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“So there is something wrong because everyone was making me feel like I was crazy.”

 EB is a passionate wrestler and has spent years training on the mat of his high school gym in a coastal town of North Carolina.

EB wrestling before his injury and thoracic outlet syndrome diagnosis - UNC Health

But in November of 2022, EB was injured during a practice when another wrestler executed a move incorrectly, hurting EB’s arm. “I started having tingles in my finger tips and numbness,” said EB. “I felt it little by little. I didn’t think anything of it until it gradually got worse.”

Dismissing the early signs as fatigue, EB continued wrestling. The following month during a wrestling match, EB was again put in a bad position and heard an audible pop. “My whole arm went dark,” said EB. “I thought it was a stinger. It’s common in wrestlers and football players. That’s when the pain started.”

Peripheral nerves are located outside of the brain and spinal cord. Brachial plexus injury, nicknamed “stingers”, occur when these peripheral nerves are injured. This type of injury can cause severe pain, numbness, lack of mobility, function, and feeling in the arm or hand. Physical therapy and other nonsurgical methods can be used to treat minor brachial plexus injuries, but severe brachial plexus injuries, such as an avulsion, may require surgery.

After his injury, EB started on his long road to finding a diagnosis and a surgeon that could help him. Over a period of 16 months, EB would see six different doctors. He was referred to physical therapy but the sessions only made his pain worse.

“I had to push to be his voice when they kept telling me that nothing was wrong, and that everything was normal when I knew it is not.”

When EB was referred to the first neurologist, he was told that all of his tests came back normal. But EB’s life felt far from normal. He could not wrestle, had daily pain that was getting worse, and had limited mobility in his injured arm.

EB’s mother, Megan, worried about her son and felt frustrated that none of the doctors could help him. “You know that your kid is not good,” said Megan. “I had to advocate for him. I had to push to be his voice when they kept telling me that nothing was wrong, and that everything was normal when I knew it is not.”

EB struggled with his mental health after his injury and the isolation that came with having to quarantine to his room after testing positive for Covid-19 around the time of his injury. “I just wanted to give up,” said EB. “I was so tired and mentally exhausted. But it started to get better once we met Dr. Attiah.”

EB finally ended up in a pediatric neurologist’s office in Greenville, NC. This provider told EB about a clinic at UNC Health with specialists in brachial plexus injuries. In November 2023, EB and his mother drove three hours to Chapel Hill for their appointment with peripheral nerve surgeon, Dr. Mark Attiah. Immediately, EB and his mother recognized that they had finally found help. “He said based on looking at your notes and talking with you and tests, I’m pretty sure what’s going on, but we need to run a series of tests,” said EB.

EB on the day of his surgery to treat thoracic outlet syndrome at UNC Health
EB on the day of his surgery at UNC Health.

Dr. Attiah wanted to confirm his suspicions with additional MRI imaging. This type of injury does not show up on an MRI.

In January and February, EB had testing done at UNC Health. “He let us do a virtual appointment at the end of February,” said Megan. “He told us it was thoracic outlet syndrome. EB’s exact words were ‘so there is something wrong because everyone was making me feel like I was crazy.’ It was a sigh of relief.”

Thoracic outlet syndrome occurs when the narrow space where nerves pass from the spine and major blood vessels pass through becomes compressed, often caused by an injury. This space is located near the shoulder and collarbone on the way to the arms. EB was experiencing pain and experiencing symptoms of tingling and numbness in his clavicle, neck, and shoulder. EB was living with a pain level from 6-7 on a normal day, and experienced an increased level of pain when he used his arm to lift anything. “Because this diagnosis doesn’t have many objective measures, some doctors don’t even believe that it’s real,” said Dr. Attiah. “But, because I highly suspected it was thoracic outlet syndrome, and EB got so much better with an anesthetic injection around the muscles near the brachial plexus, surgery for this was something that we needed to have an honest discussion about, including the risks and possibility of EB not getting better afterward.”

“To me, it seemed like they had tried pretty much everything else with no relief. Surgery was his best option.”

Dr. Mark Attiah, peripheral nerve surgery at UNC Health
Peripheral nerve surgeon Dr. Mark Attiah during EB’s surgery.

The night before EB’s surgery, Megan and EB made the long drive back to Chapel Hill for his surgery. On Friday, March 22, 2024, less than a month after his diagnosis, EB went in for surgery. He had a countdown on his phone as he anxiously awaited a surgery that he hoped would alleviate his pain and help him get his life back. “It was finally happening,” said EB. “It took a year and a half for it to happen.”

The surgery went smoothly, with no issues. During the surgery, Dr. Attiah decompressed the nerves by removing any tight bands or scars around the nerves and from the surrounding muscles. “To me, it seemed like they had tried pretty much everything else with no relief,” said Dr. Attiah. “Surgery was his best option and it went very well.”

EB with his mother - Peripheral nerve surgery at UNC Health
EB with his mother, Megan.

Now that the surgery is over, EB will focus on recovery and attend regular physical therapy closer to home. “With PT and time I can hopefully have full function of my arm,” said EB.

EB’s story is not over, but with the surgery behind him and looking into the months of recovery ahead, EB and Megan are both grateful for the specialized care they found at UNC Health. They realize that so many others are not as fortunate.

At seven weeks post-surgery, EB is able to fully lift his arm with just a little bit of effort and having little to no pain on a fairly regular basis. He is in his third week of physical therapy, which Megan feels is going very well.

EB hopes that by sharing his story, he can help other patients with similar injuries find a peripheral nerve surgeon like Dr. Attiah. Megan is grateful that her son found answers at UNC Health and is relieved that he is recovering both physically and mentally from the pain of the last 18 months. “I can’t imagine going through constant pain for a year and a half before real answers and real results,” said Megan.