@cathleenmc There could be different causes of the pain, so it's best to see a specialist. If you had a paralyzed diaphragm, you would be doing more work with upper chest muscles to breathe, which in itself, does cause some anxiety and raises your heart rate. I know someone with that condition as a result of spinal cord injury. He speaks just fine, and he was a clarinet player. He can still play the clarinet, but doesn't have any air power behind it to play as the virtuoso that he was. He is functioning without a mechanical assist.

What I think might be a possibility for you is phlegm buildup which could explain chest and lung pain, tightness, and loss of voice. I did have symptoms like this too, and I had reoccurring chest infections, and I thought I had one of the bad ones that are hard to cure. I have allergic asthma, or what they like to call Eosinophilic asthma. I have multiple allergies including to my own cats and do allergy shots, but it wasn't enough. The amount of exposure I was getting from cat dander overpowered my allergy treatments and I continually had phlegm buildup and used Guaifenesin (over the counter) to thin the phlegm so I could expel it. I would always feel it start in my left lung. By making changes at home with the position of my HEPA air filter when I sleep and wearing paper surgical masks when I am near the cats, and cleaning as much as possible, I was able to resolve the problem completely even well enough that we can coexist and the masks are good enough to prevent problems even if I don't take antihistamines or do the allergy shots. Phlegm does cause severe fatigue if it is blocking the air from getting to the surface of your lung tissue air sacs. We are also most vulnerable sleeping, because we are not expelling mucous, and it builds up, so in the morning, it is the worst. If this is happening to you, the question then is why is there excess phlegm? Infection? Allergy? Asthma? Physical issue? For me, when I had these infections, my resting heart rate was over 100/minute and I went to the emergency room. I had this problem for a couple years before I figured it out. I do now have a steroid type preventative asthma inhaler, but don't want to use that long term to avoid the side effects, and it works by depressing the immune system, so I would be more at risk for the infection I'm trying to prevent. I hope that gives you some insight on possible solutions.