United Brachial Plexus Network, Inc.

Hello I'm new to this site and have got a question. Ihad my bike accident in 1979 (32 years ago )
which left me with a paralysed right arm but with bicep movement. Is it to late for surgical intervention ?

HELLO SHAUN,
32 YEARS IS A VERY LONG TIME,WOW IT BLOWS MY MIND TO THINK OF LIVING WITH THIS INJURY FOR THAT LONG,FROM THE VERY BEGINNING I'VE BEEN TOLD THAT THE SOONER YOU GET SURGERY THE BETTER YOUR CHANCES OF RECOVERY ARE BUT WHAT I'VE ALSO LEARNED IS THAT THE CHANCES OF A COMPLETE AND FULL RECOVERY FROM THIS INJURY ARE VERY,VERY SLIM.FOR THE VAST MAJORITY OF US WHO ARE UNFORTUNATE ENOUGH TO GET THIS INJURY,FOR THE MOST PART IT'S PERMANENT BUT WITH THAT SAID ANY IMPROVEMENT IS BETTER THAN NONE AND THE FACT THAT YOU HAVE MOVEMENT IN YOUR BICEP IS ENOUGH TO PERSUE GETTING SOME HELP.SO I WOULD GET TO A DOCTOR AND FIND OUT,AFTER 32 YEARS WHAT CAN IT HURT TO TRY , GOOD LUCK.

Here is my Thought for you , Mind you that I never had treatment and at 61 with erbs is a life time. many have taught me that this place shows by FACT that treatments have change over 61 years- Is it really true that bpi issue really are permanent can this be true?? Its never to late if you want something bad enough, But still needs direction. Say what your injury are and your limitation still. Some one may say something that matches up to your BPI?? Forget the age thing. Doctors some time pull rabbits out of a hat , Nerve Transfers, ETC! Some doctors , do more for sure. Do try to see which doctors will give you the most usage back by there treatment? Because you have had the injury for years like me you also have learn to adapt in your world, I know there was no treatment offered to me 60 years ago. What was offered you 30-years ago?? I Think That the answer is nerve transfer I guess?? My erbs is permanent for life,BUT the truth is for me that I gained my brain rewired to think one handed. So I will tell you I am CRAZY, Because I think one handed in life over time , I never new what the usage of 2 arm meant. But I was born injured but worse to me is when you have a BPI later in life, You remember what usage of two arm was! To LATE NEVER-!! BECAUSE YOU TRY you never fail because you have COURAGE !!! JUSt my thoughts
Mr Positive,
Tom

As I understand it from Wake Forest University, UNC Chapel Hill and from the Mayo Clinic (I have been to all three) - Any surgery for your nerves must be done in the first 6 months Post Injury. There is slim to no chance of a successful nerve transfer after 6 to 8 months. Muscle Transfers can be done at any point. I am considering a muscle transfer for in the near future and it is 3 years post accident.

If I were in your shoes, I would seek a surgeon familiar with BPI and consult him/her. It is hard to beat the Mayo if you can swing it ($).

Good luck!

Keep on keeping on

Jeff

Hi Shaun. Amazing....my auto accident was also in '79. I lost total use of my right arm from paralysis due to brachial plexus avulsion. A little history: I was ejected from the automobile and ended up hanging over a guardrail, unconscious. Upon standing, my arm just hung at my side. Exploratory surgery was performed about a year later to no avail. For 30 years I wore a sling to prevent swelling and protection. Every 10 years I'd see a neurologist or orthopedic asking about new treatments. Well, the summer of the 30th anniversary I finally hit upon an orthopedic who gave me some hope. It's taken a year and a half of further physical therapy and researching physicians that finally brought me to Dr. Bishop's team at the Mayo Clinic in Rochester, MN. I'm scheduled for surgery June 29 for a gracilis muscle transfer. This is a muscle from the left thigh and nerve donors from behind the ribs. The muscle is then connect to the collar bone and elbow, hopefully giving me elbow flexion and stabilizing the shoulder. According to Dr. Bishop, it doesn't matter how old the injury, because those muscles are bypassed. I believe there is a way to send me a private email. Please do if you would like to talk further. I would be interested in hearing your story and see if I can offer further information.

