United Brachial Plexus Network, Inc.

hi all, on the 26th may 2007 i had a motorcycle acccident. it looks like i damaged around the c5 and c6 area of my brachial plexus. the surgeon thinks it may be a rupture, and has scheduled me in for surgery on the 4th of august. he said they would harvest a nerve from around my leg to repair if required. do you think i should go for the surgery? or wait? i have had an EMG around a month ago. thank you for any information. my surgeon is going to be dr phil griffin at the flinder medical center in south australia. thanks again for any information. ive never been so scared.

Shaunn,
I have always had in my understanding that the quicker you fix the problem, the better your chances at a recovery. I was told to wait after my accident and by the time I had my surgery it was a bit late. I have very minimal use of my arm now. As for being scared that is natural. Fear is a common factor in all of our lives. What you should be happy about is that you have a community such as this to look to for help. If you need a friend, or you need to talk my email and phone numbers are in my profile. Look me up, I'd be happy to chat.

Shaunn,
The sooner the doctors can perform the surgery the better chance of recovery you have. Being scared is understandable. I had my accident Jan 2, 2007. I had skin graft done on my left hand and forearm March 9th. I had nerve grafts July 12th. The nerve grafts were delayed because the swelling of my arm was to severe to operate sooner. I have heard the nerve graft should be done no later than 9 months after the accident. You are fortunate that your doctors feel you can have yours done so soon after your accident.

Best of luck with your upcoming surgery. Keep us all posted on how you are doing.

Janelle

Hi guys, thanks for your replies. after speaking to baseballbandit11, thanks buddy, i am going to have my second EMG before comitting to surgery. seems i have a flicker in my bicep. also i have much trepidation with this surgeon, as my mri and emg done around 5 weeks ago, were found to be inconclusive. so i would prefer to know what has actually happened with the nerve before going under the knife. i am also looking to get a second opinion. how big are peoples scars? the surgeon talked about cutting through my collarbone, armpit, near my neck etc. not exactly keyhole surgery..hehe is it necessary to cut through my collarbone? thanks guys.

Hi Shaun,

It sounds to me that your surgeons are well on to it mate...personally, if I was in your shoes I would have the surgery. So many of us have been left until it is too late to have any surgical repair done.

MRI scans and nerve conduction tests are inconclusive. Most BPI surgeons will use the results of these tests as indications only of the damage done.

In truth, most surgeons agree that the only way to know the true extent of the damage to the BP is frankly, to go straight in there and have a look. Sometimes they will do nerve coduction tests right on the affected nerves during surgery.

I could find you any number of peer reviewed studies that cover these questions, but if you have the time and energy, you could find these with a thorough search on something like Google. Pubmed.com is a good place to start.

Another thing to consider is how experienced is your surgeon in treating these injuries...they are very complicated and it would ease your mind if you maybe even talk to others who he has treated.

Don't mind too much about being scared...surgery is a scary thing even if it is minor (which this isn't)

Go back and ask him as many questions as you can. Write them down and take someone wuth you to take notes if possible. He shouldn't mind answering all of them and putting your mind at reat.

Let us know how you get on.

LizzyF (14 years TBPI. website http://www.tbpi-group.org )

ps I have a scar along my neck, which is a pretty common place for what they call exploratory surgery here in the UK. Various scars along my arm too from surgery, but these faded really quickly.

Don't let the thought of scarring put you off..they really do fade with time, sometimes very quickly depending where they are.

It does sound a bit weird to me tho that he is thinking of cutting the collar bone, but this could maybe make it easier for him to get to the nerve he wants to graft. I know when I had surgery, he was careful not to disturb my collarbone, possibly because it was only just healed from a break.

All the best mate...

Lizzyf

Shaunn,
The standard wait for BPI surgery used to be 6 months. The idea of waiting was based on getting as much natural return as possible with out disturbing the body's own recuperative ability. Since nerves regenerate very slowly, about an inch per month, people may not experience return of some function for over a year. When I had surgery 4 years ago, my surgeons opted for 4 months post injury (I hated the wait). At that time most all other surgeons were recommending the 6 months wait prior to surgery. For the last few years the wait time seems to be shortened more and more.

The extent of the scar is based on the necessity to access and test the the nerve network depending on the specific damage to your individual situation. Unfortunately one of the best ways to determine nerve avulsion, being torn from the spine, is a visual inspection, which has it's own risks in doing (risk of damaging already injured nerves and piercing your lung sack with the lower nerves C8 & T1).

The best thing you can do is to research the hell out of your surgeon and any other TBPI surgeon you can get access to. Your surgery is coming up very soon, so I'd guess your surgeon doesn't operate from the 'old school' standards, which could be good unless he is not experienced.

The only thing I could think of to do is to call the folks at the TBPI team at the Mayo Clinic in Rochester, Minnesota and ask them for a referral in Australia on Monday. The best specialists in this field all know each other in one way or another, partly because it's such an uncommon injury and unique & specific surgical intervention is required within the field of peripheral nerve surgeries. I'd bet that they know of a few good specialists within Australia.

I've never heard of a surgeon having to cut through the collar bone, but I'm partial to aggressive exploration and surgical intervention. If he wants to remove part of the collar bone I'd assume it's only to access the Brachial network for inspection and repair. If he does, it will probably have to be plated to secure proper healing and protect against movement that could damage the underlying nerves.


Best of luck to you, and keep us posted as to how things go and feel free to ask any questions you've got.

Chris


PS - Here's a little BPI library I've assembled over the years. Check out the images section, that'll give you a better idea as to why they may have to cut an access point from your collar bone.

http://homepage.mac.com/cljanney/PhotoAlbum8.html

just wanted to take this opportunity to say how grateful i am for all your replies, and the wealth of information on this board..thank you all..

Hi guys. just wondering if a plastic surgeon/ reconstructive surgeon is good? or have most guys used a neurosurgeon? thanks guys.

Chris,
Thank you so much for the incredible wen site. I printed out so many of the diagrams for me to study for a better understanding of my injury and surgeries.
Janelle