Elevated diaphragm causing COPD type symptoms

Posted by bill5 @bill5, Mar 17 8:27pm

I recently had a upper esophageal barium test as my Dr. thought from chest X-rays it looked like my diaphragm was compressing my left lung. The photos from the barium test did show a highly elevated diaphragm. My Dr. is discussing with a surgeon about the possibility of surgically lowering it. The only possibility that I can think of that might of caused this problem, would be related to a auto accident 20 odd years ago. Has anyone else on Connect possibly been diagnosed with similar?

@bill5 20 years ago is a long time ago. May I ask what your provider said regarding typical reasons one has an elevated diaphragm?

It makes sense that you want to find answers. Members @dominodad @nla4625 @jenniferhunter @annierae have discussed an elevated diaphragm and members @juy77 @saigurucharan @mariab @itsnotanxiety @yaramarthe @itsnotanxiety @mcno have been active members in the Lung Health group recently.

May I ask what symptoms your diaphragm compressing on your lung causes?

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@bill5 Don't rush into surgery. You might want to try physical therapy. Surgery will create scar tissue that gets tight and it can make it worse. My experience is in having thoracic outlet syndrome and a cervical spine problem that did have surgical correction. I had a whiplash in a traffic accident years ago. When your body is injured, you start guarding to protect yourself which causes tightness and becomes a pattern. You may want to look at our discussion on myofascial release. My diaphragm gets tight and my physical therapist releases it and that helps me breathe better. It may be that you would need to work at therapy with myofascial release for awhile before you would see results because you will be loosening layers of tight tissue to get to the next layer. You can have tightness that extends through your entire body. I periodically have to release tightness from my surgical scar and then I can move better. Here is a link to our discussion and there is a provider search on the myofascialrelease.com website. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/ There are also physical therapists who specialize in lung function.

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@erikas

@bill5 20 years ago is a long time ago. May I ask what your provider said regarding typical reasons one has an elevated diaphragm?

It makes sense that you want to find answers. Members @dominodad @nla4625 @jenniferhunter @annierae have discussed an elevated diaphragm and members @juy77 @saigurucharan @mariab @itsnotanxiety @yaramarthe @itsnotanxiety @mcno have been active members in the Lung Health group recently.

May I ask what symptoms your diaphragm compressing on your lung causes?

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I have
COPD type symptoms, shortness of breath, oxygen therapy, just don’t have the lung volume I should. For some time, Drs. have said my left lungs lower lobes were showing little to no activity or movement. I kept prodding Drs. and recently they requested the barium swallow test, this revealed a raised diaphragm, compressing the left lung. The next step is to do a upper GI endoscopic search. Scheduling has that placed out six weeks. I am open to any suggestions, have idiopathic neuropathy also, so suffer multiple directions. There are no outstanding neurologists in my area, have foot pain, causing me difficulty walking. With the lung issues, it has affected my life dramatically, I am a rancher, live alone. Makes life painful, emotional, saddening.

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@jenniferhunter

@bill5 Don't rush into surgery. You might want to try physical therapy. Surgery will create scar tissue that gets tight and it can make it worse. My experience is in having thoracic outlet syndrome and a cervical spine problem that did have surgical correction. I had a whiplash in a traffic accident years ago. When your body is injured, you start guarding to protect yourself which causes tightness and becomes a pattern. You may want to look at our discussion on myofascial release. My diaphragm gets tight and my physical therapist releases it and that helps me breathe better. It may be that you would need to work at therapy with myofascial release for awhile before you would see results because you will be loosening layers of tight tissue to get to the next layer. You can have tightness that extends through your entire body. I periodically have to release tightness from my surgical scar and then I can move better. Here is a link to our discussion and there is a provider search on the myofascialrelease.com website. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/ There are also physical therapists who specialize in lung function.

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Done some digging on MFR therapists in my area, the nearest is 275 miles away! Will speak to my local PT and see if she has any input on MFR.

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@bill5

I have
COPD type symptoms, shortness of breath, oxygen therapy, just don’t have the lung volume I should. For some time, Drs. have said my left lungs lower lobes were showing little to no activity or movement. I kept prodding Drs. and recently they requested the barium swallow test, this revealed a raised diaphragm, compressing the left lung. The next step is to do a upper GI endoscopic search. Scheduling has that placed out six weeks. I am open to any suggestions, have idiopathic neuropathy also, so suffer multiple directions. There are no outstanding neurologists in my area, have foot pain, causing me difficulty walking. With the lung issues, it has affected my life dramatically, I am a rancher, live alone. Makes life painful, emotional, saddening.

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@bill5 I have had an issue where my chest tightness keeps my left lung from moving enough and it created an issue where I was trapping phlegm and that would progress to a lung infection and this pattern kept repeating. I have allergies and asthma which adds to mucous production. What I could suggest as therapeutic stretching would be to try to side bend both directions and hold that as you can tolerate it, and also arch your back which you can do laying on your back over something like the padded arm on a couch. Most of what we do involves forward bending and bad slouching posture and all of that affects how much the lungs can move. I own a horse and rehabbed after cervical spine surgery by trail riding and doing it with good upright posture. Doing that built core strength and will also move the chest with every step of the horse. I don't know if that is something you can do, but all the therapeutic riding centers help patients because you have to move in concert with the hip movements of the horse. Some of what they have at my physical therapist's office is a power plate which is a platform that vibrates. This helps loosen the fascia and stretching on that while it vibrates helps get things unstuck. You could do something similar on your own by stretching and using a back massager together. You don't need to travel for that.

