My Brachial Plexus Injury Story

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,

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

Reaching the 9th month life quality gets improved a lot. Elbow flexion is pretty good at this point. I was able to do 5 KG weights easily for biceps, and 3 KG weights for brachiallis. Arm abduction was not close to M3, but a good range of motion was achieved. A slight increase in muscle density could be felt in the deltoid. By the 8th month I started cycling again. Not on a road bike like before, but on a comfortable, stable and more upright city bike. Swimming became an everyday thing for me since the 7th month. I believe it helps with the recovery, since in the water you can easily move the arm it is more practical to get the muscles going. I developed a set of exercises that will be shared in a separate post. Long walks of more than 10 KM with minimal arm support were comfortable. The affected arm becomes of use for the day to day. At that time I opened doors with it, carried light objects, used it to get dressed etc. I was occasionally able to snack and reposition my specs with it.

The 6th month is usually the review point with your doctor. Results at this point may vary depending on individuals. This is just how it went down for me. Elbow flexion started to be functional since around 4.5 months. This is, for example, I was able to raise a small bottle of water (not to my mouth, but to pick it up from the table i.e.). It would get much better over months to come. Flexion after supination of the forearm wasn't good until around the 9th month, but at 6th month it started to get a decent range of motion while making a fist. This means I couldn't wash my hands following the old usual motions but it was a start. I could supinate and raise the forearm while making a fist, but not with an open hand.  At this point I was doing exercises with 1-2kg weights for elbow flexion. For arm abduction, I started to have some tiny movements while standing. Laying down was easier and I could sometimes raise my arm. It was around this time that I ditched the arm sling around

A few months after the surgery is when good things will start to happen. So slowly that will be difficult to appreciate, but they are happening. From this moment onward, you will start to notice that some of your atrophied muscles are slowly becoming less bony. This doesn't mean that the muscle is back at this point, but just a tiny bit. Nerve pain might be still at its peak. This could last for a while. Around this time you will start to observe small contractions when activating the innervating nerves for the elbow flexion. For example, with Oberlin transfer, making a fist will cause some feeling around the biceps. Those sensations will soon become small but visible contractions. From there, you will observe small movements but don't expect any anti gravitational force on elbow flexion anytime before 4 months after the surgery. Depending on what transfer was done for your supraspinatus, it is possible that you will observe changes there a few weeks or months after this point.

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

You will notice changes in your body. Both before, and after the surgery. Of course, it all depends on what kind of injury you have - what nerves are affected and how. For similar injuries to mine (c5 c6 rupture), this is what I noticed for the first 3 months. First, you will start to notice occasional cracking in the shoulder when there's some induced movement (i.e. when you are using your other arm to position the affected limb in a comfortable position). This is your deltoid getting atrophied and not holding your arm as it should. This will start a few weeks after the accident, and depending on your muscle mass it could be noticeable for 2 to 3 weeks. After that you might occasionally still notice it, but the arm is loose enough to be mostly out of its original position. Eventually you will notice there's almost no deltoid left. For me it was after 2 months or so, but it depends on how muscular you were before the accident (I wasn't). If a muscle doesn't receive nerv