United Brachial Plexus Network, Inc.

My son has a post viral infection in his RBP from the west nile virus. I am not confident in his doctors at this point. I have found Dr. Nath's website and see that he does several surgeries to help the nerves and tendon and muscles transfers, BUT my son's Doctor does NOT recommend Dr. Nath. I live near Fort Worth and at this point would be willing to travel anywhere in the US to get the best opinion i can as far as the treatment i should be doing for my son. Any opinion on Dr. Nath or different clinics around the US? And then do i just ask his doctor to refer us to the clinic that i decide to go to? I don't want to burn my bridges with his doctor that he has now since he has treated him since onset in Sept of '06. Even if i do go see a different Dr. out of state i would still need to go back to his current Dr. for follow ups.

BPI injuries are a very specialized area. Although many drs know something, a BPI specialist will have all the latest and best for your son. Many of the people on here have seen or do see dr Nath. However, I think that he specializes in OBPI and is newer at treating TBPI. It doesn't mean that he won't have the answers you need. Also, many people on here travel to Mayo in MN where they specialize in TBPI. I think you really should consult a BPI specialist. There are also others listed on the resources link at the top of the page. We go to Mayo as they were the recommended ones for my sons injury. If you don't want to burn bridges with this dr that you are seeing maybe his regular GP could refer you.
I have also heard of many people just making the appointments themselves without a referral. Our physiatrist and neurosurgeon were all too happy to make the referrral as they both knew that they were not the ones most knowledgable to treat the injury Dustin has.
Sue

I used Dr. Nath for my TBPI and I would recommend him. I have also been to Mayo. I would do some research and see who might fit your particular needs.

In July of 2005, my son had a motorcycle accident, ( c5 c6 )finding no answers here, he found Dr. Naths site. I was also concerned, what do we know about this Dr. I found the Texas medical board site and Looked up Dr. Nath it had good information and thus we planned the trip and surgery. Jasons nerve transfer was done Oct 28.05 . and Dr Nath was pleased with the results. Yes he has been back to doing the job he loved for about 6 weeks, he had been laying brick for about 10 yrs. To see him have use of his arm again, is wonderful. He was back riding long before he was able to go back to his job that he loved. I think no matter what Dr. you choose, check the state medical boards and research the Dr.

2005-10-28Adult Brachial Plexus Avulsion

Author: Dr. Nath

The patient today was a 27 year old man from Ohio who was in a motorcycle accident 4 months ago. Clinically and on EMG testing he had avulsion injury of the C5 and C6 nerve roots. As expected, this resulted in paralysis of the shoulder and biceps, with intact triceps, forearm and hand. This is a classic upper root avulsion injury; in my experience, adults tend to be either C5 and C6 injuries or total root avulsion injury, and the treatment for both is nerve transfers or what I prefer to call nerve bypass surgery.

Today, I used 2 nerve bypasses from the spinal accessory nerve and a chest nerve for shoulder function and a median nerve bypass to the biceps. The median nerve bypass is one of my favorite surgeries, because it is elegant and usually results in excellent function. And hand function is not lost if this is done appropriately.

In a recent paper I submitted to a medical journal, reporting 40 consecutive C5 and C6 avulsion injuries, the results were excellent over 90% of the time if operated on before 7 months after injury. I expect my patient from today to do very well.

If you do decide to go out of state, consider the Mayo Clinic BPI Team or Dr. Belzberg at Johns Hopkins. I don't have any experience with Dr. Belzberg, but understand he is great at what he does.

I recommend a University setting, or more specifically the Mayo because the Drs. there have the ability to make immediate referrals and appointments with other Drs. in different fields of practice that are pertinent to your specific situation and needs. All the Drs. there are top notch and work together well. I found this to be one of the most rewarding aspects of my experiences there. If you have a situation that may require multiple opinions or specialists' involvement, it's hard to do better. I had several appointments for different aspects of my injury, that included pulmonologists, cardiologists, neurologists, dermatologists, pain specialists and more, and they would get me in to see top Drs. immediately within an hour or two, and then back again to confer data.

I would be very curious as to why your Dr. does NOT recommend a second opinion with Dr. Nath. If he believes that surgery is not an option or would be detrimental to your son, I understand, but at the very least he should be encouraging second opinions, especially when the welfare and future of your son's arm is at risk.

You don't need a referral to get an appointment at the Mayo Clinic, but you may need one for your health insurance to fully cover a visit. I would not think, by protecting your son's future, that you would be burning any bridges. Any doctor that made me feel that way would be off my list of doctors to see.

Best of Luck,
Christopher

Hi there, good luck with your choices...I know it's hard to work out if you are doing the right thing.

Your Dr may not have an aversion to a second opinion per se, but he may well have an aversion to the Dr you mentioned. Many other Drs & people do not like him or his methods for various reasons. You would be wise to investigate ALL Drs thoroughly as this is as you know a very difficult and an emotionally charged injury.

All the very best to you

LizzyF

Well i decided to make my own opinions about Dr. Nath and go and see him for myself. He got Drake in THIS Friday for an appointment, so we will be making a day trip to Houston. I am just so worried about what he is going to tell us. I think it is hard for me to accept ANY surgery because we weren't told in the beginning that surgery of any kind would be done. All the reading i have been doing on BPI tells differently. Even if nerve surgery is not the answer it seems no one gets out of a BPI without some kind of surgery, it may be muscle transfer or tendon transfer or on the bones. So any advice on how to deal with the reality of having to decide to do surgery and when. Has any one gotten thru a BPI without any surgeries?

By the way i love this message board, it is a great way to vent and talk to people who know EXACTLY how i and my son feel.

Hi Drake's Mom,

Just a heads up I sent you an email.

Ellen

Just wondering how your appt went. Hope they had some answers for you.

I think it is rare when people make it through a BPI without surgery, but it does happen.
Best of luck,
Sue