Diaphragm Paralysis

I have four questions for some of you.

1 - Do any of you have paralyzes of the diaphragm?

2 - If you do, or did, have you had surgery to correct the problem?

3 - What were the results of the surgery. Namely, how long was recovery time and how much pain did you have and for how long?

4 - Do you know what caused your problem?

5 Comments

What side?

by Angelie - 2008-11-07 01:11:01

I'm with you. Wouldn't wish it on my worst enemy. I think having diaphragm paralysis is different than just being SOB......it's worse, but I'm glad that I regained some function.
My problem is mostly the bottom right lung. What side is your problem on?
Bless your heart. I can't imagine being 80 with our problem, as if we don't have enough against us.....hee, hee.
I'm 33 so I figure that even though it's been rough, at least my age maybe makes me a little bit more resiliant....at least that's what I try to believe anyways.

don't hesitate to shoot me a line anytime.....my paralyzed friend. LOL

Right Side

by SMITTY - 2008-11-07 04:11:44


I can't imagine being 80 and I'm almost there. Every time I say that I'm sure I subconsciously think I'm talking about someone else.

My problem is on the right side. I got to look at the most recent Xray and the bottom of my lung is plainly "pushed" up. I guess I have not let it really sink in yet that I have a disabling problem because I still find my self walking at my normal pace (which all my boys always told me was too fast) only to find that before I get to my destination which may by only a few hundred feet, that I am gasping for breath.

As aggravating as the CPAP is, I do find that I am more rested in the mornings when I get up. When using it, my blood O2 level will be about 96% in the mornings and without it I will have one in the mid-80s and the doctor gets a little disturbed when I have any thing below 88%. I understand that people with this problem sometimes have to sleep sitting up and with the CPAP I can still sleep flat of my back using just one pillow.

Oh well after living through political highs and lows we have just been through I figure I can fight bears for a little while.

Take care,

Smitty

My God, I've finally found someone!

by Angelie - 2008-11-07 10:11:36

Yay, (well, not yay) but so far I think I've been the only one on here with this problem. My goodness, it's been lonely.
My right phrenic nerve was frozen during a cryoblation back in April in an attempt to ablate my atrial tach/flutter. My right diaphragm was paralyzed, but it's a lot better than it was right out of surgery. My goodness it was HORRIBLE. I thought I knew what shortness of breath was. By golly, I do know now what it's like to not be able to breathe. My lung function has improved on it's own as the nerve has slowly healed, but I'm left with some residual damage that I feel I'll just have to deal with from here on out. I can do everything just fine, most of the time, but my right lung function won't ever be perfect again. No matter how deeply I breathe, air doesn't get all the way to the right lung leaving me with diminished breath sounds. The only thing I'm plagued with now is increased chance of pneumonia and collapsed lower right lung (which I've had twice already)
I didn't need surgery to correct this, as the doctor has always said the nerve wasn't permanently damaged. He said it just takes time. I think we're both a bit surprised by my residual problems. One day at a time, I guess.
Do you have diaphragm problems as well, or are you just curious, or know someone who does?

Mot Alone

by SMITTY - 2008-11-07 12:11:55


Hi Angelie,

Thanks for letting me know I'am not home alone, although I wouldn't wish this on my enemy.

I was diagnosed with the problem a year or two ago and apparently it is getting worse. For a several years bending over would cause me to be very SOB, but I just attributed it to being old, fat and out of shape. I lost about 25 lbs. and noticed that and exercise did not give me the improvement I expected.

I complained of the SOB to my cardiologist and he referred me to a pulmonologist without telling me anything, but at this place it is not uncommon for that to happen. The pulmonologist ordered some tests that I no longer remember, except for one. Frankly I just thought I was being passed around for purely mercenary reasons, but there was one test for which the name caught my attention. It was the sniff test.

