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Old 07-25-2011, 07:44 PM   #1
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Nerve healing -- How can you tell?

All right. I've come to the realization that my nerve damage is going to take a while to heal, though I'm now more confident than ever that it will happen. But how will it work? It's plain I'm not going to jump out of bed one morning screaming, "I'm healed!" So how does this work? As my left peroneal nerve heals will I be able to feel the good old anterior tibialis start working little by little, allowing me to pick up the toes a little bit easier as the days go by -- or will the repaired connection be good as new one morning but wear itself out as the day goes by, losing some of its function as it tires?

How about the right nerves causing this wondrous capade of unpleasant feelings, especially in my foot? Will the level of intensity begin to ebb or will the affected areas of the foot begin to get better one by one?

In other words, please give me some milestones and changes to look for as my nerves slowly heal. Those of you who have been through this before, please speak up and relieve the sufferings of this anxious schoolteacher. You'll be helping a groupp of fine schoolchildren by allowing their teacher to face the day with a positive attitude and, best of all, something to share with his class. It's amazing how much kids really care about the health of their teachers.

Is anybody out there who can help?

Last edited by bracer; 07-25-2011 at 07:44 PM.

 
Old 07-25-2011, 09:24 PM   #2
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Re: Nerve healing -- How can you tell?

So Bracer, A neuropraxia, a minor blockage of nerve conduction gets beter in a couple of months. No Wallarian degeneration takes place.
In Axonotmesis Wallarian degeneration happens. When it happens it not only happens distal to the injury but slightly up from as well. The outer tube of the nerve is intact but the inner fibres degenerate, these fibres being sensory, motor and sympathetic. Neurotmesis is total severance of a nerve.
You seem to have a Axonomesis. Therefore the nerve fibres will have to grow down the uninjured sheath. Googles "**********'s Classification", and get the nitty gritty. No you will not waken up one day and all will be well! Growth of regeneration is faster in large nerves than small, yours probably medium say 3 to 5 mm a day. Google again this time "peripheral nervous system regeneration". Lots to read on this subject.
James

 
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Old 07-26-2011, 07:03 AM   #3
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Re: Nerve healing -- How can you tell?


[COLOR="Magenta"][SIZE="4"][FONT="Comic Sans MS"]Well not much to add after James079 except I can assure you that each person heals different. The one definate I have learned is that the nerves healing like they should is not what is the norm. I have perm nerve damage on the left side causing mostly my left foot and up to my knee to be in turmoil even with the meds. The nerves that have healed seemed to feel worse then better then worse before they calmed down. Also after the healing was over every now and then the nerves had a little lapse in memory and would throw out a small twinge of pain just to remind me they were ok I guess, lol. I know it's not very calming to hear that you may feel worse before you get better, it sounds like your on the road to healing though.

God Bless[/FONT][/SIZE][/COLOR]


 
Old 07-26-2011, 07:36 AM   #4
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Re: Nerve healing -- How can you tell?

[QUOTE=james079;4808222]So Bracer, A neuropraxia, a minor blockage of nerve conduction gets beter in a couple of months. No Wallarian degeneration takes place.
In Axonotmesis Wallarian degeneration happens. When it happens it not only happens distal to the injury but slightly up from as well. The outer tube of the nerve is intact but the inner fibres degenerate, these fibres being sensory, motor and sympathetic. Neurotmesis is total severance of a nerve.
You seem to have a Axonomesis. Therefore the nerve fibres will have to grow down the uninjured sheath. Googles "**********'s Classification", and get the nitty gritty. No you will not waken up one day and all will be well! Growth of regeneration is faster in large nerves than small, yours probably medium say 3 to 5 mm a day. Google again this time "peripheral nervous system regeneration". Lots to read on this subject.
James[/QUOTE]

James, thank for the info. I'm going to spend quite a while researching this. Actually, gathering more info about my condition makes me feel better. My neurosurgeon agrees with you. When I asked him if I had axonal damage, he said that would be his guess. However, when I quizzed him about the healing rate, he said that the distance per day really didn't apply in my case. He said that since it's not a crush injury, but likely a result of inproper positioning during my four hour operation, that my nerves were more "asleep" and it would just take time for them to heal enough to "wake up." Since the EMG showed electrical activity was getting through the peroneal nerve and I had good "recruitment" in all muscles, he was positive that I'd completely recover.

I may have told you this before (forgive me if I have, please), but he said that I should begin to show noticeable improvement in about 2 weeks (this was last Wednesday), considerable inprovement with 3 months, and complete within 6 months. He and my pain doctor both said that those are conservative estimates and that recovery times should be shortet than those mentioned. Based on what you know, do you agree? Can you shed some light on what my surgeon meant when he said the healing rate didn't really apply in my case since it was localized to one area (around the knee in both legs)? Am I being fed a line as he hopes things get better for me?

