Elevated diaphragm causing COPD type symptoms

Hi Kevin -- Thanks a million for the update. I don't know if I should be happy for you or not. I guess I'm glad you don't have a paralyzed diaphragm but feel really badly that you don't have a diagnosis or treatment plan for your SOB symptoms. I quit reading heart-wrenching posts from hundreds of Mayo Connect members regarding going years with no diagnosis or relief for their SOB issues. Conventional medicine was definitely failing them, and I hope it won't fail you. If it does, please find the best functional medicine practitioner you can and have him/her take a look for underlying causes of your symptoms and treat them. I'm convinced that's the way to go, particularly when conventional medicine fails you. I talked to my pulmonologist today about next steps for me. He's astounded that my pulmonary function test shows my lungs with a paralyzed diaphragm are operating within normal parameters and said I must have had this for a long time for my lungs to be compensating so well. He agrees I'm doing the right things, ie lose more weight and build up my strength before considering surgery, and prescribed pulmonary and physical therapy for me, which I wanted. One odd thing I've traced back to my PD is that I'm grinding my teeth. Anxiety evidently results when CO2 isn't expelled properly and builds up in the body and that anxiety is causing me to grind my teeth. Hopefully, the respiratory therapist can teach me how to be sure I've expelled all the CO2 I can when I exhale. I'm investigating getting a mouth guard in the meantime. I'll really look forward to your next post when you have this figured out and are playing 3 hours of nonstop tennis again. Take care! Nancy

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Has anyone been treated at Mayo in Rochester for an elevated diaphragm ?

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Welcome @toby77. Here are two related discussions that you might be interested in reviewing.
- Elevated diaphragm causing COPD type symptoms: https://connect.mayoclinic.org/discussion/elevated-diaphragm-causing-copd-type-symptoms/
- Phrenic Nerve damage and paralyzed diaphragm: Anyone else have this? https://connect.mayoclinic.org/discussion/phoenix-nerve-damage/

@jenniferhunter may have some insights to share from her surgical experience at Mayo Clinic.

Toby, what led to your elevated diaphragm and paralyze phrenic nerve issues?

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Thanks for replying.
It’s rather complicated to explain and hard to follow but I’ll try.
I’m 76. I’ve been relatively healthy all my life. No diabetes, heart problems or cancer only minimal BP medication. Married and had 4 children. Owned and operated child care centers for nearly 40 years. The only chronic conditions I’ve experienced are frequent UTI’s, having to take Nexium for acid reflux, several bouts of inflammation of the colon and chronic constipation. I’ve had a left hernia repair a benign right auxiliary tumor, a bladder sling and partial hysterectomy. I know of no injuries that could have caused it. I also have kyphosis which adds to crowding the lungs.
I started experiencing shortness of breath after I retired in 2010. I was diagnosed with COPD and given Ventolin. It got worse and I had pain in my left shoulder and ribs. I failed a stress test and was sent to a Cardiologist who did an angiogram and found nothing.
Almost by accident a chest X-ray showed an elevated diaphragm with stomach and intestines protruding into the left lung cavity and pushing it upward. Sniff tests at 2 different hospitals show a paralyzed phrenic nerve. I’ve seen 2 pulmonologist and both say they could do placation of the diaphragm. Both also said it is not a pleasant surgery with long recovery and varied results. One basically laughed at the idea that intestines being jammed into areas where they shouldn’t be could cause digestive and elimination issues.
Covid put a damper on following up but my primary and a local chiropractor have helped me to cope with
the discomfort. Daily laxatives, a modified diet, limiting activities and deep belly breathing have helped tremendously. I have good pulse-ox readings 95-97 consistently. My oldest chest X-ray from 2008 shows it was elevated at that time. I’ve recently learned my cousins chest X-ray is almost identical to mine. Hereditary???
My primary encourages me to pursue a real answer from someone who has experience. Evidently it isn’t a wide spread problem. Although I’ve learned to cope with most of the effects, my biggest concern is, at some point will I be told I should have done “something” sooner and I will be too old for surgery etc.
As you can see it’s complicated and most specialists won’t listen long enough to understand and you end up feeling like they just think you have a very vivid imagination.

