Phrenic Nerve damage and paralyzed diaphragm: Anyone else have this?

Posted by jgreg1954 @jgreg1954, Nov 28, 2017

Phrenic nerve on the right side was destroyed due to radiation for breast cancer. Diaphragm is now paralyzed & taking away lung capacity. Anyone else experience this?

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@giller198

I was diagnosed with a paralyzed right diaphragm back in January. I also have shortness of breath especially when I swim. I had open heart surgery back in September of 2016 and my heart doctor has ruled out phrenic nerve damage because of the time between the heart surgery and when this started. The doctors think I injured the diaphragm somehow and if I did I never had any pain or any other symptom. Has anyone read or had a surgical procedure that can be done to pull the diaphragm away from the lung?

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Yes it is a diaphragm plication. You need a cardio/thoracic surgeon to do the surgery. I had it done 2 times. The first time was arthroscopic. I got pneumonia and coughed so hard I broke the sutures. So I had the big surgery the second time.

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@machak

I have been dealing with right hemidiaphragm paresis since about 2000. Happy to give any pointers I can, though mine is caused by An autoimmune condition attacking my nerves. The biggest difference is mine comes and goes as the nerve gets damaged and repairs itself during flares and calm times in the disease. For me it last from days to months, but so far has always come back eventually.

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Your post caught my curiosity. I have suspected for a very long time that I may have some sort of undiagnosed "nerve autoimmune" condition. or the last 20 years or so, to the present time, I have experienced 3 episodes of "shingles without the rash" which was so painful that it took me to the ER. Both went undiagnosed at those times, and resolved on their own (although the neuropathy was VERY painful...).
Not, I have a paralyzed phrenic nerve with no known etiology.
Can you share what kind of condition you were dianosed with?? I am also seeing an Immunologist that specializes in autoimmune diseases; however, no diagnosis yet. Thanks in advance.

.

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@debkl

Advancedreconstruction.com in NJ

I believe some members here have consulted with Dr Kaufman in this group.

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My symptoms (shortness of breath) began about a year ago. I was snorkeling in the warm waters of the Caribbean, lost my breath completely, and had to be rescued. Very scary. I immediately saw a Pulmonologist in NJ, and he did some tests, including a Sniff Test, and a CT of the Cervical region of the spine. Sniff Test was positive. He referred me to Dr. Kaufman in New Jersey; he also performs surgery at Cedars-Sinai in Los Angeles, CA. He apparently ONLY does this surgery, using his own developed technique. I am 77 years old, in good health, but I was rejected because his protocol only accepts patients less than 67 years old. Apparently, the success rate decreases with age. I then became my own advocate and sought information on this condition. I found Dr. Mar Ginsburg at Columbia-Presbyterian Hospital in New York City, who specializes in this kind of surgery (plication). I also contacted the Mayo Clinic in Rochester, MN. Both concurred with wait-and-see to determine if the nerve will/can repair itself. I just saw my medical Pulmonologist this week, and, since it has been 6 months since my first Sniff Test, he is repeating it. Conclusion: we are still on the proverbial fence with only 60% of lung function.

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@renecurro

Please, anyone with very serious breathing conditions stemming from phrenic nerve (for any cause) miss/malfunctioning, share whatever you can. I have strong diaphragm spasms (“mega-hiccups”) that if not stopped conduce to the entire diaphragm “disappearing”. To make it much worse, very potentially lethal, my intercostal muscles go “out of commission”…but the phrenic nerve has nothing to do with the latter muscles. I don’t feel asphyxia or anything like that; feel nothing but, only in my head, the deprivation of oxygen… as my vision goes dark as in gradually fainting. Immediate CPR with a sublingual TINY tablet of OTC candy laced with peppermint (e.g., altoids) gets me out of it. By the way the sublingual peppermint tablet stops the whole process but only when still in the mega-hiccups phase… which occur irregularly-sporadically, anywhere, anytime, triggered, usually by swallowing anything including saliva, or even without swallowing anything. I have an old serious lesion (from teenager Greco-Roman wrestling) on C3-C4 that, a neurosurgeon suggested, may be affecting the phrenic nerve, in turn affecting the entire diaphragm, by he couldn’t say anything regarding the intercostal muscles. Idiopathic causes is all what all specialists that have seen me “diagnose” and don’t give me treatment (even the neurosurgeon advised me to stay away from surgery ). Boxes of those tablets are in every single room in my house, including garage, shed, backyard, in my pockets, and never leave home without the little tablets… and without my wife, who is very well trained and has robust practice on CPR. I take a daily 50 mg “pearl” of OTC peppermint oil, and “deploy” a sublingual big tablet before even starting the car…always with my wife in the passenger seat. I drive only on backroads; my wife does any other driving.

