The first and last moped accident: Brachial Plexus Injury

 

Family, Friends, Foes, and world at large, the following message from the SW outlines a major turning point in his 25th year

I am writing you this message with my one good hand. My left arm-hand’s function was jeopardized in an accident 10 days ago one late, weary drive back from post academic trivial socializing, when 99 percent to my apartment, my mind wondered for a split yet vital second as I crashed into a tree lining the road. The helmet probably saved my life from any serious head injuries, and though not losing consciousness–dizzily on my feet within moments, I realized that function in my left arm had vanished instantly–a lifeless hanging limb. I was convinced it would be amputated. Two decades ago, it probably would have.bike_crashside

bike_crashfront


I left the hospital uncertain and received contact from my US mentor who happened to be in Thailand for medical checkup at the internationally renown Bangrumrad hospital. After informing him of my situation, he insisted that I seek a first class checkup/prognosis at Bangrumrad. Timing is everything.

The next day, I met him at the hospital and pursued to getting checked up by a neuro specialist. I was immediately admitted for thorough VIP checking/monitoring over the next several days including X-Rays, blood screening, two long suffering MRI scans, lots of nerve and muscle related drug injections, three full nights of sleep, four physical therapy sessions, and consulting with five different Neuro MD specialists who were handling my file.

steven_hosp

That rang up a wopping 90,000 baht in non-insurance covered (the standard motorcycle insurance I had is void in the event I am of fault)
expense of which my mentor graciously fronted. Basically, from the inspection and MRI, the docs suspect that one, maybe two nerve roots experienced avulsion, though can not be 100 percent due to inflammation interference with scans. They also found a blood clot on my spine of which they had to monitor me several days to be safe. My condition did not worsen so its been assumed, the blood clot was/is not threatening though probably connected with my BP injury.

Now I’ve been back at the apartment recouping for several days now with the help of a close friend I’ve paid to temporarily support-help watch over for at least several weeks–i.e. laundry, standing up, laying down, washing, and ultimately when I need to start going out as normal (no I will not be capable of getting back on that motorcycle nor do I have will to even if I could)

Life isn’t what it was nor will it ever will be again–it is what it is and will be as good as I can make it. That is certain. As for my condition, most important factor is that I must undergo physical therapy of which will be mostly self directed–I am resourceful enough to say the least. Since my case of BPI most likely involves root avulsion affecting primarily the radial nerve (I have no feeling-function in my bicep and forearm with still 0 percent motor power e.g. flexing, lifting arm, etc,) there is slim possibility that it will recover naturally though time and inspection over the next few weeks can be the only final confirmation. I have limited feeling and sensation in my shoulder, triceps, hand and fingers, that thankfully have experienced slight improvement-sensation increase with time suggesting the nerve roots associated with these weren’t completely avulsed but raptured and/or stretched, or perhaps inflamed with scar tissue suggesting that natural nerve regeneration accompanied by will and physiotherapy are far from finishing its natural cycle.

As far as maximizing my full recovery potential, the biggest concern is with the suspected nerve roots that experienced avulsion. Luckily it’s 2009. Particularly, there is micro surgery of nerve transplant that will help stimulate nerve regeneration for cases of root avulsion. That may be something I will consider in the future but is not pressing now. On the safe side, the best outcome window is up to 6 months after the initial injury that useful micro surgery could be undergone–only after it is certain that the body’s natural process of regeneration are deemed maximized already; a window requiring at least 6 to 8 weeks after the injury to confirm. There is no easy fix and surgery may / may not improve condition and I’ll cross that path when it’s time.

Either case, after few weeks, assuming I experience no regeneration in my radial nerve motor power sections as mentioned, the next step will be to undergo an EMG test to pinpoint exactly the severity and extent of damage (dis)function, and recovery of the savaged nerve root-line. This EMG is the ultimate prerequisite to any surgery if it is to be considered as a considerable card…

I’ll be asking-seeking-welcoming your love & support in the coming years, so I owe you all the least this update. No need for blind and hallow hope or encouragement (i.e. everything will be back to normal soon, etc.). I’m strong, forward thinking, yet a realist at the same time. Constructive & Positive–absolutely, otherwise I’d been dead, if not dying.

For more info about Brachial Plexus, the following references have proved useful:

basic BPI diagnosis/treatment overview

as outlined on the Hospital for special surgery website…

My Brachial Plexus Injury

an Aussie kid’s blog detailing his similar injury, persevering through upward moving recovery despite the apparent odds

And for technicality, wiki BPI is an extensive resource.

–a brother, son, father, teacher, student and friend signing off until next time…

 

Thank you for providing this information. I really enjoyed it. Keep up the quality work, man!

The Universal Envoy says:

Steven,
You have always been an inspiration in my life. Your passion, intelligence, and diligence in life are traits that few posses at your level. I know that whatever the outcome of you surgery, you will continue to live a very full and rich life.