 
Old 07-26-2011, 07:42 AM   #5
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Re: Nerve healing -- How can you tell?

[QUOTE=hand made;4808411]
[COLOR="Magenta"][SIZE="4"][FONT="Comic Sans MS"]Well not much to add after James079 except I can assure you that each person heals different. The one definate I have learned is that the nerves healing like they should is not what is the norm. I have perm nerve damage on the left side causing mostly my left foot and up to my knee to be in turmoil even with the meds. The nerves that have healed seemed to feel worse then better then worse before they calmed down. Also after the healing was over every now and then the nerves had a little lapse in memory and would throw out a small twinge of pain just to remind me they were ok I guess, lol. I know it's not very calming to hear that you may feel worse before you get better, it sounds like your on the road to healing though.

God Bless[/FONT][/SIZE][/COLOR]

[/QUOTE]

hand made:

Though I'd always rather hear good news than bad, please don't worry about sharing your story and knowledge with me. I believe it's always preferable to gather as much info as possible in order to really know what's going on and to make the right decisions, ask the right questions, etc. I have to hope that my left peroneal nerve heals properly and takes away this drop foot. Right now, I can't imagine what it would be like to be permanantly disabled, especially when I chose to have this surgery in order to rid myself of the pain that accompanied physical activity. At least I could walk and run normally before my surgery, though I would pay a heavy price while and afer doing so. To think that I could still be taking pain meds and walking normally if I had made a different choice really makes me depressed.

I know that things won't be perfect in six months or a year, but I'd like to at least have back what I had prior to the surgery. Right now, anything else would be a bonus.

 
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Old 07-26-2011, 08:01 AM   #6
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Re: Nerve healing -- How can you tell?


[COLOR="Magenta"][SIZE="3"][FONT="Comic Sans MS"]I had a slight drop foot after my first fusion surgery, the odds are greatly in your favor of that going away. I did not mean they will not heal but that it's unpredictable as to the rate they heal from one person to another. You should always have hope that they will heal, a positive attitude is a big part of healing well. I have seen many with no drop foot before surgery that had it after surgery and 90% of them were totally back to normal but the time frame of that healing is all over the map so to speak. So hang in there and just concentrate on healing not so much on how fast it occurs, lol.

Did you have an PT for the drop foot? if so I would continue that daily so those nerves don't "forget" what they do. Just physically moving your foot even if with your hands will keep the "memory" in place and should help alot while your healing process continues.[/FONT][/SIZE][/COLOR]


 
Old 07-26-2011, 08:07 AM   #7
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Re: Nerve healing -- How can you tell?

Oh, yes. I have several exercises I do for the foot drop, as well as for the associated ankle weakness. I'm also doing twice weekly aquatherapy and walking four or five times for 20 or 25 minutes every day. I'll do everything I can to deal with this foot drop. Now, those nerves need to hurry up and do their part!

 
Old 07-26-2011, 08:19 AM   #8
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Re: Nerve healing -- How can you tell?

[COLOR="Magenta"]I will be praying for ya![/COLOR]

 
Old 07-26-2011, 08:28 AM   #9
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Re: Nerve healing -- How can you tell?

[QUOTE=james079;4808222]In Axonotmesis Wallarian degeneration happens.
You seem to have a Axonomesis. Therefore the nerve fibres will have to grow down the uninjured sheath. Googles "**********'s Classification", and get the nitty gritty. No you will not waken up one day and all will be well! Growth of regeneration is faster in large nerves than small, yours probably medium say 3 to 5 mm a day. Google again this time "peripheral nervous system regeneration". Lots to read on this subject.
James[/QUOTE]

Whoa.... If the degeneration takes place from the site of the injury to the muscle involved, we're talking maybe 18 or so inches (I'm not great at estimating and have no measuring tape at hand) from my knee to my toes. That's about 450 mm. At 5 mm a day, we're talking 90 days. Is that where they get the 3 months from? So the earliest I'll begin to recover is 3 months from the date of the injusy (one month ago)? (At 3 mm a day, that's about 180 days, or six months) If so, where are they getting the two week or so time table for beginning to see recovery? Or am I just totally off here? It's tough to tell just how long the peroneal nerve is from the tibialis anterior, since they both run the length of my leg from foot to knee. I feel like an idiot here.

 
Old 07-26-2011, 08:41 AM   #10
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Re: Nerve healing -- How can you tell?

Bracer how do you get the lil smiley mood guy under your info?

 
Old 07-26-2011, 09:52 AM   #11
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Re: Nerve healing -- How can you tell?

