United Brachial Plexus Network, Inc.

I was on my way to work on 1/2/07 at 5:00 am. I hit black ice at about 60 MPH. The car spun, hit a tree & rolled over. I broke 3 ribs, shattered my left arm, broke my clavicle, left lung collapsed, & severed an artery. I have no movement from my elbow down. The only feeling is constant tingling & various levels of pain.

I have surgery scheduled on 7/12/07 to have nerves removed from the left leg & probably my right leg to be placed in my bicep & attached to the damaged nerves in my shoulder. Nerves will be removed from 1 or 2 legs and placed in my left bicep and attached to my shoulder to repair the damaged and stretched nerves. My left arm is paralyzed from the elbow down. My bicep and triceps muscles do not work now. Has anyone had this type of surgery? What should I expect?

Yep! Nerve graft from left leg surel nerve to median & musculotaneous nerve (for bicep return)@ mayo 1/4/7. Where/Who is doing your surgery?

Janelle,

I'm sorry to read about your injury. Sounds bad, but there are worse out here if that is any consolation. I grew up in Hanover, NH and lived in Portsmouth while attending UNH. I'm hoping you've found adequate medical attention. Brachial Plexus Injuries demand very specialized neurosurgical involvement and action. There are less of these types of specialists out there than one would think. Who is the doctor(s) you have been seeing, and at what hospital. We are usually pretty knowledgeable on every BPI specialist out there.

Your surgery type depends on the specifics of your injury, obviously, and not knowing the exactness of your nerve damage, it would be difficult for anyone to give you any legitimate advice in terms of your pending operation. Do you know which nerves were damaged, and at what location they were damaged (avulsed/torn nerve roots from spine or somewhere down further from the spine towards your hand)? This type of information would help anyone be able to give you some better advice or suggestions as to what you might be dealing with and looking forward to. I hope we can help out.

Best of Luck,
Christopher

I am seeing Dr Sang-Gil Lee, Dr. Neal Chen & Dr David Ring at Massachusetts General Hospital (MGH). My post op notes from 1/2/06 state 1) Open left clavicle fracture; 2) open right hand (I believe this is a misprint and should say left hand) metacarpal fractures index through small and thumb base with extensive degloving injury; 3) Both bones forearm fracture associated with brachial artery disruption, musculocutaneous nerve avulsion from the brachial plexus, and severe stretch injuries to all major peripheral nerves.

I hope this provides the answers you were looking for.

Last night & today I have been experiencing severe to violent and painful spasm from my left shoulder down my left arm. The spasms shake my whole body and cause pain, compression, and tingling right down to the fingertips. I started taking flexural and Demerol for this. Has anyone else had this?

You might need an actual anti-spasmodic for the spasms... Baclofen (Lioresal) or Zanaflex (Tizanidine).
Demerol is for pain (narcotic)and Flexeril is used for pain as well as MILD spasms. Sounds like you need an actual anti-spasmodic, like the 2 I mentioned above.

Talk to you MD about it, see if he/she will get you a prescription to try.

Good Luck!
Marieke (31, LOBPI)

Hi Marike,
Thank you for your suggestions... (You might need an actual anti-spasmodic for the spasms... Baclofen (Lioresal) or Zanaflex (Tizanidine).) .. I talked with my PCP and she said I have not been off methadone long enough to take those meds. In fact, she wants me back on 5 mg of meth once a day and Diazepam twice a day for spasms.

Learning and accepting how to deal with my new situation is quite a project. I have never been the kind to be dependent on anyone or anything. Taking something as simple as a shower now requires a shower chair and my husband washing my hair, back and right arm. Driving is now a one handed ordeal with the assistance of a suicide knob. I drive just to therapy now. When I go back to work it will be a hour drive mainly on the highway.

It is unbelievable how much my life has changed since this accident. So much to get used to and accept. It's like a bad dream you feel you will just wake-up from and everything will be back to the way it used to be. The fact is nothing in my life will ever be the same.

Thanks to all that have responded to me.

Janelle

Janelle,
From what I read here, it looks like you have no nerve root avulsions, which is actually great. A nerve root avulsion is the most severe damage that can be done to the BP, as neural impulses and communication can no longer be accessed from the spinal cord from that avulsed nerve. Your avulsion seems to be repairable because it is a nerve avulsion from a branching Brachial Plexus nerve, not from the spine itself.

A lot of different factors dictate weather a nerve 'takes' after repair or grafting. One of the few we can control is the choice of surgeon. I know you are scheduled for surgery soon, but if it was me, I would try and get an added opinion to your situation from another BPI specialist before going under the knife if possible. I met up with over 8 different BPI specialist and they all had varying approaches and tactics for treatment of my specific situation. I ended up learning a lot from all those consultations which enabled me to choose the best possible surgery to give me back the most return of function possible. I was extremely athletic prior, so my motivation was clear. Other folks seemed to have an easier time accepting the change that this injury brings than I did, so pardon me if I appear aggressive about this. I just hate to think of someone being able to get more back than they got.

Obviously Mass General is a great hospital, with it's Harvard affiliates, and I bet the surgeons your working with are great as well, but why not get an appointment with a doctor like Dr. Peter Waters (who specializes in children's BPI) or at the very least get a referral from him for someone that he would recommend that treats adults. Enough said, and I apologizes again if I seem pushy, but new injuries bring back all the chaos this injury brings with it and I only want to help out.

Best of Luck,
Christopher

http://ubpn.org/medicalresources/wa ... ntact.html

great advice chris. i look back now and although i have been getting some signifigant improvement i really wish i would have gotten more opinions, i especially wish i would have kept my appointment with mayo. at the time i was looking for the fastest surgery because i new this was a time sensetive matter, so i opted for the local university of pennnsylvania. (dr. zager) i really do think he did all he could for me but theres always that thought of what i could have gotten more from mayos team.janelle i hope you weigh all your options and what ever you decide YOU have to be sure that you took every measure to enable the best recovery possible. like chris said you dont have any avulsions from the spinal cord so your recovery depends on the best drs. available. i wish you all the luck in the world. just remember whatever happens and whatever recovery you do get or dont get, dont let it control your life. ther are good times ahead. its hard to believe now but i promise you things will get better. you cant keep a good person down. lots of luck to you and keep us posted.

jim





















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Even though I haven't been dx'd as yet, and my neck, shoulder and arm pain is intermittant, (though mostly due to the fact I am learning how to avoid the episodes) I take Tizanidine. It seems to work well for me when the muscles stiffen up. I also take vicadine for the initial pain. My situation is a bit different, I probably do have a BP injury, but I think there is more since it involves my neck as well.

And you're right, it does change your life.

Good Luck with whichever option you choose.

The part about this injury changing your life is like the understatement of all time. I'm sure everyone has thier own story of how it has changed their life.

On March 24, 2007 my husband fell 25 feet from a cell tower, and bounced of 2 metal buildings before hitting the ground. He had a broken left femur requiring a steel rod, fractures at T-11 and T-12, multiple rib fractures and TBPI to his right arm/hand.

He is still doing PT 2x/week and OT 2x/week without any real progress on the TBPI except to keep passive range of motion and decrease muscle atrophy to whatever extent possible.

We had a plexus MRI in June which showed no spinal avulsions (good news)but has de-nervation up through his tricep. He has some range of motion in his upper arm, but no functional use of his right hand. Being a computer techie this was devestating at first, but he has developed a system to use the mouse with a right arm grip and then uses his left hand to click.

The point of my story is that you find ways to adapt and while it won't be the same, it doesn't have to be quite as devestating.