United Brachial Plexus Network, Inc.

Hello everyone,

My girlfriend Marylene posted aearlier and I felt I should add something myself.
I found out about a week and a half ago that I recieved a traction injury to my brachial plexus accross C5-T1.
The first thing I want to say is that when I found this site and read through many of the posts it was like huge weight had been lifted off my shoulders. My family doctor told me I have a 5% chance of recovering. I know that this is like many other new members posts but I would like to tell my story and hopefully get some feedback from those of you that have the experience and knowledge.

On Dec 26 I was in an avalanche and I am lucky to be alive. I sustained a great deal of trauma but many of my injuries have been resolved and are healing. I broke my right humerus which severed my radial nerve, a plastic surgeon grafted a nerve from my calf and replaced 6cm of new nerve. After I recieved an MRI which showed either soft tissue injury around the brachial plexus or stretching of the root sleeve on the trunks between C5 and T1. My nerve conduction and EMG results showed limited or no conduction to my bicep, triceps, deltoid and rotator cuff. I have a wrist drop and cant extend my fingers. This initiall is probably do to the nerve graft still healing. I can flex my triceps, use my deltoids and rotator cuff but there is no movement of my bicep in anyway. its atrophed a great deal now as it has been close to 2 months. I am seeing a PT and OT and the work we do is dedicated to maintaining mobility and improving strength in muscles that do work.
The nerve conduction Dr. has refered me to 2 specialists in the area but my appointments are not for at least another month because I am neither a priority and they think that waiting another month might lead to some improvement.

I have so many questions, many of them have been answered by reading papers and journals and of course reading posts on this board.
But I have many others...

It has been 2 months now since the accident and at least another month before I see a specialist, should I put the pressure on to get an earlier meeting?

I looked on the Doctor reference page but cant find any referals for the Calgary area, does anyone have suggestions on specialists?
I have done some research on nutrition and natural medicinals. Currently I'm taking Arnica, St. Johnswort and symphytum officinale. Also 2000mg of B12 a day, multi vitamins and eating as healthy as possible. I believe good nutrition is the first step in healing properly. I'm wondering if anyone has anything to add or have comments on this.

I found information on a MRN which is similar to an MRI but dedicated to neurology. I'm not sure if there any in my area but I am curious if this is something I should suggest to my doctor so we can get a better idea of the extent of injury?

The Neurologist at my EMG says that I have nerve issues to my deltoid, rotator cuff and tricep but they all seem to function. Not as well the left arm but this could be because of the imobility due to the humerus fracture. My bicep in my upper arm is atrophed a great deal and has no inervation. is anyone under similar circumstances and what kind of recovery have you had?

Has anyone had success with electrical stimulation to help heal and regenerate the nerves?

Has anyone tried acupuncture and/or massage, I'm considering both of these as time continues?

I havent had any pain up until a couple days ago but today I have definetly had some sharp twinges down my radial. Does pain mean I'm healing? Do the majority people have pain?

What can anyone suggest that would also give the best chance to heal that hasnt been mentioned, possibly something that felt insignifant initially but looking back was something that meant a great deal?

I understand many of these questions should be directed at my specialist but I believe experience counts for so much more. I want to thank you all for help and understanding and if someone wishes help from me feel free to ask

thanks again
Ben
Canada

Ben welcome,

I'm really hoping people with more exprience than I respond, I'm pretty new here and I really know only the basic stuff. And still learning only being two and half months in myself.

I've talked with many people and they all have been a great help, I really wanted to respond to bump you back to # 1 spot to get the wiser ones to respond.

Best of luck,

Mary Beth

Welcome Ben,

My injury was sustained when my ortho doctor entrapped my ulnar and mediam nerves as well as my brachial artery in 2 sutures, This was during a simple rotator cuff & bicep tendon repair. Much the same as you, I have a drop wrist and no use of the hand at all. 2 EMG tests 7 months apart have reflected no improvement, but I swear I can feel the ulnar nerves from the elbow sheath (funny bone) to my 3 fingers on the left side of the hand. I have been told that I will not regain the use of the hand since the nerves regenerating will not reach the muscle in time. The muscle is already atrophied and shrunk up as they stated it would. My answer to you is to keep a positive attitude, keep working your PT/OT exercises to keep the hand muscles and joints freed up, and make sure to inform your therapists/doctors as to each little thing you feel from one session/visit to the next one, no matter how insignificant you feel it is. I hold out hope that one day modern medical technology will allow me the use of my hand again. Good luck and God Bless!!

