United Brachial Plexus Network, Inc.

I was riding my motorcycle home one when a pickup hit me head on. My left arm has been completly flail since October 4. The Doctor said he could probably get some shoulder and elbow motion but that the hand would atrophy before the nerve would get to it. I'm not ready to lose my hand, so if there is anything available please let me know. I will do anything to get my hand back.

Hi Allen;
Sorry to hear about your accident and the outcome.

It is VERY important that you see a Doctor who has experience of treating bpi's; I can't stress this enough. I am assuming you are in the States, I am in the U.K. so its no use me recommending any, but I know many people here can help you with this.

Keep you fingers and wrist, and the rest of your arm supple by doing ROM excercises..this will at least help to stop the tendons shrinking.

There are many people here who can give you lots of advice, and I'm sure you will get some answers. I am at the moment due to go into hospital myself for a bit of routine stuff, so won't be around for a bit, but if you want to email me for any further info. or anything else I can do to help, please don't hesitate.

I have had a bpi for nearly 9 years,and have been researching everything related to this subject for a long time now...

Best wishes... Liz

Hi Allen, i was pretty much told (or left to work out anyways) the same thing, it's 2 yrs gone now and my intrinsic hand muscles have visibly gone, but my fingers can bend and extend from the muscles in my forearm (pronator digi-something i cant remember the names) if you see what i mean? The nerves that were regrowing reached those musces in my forearm in time to innervate some but i've had no actual new innervation of previously paralysed muscle for well over a year now, just strengthening of what i do have (which luckily is way more than most thought it would be). So you dont have to have actual intrinsic hand muscle use to have hand use, like in my case. Knowing the muscles might be screwed before any nerve regeneration reached them i also desperately tried to think how to save them, i bought an EMS (E-stim) machine and asked my surgeon if i should use it to work my injured muscles, he said go for it but my physio said not to use it while nerves were still regrowing in case the strong signals diverted their path. So i looked into E-stim and the type i used, AC (alternating current) faradic type, does/did not contract denervated muscle, it relies on innervation to complete the circuit. DC (direct current) apparently DOES contract denervated muscle, (Im sure i remember reading about it on the old board's 'ask the doc' section) but burns the skin so has to be applied intramuscular through needles or rods. i wondered if that was available as a treatment option to prevent atrophy while regrowth occurred, the docs and physio's didnt seem interested in the option, but they didnt have a paralysed hand either. I wondered if getting that treatment a couple of times a week, say, would save the fine hand muscles, and i still do wonder about it, ask your doc's opinion on E-stim and good luck mate!

hi allen

You should contact dr nath. he suggested electronic implants to stimulate my muscles. A bit drastic for me but i was quite a ways along before I found out this could be done. But Dr Nath is probably the most progressive dr in treating bpi's. I would suggest working through a trusted local dr. Have he/she forward your records to Dr. Nath therefore he can help make the desicion if any options are right for you. In the end it must be something you are comfortable with. Time is of the essecnce but dont rush your judgements gather the facts first.
Best of luck to you.

What about TES e-stim? I don't know if it's used on adults - but it's microcurrent e-stim - it does not cause muscle contraction but it just brings blood and hormones to the muscles - it is worn and on all night. Dr. Karen Pape is the inventor of it and more information can be found on http://www.tascnetwork.net. Again, I'm not sure if it's used on adults. My 3 1/2 year old daughter uses it and we've had good results.

Anyway, good luck to you,
francine

I had a long discussion with my EMG Dr. ( he's obpi ) and my hand surgeon regarding muscle stimulator implants to stop the muscles from atrophying.

The answer from the guys in the trenches who have tried this type of treatment is it doesn't work. It's like trying to FAKE a real signal from the brain. Then they end up having to take the implants out with the risk of infection etc.

The best defence against atrophy is lots of stretching and working the arm as best as you can with the muscles that do work. Even the muscles that don't work right now will do better if you stretch them and mimic movement.

In my case my upper arm and elbow was re-innervated after surgery but it was over 8 months before really strong signals began to get thru...until the arm got to that point I relied on alot of physical therapy and exercise to keep those muscles loose and flexible...I did alot of e-stim therapy early on. The goal was to remind my sleeping muscles to take electrical stimulation and expand and contract.

Once the newly regenerated nerve reached it's target muscle things progressed quite quickly and I'm sure the e-stim helped alot.

I avulsed C8 and T1 nerve roots so hope for intristic hand movement was nil. Still 3.5 years after I have limited use of my hand. I can't hold anything with my fingers but I can use the hand for various activites.

Remember you body wants to heal itself and your arm wants to WAKE UP...You have to help it along by stimulating those sleeping muscles with lots of exercise and physical therapy...

Keep at it, it's worthwhile in the long run...Take care, Mike

OUCH...They tried that one on me Francine and it just hurt...The estim machine expanded and contracted my muscles ( which was good ) but the other one, the TENS machine just felt like they put my hand into an electrical socket....I think it's the way the signal is sent that makes the difference...It works for some but not for others...Must be the nature of the injury, or the fix...I'm not sure ?

Interesting