Sunday, August 5, 2007

I'm down, but not out!!!

Viral brachialplexopathy... Who in the bloody hell ever heard of that?!?!?

Certainly not me. I've been involved with orthopedic medicine for a few years now, and that was a new one to me. I've heard of and treated people with virus-based diseases that attacked the nervous system - such as shingles & Guillain-Barre - but I definitely didn't recall learning about any disease where a virus attacks a specific branch of nerves, causing debility.... until it struck me.

A little more than 2 or 3 weeks ago, I started noticing some discomfort in my left arm. I figured it was just mild soreness from training, so I didn't pay much attention to it. Around the same time, I'd also had a mild stomach flu, so I assumed that the shoulder discomfort had to do with some flu-related body-aches as well.

The only problem was that the mild discomfort progressed into real pain, especially along the side of my neck and at the shoulder joint itself. The pain also came with pronounced weakness. Usually, most people can't differentiate weakness caused by pain inhibition and actual motor deficit. In my case, I've learned how to differentiate motor weakness from mere pain inhibition in my own body, and I could clearly tell that the arm/shoulder was getting seriously weak. I'd gone from working on pressing a 70 lb kettlebell to being unable to do a pushup.

I tried backtracking... What did I do that might have caused this? Did I strain it? Did I overtrain it? Did I take a bad breakfall in Shuai-Chiao? Did I hit something from a bad angle? Did I sleep on it funny? Did I get a venomous spider bite? Did I aggravate a pre-existing shoulder injury?
The answer to all of the above were a resounding NEGATIVE. So I started calling on my health care connections and made appointments to get treatment from 5 different doctors - 2 chiropractors, 1 osteopath, 1 acupuncturist, and 1 neurologist.

- All the standard orthopedics tests for rotator cuff tears or impingement were negative.
- The tests for nerve root compression were negative.
- And the only theory that sounded remotely credible (albeit weird) was that the root cause was viral.

I didn't get much explanation about that "viral" thing, and I assumed that to mean that the problem was lymphatic, so a good lymphatic drainage would lead to a major reversal in my symptoms... A little too presumptuous, however.

The posterior parts of my shoulder & arm were tightening up and really bothering me now. The teres muscles and the triceps were throbbing more often than not. It hurt to type, it hurt to treat patients, and it hurt to sleep! I was getting more miserable and increasingly desperate to find solid answers about what was going on. I knew this felt radically different from the rotator cuff injuries and tendinopathies I'd had over the years and from the shoulder joint injuries I'd also suffered.

Finally, a former student of mine, Dr. Tony C. Lin, who's a hot-shot orthopedics specialist in Hawaii, e-mailed me with a great explanation - viral brachioplexopathy. Immediately remembering that the other physicians mentioned a viral cause, although not giving me an explanation of the mechanism of injury, Dr. Lin's explanation made perfect sense.
The bottom line is this. The shoulder/arm/neck will hurt for a couple of weeks, and then the patient (me) will be left with lingering weakness and possible loss of range of motion for anywhere from 2 months to 2 years.

This same problem attacked one of my kettlebell students, and he told me that it hits him about once every 5 years. Now that the acute phase is over, where I was in nothing but pain, now I'm left quite weak on my left side.

But that's no problem. I'm not going to be left looking like the 1-armed bandit. Using a light kettlebell, I've begun rehabilitating my left side. While I can clean a 53-lb KB with certainty, I can't press more than 26 lbs right now with any measure of stability. No problem.

Slow, steady, consistent progress is the way to make things happen. It still hurts to type since my left arm starts tiring, twitching, and locking up, and last night was a difficult night of sleep. But I'm focused on making this get better.

I'll keep you posted. If all goes well, I'll be back to snatching the 53 lb KB for reps on my left side in time for the September RKC.... and a big thank you goes out to those of you who've dropped me e-mails and called to wish me a speedy recovery.

People often say, "Physician, heal thyself!!!" And with my trusty kettlebells nearby, I'll do my best not to let you down!

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