 2 Intercostal nerves grafts.
-2 Sural nerves harvested from both Calves for nerve grafting.
-Partial Ulnar nerve grafted to Long Triceps.
-Uninjured C7 Hemi-Contralateral cross-over to Deltoid muscle.
-Wrist flexor tendon transfer to middle, ring, & pinky finger extensors.

Surgical medical facility:
Brachial Plexus Clinic at The Mayo Clinic, Rochester MN
(all surgeries successful)

"Do what you can, with what you have, where you are."
~Theodore Roosevelt
Location: Los Angeles, California USA

Re: Repeat Question,..Maybe.?

Post by Christopher »

Hey Marshal,

There are a few different diagnostic tests that are typically done by BPI specialists. Only a couple of them gave me answers that were close to what the actually exploratory surgery discovered. Going in there is the only true way to determine what damage has been done. But that doesn't mean you can't get a better answer than what you've already got (or don't have).

The two that Ellen mentioned are the ones that were best for me. An EMG, Electromyography ( http://www.nlm.nih.gov/medlineplus/ency ... 003929.htm ) and a Myelogram ( http://www.nlm.nih.gov/medlineplus/tuto ... /index.htm ). With the Myelogram, the dye is injected into your spinal cord and then the area where your Brachial Plexus roots merge into the spinal cord will be x-rayed and CT Scanned as well to determine if any of the dye leaks out of your spine (where the roots would be pulled out if you have avulsions).

My Drs. in LA thought I had only one nerve root avulsion after two months of MRIs. It wasn't till I had a Myelogram done that I could see the dye billowing out my spine that I knew how severe my injury was (3 avulsions). I've had about 6 different EMGs done. The test results are partly determined by who ever is performing it on you. So getting a good specialist to perform the test is very important. The most accurate EMG I had done was at LSU in New Orleans, I forget the name of the Dr., but he was this very considerate and wise older Englishman that worked with Dr. Kline (LSU's BPI specialist). He found out that my phrenic nerve to my right diaphragm was shot, while Docs in LA thought my right lung was scarred full of blood from being collapsed. Big difference.

I imagine the EMG being the least expensive of the tests, and if done with a good practitioner, it could give accurate results hopefully. The Myelogram is a detailed procedure that would be more expensive I'm sure. Marshall, what ever you do, get the hospital or Dr. to charge you no more than what they agree to charge insurance companies. It's BS that if you don't have insurance you have to pay 3x more. Total BS! If I didn't have insurance when I had my accident, I would have tried to use one of my older brothers insurance cards, like I used to use their drivers license when I was a kid.

Anyway, I hope some of this helps! The search engine on this site works now, so you might find more stuff by searching EMG or Myelogram... who knows.

Best of Luck!

Chris
admin
Site Admin
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Joined: Mon Nov 16, 2009 9:59 pm

Re: Repeat Question,..Maybe.?

Post by admin »

Marshall, Melanie had many different tests to try to find the extent of her injuries. She had 2 EMG's which seemed to be inconclusive as to how many nerves were avulsed. The MRI was also inconclusive. She had a CT Myelogram in which the dye(contrast) was injected into her spinal canal. It showed at least 4 avulsions but was still inconclusive with C5. It wasn't until they actually did surgery and saw for themselves that all 5 nerves were avulsed. When the do the surgery they do nerve studies right on the nerves themselves to actually check the activity. If you had an EMG done to test the nerves of the brachial plexus, the doctor that performed the test should read it and make the final report. As for the other tests (usually MRIs, CT's, and Myelograms) they should be read and interpretted by a radiologist. A radiologist interpretted Mel's and then the docs at Mayo pulled all of the tests right up on the computer and they explained them to us. Sometimes you really have to be persistant and be your own advocate! Good luck! Sue
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