My Injury

The Accident

On Sunday 1st of March 2015, I had a motorbike accident. My bike hit some gravel on the road and threw me and the bike left onto the dirt shoulder of the road. I tried but could not regain control of the bike and I slammed into a tree, bounced off and landed in a barbed wire fence.

 

One of my husband’s friends who had been riding behind me got me out of the fence and one of the people passing by happened to be a doctor and he helped make sure i was stable. I was conscious. Quiet and calm. Just laying still.

 

My husband and our other friends who had been just ahead of us noticed or absence and came back. My husband was freaked out. When he saw his mate and realized the crashed bike was mine he thought I was dead.

 

The ambulance arrived and after giving me some medication and maneuvering me back through the barbed wire fence, I was taken to the nearest hospital.

 

I was lucky to survive, I broke the ulna bone in my forearm and shattered my upper arm and had a few scratches on my leg.

 

I was transferred to another, more equipped hospital. The next morning I had surgery, on the 2nd of March, and they installed metal plates and screws to fix the breaks. They were worried my Radial nerve was severed, however it wasn’t, so they pulled it out from around the breaks and straightened it out. The surgery went well and after a few days I was allowed to go home to my husband and 17 year old daughter.

 

I had a pretty crappy time in hospital. No amount of pain killers dulled the pain enough. I’m a control freak, and having made it to the age of 39 without ever breaking a bone or being in hospital, it was all a bit of a rude shock!

 

After getting home, I had to get settled in and heal. I was told 6 weeks for the break and possibly a few months for the radial nerve.

First Checkup and Staple Removal

I was unable to lift up my arm at the shoulder or elbow. Could not bend my wrist outwards and could only just wiggle my fingers.

 

2 weeks after the accident I had a check up at my local hospital to have the 51 staples removed from my arm, and during the check up I mentioned to the Doctor that the top of my shoulder was numb and tingly in addition to all the numbness in my arm and hand. He was concerned and sent me for an MRI.

 

I spent the next few days worrying. I was really struggling with the pain. I was sleeping for 2 hours at a time. I was frustrated and couldn’t wait for my arm to be healed. All our home routines were messed up. My husband was amazing. Taking care of everything and looking after me. My daughter too.

 

I was also bored so i spoke to my boss and arranged to start working from home. I was so grateful for that. Working made me feel worthwhile. It was weird typing with only my left hand. And it wasn’t too hard using the mouse with my left hand!! At least I could do something!

Devastating News

 

A week later I was back at the hospital to get the MRI results and the Doctor informed me that I had a Brachial Plexus Avulsion injury. He explained that 2 of the nerves in the brachial plexus cluster had pulled off from my spinal cord. And another one was severely damaged.  (I later found out 4 of the 5 nerves were avulsed, not 2) He said it cannot be repaired. All the parts of my arm and hand that I currently can’t move will not heal. I would never be able to use my right arm again.

 

I was utterly devastated.

 

It took a few days for it to really sink in. Every time i tried to do something and failed I burst into tears thinking I would never be able to do it.

 

My nature took over though and I soon found I could put on make up. Yay Yay Yay! That made me feel a bit better. Showering was a real pain. My husband had to wash me and shave my arm pits. I felt like I had lost all dignity. I discovered I could make coffees and do a few things around the house. Each challenge I overcame made me feel slightly better.

 

I was feeling worse about my personal appearance though. My legs were really hairy, my hair hadn’t been washed. I felt disgusting. Thanks to my amazing husband though, he helped me sort these things out and I felt more myself. He even washed my hair in a basin. Love him to bits.

 

It’s a bit hard being so far from my family and friends. We are in Perth, WA and all our loved ones are in Sydney or country NSW.

 

The pain was still really bad and I have a fairly high threshold for pain. I was taking morphine based pain killers and nerve pain killers. Neither of them stopped the burning, tingling, extreme pressure sensation or shooting nerve pains.