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Thanks for replying.
It’s rather complicated to explain and hard to follow but I’ll try.
I’m 76. I’ve been relatively healthy all my life. No diabetes, heart problems or cancer only minimal BP medication. Married and had 4 children. Owned and operated child care centers for nearly 40 years. The only chronic conditions I’ve experienced are frequent UTI’s, having to take Nexium for acid reflux, several bouts of inflammation of the colon and chronic constipation. I’ve had a left hernia repair a benign right auxiliary tumor, a bladder sling and partial hysterectomy. I know of no injuries that could have caused it. I also have kyphosis which adds to crowding the lungs.
I started experiencing shortness of breath after I retired in 2010. I was diagnosed with COPD and given Ventolin. It got worse and I had pain in my left shoulder and ribs. I failed a stress test and was sent to a Cardiologist who did an angiogram and found nothing.
Almost by accident a chest X-ray showed an elevated diaphragm with stomach and intestines protruding into the left lung cavity and pushing it upward. Sniff tests at 2 different hospitals show a paralyzed phrenic nerve. I’ve seen 2 pulmonologist and both say they could do placation of the diaphragm. Both also said it is not a pleasant surgery with long recovery and varied results. One basically laughed at the idea that intestines being jammed into areas where they shouldn’t be could cause digestive and elimination issues.
Covid put a damper on following up but my primary and a local chiropractor have helped me to cope with
the discomfort. Daily laxatives, a modified diet, limiting activities and deep belly breathing have helped tremendously. I have good pulse-ox readings 95-97 consistently. My oldest chest X-ray from 2008 shows it was elevated at that time. I’ve recently learned my cousins chest X-ray is almost identical to mine. Hereditary???
My primary encourages me to pursue a real answer from someone who has experience. Evidently it isn’t a wide spread problem. Although I’ve learned to cope with most of the effects, my biggest concern is, at some point will I be told I should have done “something” sooner and I will be too old for surgery etc.
As you can see it’s complicated and most specialists won’t listen long enough to understand and you end up feeling like they just think you have a very vivid imagination.

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@toby77 Thanks Colleen for inviting me to this discussion. Toby, What stands out in my mind is that you have have several abdominal surgeries, and all surgery creates scar tissue, and internal scar tissue in the connective tissue and fascia. There can be adhesions in the connective tissue that supports the colon. It is tied in there normally and can move a bit, but is not loose to roam around like a bowl of noodles. If you get the GI tract moved and stuck in an unusual position it can cause problems. The other thing that affects the colon is when the hip flexors get tight from sitting too much, it compresses the area where the colon is on the way to the exit. It gets overly tight right on the inside of the pelvis hip bones. You would be able to tell this if it's tender there, and if your walking strides are shorter and your leg doesn't extend backward enough, or if stretching it back while standing like in a lunge position is tight.

What I think could help is physical therapy with a PT who understands myofascial release which is a way to stretch out tight fascia and connective tissue. That sometimes can help a posture related kyphosis a little bit, and it can release tightness in the chest. I have breathing issues related to chest muscle tightness because of thoracic outlet syndrome, and MFR work does help that. Frequently my PT releases the diaphram and elevated first ribs when I start using my neck muscles for accessory breathing. It's common that the front of the chest can be too tight as we do so much forward with our head and arms, and forget to stand up straight and stretch. I have had chest tightness and spasms that caused chest pain and I don't have heart disease (confirmed by doctors).

Here is our discussion on MFR
– Myofascial Release Therapy (MFR) for treating compression and pain https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

and there is a provider search at https://www.mfrtherapists.com/ .

That could be a place to start, and a PT is also a good source to help identify and narrow down issues. A PT can also work on your neck. The phrenic nerve exits the spine up around C3 traveling downward toward the lungs and there could be tightness in the neck or chest compressing it. That is where myofascial release may help by loosening a tight neck and chest. If the phrenic nerve is paralyzed and non functioning, there is a surgeon who does nerve graft surgery to replace the phrenic nerve. I don't have experience in that, but other members have posted the information so I can share the website here.
https://www.advancedreconstruction.com/

Have you heard of myofascial release therapy before? Does that sound like something you would like to try?

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Hello everyone,
I'm a 65 year old male Asian. 2 weeks after my second Covid vaccine shot, I returned to the tennis courts to play with my friends, but I didn't have the stamina to play more than 30 minutes, I ran out of breath and had to slow down or took a break. It was strange since I used to play at high competitive level, continuously for 2 to 3 hours, 3 to 4 times a week without feeling tired. So I thought my weakness was related to the vaccine, but after 2 months the situation didn't improve so I went to see my family doctor and he ordered an X-Rate, then they they found out that I have an "elevated lung diaphragm". He then sent me to see a lung specialist, after she interviewed me and listened to my lung, she ordered : a sniff test, a diaphragm test, a CT scan of chest, a Echocardiogram, and a Pulmonary function test. At this moment I'm waiting for her office to make appointments with Torrance Memorial Hospital for these tests.
I think my current health problem is caused by the vaccine since I got all kind of side effects that lasted for 4 days after the second Modena shot (high fever, headache, tiredness, high blood pressure). Then 2 weeks after the second shot I found out about the shortness of breath and lack of stamina while playing tennis.
I saw a few comments here mentioning about "problems with phrenic nerve that could affect the normal functions of the lung's diaphragm", so I think that somehow the vaccine might cause too much inflammations and had detrimental effects on the phrenic nerve and the lung's diaphragm.
Do you have any suggestions/advices on what I should be doing while waiting for further tests ?
Thank you so much for reading this. Your inputs or advices are greatly appreciated.
Kevin Tran

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