I'm so sorry you're dealing with this. Having both halves of your diaphragm paralyzed is even more rare than having the right or left half paralyzed. The only strategies I've read about for this condition are training other muscles to help you breathe, which I assume your respiratory therapist helped you with, and having pacemakers put on your hemidiaphragms. The leading expert for diaphragm pacing in the country is Dr. Onders at University Hospital in Cleveland; but I think other doctors are now doing this. The fatigue from not being able to breathe properly is terrible. One of the things that helps me every day is pursed lip breathing, which mimics breathing in and out through a straw.