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Elevated diaphragm causing COPD type symptoms
Lung Health | Last Active: Nov 17, 2023 | Replies (33)Comment receiving replies
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.
Replies to "Thanks for replying. It’s rather complicated to explain and hard to follow but I’ll try. I’m..."
@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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@toby77, I appreciate your taking the time to describe your situation. There are definitely similarities to what @bill5 @nla4625 and @kevintran are talking about in this discussion to which I moved your post as well.
– Elevated diaphragm causing COPD type symptoms: https://connect.mayoclinic.org/discussion/elevated-diaphragm-causing-copd-type-symptoms/
I encourage you to read through the past posts.
Toby, if you would like to seek a second opinion at Mayo Clinic, here's more information about submitting a request for an appointment: http://mayocl.in/1mtmR63