In regards to electrostimulation, I have been using it to stimulate my tricep which went dead due to the Brachial Artery being entrapped. It seems to my therapists to be working even though the EMG shows no improvement. Remember, EMG tests are not infallable in showing results. Machines and human intervention do not always make for correct results.


Message was edited by: Greeny


Message was edited by: Greeny

Hi Ben,

I would push to see the doc earlier if possible and you want to see a doc that specializes in Brachial plexus most nero surgeons don't. In the US most brachial plexus specialists are plastic surgeons. If you need to have surgery the the closer to the time of the injury the better. There is a 6 month window of time where surgery can be effective. Out side of that the muscle plates die before the nerves can regrow in after surgery.

I was in a skiing accident (also lucky to be alive) March 2nd of this last year. I hand no movement in my shoulder and elbow and could only flex my wrist and had limited grip. The first docs I saw kept telling me to wait. They had me wait so long that I almost ran out of time. Before my surgery I was pretty much the same as right after the accident. The wrist flexers and grip were a little stronger but I had no other movement.

I had surgery done in August and now I can bend my elbow 90 degrees with my bicep, and extend with the tri-cep, Shoulder muscles are firing and without gravity I can move my arm around quite a bit.

The surgen told me 1 more month and they wouldn't have been able to do much. My two cents is see the specialists as soon;s you can and go armed with lots of info. You really have to be your own advacate.

Check out my blog for my experience (www.leftarmbandit.org)

Cheers,
Joel

27 year old, RTBPI tri-athlete from OR

Ben and Marylene,
Welcome to the club no one wants to join. Hopefully I can give a little information. First of all though remember that each injury is unique so, what works for one may not work for another. You said that you had a nerve transfer from the calf. Although 2-3 months will surely feel like a long recovery time, with a BPI it is completely different from other injuries. The majority seems to believe that nerves heal at about 1cm per month. Thus being said I think I saw where your graph was 6cm plus you have some stretch that also needs to heal. The good news is that you had your nerve transplant early. It is best if done by 6 mos post accident. As for pushing to see another dr before your month wait, from what we have been told by the BPI team at Mayo as long as there are no nerve transplants/graphs to be done it is good to wait and see. The best recovery will be on it's own. My son also had no biceps. It was several months post accident before we saw even a flicker. He now has a grade 2. We have taken him to Mayo on 3 occasions for a muscle transfer and so far he has decided to keep working. The muscle transfer has no time frame so it is up to him to decide if he wants to have it done. He now can bend out of gravity. We started by using a skate board on a table and had him move the arm this way. That gave him no resistance and he had to struggle to move it at all. Now he is able to move 5 lbs when laying on his side. So, I did want to mention to try doing things out of gravity. Like bending the arm when laying on your side. Water is also great when trying to move. He could always do many more movements in water than on land. Electostimulation is often used in these injuries. Though I think more for muscle than nerve. It will help to keep the muscles from atrophying and also help to stimulate them and promote strengthening. Though on it's own it won't be enough. You will find several people who use it. Dustin also used this before he could move out of gravity. Yes, most people here do seem to have pain. It is as varied as the injury. We are fortunate in that Dustin does not have pain often. He has had a few twinges or pangs when different things seem to be healing. When he started he could not move the shoulder or arm, he does have full hand movement. Now he can move it all out of gravity and some movements in gravity. So he has seen quite a bit of recovery but because of the slow return on biceps it is not funtional yet, but we keep hoping. I have been making up different tools to use to try to get this working. You will also find several people who are now using the biofeedback. This will give you feedback when you fire the right muscle when trying to make a movement. It has been beneficial to many. I am sure I have missed a great deal that you asked but here is a start. You may have read much of this information already by checking out other threads. First and formost I think is to be seen by a BPI specialist. We are not from Canada so I can't help you there. I do know that Marieke is from Canada. There was also another family who brought their son to the Mayo in MN for treatment. Remember that the EMG, while being very helpfull in reading these injuries, are open for interpretation. Also they are not 100% accurate. My sons reads closer to normal all the time but he doesn't have functional movement, while the family from Canada whose son was seen at Mayo had an abnormal EMG yet he has had a good recovery. Sorry, there are no black and whites with this injury. Well, hope I have been of at least a little help.
Sue