My Brachial Plexus Injury Story

Has been one year and a half since the surgery, and things continue to slowly improve. As usual, visual changes compared to 3 months ago are low profile. However, it doesn't feel that way at all. There's a very significant improvement of strength and usage of the affected arm, slowly making my right arm the dominant arm once again - at least for anything that doesn't require more than 90 degree elevation angle, then it needs some help. I barely keep track of new movements and "milestones" achieved nowadays, not as much because of wearing off from time consuming toil, but mostly because life as normal is mostly achieved at this point. Nevertheless, I still do keep my routine of recovery exercises. With the increased muscle mass in the deltoid, it's visual atrophy is less prominent and cracking noises are less frequent. Hypersensitivity of certain areas of the hand is improving. Mostly remaining in the thumb and lower part of the palm.

Recovery exercises and rehab are very important for this injury. You may quickly realize that it is not feasible to visit a physio every day - it would be challenging, both organizational and cost wise. During my days in occupational therapy, at the beginning of the injury, I noticed the environment and what could be expected of a continuous visit to that hospital (government sponsored). I tried a physio with alleged previous experience with BPI, and the prospect was not any better. On top of the mandatory nerve transfer exercises, I came up with a few series of exercises I've been doing since I was able to slightly move the arm. I don't know if these are the most optimal I could do, but I've heard that people doing physiotherapy on their own still can achieve decent recovery, so I thought I couldn't get too wrong on them. Before being able to trigger functional movement, I believe the most important is to send stimuli to the nerve. This is mainly achieved via the nerve

So 15 months have passed by... And feels great! Using the arm gets easier as time goes by.  Visually, doesn't seem to make a huge difference compared to 12 months mark. But I can feel quite a difference since.  A few weeks ago I started doing small planks, and I think I might be able to do one push up at some point. I started using my right arm to soap my hair and to brush my teeth, generally I try to make it the leading arm again. Some movements are easier than others, and most of them are not fluid yet.  To me, some of the key recovery points are achieving the movements needed to perform my hobbies. I'm a big fan of eating, so there goes one. Running, swimming and cycling are there too (although might not get on a road bike for some time, MTB or city bikes are good for now). The ultimate challenge will be riding my motorbike regularly again - or at least, have the choice to do it if I feel like it. Combined movements (flexion / abduction) are still a challenge and not very ac

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

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 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