Pat

Hi Shaun, I don't get on here as much as I should but I read your post and thought that I could answer your question for you. I recently had surgery at the Mayo clinic that transfered my trapezius (sic), think "backstrap", to my elbow which gave me a quasi tricep muscle. You see my entrire arm was paralyzed then after a couple years my shoulder came back, then soon after some of my bicep came back, everything else stayed paralyzed. No hand function, limp wrist, no feeling, etc. So I could basically bend my elbow but thats it. So I had this surgery at Mayo by Dr. Elhassan that gave me a tricep so that I could bend and straighten my arm, I also had my wrist fused so that it was no longer limp. Although this didn't give me a whole lot of funtion it really helped esthetically as well as holding and carrying things, and many other things that I am learning. I don't know what your exact situation is but there are many things that are possible besides this particular surgery. The Graccillis muscle transfer which was mentioned earlier is another surgery that the Dr.s at the Mayo clinic can do. They are the First Best choice when it comes to this type of injury. I wrecked on a mountain bike 6 years ago and only had this surgery a year ago so there is hope. Contact the Mayo clinic in Rochester Minnesota and ask to speak to someone about a Brachial Plexus injury.
If you have any questions feel free to ask.
Brandon

Hi Shaun. Just wanted to chime in again now that I'm recovering from the gracilis muscle transfer on June 29, 2011. Like you, my injury was 32 years ago. My right arm is completely paralyzed by a full avulsion C6,7,8, T1. Dr. Bishop and Shin at the Mayo Clinic in Rochester performed the surgery. This procedure is expected to give me elbow flexion and some shoulder stabilization. I'm currently pursuing the next step of the trapezius transfer by Dr. Elhassan for shoulder movement (lifting my arm out to the side).

The gracilis transfer was a bit rougher than I expected but I'm confident it will be worth it in the end. I'll start by creating a timeline of the surgery.

June 28 Tue - preop at Mayo Clinic
June 29 Wed - surgery day at St. Mary's Hospital
June 30 Thurs - ICU
Wed and Thurs in ICU, I was pretty much out of it ... was definitely not feeling any pain. The entire stay, for such an extensive surgery, I was made very comfortable by everyone from the desk personnel to the nurses to the surgeons.
July 1-3 Fri - moved to regular room, stayed Sat and Sun
July 4 Mon - Discharged
July 5 Tues - Hard Cast put on (for 6 weeks)
July 6 Wed - traveled home to Atlanta

Once the hard cast is off, it's another 6 weeks in a splint and sling which I'm in my last week of. I've been going to physical therapy where they are doing wound care and have just started passive elbow flexion. The wound care is because of the disconnected tissue and nerves of the thigh. I see a local surgeon here in Atlanta that Dr. Bishop referred for my post-surgical care. I'll see him again in a week. Dr. Bishop at Mayo wanted a 6 month followup in Rochester. Until that time, it's pretty much a "wait and see" until the nerves and muscle start to fire which is on average 5-8 months.

As far as time off from work, I was hoping to go back after a month. I ended up only extending that by a week. So, all-in-all, I was feeling fairly well at that time. Fortunately, I have a desk job so it's not too strenuous. I started back part-time and at 7 weeks post surgery back full-time.

The Brachial Plexus team at the Mayo Clinic is outstanding. Jim Bell is Dr. Bishop's physician assistant. Jim has been great answering all of my questions pre- and post-surgery. Dr. Bishop even called me one evening. How often does that happen when the surgeon actually calls!!?? Needless to say, I am very pleased with the care and would recommend them hands down. Having the surgery is a big decision even after 32 years. I investigated this and other options seriously for 2 years before deciding to more forward. I hope the forum helps in your journey.

Regards,
Pat

Hi Shaun. I made a post today titled "Results from Trapezius Transfer". This was 32 years post injury. I hope it helps with your journey.

Pat

i was losing function rapidly in my injured hand. i went to dr susan mackinnon. she did a new procedure on my arm called R.E.T.S. i almost immediatle started seeing function return to my fingers. by losing function i mean my hand was starting to claw severely. i could not straighten my fingers. or make a full fist. it is a procedure dr mackinnon came up with a couple of years ago and is starting to trickle down to other docs. my surgery was in july of last year and i am very happy with the results. cant believe it has been almost a year already. and still seeing small improvements on a regular basis. good luck to you. would not hurt to ask about the R.E.T.S. before you have your wrist fused.

That's very interesting. I was not aware of that procedure. I just read another post, "new methods that speed up recovery after nerve injury". This is very encouraging.