Learning to Swim Again Part 1

After the accident I was very worried about how I would be able to swim again. It took me considerable time to even think about going for a swim. In fact it was probably six months before I got into the water and had a play around with the concept of swimming with one arm. I had been very worried about where my paralysed left arm would hang. That was one thing I didn’t need to concern myself with as it just floated next to my body. It wasn’t the anchor I had suspected it might become.

Before the accident I had been a non-kicker in the pool, purely relying in my arms. Now with one arm I knew I had to do something about the kick. Trouble was the reason I hadn’t kicked in the past was that when I did. nothing happened in terms of forward movement. So now I was experimenting with kicking. The freestyle kick was useless so I started trying the breaststroke kick with a freestyle arm action. Surprisingly it felt comfortable even though it looked unusual. Here is s video with a little look at the columns of the Fullarton Hotel in Singapore.

 

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The Months Immediately After Surgery

After the surgery in March 2012 it was down to the rehab and associated exercises. There was plenty of nervousness waiting for the first signs that the operations were successful. Melanie, my arm therapist had warned me that the first signs that the operations had been successful would be a flicker in the brachiallus or the bicep. Being an impatient person I would come away from the therapist disappointed every time there was no sign of a flicker. I think it was about May before we saw the first sign and then it was down to all the associated exercises to get the muscle stronger and get some movement. Whilst you are warned not to expect things to happen to quickly, I still couldn’t believe that the muscle development was so slow.

The highlight came when I discovered that movement was much easier in the pool. I started practicing and discovered that it wasn’t too long before I could bend my arm. It was the oddest feeling. It seemed that the bending and the thoughts associated with the bending were separate. Perhaps this was just the mind getting used to the whole process of bending. My first bend came in the pool at the Fullarton Hotel in Singapore. A grand hotel with the most beautiful pool; a great place for this to happen. My wife videoed it  and this is attached.

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Details On My Brachial Plexus Injury and Surgeries

Writing this blog has forced me to find out a little more about the exact nature of my injuries. I am told I had a palsy to C5, C6, C7, with C8 and T1 palsied but with recovery. I was lucky that the hand function although lost initially has recovered to some extent.

The injuries resulted in my arm initially being totally paralysed. The arm therapy gradually has brought back some movement to my hand although it is now 18 months since the accident and my injured hand is still very weak compared to my right. I still have little feeling in my thumb and first finger and the feeling is improving in the other fingers. The back of my hand and arm have little feeling, as do parts of my shoulder. However the only loss of feeling that bothers me is the hand.

My Surgery

I had two nerve transfer operations and was exceptionally lucky to be referred to Dr Wheel by the Trauma Unit at the Alfred Hospital. It is amazing that there are some surgeons who you talk to who are unaware of nerve transfer surgery. If you have a brachial plexus injury make sure that you get a surgeon who is up to speed with the latest techniques.

For those interested in the details here are the specifics.  Dr Wheel performed two operations of about 7 hours each. In the first about 3.5 months after the accident he did a double nerve transfer for left elbow fexion (bending). The ulnar nerve was moved to the bicep and the median nerve was moved to brachialis. This meant that in the future I had to clinch my fist to activate the bicep and brachialis muscles. The second operation was exactly 4 months after the accident.  The accessory nerve was transferred to the suprascapular nerve and the two tricep nerves from the long and medial muscle heads were transferred to the  anterior branch of the axillary nerve. This meant that shoulder shrugs and arm extension activated a range of arm and shoulder movements.

The future will revolve around making sure that the nerves in my shoulder grow and that the muscles gradually grow and regain there strength.

 

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Dan Aldrich

Dan Aldrich has been of great assistance to me. He not only provided the running sling, but also has assisted with swimming technique.  I received one of his early emails about 7 weeks after the accident. The reality of my situation was causing me to be feeling pretty low.

Dan Aldrich

Dan Aldrich

I read the email as my wife and I were driving to our holiday house. The email was memorable for lifting not only my spirits but also my wife’s. We were moved as I read it aloud to her. I hope Dan doesn’t mind me sharing it with you in this blog and I hope it gives you the hope it gave me.

Hi Craig,
 
Make sure the Dr’s specialize in Brachial Plexus, extremely critical because time is very important right now, sooner the better.
 
Having a paralyzed arm shouldn’t stop you from being athletic.   I have a complete paralysis of my arm and all I do for my sports is get the arm out of the way.  There are many people who have partial paralysis and there are sports they can get some use from their arm in sports, just depends on the sport and type of movement.
 
