So, first, a review of the facts so far: as of October 2023 they had cut out a piece of my radial nerve and sewn in a piece of my sural nerve, and I had begun the 2-3 year recovery process. The surgeon had informed me that first the nerve needed to grow over the removed area – the grafted nerve wasn’t just a live wire the signal would instantly shoot down – it was more a track laid for new nerve growth to happen on. And nerves grow about an inch per month; and they’d taken over 4 inches of nerve out of my arm; so they didn’t expect to find out if that connection had regrown for about six months; after which the nerve would continue growing down my arm, inch by inch, month by month, slowly reconnecting first one and then hopefully many strands to the various muscles it was responsible for.
Unfortunately, nerves that are not receiving signals are also prone to dying back, and motor nerves die back permanently, so we were starting a race between the nerve growth and the nerve death.
Remember that I was already feeling weakness in my fingers before all this surgical intervention? Well upon examination they found there was already some amount of nerve atrophy in my radial nerve below the elbow – in fact there was even muscle atrophy in my extensor muscles on my forearm.
So the surgeon was very up front with me: we were not likely to be able to regrow nerves that were already nearly gone. I don’t expect to recover any of the function I lost prior to 2022. We are hoping to recover most of the function that i had the day I went in for surgery, but there are no guarantees. We took the growth out because there was a chance of saving my wrist and elbow function from it if we did it now, whereas waiting till the growth fully eclipsed my radial nerve meant that the nerves downstream would likely be fully irrecoverable.
If I do not regain nerve connection enough for a basic level of function in my hand, we will look into a tendon transfer procedure. That’s the potential third year of recovery. It would entail detaching one of the flexion muscles from the tendons on the palm side of my forearm and reattaching it to the extension tendons on the upper side of my forearm, giving me muscle power to extend everything, but also forcing me to learn to fully rewire my brain. I’m not personally SUPER excited for that challenge, but if I need it I need it, y’know?
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