Waiting Game

I was referred to specialist Surgeon, Dr Alex O'Beirne, who explained to me that it is possible for me to have nerve transfer surgery to give me back movement in my arm.

 

The success rate is pretty good, but there are no guarantees. So I had to go through the motions of living. Occupational Therapy with Jaslyn Cullen, Physio with Anthony, Exercise exercise and more exercise and I just had to learn to deal with the pain!

 

Alex told me that he needed to wait to see what recovery I got on my own, and then he could assess what nerve transfers he would need to do. He also told me it is a 2 year healing period from the date of the accident! I changed my way of thinking. If I was going to mentally survive all this, I had to live as though I'd never use my arm again. Teach myself new ways of doing everything. I taught myself to write neatly with my left hand and found my way around the kitchen slowly but surely.

 

I researched everything I could about brachial plexus injuries and I discovered there is no support in Australia for people with BPIs... So being the sort of person I am, I started collecting info, surgeons, therapists and contacts, and started Facebook Groups and a website. Read more on the BPIA page.

 

Surprisingly, I’m getting on with life.

 

I’m off the morphine and I take Tramadol slow release 150mg x 2 per day, Lyrica 150mg x 2 per day for nerve pain.

Nerve Transfer Surgery

My surgeon, Dr Alex O’Beirne (Perth, Australia) spliced about 25% of each of the following nerves and joined them onto the other nerves as close to the muscles as possible to allow the shortest recovery time possible. Amazing stuff!

 

This is the descriptions of what I had transferred - 

1. I have no power to rotate my arm at the shoulder and my upper arm is falling out of the shoulder. 
They will transfer the Accessory spinal nerve (shoulder shrugging) to the Suprascapula nerve which powers the supraspinatus and infraspinatus (rotator cuff) muscles (moving upper arm and holding humerus bone in shoulder joint) 

2. I have no power to lift my arm upwards. 
They will transfer the Radial nerve at Triceps Brachii (extend forearm down) to Axiilary nerve for Deltoid muscle and Teres Minor muscles (lifting arm from the shoulder) 

3.I have no power to bend my elbow. 
They will transfer the Ulnar nerve at Flexor carpi ulnaris (lift and bend wrist) muscle to musculocutaneous nerve for Biceps muscle(bending elbow)

4. I have no power to turn my arm palm side up or down, or bend my elbow.
They will transfer the Median nerve at Flexor digitorum profundus (bend wrist), flexor pollicis longus (move thumb) muscles to brachioradialis muscle (flex forearm at the elbow and turning forearm palm up or palm down)

 

My hand has improved on its own. The radial and ulnar nerves took  a beating but seem to be healing. My surgeon was puzzled why I had such good hand control, but he discovered I have extra nerve endings going into my hand that are shared over more of the 5 nerve roots. So I'm lucky. When my arm is in the sling, I can use my hand to help with day to day things. I can't feel what I'm touching though, so I have a tendency to squash, break and drop a lot of things, a lot of the time hahaha.

Rehabilitation

So the nerve transfer is complete, now I have to exercise and do as much therapy as possible all the time.

 

At 6 weeks post-transfer, my bicep and brachialis muscles were starting to engage. A week or 2 later my deltoid joined in, my rotator cuff muscles are engaging but are struggling. And finally my other arm lifting muscle (my mind has gone blank) has started to show signs of a successful transfer, but it relies on the other muscles to be working before they can really be exercised!

 

My OT Jaslyn Cullen say I'm right on track, and that before too long I should be able to put my hand to my mouth. Imagine that! Using my right hand to feed myself! 

 

I'm realistic too, I know my arm won't ever look normal or act normal. But if it can be useful to me that's awesome! The pain ... well the pain will be with me forever. My surgeon mentioned transferring between the ulnar and median nerves in my hand to help with the intense sensation issues I have. I'll jump for the chance of that surgery, my hand literally drives me mad with pain 24x7!

 

Well, that's the story of my injury. The rest of my news and journey will be in my blog until there is some major news to update this story with!

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