United Brachial Plexus Network, Inc.

Hello again,

I posted about this couple of weeks back, unfortunately there wasn't much reply. I am a little disappointed about this I have to admit.

Anyway, the new doc said my deltoid seemed to work too little and too late so he thought it would be better to go in and have a look. Otherwise I'd lose the rest of my options available within the two year muscle atrophy time frame. So he went in, the day before, and saw that my axillary nerve was totally ruptured just after it branched off the plexus' trunk. The distal part went into edema rather than wallerian degeneration so it was irreprable. So, he checked for the shortest route and the best signal to go for nerotization. So, he patched my axillary nerve with a branch of my properly working triceps nerves.

14. month post-accident, he says our only advantage, about which he is actually optimistic about, is that the distance for the nerve to recover is just 5cm.

He expects innervation around 3 months and some proper recovery around 6 months.

What say you?

Anyone?

I wish I had an answer, and I'm very interested to hear what others say. My husband had a simliar surgery in March- a nerve from his tricep was moved to his deltoid (you know the terminology far better than I do). We are about 5.5 months post surgery and he had no movement, but we THINK we see the muscle is flexing (as does his PT), but it is so hard to tell because the muscle is so atrophied (surgery was performed 7 months post accident). And we don't want to get our hopes up until we get a definite answer when we return to Mayo at the end of September. At the time of surgery, the team told us that 20% of these surgeries are unsuccessful, and then of course within the 80% that do work, the amount of recovery varies widely. If we learn anything new about the srugery and recovery when we go back at the end of the month, I'll be sure to let you know.

Hey buddy,
really interested in this surgical option too.
I think im in the same boat as My recovery so far has been only my bicep and brachiallis, not my deltoid.
And i too am reaching towards the end of the recovery window as my accident was on the 26th may 07'.
That recovery window sounds really good!
It is amazing how many little motions that we take for granted, as building up my bicep and brachiallis is a pain!

Shaun

I wanted to post a little update as I said I would once we got back from Mayo. My husband had a similar surgery in March and we went back for an EMG and checkup (so 6 months post-op) We weren't feeling optimistic as we thought that perhaps we saw the muscle flexing a little, but he didn't have any movement. As it turns out, the surgery appears to be successful, the muscle is starting to be innervated, though the nerve braches are still immature(which is a good thing, since it means they will likely keep growing). At any rate, they said it was extremely early to see this progress--so I'm not sure you would start to see actual movement at 6 months (though who knows, every surgery and patient seems to be different). They said he would start to notice aching sensations in his deltoid as it started "awakening" and he's added a bunch of new strenthening excercises to his regular PT. I don't know if that helps or not, but I figured I would pass it along.

Me again...

Update:

20 months post-trauma now. OK. 'Relatively' better. Better infraspinatus, thus 'relatively' better external rotation... Still had no confirmation of any reinnervation of my deltoid on the EMG when I got checked three months ago. And still no visible deltoid function recovered by now.

Going to get it checked again next week. At the three-months-post-op-check Doc said he was still not expecting anything until 9 months post-op. And that he might want to go in and check again only then. But that equals to almost two years post-trauma for me which is statistically when you don't want to be hoping for anything. He is supposed to be one of the internationally acclaimed docs on BPIs. Still, I feel like he might have even forgotten about my story and is trying to make me feel easy.

Frustrated again.

Opinions?

Anyone got his deltoid back and properly functioning AFTER 2 years post-trauma?

Really?

Hey Motormonk,

i had very similar surgery 3months and 12 days ago now.
my alleged window of opportunity ends on the 26th may.
still no sign of reinnervation of my deltoid as yet.
and my humerous is starting to sublax..bummer.
so fingers and toes crossed for us both on this one.
had a checkup last week & my surgeon said it is probably too optimistic to expect reinnervation to occur yet.
so wait another month.
my motion currently is from supraspinatus and infraspinatus.

shaun

Thanks for the reply Shaun!

This time I'll be extracting doc's knowledge and personal opinion on this one by whatever means necassary. All of it! And report it back to you.

: )

Well, except at the beginning I didn't have a major sulcus sign (subluxing of humeral head?). My movement is also mainly from the rotator cuff, levator scapulae and other scapular muscles. But the funny thing is not a single medical expert can come up with a satisfactory explanation of the movement that should be related to deltoid (around 120 degrees of anterior flexion) when it neither contracts visibly nor shows any signs of reinnervation on the EMG.

I mean this BPI thing is such a case that you are left to face with a large spectrum of concepts; body over mind or mind over body or neither, spirituality versus positivist rationalism, fate and deterministic universe... I think it all comes to a personal interpretation of it all. It forces you to perceive and take part in your perception of life thoroughly, utterly. So getting depressed is so easy and almost the natural thing to do. But whenever someone with a similar problem comes up, I still want to encourage their personal interpretations of the universe around them. Although it is not my taste, even some kinds of false hope help people fight and get better. I mean it is personal and OK when I feel down, but when my depressed state affects other people it is not OK. In short, we should think along the hard facts allright but still keep our spirits high. It is harder than cheating with self-deception but it is still the only way until the big-time cheating of gene therapy or similar 'sci-fi stuff' comes around. By the way, when that comes we'll probably have other problems to talk about. : )

Anyway, I got carried away and turned whatever I was going to say into a lecture. : ) I actually wanted to say that since your mechanism of movement is somewhat similar to mine maybe you can strenghten those muscles and stabilize your humerus' head.


I just got sick of gradually losing my motivation to fight, doing half-assed PT sessions with those caring people at the clinic. They are like a family to me by now. So we had a talk on waiting on the deltoid and my declining self-discipline etc. We decided to switch back to my programme before the neurotization surgery: Two days of pool and one session of PT a week. I really think pool helps with your awareness of the slightest change in your body. And PT session helps evaluate any changes in a professional environment.

I'll keep you posted.

Take care,
Nazim