@grump. If my phrenic nerve was working, I would definitely see if I was a candidate for diaphram pacing before I'd even consider plication surgery. Because my nerve isn't working, I don't have that option....but it sounds as though you might. One of the members of the facebook paralyzed diaphragm group has posted extensively about his really positive experience with diaphragm pacing, and it might be valuable for you to join the group to read about it. I posted information about this on Mayo Connect before with the name of the doctor doing it at University Hospital in Cleveland. You could google him or contact his office if you wanted to pursue it.