[QUOTE=bracer;4808483]Whoa.... If the degeneration takes place from the site of the injury to the muscle involved, we're talking maybe 18 or so inches (I'm not great at estimating and have no measuring tape at hand) from my knee to my toes. That's about 450 mm. At 5 mm a day, we're talking 90 days. Is that where they get the 3 months from? So the earliest I'll begin to recover is 3 months from the date of the injusy (one month ago)? (At 3 mm a day, that's about 180 days, or six months) If so, where are they getting the two week or so time table for beginning to see recovery? Or am I just totally off here? It's tough to tell just how long the peroneal nerve is from the tibialis anterior, since they both run the length of my leg from foot to knee. I feel like an idiot here.[/QUOTE]

The nerve does not have to reach your toes, only into the belly of the muscle before you see the improvement begin.
James

 
Old 07-26-2011, 10:00 AM   #12
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Re: Nerve healing -- How can you tell?

[QUOTE=hand made;4808449]
[COLOR="Magenta"][SIZE="3"][FONT="Comic Sans MS"]I had a slight drop foot after my first fusion surgery, the odds are greatly in your favor of that going away. I did not mean they will not heal but that it's unpredictable as to the rate they heal from one person to another. You should always have hope that they will heal, a positive attitude is a big part of healing well. I have seen many with no drop foot before surgery that had it after surgery and 90% of them were totally back to normal but the time frame of that healing is all over the map so to speak. So hang in there and just concentrate on healing not so much on how fast it occurs, lol.

Did you have an PT for the drop foot? if so I would continue that daily so those nerves don't "forget" what they do. Just physically moving your foot even if with your hands will keep the "memory" in place and should help alot while your healing process continues.[/FONT][/SIZE][/COLOR]

[/QUOTE]

It is not really unpredictable as to compare one person to another. If they both had the same neurological damage, all being equal they would heal at the same rate. What is different is that you can't compare nerve injuries. One nerve could have only partial degeneration and another one full degeneration.
James.

 
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Old 07-26-2011, 11:17 AM   #13
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Re: Nerve healing -- How can you tell?

[QUOTE=james079;4808534]The nerve does not have to reach your toes, only into the belly of the muscle before you see the improvement begin.
James[/QUOTE]

That's good news! So once it reaches that area, my foot drop should begin to get better? I guess I'd start to notice an increase in the ability to lift my toes and maybe walk on my heel. I reach down on my left leg every day and check that muscle as it runs along the side of my tibia. I try to compare it to my right leg as I try to lift my toes. Right now, there is no movement in that area. It just sits there, depressingly flat, while that same space on my right leg has muscle popping up just fine. Is there any way I can find the general area the belly of the muscle is? Is it somewhere along the bone? I know you're not a doctor (at least, I don't think so), but there's no harm in asking. Any info you have or just your best guess based on yout experience is fine with me.

Jeff

 
Old 07-26-2011, 12:25 PM   #14
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Re: Nerve healing -- How can you tell?

Bracer,Google Tibialis anterior and also Common fibular nerve. See if you can find anything on Tinel's test.
No I am not a doctor

The waiting is the worst for such a condition such as yours
James

Last edited by Administrator; 07-28-2011 at 01:31 AM.

 
Old 07-26-2011, 02:33 PM   #15
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Re: Nerve healing -- How can you tell?

[COLOR="Navy"]My back broke the day after I had a three level fusion. The came to get me up out of bed, and as I started to pushup my back broke. Nobody lisened to me and the continued to gte me up to walk twice day with broken back for a week. Long story short. I ended up having to have 7 more hours of surgery (on top of the 9). They took out the hardware, realigned the spine and started with 2 new titanium 15" rods-and twenty of the gold toped screws. I am fuse from T9-sacrum. Lost use of my left leg, nerve damage down the entire leg and the prognosis of "With 2-4 years of therapy and meds, we HOPE you can regain full use of your left leg." 6 yrs. later I am going steady with my therapist, my cane is a good friend, and I do have permanent nerve damage....and just to prove that they are not working right they will send shocks like I have been hit with a taser.

I didn't want to cause doom and gloom, but that just shows you a differnt view. My internist told me that after a year and a half you will not regain feeling in whatever area is numb. That caused tears. I knew it in my brain, but my heart wasn't ready to hear that. One good thing about it is that I have a pedi every month as my hubby refused to do my toes....

If you are healing, it will be such a gradual thing that you will one day look down and go"Oh, look what happened." There is no ringing of bells or sounds of snpping muscles...it jsut happens. the best thing you can do is to keep on the exercises. A thought. Have you tried accupuncture? IT was a help for me. I went for year to a traditional chinese accupncturist and she was GOOD. Just a thought for you.

How wonderful that you are a teacher. This is such a great learning experience for kids. How nerves and muscles affect your movements....i see science fair projects just papered all over your leg!

Keep on pluggins and walking and don't give up because without that drive and hope-where would we be?[/COLOR]

 
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