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Showing posts with the label Treatment

Keeping track of improvements

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During the first 10 months it will be easier to track progress. First contractions, start flexing the elbow, start moving the arm and so on. I found that around the 10th month it was harder to track progress, I felt the arm abduction was very similar week after week. And I often found myself thinking the arm improvements slowed down. Eventually I came up with measurements that showed me otherwise: The numbers are time references (10th month and 1 week, and so on). As you can see, there's a weekly improvement on the measurements. This keeps my motivation up for daily rehab exercises. I think finding your motivation is an essential key for the best final result, which can be 2 to 3 years down the road. What I do is, pick up a few movements I can do, and measure how high I get on them against the closet and mark them with a timestamp. There are other ways to measure progress, for example, how high you get while soaping your hair in the shower or how far you get trying to open that tal

Timeline of changes in your body - 12 months after surgery

It's been 1 year from my surgery. And I'm really happy with the progress. I'm back to running since the 10th month. That completes the last sport I used to practice (running, cycling and swimming).  I can eat with my right arm again. All the motions to turn the spoon and so on takes some adjusting, but the movement is there. After so long being a left-handed, it takes some "rewiring" to get used to do some things with the right arm again. Around this time, a measurement is done to find out the transfer efficiency (M2, M3, M4...). I am not sure which 'M' I have at this moment, but this is what I have: For some people, this could be seen as little. To me, this is great. After all the bad expectations I was put upon at the beginning, this feels like a second chance to have a full movement life. This might not be the final result. I've shared my progress with my physicians and they believe I could improve further - if I stick to my current rehab exercises

Oberlin nerve transfer: choosing double or single fascicle

Oberlin transfer is commonly used to restore elbow flexion. Single or double fascicle can make a difference for you, but from a medical point of view, surprisingly it doesn't. The medical objective is to reach M3, which can be accomplished by just a single transfer from the ulnar nerve to the biceps. Pros are basically a lesser chance of side effects of a nerve transfer happening, like accidentally damaging the nerve or residual weakness in the hand. Cons are, basically, less strength on your elbow flexion. A double fascicle transfer will additionally innervate the brachiallis from the median nerve. Arm movement might be similar to single fascicle transfer (or that's the general believe), but about half of the elbow flexion's strength comes from this muscle according to physicians. To you, his means you might not be able to pull up that box of milk anymore when carrying groceries - although this is just an speculation from my side. A double transfer will be more expensive,

Clinical details about my injury

I ruptured my C5 and C6 nerves - from what I have been told, these are the usual nerves affected in motorcycle accidents. C7 was initially damaged as the MRI reported, but luckily it was just a pull and quickly recovered. My C5 is supposed to be post ganglionic, but the supraspinatus nerve was affected as well. I lost elbow flexion and arm abduction. This is, I couldn't move the arm but I could move my wrist and fingers. Sensation, however not as before, remained in the respective areas. Some doctors believe some fibers survived hence I conserved sensitivity, others mentioned sensory nerves can sometimes be innervated by different nerves. Pain wise, it was excruciating. C7 nerve pain while reconnecting wouldn't let me sleep. C6 sensory area was like having your skin on fire. This lasted for about 2 months, then the pain was more manageable. MRI done 1.5 months after the accident was very clear about the damage. Electromyography and nerve conduction studies performed 1 and 2 mon

Timeline of changes in your body - Right after surgery, few first weeks

At this point the surgeons have cut about about half of selected working nerves and placed them in position to energize inactive muscles. There will be a decent amount of pills and you'll be feeling like badly hangover for a week or so. Your fingertips will have some degree of numbness. It happens frequently. For double Oberlin transfer, you may feel some degree of weakness in your hand, specially in the index finger. Weakness should recover in the upcoming months, so try to not worry too much about it. In another post I will cover my thoughts about single or double Oberlin transfer. It is possible that some new areas in your hand become hypersensitive. For me it was the lower part of the palm. This is supposed to go away with time, for me after 10 months it lowered the threshold just a bit. You'll be in immobilization period for one month. Depending on your Doctor, you will either be told to have the arm tightly immobilized, or to allow just a little bit of movement. At any ca

First weeks of injury

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The two best words that can describe my first weeks of injury: confusion and pain. I don't know if this is just coming across the wrong people. After crossing the border with Malaysia, I went straight to the General Practitioner who sent me right away to hospital emergencies. They started their tests. One of the male nurses (or doctors, I can't remember) was asking me questions about the accident, and he mentioned I might need some micro surgery. Right away he checked for my sensitivity on the C5 and C6 sensory areas. He explained to me I had a brachial plexus injury, and that I could google it to get more details (seriously). He gave me meds and set up an appointment to see a hand specialist a few weeks later. He gave me a specific medication for the arm pain. I mentioned I did't have any pain in the arm. You will - he predicted. Then I was on my way home. Fuck yes I had pain the next day. It was like someone was stabbing me with an electrified knife all around the arm. At