When I woke up from my mastectomy, I discovered that my left arm was paralysed. I couldn’t lift it. The arm, down to my thumb and half the index finger were numb and unfeeling. Turns out that I had a compression injury to the brachial plexus during surgery probably because the arm was tractioned for about 3 hours. Why it happened to me, I don’t know. I don’t know anyone else who’s had this happen to them. But here’s my story.
So, what’s the brachial plexus?
The brachial plexus is a network of nerves leading out of the lower 4 cervical nerves (C5-C8) and the first thoracic nerve (T1). The plexus is responsible for controlling all of the muscles of the upper extremity (with the exception of the trapezius and levator scapula) and sensation.
Think of the brachial plexus as a tree, with branches that fork out and then join back and then fork out again.
My injury was to C5, C6 and C7. These are the nerve supply to the arm. How the injury happened was that the nerves emerge at a point called the thoracic outlet which is near the collarbone. According to the nerve surgeon, my collarbone was shallow, which meant the thoracic outlet was narrower than normal, and the nerves got squashed.
Just my luck to have a narrow thoracic outlet.
An MRI scan confirmed that it was a neurapraxia injury.
Interestingly, this kind of injury is experienced by motorcyclists who get thrown head-first off their bikes, while holding on to the handlebars. It also happens when babies have difficult deliveries.
I could use my shoulder, and my fingers, but the thumb and index finger were numb. After about a week, suddenly my arm felt lighter. Turns out that C7 function had returned, so that I could hold my arm. You won’t believe how heavy an arm can be when the nerves aren’t working: it felt like I was heaving about a bag of sugar from my shoulder, all floppy and useless. And then suddenly, the bag of sugar vanished and I was carrying my arm again.
Of course I was on the internet day-and-night, researching brachial plexus injuries and cures. The information was depressing: it was watch-and-wait, and surgery. And as nerves generate very slowly – about 1mm per day – results would only be seen months after surgery.
It was a dark period for me, not seeing any improvement, and not knowing if there would be any improvement. One night, early on after the mastectomy, I woke up and panicked, not feeling my arm – it was like it wasn’t there. So in a bid to convince myself I had an arm, I rubbed and rubbed it, trying to wake it up. I even put embrocation on it. It only resulted in bad friction burns.