People look forward to socializing, dating, being outside and shedding winter layers. It‘s also the season where people start home repairs, outdoor (team) sports, or riding motorcycles with friends. For many, this time of year may also trigger concerns about body image as people transition into warm-weather clothing. Awareness of how we feel, appearance-wise, may activate concerns about self-worth, self-identity and how we are perceived by others.
Those with brachial plexus injuries (BPIs) may feel especially vulnerable. Short-sleeved shirts and shorts may expose scars and injuries. Body image concerns may cause us to focus more on how clothing fits, or on the aesthetics of our injured limb(s). Thoughts of being less physically attractive, beliefs that no one will want us now, that there is ‘no point’ in socializing, or wanting to hide away because of our appearance may surface. Going outside in the warmer months may expose you to people asking uncomfortable questions about your BPI. Sometimes we may even feel cautious about getting out because a BPI may impact how safe we feel in crowds or in our ability to protect our self.
When it comes to socializing, many factors impact our desire to engage with others. We may be negotiating unpredictable chronic pain, fatigue and medication side-effects that make socializing harder. Sometimes it can be about feeling more limited in our ability to partake in warmer season activities. Even though people urge us to ‘just join in’, attempting to participate may be too upsetting as we confront the physical limitations of BPI. As a result, many describe reactions of isolation or helplessness as they try to cope with not feeling how they used to. Negative feedback cycles may become our norm where worthlessness, depression, hopelessness, and/or frustration dominate our thoughts.
So what can we do?
- Don’t isolate, stay social! Talk to people about how to best support you. Tell them what you need—is it to wait until you ask for help, to not ask about your BPI, to find less crowded places to hang-out, to suggest new activities, to encourage you, or to treat you as they did before? To improve your overall mood, self-care is crucial: take time to relax, to walk, to advocate for yourself, to put sunscreen on, to connect with nature and loved ones, to meditate, or to develop new interests.
- Allow that accepting our change in physical capacity and redefining our self-identity is challenging. There will be ups and downs as you adjust.
- Talk to a trusted person or take action to change your thoughts.
- Join a brachial plexus social network group.
- Develop acceptance and gratitude for what you can do instead of focusing on what you cannot. Those who do have a healthier outlook on life and better mental health outcomes.
- Stay present with what is possible today instead of allowing your thoughts to engage in a ‘compare and despair’ cycle.
- Don’t lose hope: BPI recovery following reconstructive surgery continues for longer than previously thought, especially when we stay engaged in physical therapy, occupational and hand therapy, and our medical treatment.
Schneider K. Rancy, BA is an office and clinical research assistant at Hospital for Special Surgery. As part of the research team on the Hand and Upper Extremity Service, he conducts research on distal radius fracture fixation, patterns of degenerative and inflammatory arthritis of the wrist, salvage procedures for wrist reconstruction, and long-term motor outcomes following nerve and brachial plexus reconstruction.
Zoe A. Landers, LCSW is a licensed clinical social worker at the Center for Brachial Plexus and Traumatic Nerve Injury (CBPTNI) who evaluates and facilitates treatment for brachial plexus injured patients experiencing psychological and psychosocial stressors following injury. Ms. Landers has actively participated in research with the CBPTNI multidisciplinary team to develop a deeper understanding of the psychosocial and psychological impact of brachial plexus injury. Findings from this research have been presented at major hand and upper extremity orthopedic conferences.