United Brachial Plexus Network, Inc.

hey just wandering if anyone has had this surgery and their benifits from it or not i had mine in jan 2003 and just getting to the six month mark I think there is some changes my shoulder seems to be flickering and my bicep feels like it is tighting up but not enough to see a twich or move anything yet this process is so slow its almost hard to tell if there is any results i am using the e stem unit and it does make my shoulder jump know if i find the right spot thanks for any input

Hi Chris

I had the same surgery years ago and yes, it does take a good long while for the results to become apparent.

It took around 9 months from the sugery to be able to lift my arm against gravity and it got stronger every day from then. I seem to remember having a lot of itchiness around the grafted area for weeks before any flicker of movement...I can still lift the arm fairly strongly although it can't take any great weight since it is ONLY the bicep that is reinnervated. To be brutally honest, it is of no practical use to me whatsoever, just makes my arm look a bit more 'normal.' I don't get any pain in the upper arm either and this is probably due to the surgery. :0)

Just a word of caution about the E-Stim though; you probably know this yourself but it is for the benefit of others who may be reading; make sure that the right muscles are being stimulated...using E-stim incorrectly can actually cause more damage when used on muscles that aren't actually innervated.

Good luck and happy healing...!
Liz x

Liz, did your Dr. tell you that if you put e- sim on th musces that are not inerveted can cause damage. I am doing that and after what you said I got worried.

Thanks,

Susana

Hi Susanna, I didn't mean to worry you...my apologies if I did...the E-Stim for adults with a TBPI is something I am often asked about and I have tried to find out as much about it as I can. I have asked quite a few physiotherapists and a couple of BPI surgeons in the U.K. about it and they have all given me their honest opinions based on research (of which there is very little in long term use of these units)and observations of their patients.

They have concluded that using E-Stim on muscles which are not innervated will have little or no effect and the muscle will atrophy in time anyway. Also, without strict supervision and guidelines in its use, it would be too easy to cause damage or 'burning' of any nerve endings that are left since the patient can't feel if the levels are set too high.

Using E-Stim to help a muscle that is re-innervated to regain strength can be useful in adults but there is no reason why the same results can't be had by a regime of physiotherapy and targeted excercises. These are not my personal opinions but those of the medical practitioners I spoke to.

Sorry again if I worried you :0)...you obviously have to do what you feel is right for you and discuss all aspects of this treatment with your neurosurgeon or doctor. I hope others will come in on this thread too and post about their experiences with this treatment.

All the best

Liz :0)

hey thanks for the reply and that does make a lot of sense on the e stem unit im gonna talk to my doc and therapist immediatly because they didnt give me any real strict guidelines on how to use it and what strength to use it on i have been maxing it out on my forearm because there is very little sensation there have you used the tins unit also and is there any side effects to it that you are aware of

Hi Chris...the ONLY time I ever used a TENS machine was under supervision, while I was in hospital. I used it to relieve the chronic pain I had in my neck caused by breaking off a few of the spinous processes in the accident. (bony bits that stick out from the spine...) and to be honest, even at the highest setting (which left burn marks) it didn't do a lot to relieve the pain. Other people swear by them though...once again though, the nerves have to be intact for this to have any effect at all. It is probably more useful psycologically...

Liz

Hey HD and Liz
I am getting Estim from my OT at the instruction of my DR. We are only working with the deltoid after getting flickers of movement. My OT and I both feel that It is working as my subluxation is slowly returning from where it came from. It's been about 6wks since we started. keep the faith, Red

David, how long do you use the TENS and how many times a day or a week?

Thanks, Susana

hey thanks for the info guys i see my therapist tommorrow and find out what my limits are as for the tens i seen results sometimes and other times i didnt its hard to understand all the muscle groups in the shoulder area and whats working and whats not and were to place the pads and were not to ive got one muscle group in the back of my shoulder that jumps like crazy with the unit but other places up their like the front part of my shoulder i cant go past 10% and i dont think thats strong enough to do anything as for the forarm no sensation at all what restrictions did the oc give you on yours dave they sent mine home with me and told me where to place and use it on each area 15mins three times a day at the highest setting i could stand and as the settings decreased the better

Hey Susana
I am having E stim two times a week for 15mns a visit. We are alternating between the three muscle groups that make up the deltoid muscle. What I am having done is not TENS but Estim done in the Russian Progam which has a different ratio of stimulation and rest of the targeted muscle. We may go to more sesions in the future depending on results and more signs of reinervation to my bicept.
I don't know more about the Russian style but was told that it was best for my situation. My OT has been adiment about not starting to soon and consulted with my nuero surgen befor starting. Hope this helps.
Red