Adult OBPI

What tests should be performed on the adult OBPI to determine extent of injury?

Some tests that will help uncover the extent of your initial injury are; EMG, MRI of the brachial plexus and cervical spine, nerve conduction studies, and X-rays of shoulder and neck.

OBPI adults should request a full Physical Therapy evaluation on the condition of their spine, arms and legs. The bpi side of the body should be fully evaluated including any gait and balance issues.  If Horner’s Syndrome is part of your injury, you should request that it be noted in all medical records.  Some OBPI adults have experienced breathing difficulties and recurrent battles with bronchitis, pneumonia and asthma.  This could be the result of diaphragm damage due to c4 involvement. While all these tests are not an exact picture of your initial injury (due to natural healing processes) they will document the present extent of your injury.

What problems might I have with the unaffected arm over time?

There are no long term studies explaining the impact on the unaffected arm that we are aware of. The unaffected arm supports the majority of life functions and work. The result of a lifetime of compensation can be overuse and many of the problems connected with repetitive stress syndrome. The extent of the initial injury predicts the amount of overuse. Many adults report arthritis, spinal problems and nerve compression on the unaffected side, therefore, it is best not to push one's endurance to the limit. Overwork or heavy lifting can put a strain on the unaffected arm and may cause damage later on in life.

What does my doctor and the hospital need to know about my bpi prior to a non bpi surgery?

Make sure you talk to the anesthesiologist prior to the surgery and stress that neither arm should be rotated away from the body (the usual position, particularly if it is abdominal surgery is to rotate the arm out about 90 degrees). Some even position it over the head, which is a real "no no" for us. Ask the anesthesiologist to tuck the arm to the side.

Also if there is Horner's Syndrome present, this is also critical, as one pupil will be smaller than the other which could lead them to think that there is something else happening (like brain damage) when it is not. Make sure they look carefully prior to the surgery to determine any differential in pupil size and iris color.

Do not let them take blood pressure or put the IV into the bpi arm under any circumstance. False readings can happen and the arm can be injured further.

Is it important to get copies of medical records?

You should request copies of all test results and films at the time of testing. It is important to keep your own personal file of all medical reports, tests and films. These copies of test results and films will make your visits to other specialists easier and less stressful.  OBPI adults frequently face the lack of medical information on the extent of their initial injury as well as the lack of medical information on the care and treatment they require to function without incurring secondary injuries due to compensation.

There are few long range studies on this injury, therefore many doctors are not aware of the secondary injuries or the toll it takes on your body. This injury impacts your entire body and this impact may have been undocumented and untreated for most of your life. Because of this, all records should be checked for accurate information and kept by you. Should you decide to file for retirement disability (through SSD or your place of employment), these tests will present the necessary documentation and information.

Is arthritis more of a problem for adults with this injury?

Yes, arthritis is associated with overuse of the unaffected shoulder, arm and hand and also with surgeries on the affected shoulder, arm and hand. Many adults have reported good results in pain management for arthritis by using various prescription drugs.

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