I do triathlons and you should have no problem biking and swimming again.  Yes, the sling will help you when you run and any other sport you need to secure your arm down.  I not only do tri’s but basically anything else I have wanted to do since I got hurt 25 years ago and can do most of them at a very high level.
 
As you learn the level of paralysis you have, I can help you with setting up your bike, either like I do it or like a few others who have more mobility than I do.  I can also help you with the swimming, I have an older very rough video of a bunch of use learning to swim a “new” way with one arm and hopefully can get a good video of this new swimming style.  And to let you know, there are three US Paratriathlon National Champions in the video I have, so the top guys and gals in the “winger” category are swimming this new way.
 
What I am trying to say, you ARE still an athlete and this injury hasn’t changed that, they are just a few different ways you will execute your sports and either I can help or I can direct you to someone who can.
 
By the way, I am going to be competing in the One Armed World Golf Championship this July, should be fun.
 
Dan
Dan is obviously on very determined and talented athlete. I am sure he has helped many people and I thank him for giving me the inspiration to get out there and have a go.
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The Dan Aldrich Sling

My Aldrich Sling

My Aldrich Sling

In the early days after my accident I started to research how I was ever going to do the activities I loved. Swimming and bike riding were not on the immediate agenda, but my main passion of running seemed something I could achieve. I had tried to jog a few steps in my normal sling and there was no doubt that the arm bouncing was going to be a massive problem. I started looking on the ubpn (United Brachial Plexus Network) site and stumbled across a gentleman called Dan Aldrich who had designed a sling. An email was sent and Dan quickly replied with all the measurements that I needed to send. They were sent and the wait for it to arrive began.

The sling arrived around April and was soon put to use. It has been great in getting me moving again. The highlights of its use has been running the 10 km leg in a team in the Noosa Triathlon, the 14km City to Sea run in Melbourne and the last leg in my first triathlon in March 2013.  I have struggled a little with niggling injuries related to the changed running style, however I am looking forward to a lot more running in the Aldrich Sling.

 

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Christmas 2011 to March 2012

The months between Christmas and my first nerve surgery in March were very interesting in terms of my development. It was about allowing the body to rest and repair. I am not sure I saw that at the time!

My wife and I have a holiday home at Apollo Bay and we traditionally spend the weeks after Christmas and the New Year at the beach house with friends who have houses nearby. Apollo BayNew Years Eve is traditionally a robust evening with lots of laughter and celebration. However I knew this year was to be different, I was still heavily medicated to relieve pain and it had to be a night without a celebratory drink. Unfortunately the drugs and the tiredness saw me heading home at about 9pm; so much for seeing the new year in.  I mention this as an example of how I still had not recovered from the trauma of the accident and my injuries. I was in denial and in hindsight should have taken things much more slowly.

The rest at the beach was very beneficial although I didn’t see much of the beach and spent many hours in front of the television watching sport or dvds. Not a bad thing to be doing.

We headed home around mid January and we both normally return to work at that time.  In my normal stubborn manner I tried to head off to work, now two months after the accident. I am Vice Principal of a large school and initially I was able to cope, as the teachers and students had not returned and I was able to work reduced hours.

I was in for a rude shock when the school became fully operational. After one week it was obvious to everyone (including me!!!) that this was not going to work. I had to reduce my hours by half to allow myself to recover. The hours remained this way until I went on leave to undergo surgery in March.

For anyone reading who has similar injuries, I suggest that whilst you want to work hard to recover, you should be prepared to give yourself time. The reality is that after  huge trauma on your body it needs time to rest and recover. Getting the balance between rest and pushing yourself is important and an individual thing.

 

 

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A Really Useful Website

One of the first things I did when I was able was to start searching the Web for information. The best website I have found is:

http://www.ubpn.org/

It is the support group United Brachial Plexus Network in the USA and has some excellent and useful information. The discussion groups are very good. you can also subscribe for free to their magazine which has stories of people in similar situations.

You can also find them on Facebook at ubpn.

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Up to Christmas 2011

I arrived home with only a few weeks to Christmas and it seemed there was plenty happening at home as it was a very busy time for my wife, Kerry who works in a challenging role, our daughter was overseas and our son had just finished his degree. Despite everyone being busy I was shuttled to an endless string of medical appointments. There seemed very little time to sit and do nothing.

