Scott had a surgery in October of 2023 to remove a clog in his stomach. The procedure was done through a small incision in his left arm where the surgeon accessed Scott’s radial artery to put a stent in one of the arteries that supplies his intestines. The surgery was a success, but while in recovery, Scott noticed swelling in his left hand extending up to his elbow. He could not move his thumb, index finger, or middle finger.
Despite these symptoms, Scott was reassured that the swelling would go down and normal function would return. The swelling eventually went down, but Scott still had numbness in his left hand and could not move his fingers. Scott works in construction and needed to be able to use his hands at job sites. “I was still able to work, but it had an impact on my work,” said Scott. “With the grip issue that I had, it made it difficult to operate the equipment.”
Scott was told by his surgeon that he had nicked the median nerve, which is right next to the radial artery, in Scott’s left arm during the surgery, but reassured him that it would heal in time. Months went by, and Scott was still struggling to function around the house with simple everyday tasks such as opening drinks and jars, snapping his pants, buttoning his shirts, or running certain lawn tools. “I had to do it all with one hand,” said Scott.
When the symptoms persisted, Scott was referred to another doctor for a nerve test. From there, Scott was referred to peripheral nerve neurosurgeon, Dr. Mark Attiah at UNC Health in April of 2024. “My initial impression was he was very honest about the possibilities and what was going on,” recalled Scott.
Medical imaging confirmed that scarring had occurred around the nerve at the point of the incision from the operation. Because the issue had been left untreated for six months, Dr. Attiah explained to Scott that he had a 50/50 chance of a full recovery with surgery. Without surgery, Scott would stay the same.
Scott opted for surgery and was scheduled for surgery that same month. “I felt positive about it because of the way Dr. Attiah carried himself,” said Scott. “The vibes off of him made me feel good about it.”
Dr. Attiah performed three procedures during Scott’s surgery. First, Dr. Attiah performed a median nerve decompression, then he opened Scott’s original incision at the radial access site and found the median nerve deep to the biceps tendon right above his elbow. The nerve was decompressed and the scar tissue was removed from all around the nerve. “There was rind of scar tissue around his nerve in his upper arm that I had to peel off like a sausage casing,” said Dr. Attiah.
The nerve was then stimulated in both places, and Dr. Attiah found that it conducted electricity, showing that the nerve would recover function. Finally, Dr. Attiah did a carpal tunnel release at the wrist to ensure there was no compression on the nerve at Scott’s forearm to his hand that could potentially slow down or stop the nerve healing process.
After surgery, Scott experienced immediate results and was discharged that same day. He immediately started physical therapy. Before surgery, Dr. Attiah stressed the importance of being consistent with physical therapy to increase his chances of a full recovery. “Now I can do a lot of things that I couldn’t do,” said Scott. “I can make a fist now. I can use my fingers.”
A nerve injury like Scott’s can take up to 18 months to heal, but Scott is proud of the progress that he has made in just six months. “What grip and function I have now, you couldn’t make me any happier,” said Scott. “Any more progress from now is just a plus.”
Scott still has some numbness in three of his fingers, but noted that his grip is getting stronger each day. “Thank you to the UNC team,” said Scott. “They took care of me. They’ve got me to where I feel like 100% and I can do what I need to do.”
Article by: Makenzie Hardy, Marketing Coordinator, UNC Health Department of Neurosurgery