That was the darnedest test I ever had. I walked in and was positioned in front of something and told to take three short breaths as quick as I could. I did and they said O.K. we got it. So help me it takes longer to read those few words than the test took. But when the pulmonologist got the results he told me my SOB problem was being caused by a paralyzed diaphragm and nothing needed to be done. But he did want to watch it and I have been seeing him every 3 or 4 months since,

I asked about surgery to "take the slack out of the diaphragm" but he said very candidly that I was not a candidate for surgery (I took that to be because of my heart disease and my age - 80 in a few months now) but during my visit last week he seems to be changing his mind. But, from what I have read on the surgery, he will have a ways to go to change my mind though.

Other than the SOB and having to wear a CPAP mask while I try to sleep I have no problems. I do notice that it takes less physical activity to cause the SOB, but no pain or anything. But I figure Mother Nature will probably solve all my problems before things get too far out of hand.

Smitty

Cabg Patch

by SMITTY - 2008-11-09 12:11:08

Cabg,Below is a little bit of an article on diaphragm paralysis that I found on Google. I'm not trying to post the entire article because it is very long and goes into detail on the surgery along with many pictures which, of course, I can't post. But I got this by going to Google and putting in Paralyzed Diaphragm. There are many articles on the subject but few were really worth my reading. I don't know how many I looked at before I found this one which I cut out, but failed to get the title. If this is of interest to you I suggest you take a look at Google or any other web site you know of and please let me know where and what you find. Smitty

Diaphragm paralysis in adults results from an acquired dysfunction of the phrenic nerve. Patients usually present with dyspnea on exertion; however, the severe and progressive dyspnea when bending over or changing to supine position is in most cases even more disturbing and almost pathognomonic for this disease. Patients eventually have to sleep in upright position and have to stop working. The progression of dyspnea is caused by a decline in lung volumes, i.e. vital capacity (VC) and forced expiratory volume in one second (FEV1). Also immersion in water (taking a bath or swimming) causes deterioration of dyspnea by the increased pressure on the abdomen.

Etiology
Phrenic nerve dysfunction can be caused by any disorder which affects nerve tissues, including trauma. Iatrogenic trauma during cardiac and oncological surgery of tumors involving the area of the phrenic nerve have to be mentioned. Diaphragm paralysis can also be part of a neuropathological entity called neuralgic amyotrophy. Although this can occur without any symptom at all, most of these patients have a history of a viral infection like a common cold or influenza and a sudden pain in the shoulder or neck region before the onset of progressive dyspnea. These patients typically suffer from a weakness of the arm, which eventually recovers. The recovery of diaphragmatic strength, however, is highly variable. If there is no sign of recovery at all after one year, the chances of complete recovery of muscle strength seems small.

Diagnosis
Diaphragm paralysis can be suspected on a chest X-ray. Pulmonary function tests in upright and supine position and a paradoxical diaphragm movement in a sniff-test with fluoroscopy or ultrasound are all that is needed to confirm the diagnosis.

Treatment
Surgical treatment by diaphragm plication has been described since 1985 in small series for unilateral paralysis and bilateral paralysis. Some of these studies only or mainly concern patients after cardiac surgery with problems at weaning from ventilation. Follow-up in most studies is limited both in number of patients and in time.

We describe the technique performed until now in 28 patients of whom five had bilateral and 23 unilateral paralysis. The long-term effects of 17 of these procedures were presented at the 2006 EACTS/ESTS joint meeting and have recently been published. All values of spirometry tests improved significantly resulting in a remarkable decrease of the loss of lung capacity going from upright to supine position. Also the dyspnea scores show a substantial and persistent improvement of dyspnea resulting in the possibility for the patients to return to a more or less normal way of life.

You know you're wired when...

Trade secrets can be smuggled inside your device.

Member Quotes

I had a pacemaker when I was 11. I never once thought I wasn't a 'normal kid' nor was I ever treated differently because of it. I could do everything all my friends were doing; I just happened to have a battery attached to my heart to help it work.