I was very lucky that the Trauma Director at The Alfred Hospital referred me to a surgeon who was regarded as the “best”. Let’s call him Dr Wheel. I had my first consultation with him and he was an optimist. He indicated that we needed to get some tests done but there was hope that surgery may be able to restore some movement in my arm. It would be a few months before he could make a firm prognosis. Dr Wheel did refer me to an arm therapist who I was going to see a lot of in the next few years. The therapist, Melanie had rooms next to Dr Wheel, so there was great communication between the two of them. It would be two visits a week from now into the future.

My first consultation with Melanie highlighted the extent of my injury. I remember the realisation this as I sat at the consultation table trying to move my little finger. My comment at the time was “I have gone from an Ironman to this”. It was a bit devastating.

Just before Christmas about 4 weeks after the accident I was scheduled to attend an annual lunch that I organise for about 12 friends. I was determined to get there. Kerry dropped me off and I had a great afternoon. The low light being confronted for the first time publicly with not being able to cut up my food. I asked if the chef could do it. Well, it came back as if it had been through a mincer. I learnt to be a bit more specific in the future. I took the train home with my friends – not wise and was exhausted at the end of the day. The day raised my spirits.

By Christmas I was moving around okay but had little endurance. I am a determined person and tried to get out with Kerry whenever I could.  Christmas day was the normal long day and my traditional role of cooking the turkey had to be managed by son Tim. He did a great job. It was lovely to be alive and with the family.

 

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The First Month

Day 2 after the accidentThe accident happened on 20 November 2011 and I was in the Trauma Unit of the Alfred Hospital before moving to a rehab hospital. Whilst in the Trauma Unit I had two operations one to pin my collarbone together and the other to wire my hand bones together. The collarbone surgery was two days after the accident and was rather traumatic. After the surgery my blood pressure went “through the roof” and they feared I was about to have a stroke. My wife was urgently called to the recovery room. Luckily the treatment worked and all turned to normal.

I haven’t mentioned that I am a bit of a fitness nut and this has influenced my recovery. I was never going to sit and wait for it to happen. As soon as I was told to get out of bed and try to move, I was at it. Sometimes to my own detriment. Nevertheless I remember staggering around the ward trying to convince everyone I was getting better. It was horrible how you can be reduced so quickly from extremely fit to a staggering mess. It was only months later that I realised how sick I was.

My wife convinced the doctors that I was not able to go home and I needed to go to rehab. She was correct and rehab provided an opportunity for  me to learn how to cope with one arm that didn’t work at all. It was not only the inability to do simple tasks but getting my head around the dramatic change this was going to make to my, and my family’s life. The rehab staff where fantastic, especially the young physiotherapist, Nicky, she was amazingly supportive for one so young. She understood all the issues spinning around my head. All you want is someone to be able to tell you if and when there will be any improvement. The reality is no one knows until there is some detailed imaging and testing done. What is important is that people are honest with you, and if possible, give you hope. That is exactly what Nicky did! The neuro-psychologist meetings where  the most dreaded. As I had a brain bleed they kept testing me for the its impact. My word retention skills were diabolical, however my numeracy skills created records. Something to do with being a maths teacher. I suspect there was little impact from the accident, but that was not their prognosis. Who knows!!

After two weeks I was out of rehab ready to tackle the world of home. I was keen to get home, although a little nervous of what lay ahead.My wife Kerry then stepped in and took over my management. She is amazing at organising and I was able to sit back and focus on recovering. The next weeks seemed filled with medical appointments. They seemed endless and told me little about my hopes for recovery until I met my surgeon.

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My Brachial Plexus Injury

On November 20 2011 my life took a dramatic turn. What had been a very pleasant and lovely ride on the Mornington Perninsula of Melbourne, Australia ended dramatically as a van turned across my path as I had just come down Oliver’s Hill. I hit the passenger door at 55km/hr and was launched head first into the passenger door window. My injuries included concussion, three chipped vertebrae, broken right hand, broken left wrist, shoulderblade and collarbone. I also had a minor heart episode and small brain bleed.

In short I am lucky to be alive. All those injuries improved but the injury yet to be mentioned, the left brachial plexus will be with me forever. I have partially avulsed three of my nerves. It is now April 2013 and I intend reviewing my journey for those interested and will endeavour to keep it up-to-date.  I hope it helps people who find themselves in a similar position

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