Paralized Diaphram

My husband had bypass surgery a year ago, we are now just finding out that his diaphram nerve was cut during the surgery and his diaphram is now paralized. He is on oxygen and well he states that he cannot get his deep breath. He had to retire early with medical from his job due to this and due to the bypass. He seen his pulmonary Dr. today and out of the ble he brings up this surgery and starts confirring with the Dr. taht damaged the diaphram about surgery. My husband does not want this, he feeels that he has been through too much now as it is. but can someone tell me if he had the pacemaker inplnted, would this be a help or not. Is it worth it or not. Is this major surgery or not? How would this affect his medical disability from work and future social security disability. A lot of questions but I never heard of this procedure before today.

5 Comments

Phrenic nerve ??

by pete - 2009-07-17 06:07:07

Are you telling us that his phrenic nerve was cut accidentally during the bypass surgery? The disfunctional diaphram that would be caused by this is a separate problem to his heart. This is most unfortunate. The only device that should help him would be a "Diaphragmatic Pacemaker". They are fitted in the same place as a normal pacemaker but the lead/s are pacing the diaphram. The proceedure to fit one is not anything like as invasive as a heart bypass. Possible downsides are that these devices are fairly new and I believe there is an external transmitter which sends "signals" to the diaphram pacemaker. I suspect this will restrict movement to some degree. I do think though that such a device would improve his quality of life considerably. Your post is a very interesting one and I am sure the other menbers would be very interested in the outcome. So pleaee keep us posted. Cheers Peter

strange......

by Angelie - 2009-07-17 11:07:11

My right phrenic nerve was damaged during an ablation, and I knew immediately upon awakening that something was wrong. Also when your diaphragm is paralyzed everything gets moved around and it felt like my internal organs had been rearranged.
I'm just wondering if your husband felt this right away after his open heart surgery. Also the surgeon should have told you this immediately after the surgery, and it should be VERY evident upon a routine chest x-ray.
People can function quite well with one lung. Has his doctor(s) suggested tacking his diaphragm down first before the diaphragm pacemaker. When your diaphragm is paralyzed everything shifts and the paralyzed side moves up into your chest wall and squishes your affected lung. I personally don't think pacing the diaphragm would help if it doesn't have the ability to stay in place.

Good luck,
Angelie

Paralyzed Diaphram

by SMITTY - 2009-07-17 11:07:57

Hello Sharon,

I have had bypass surgery, now have a pacemaker and have a paralyzed diaphragm. The three are connected but in a roundabout way. Heart disease got me the bypass surgery. Continuing decline in heart function got me the pacemaker. An unexpected complication from the pacemaker got me the paralyzed diaphragm. Now I’ll try to add some details.

My pacemaker was a trip form hell until I got an injection to deaden a nerve. My pacemaker was shocking me on a regular schedule and it was finally determined that the “shocks” were the result of the pacemaker impulse going to the ventricle lead was impinging on a nerve (I think it was probably the phrenic nerve but I have no proof of that) and the cure was to either remove and reposition the lead to the ventricle or get an injection to deaden the affected nerve. Since my leads had been in place more than five years and moving one would involve laser surgery, the injection seemed like a better way.

The injection worked perfectly as my “shocks” ended almost immediately. Shortly after that I was lying in bed one night and started to sit up. As I sat up I noticed that the right side of my abdomen looked as if I swallowed about half of a basketball. Since it didn’t bother me (so I thought) I went about my merry way and during my next visit with the doctor that gave me the injection I mentioned my new curiosity. Well one thing led to another and finally I was sent to a pulmonologist, who after a bunch of tests, determined that my diaphragm was paralyzed on the right side.

By then I had noticed that I would get very short of breath any time I bent over at more than about a 45 degree angel. I reported this to the pulmonologist and he explained that when I bent over the paralyzed diaphragm was allowing internal organs to press on the bottom of my lung(s) and this was causing the shortness of breath. The solution (for me) was to have surgery to, in effect, take a fold in the diaphragm suture it down and that would tighten up the diaphragm and prevent the internal organs from pressing on my lungs. However, the ringer was that to him this it is major and delicate surgery and that due to my age (80 years old) he did not recommend the surgery for me.

So I continue to feel like somebody stepped on my stomach every time I bend over and it does drastically reduce my physical activity.

If you would like to see more about this surgery go to http://mmcts.ctsnetjournals.org/cgi/content/full/2007/1217/mmcts.2006.002568.

As for the pacemaker, I cannot say it will or will not help your husband. That is one for his doctor. I will say that if all of his inability to take deep breaths is cause by the paralyzed diaphragm I would doubt that the pacemaker would help. But if he also has some heart function deficiency then it may help. Again this is one for his doctor. The implanting of a pacemaker is not major surgery. The surgery usually takes about an hour and it may involve an overnight stay in the hospital and total recovery time is usually less that two weeks

Now I’m only talking about a heart pacemaker. I had not heard of the pacemaker Pete mentioned in his comment but I will learn more about it next month when I visit my pulmonologist.

I wish your husband the best,

Smitty

alternative to repritory pacemaker

by fred e bassett - 2010-03-15 02:03:53

If you have phrenic nerve damage you might be a candidate for a new procedure! I’ m very excited and hopeful as I was operated on 1 week ago by a great team of surgeons. There was testing involved to make sure I was a candidate as not all will be. My chances of a complete recovery will have several limiting factors. 1. The length of time my nerve was damaged (over 5 years). The fact that my diaphragm was logged in my chest cavity. Made the surgery difficult. (the latter is unusual and will not apply to most).

The recovery time is approximately 1 year. During this time a transplanted nerve will be growing into place to replace the damaged nerve. I will be posting updates on my own progress over the next year for anyone that is interested in this procedure

I can say that if nothing else happens I have gained back several functions that have already made a change in my life. I can now lay flat on my back w/o grasping for breath. I can bend over and tie my own shoes , again w/o grasping for breath. And last of all the fact that there were faint sounds coming from my right lung for the 1st time in 5 years leads me to have a hope that did not exist just 1 week ago

I too was told I had COPD. That diagnosis came along with my paralyzed diaphragm. I've been to the Mayo clinic and they confirm my belief that it was the problems with the diaphragm. My problems to worsened as I got older. My diaphragm eventually ended up in my chest cavity. It’s been a long road but for the 1st time in years I feel there is some hope for me.

The Dr's are great and it only cost me a few minutes on the phone with the Dr and a 2 day trip to see if I qualified. I'm case # 13 so it is a new use of an established technique

Diaphragm pacer

by Rebecca121760 - 2012-08-23 11:08:24

My mom had bypass surgery last week and the surgeon said that the ice used around the heart during surgery had damaged the phrenic nerve supplying the left side of the diaphragm. She has only a little air moving in the upper left lobes. I have been trying to look up information on this also. Mom is 86, but she has been exceptionally healthy all of her life. She was mowing 2 acres with her rider up until a couple of months ago. He said that it may resolve on it's own. Praying... She is doing well other wise. Wondering if this is why she feels sick after she eats a large meal?

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