United Brachial Plexus Network, Inc.

Hi all,
I am sorry to say that I will be applying to the club that no one wants to join (43 y/o male). On 3/15/08 I was in a bad car accident. I was in the hospital for 3 weeks and rehab for 3 months(for various ortho injuries). My left arm is totally flail from the elbow down. I have been told that i likely have some avulsions based on poor EMG results,etc. Just today (7/11/08) I had a myleogram and will discuss the results with the Mayo team on Monday and will likely have a surgery on Tuesday. Does the surgery alleviate any of the pain?
Also as I said, my wife and I are currently at the Mayo in MN, this place is pretty impressive and I feel I have made a good decision in coming here...thanks for your time!

Good luck if you have surgery on Tuesday! I hope that whatever happens you get some relief. The Mayo has some great doctors. I was just there on Monday. It is huge down there. So much to see.
Sorry you have become a member of the club noone wants to be in. Best of luck to you in hopes of a successful recovery!
Hugs,
Amy 21 years old ROBPI from MN (where the weather is rediculous! Its the middle of July and 50 degrees, darn Lake Superior!)

My husband had surgery at Mayo in March of this year. I can't say that the surgery itself has lessened the pain, but I think time has helped. And amazingly, the recovery from the surgery was not bad at all (other than the arm immobilizer- which made him crazy). He had surgery on a Friday afternoon and we were on an airplane to come home Saturday morning at 10AM. Like everything else with this type of injury, the pain, surgery and recovery are so variable depending on the injury. But you are in wonderful, wonderful hands. The Mayo team is superb- we are so thankful we found them. Best of luck to you!

I can't remember where the study is that I read years ago in regards to BPI surgery and chronic pain, but it went something to the effects that if an injured individual had received surgery that was "successful", they had a much better chance of experiencing less pain than those that had no restorative surgeries at all.

FOUND IT...
(Dr. Birch, study author, is one of the top BPI docs out there)


http://www.ncbi.nlm.nih.gov/pubmed/9583755
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"1998 Apr;75(2-3):199-207.Links

Pain following human brachial plexus injury with spinal cord root avulsion and the effect of surgery.

Berman JS, Birch R, Anand P.

Department of Anaesthetics, St. Bartholomew's and the Royal London School of Medicine and Dentistry, Royal London Hospital, Whitechapel, UK.

Brachial plexus injury leading to spinal cord root avulsion in humans produces a characteristic constant crushing and intermittent shooting pain, which is often intractable. Preliminary observations suggested that this pain might be alleviated after successful nerve transfers to restore limb function. We therefore studied a group of 14 patients prospectively, to establish the validity of this observation, and to elucidate the underlying mechanisms. We found a strong correlation and temporal relationship between reduction in pain and successful nerve repair. All five patients with motor recovery experienced significant relief of de-afferentation pain, while in the seven patients with persistent pain, none had motor recovery. There was no correlation between pain relief and the minimal recovery of sensation in some cases, and no case had any return of sensory or sympathetic cutaneous axon-reflexes. While skin sympathetic axon-reflexes were reduced with T1 root lesions, there was no relationship between T1 root damage and pain. It was concluded that nerve repair can reduce pain from spinal root avulsions and that the mechanism may involve successful regeneration, and/or restoration of peripheral connections prior to their function, possibly in muscle."



http://www.ncbi.nlm.nih.gov/pubmed/3056648
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"1988 Dec;(237):87-95.Click here to read Links

Occurrence and treatment of pain after brachial plexus injury.

Bruxelle J, Travers V, Thiebaut JB.

Pain Clinic, Hôpital Tarnier, Paris, France.


The occurrence of pain was investigated in 118 patients with posttraumatic brachial plexus injuries (BPI). Ninety-five patients were operated upon by the same surgeon. Three to 14 years after BPI and reconstructive surgery, 91% of the patients experienced permanent pain that was severe in 40% and mild in 51% of cases. When early reconstructive surgery was successful, a significant decrease in pain occurred more frequently. For 57% of patients with pain, a plurimodal medical treatment with tricyclic antidepressants, antiepileptic drugs, and behavioral therapy efficiently reduced pain. For the patients with unbearable paroxystic pain, when medical treatment failed, the destruction of deafferented dorsal horns at the level of avulsion (Nashold procedure) could produce pain relief. In all cases psychosocial management produced early rehabilitation."

By the way... Good Luck!!!

You made an extremely smart choice and will be getting some of the best care available.

Tell the team Chris Janney says "Hello & Thank You!"

Thanks so much for the words of encouragement!
Christopher, thanks for the link, I'll see the team again on Monday, I'll tell them you said "hi"
It will be nice to know finally what the extent of the damage really is...I wouldn't be surprised if there is all 5 avulsed...but I am expecting the worse and hoping for the best...anyway have a good weekrnd all! I am off to the Mall of America today...our first visit

Hi Peter,
good luck with the surgery!
you definitely have found a source of great information, friends, and support here.
I just wish we had something similar to mayo clinic here in Australia, as i have only heard great things about them.
I myself would have been lost without finding this site, and great friends, and i would be in a much worse place without it.

god bless

shaun

Just wanted to say good luck with your surgery. You are in good hands with the mayo team. They are a pretty impressive bunch, I agree. Let us know how everything goes. My son was injured in 2003 when he was 11, hes 15 now. He has had nerve grafting and 2 other surgeries with the Mayo team.

Thanks everyone... I have so many questions...some of them may seem dumb eg. if and when I get function back after surgery will I get any sensation back as well?

I'm sorry you're here(the price for membership to this elite club SUCKS) but, since you're here welcome. Congratulations on such a team of MD's so as to know to send you to Mayo. I myself missed out on that by about 1/2 year because I was in a VA Hospital and 1.The least they can do for you the better for them and 2.I was in the V.A. for probably 2 months before I 'overheard' my OT Therapist explain to a student (OT Tech) that my condition was called a brachial plexus injury and this is how we work with the PT,yada, yada, yada. When I heard that my ears perked up and questions began to flow and info provided. But, like I say I had no clue why I was suffering debilitating pain 24/7 and why my arm was disconnected. Boy, was I upset to learn of and hear about the time frame and when procedures could be successful or not. Now I'm 2 years plus into it(this plight) and because of friends right here in this network I am only just now beginning to think that I can crawl out of this hole and do something. Maybe even something worthwhile we'll see about that.
So once again welcome and good luck with your procedures. Be sure and let your doctors know how much they're appreciated when all is said and done.
Peace out and free the rice!
Scott
http://www.freerice.com