Shouldering Through: Nerve Repair Restores Arm and Shoulder Movement for Cancer Survivor

New York—September 12, 2012 

Two years ago, during Anne’s ovarian cancer surgery the surgeon biopsied some of the lymph nodes in her neck and, in doing so, accidently cut a spinal accessory nerve, which signals the trapezius muscle. Anne awoke from surgery with a slumped shoulder and the inability to lift her arm over her head.

Anne, who works as a molecular microbiologist and college professor, was told that the nerve may be just bruised, and to wait several months to see if the movement would return. “I had a lot to deal with,” recalled 63-year-old Anne, who not only needed to recover from major surgery but also four to five rounds of chemotherapy.

After several months, the movement had not returned and Anne consulted a Long Island neurologist who confirmed what Anne had most feared. The nerve had indeed been severed, and therefore the movement would never return to her shoulder. “He told me that it ‘wasn’t that bad an injury.’” Anne felt otherwise. Her left arm motion was limited, interfering with her work. She needed help putting on a coat or sweater, was unable to hold a hairbrush overhead or get out of a car on her own. “I didn’t stand straight and people noticed it right away. I’d always been graceful and now I wasn’t.”

To Anne, this news felt like more bad luck as she struggled to cope with a cancer diagnosis, rehab from surgery and chemotherapy. “I asked the neurologist if there was something that could be done to fix my shoulder. He said, ‘Don’t be ridiculous. No one is going to fix that. Plus you have cancer – just learn to live with it.’"

Anne was crestfallen from the neurologist’s words, especially in light of all the other discomfort she’d coped with during the past several years. A neighbor in her hometown, who worked in the area of physical medicine, suggested to Anne that there may be a possibility that the nerve could be repaired.

A researcher by profession, Anne was determined to find a better solution and combed the Internet for answers.  She found a story about Dr. Scott W. Wolfe, a hand and upper extremity surgeon and director of the Center for Brachial Plexus and Traumatic Nerve Injury at Hospital for Special Surgery in New York City. The article explained how Dr. Wolfe had fixed the arm of a man who had a tree fall on him. Another story talked about how he performed surgery on the hands of the concert pianist, Misha Dichter. Said Anne, “I thought, this is my guy and called his office.” The article also said that the best results from the surgery occurred within the first few months following the initial severing of the nerve. “Because I had been so focused on my recovery from surgery and chemotherapy, it had been almost a year since the nerve had been severed. I was worried that the window of time when the surgery could be performed had passed,” said Anne.

After reviewing her records and performing an exam, and having her undergo electodiagnostic testing with a Special Surgery physiatrist, Dr. Wolfe told Anne that she was a good candidate for nerve repair surgery and that he thought he could help her.  He also pointed out that a year was the outer limit for success with the procedure. “He said that I had a seventy percent change of having my movement restored – but that I should do it pretty soon.”

Having already undergone one major surgery, several months of chemotherapy and not knowing her long term prognosis as a cancer survivor, Anne was uncertain about having another surgery. She consulted her cancer support group for advice. Recounted Anne, “One of the women in the group said, ‘Figure you have ten years as a cancer survivor. So, if you have ten more years, how to want to spend it?’ That pretty much answered my question.”

In April 2011, at Hospital for Special Surgery, Anne underwent the six-hour nerve procedure, which involved Dr. Wolfe locating the severed nerve and repairing it microsurgically. Following the operation, Anne kept her arm in a sling for eight weeks and underwent physical therapy. After six months of healing and therapy, Anne felt a flicker of sensation. “I could tell then that the surgery had worked,” she recalled. Within months, Anne was standing up straighter and slowly but surely she was able to raise her arm a bit higher above her head.

“Then one day, while boarding a plane,” she said, “I reached up to place my bag in the overhead compartment and my arm sailed above my head.  It happened automatically and it was only afterwards that I realized what had happened. I was so happy.”

Since then, all of the function in Anne’s arm has returned. A few months later, rather than selling her kayak, which had been her plan, she decided to use it. In addition, during June 2012, her dream of one day white water rafting down the Colorado River became a reality.

“Dr. Wolfe really helped me and gave me hope when other medical professionals said there was none,” she said. “If I had settled and listened to the other doctors, I would be partially immobile. He really changed my life.”

About Hospital for Special Surgery
Founded in 1863, Hospital for Special Surgery (HSS) is a world leader in orthopedics, rheumatology and rehabilitation. HSS is nationally ranked No. 1 in orthopedics, No. 3 in rheumatology, No. 10 in neurology, and No. 5 in geriatrics by U.S.News & World Report (2012-13), and is the first hospital in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center three consecutive times. HSS has one of the lowest infection rates in the country. From 2007 to 2011, HSS has been a recipient of the HealthGrades Joint Replacement Excellence Award. HSS is a member of the NewYork-Presbyterian Healthcare System and an affiliate of Weill Cornell Medical College and as such all Hospital for Special Surgery medical staff are faculty of Weill Cornell. The hospital's research division is internationally recognized as a leader in the investigation of musculoskeletal and autoimmune diseases. Hospital for Special Surgery is located in New York City and online at www.hss.edu.
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