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A paralyzed or weakened diaphragm can be a symptom of a neuromuscular disease or some other disease. Thus, it's important to rule out possible underlying root causes of your diaphragm problems before you or your doctors just decide you have a paralyzed diaphragm with an unknown origin and resort to surgery. Since you mentioned the impact on your muscles, I really recommend you see a doctor who knows about ALS and other neuromuscular diseases. I'm confident my paralyzed diaphragm is not a symptom of something else and have a whole list of things that could have caused it: accidents, vaccinations, viruses, x-rays, etc. I hope you will keep us posted...best wishes!

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I have issues in my diphragms from complications from a lung surgery a number of years ago. Can anyone suggest a doctor in the Washington DC area that specializes in diseases of the diaphragm? I have had trouble finding a pulmonologist or thoracic surgeon that can really address my issues. Mine are not paralyzed yet, just partially functional. Thanks.

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I have also been diagnosed with a paralyzed diaphragm. I had a positive Sniff Test which clearly shows the frozen diaphragm. It has no known cause. Mayo Clinic suggested "wait-and-see" and re-evaluate in 4 to 6 months. My lung capacity is currently at 60%.

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Had cardiac ablation-heat or electrical impulse to burn pacemaker cells in atrium of heart.
Burned the phrenic nerve- paralyzed diaphragm etc
**I saw a pulmonologist
**I had lung function tests done
**I am doing breathing treatments 3x day and on another inhaled medication

I did not qualify for pulmonary rehabilitation because my oxygen saturation was 1 point higher than insurance coverage

You have to be your own advocate if you want to breathe. Be kind but relentless. It took 2 months to get in to see the lung guy. Hope this helps
**

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@eviggiano

I have also been diagnosed with a paralyzed diaphragm. I had a positive Sniff Test which clearly shows the frozen diaphragm. It has no known cause. Mayo Clinic suggested "wait-and-see" and re-evaluate in 4 to 6 months. My lung capacity is currently at 60%.

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Do you know which Drs you saw at Mayo? I am being seen in Rochester and I’m totally impressed with the thoroughness and advice I’ve received. I just can’t get clear information on how many Diaphragmatic Plication surgeries they preform and the success rate. My situation is different than some and involves the Gastroenterologist dept. ( also an impressive group).
Thank you
Toby77

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@giller198

It has been determined between my heart surgeon and pulmonary doctor to much time elapsed from my heart valve surgery to when I started having breathing issues. It was about a fourteen month time interval. The doctors have ruled out phrenic nerve damage. Somehow I must have been doing something that caused damage with that right diaphragm.

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Sometimes it can be inactivity that can cause the diaphragm to become inactive. I had this problem myself from heart failure 💔 problems and was at a place where they had an Austrian trained physiotherapist they had me see as I could not take deep breaths anymore. He worked on my diaphragm for 1 session over a year ago and it solved the problem even before I left the office! Perhaps if you find someone who can do diaphragm work it may help. I had never heard of this kind of deep tissue work before. Take care.

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@toby77

Do you know which Drs you saw at Mayo? I am being seen in Rochester and I’m totally impressed with the thoroughness and advice I’ve received. I just can’t get clear information on how many Diaphragmatic Plication surgeries they preform and the success rate. My situation is different than some and involves the Gastroenterologist dept. ( also an impressive group).
Thank you
Toby77

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No. From what I see, the Mayo Clinic model is a Team of multi-disciplinary medical professionals that do the initial evaluation. It is a top-down concept so the identity of the actual surgeon is probably not known til you are accepted as a surgical candidate and are evaluated in-person at Mayo's facility.

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