" oh ya...sure.You may send him now."
That was the conversation between me and one of the medical officer in district hospital last week.When I heard the word 'brachial plexus injury' , I know already that I'll encounter an interesting and rare case for that day.Hmm...Alhamdulillah Allah wants to teach me something.
2 hours later, I got a call from A&E.
" Dr Hidayah, patient with brachial plexus injury already arrived here.Are you going to see him at casualty ? "
" yah...I'll go down now.Thank you."
At first glance, I thought the patient was a female, but suprisingly the name written in the card belonged to a male...ya it got bin, not binti.Huh..realy, it challenged me already.Now in my mind, suspicion came the first.
His neck was kept in left lateral position.He said he it was very painful to move his neck towards normal.He was unable to move his left upper limb and the sensation lost.Basically the neurology involved was from C5 to T1.
It sounds like he realy got some injury towards brachial plexus.Maybe the high velocity accident strecthed the nerve root which result with loss of motor and sensation around his unilateral upper limb.I need to consult bos now...
" Mr Aaron...Hidayah here,I need your opinion.Would like to show you a patient who suspected to have brachial plexus injury "
Mr Aaron is a very nice orthopaedic speacialist.He is generous and kind, always willing to help..and most of the time when we see him, he gives us smiles.
" well..Hidayah.I don't think he injured his brachial plexus.I think more of psychological.You see...when I passively flex his elbow, he actually can resist me.But never mind we'll see him again in 2 weeks time, see how he progress."
Hmm...my suspicion turned to be true anyway.Quite a number of patient have psycogenic component in their complaints.But as a doctor, we try not to put that as the first diagnosis.In this case, the apperance of a patient may give us a lot of clues,how a man could have lipstick on his lips, and he definitely was wearing a female cloth !
Subhanallah...
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