I understand how much lung issues shut down your health and energy, but the key is getting back to being able to move to improve lung function. Keep looking for a good physical therapist. A manual therapist can release the diaphragm. I know from my own issues that I have tightness that extends from my neck and shoulders through my chest wall and to my pelvis which is enough to pull one side of the pelvis forward. This happens also when hip flexor muscles are too tight and that happens from sitting too much. You can use a hard ball and put it just inside the hip bone (illium) and while standing press up against a door frame and hold it, pressing to get the tightness to release. If you can lay on your stomach, you can put a small ball inside each hip bone and lay on that. I have to keep working on that myself because I'm rehabbing from an ankle fracture and because I had to sit too much and could not bear weight for months, my hip flexors got too tight. That will affect your breathing. If you try these small changes and notice a little improvement, you'll know you are on the right track. These ideas are all things that my own PT has suggested for me.

A lot of times, physical therapy is the best medicine. Surgery will create tightness with scar tissue and that could very well make things worse and further restrict movement. Make sure to ask questions about this. I know this is frustrating, but give some of this a try if you can. The body really does have the ability to heal if you can get back to better mechanics. Injuries change things and you start guarding because of them and soon you find yourself locked in a pattern and can't move. Myofascial release is about breaking that a pattern and there is a lot you can do to self treat like laying on balls. There are a few books that show different ways to stretch and things that help like foam rollers, arc barrel (to stretch backward), devices to stretch the back of your calves, etc. Look on the myofascialrelease.com website.

Also think about how nerves travel through some very small spaces and having overly tight muscle and tissues compress nerves and that could be causing neuropathy. If it is a physical issue, physical therapy might help. The nerves that service the lungs exit the spine in the neck and travel down through the chest. If your chest is too tight, it may be compromising those nerves and if they are decompressed by stretching out tight tissue, they might be able to function better. There are some patients with paralyzed diaphrams because of problems with the phrenic nerve. There is also a surgeon who does nerve transfer surgery to replace the phrenic nerve. I'm not suggesting this describes your case, but a lot of doctors don't know about this procedure and you have to ask questions about why your lungs don't move properly. Some neuropathy can be helped with supplements. It depends on the cause.

Don't give up! Set a goal for yourself and see what you can do to help yourself. Remember to stay well hydrated. Tight tissues store waste products of metabolism and stretching releases those, so you need water to help the kidneys clear that from your body. The tight fascia in the body is dehydrated tissue and you'll help by getting it re-hydrated and functioning better. @johnbishop can also help with understanding neuropathy and you might check out some of those discussions.

I can also suggest that traveling to be able to see good specialists might be a good thing. I did that myself when I could not find local surgeons who would help me with my spine problem and I drove 5 hours to get to Mayo. It made all the difference in my life. Research who the good ones are, and make your decision on what you think is best for you. You can also travel for intensive sessions of myofascial release work. The clinics owned by John Barnes do this. The MFR website is his and he created this treatment protocol and his people train and certify physical therapist in these treatments. It is pricey, but that is an option, and it may not be covered by health insurance.

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@bill5

I have
COPD type symptoms, shortness of breath, oxygen therapy, just don’t have the lung volume I should. For some time, Drs. have said my left lungs lower lobes were showing little to no activity or movement. I kept prodding Drs. and recently they requested the barium swallow test, this revealed a raised diaphragm, compressing the left lung. The next step is to do a upper GI endoscopic search. Scheduling has that placed out six weeks. I am open to any suggestions, have idiopathic neuropathy also, so suffer multiple directions. There are no outstanding neurologists in my area, have foot pain, causing me difficulty walking. With the lung issues, it has affected my life dramatically, I am a rancher, live alone. Makes life painful, emotional, saddening.

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@bill5 – I have idiopathic small fiber peripheral neuropathy also but no pain, just the numbness. One thing I think that is really important was mentioned by @jenniferhunter, that is the need to stay hydrated. I try to drink an average of 64 oz of water daily although I sometimes miss the mark. Another thing that I have focused on is keeping my legs and feet moisturized with a skin lotion daily. I usually put lotion on my feet and legs in the evening. This is because the nerves are close to the skin and dry skin makes it worse. Some people have found that a magnesium lotion is calming. I've used Life-Flo brand but I think any good skin moisturizer will help.

You may find the following discussion helpful – Member Neuropathy Journey Stories: What's Yours?: https://connect.mayoclinic.org/discussion/member-neuoropathy-journey-stories-whats-yours/

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@bill5

I have
COPD type symptoms, shortness of breath, oxygen therapy, just don’t have the lung volume I should. For some time, Drs. have said my left lungs lower lobes were showing little to no activity or movement. I kept prodding Drs. and recently they requested the barium swallow test, this revealed a raised diaphragm, compressing the left lung. The next step is to do a upper GI endoscopic search. Scheduling has that placed out six weeks. I am open to any suggestions, have idiopathic neuropathy also, so suffer multiple directions. There are no outstanding neurologists in my area, have foot pain, causing me difficulty walking. With the lung issues, it has affected my life dramatically, I am a rancher, live alone. Makes life painful, emotional, saddening.

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@bill5 i was diagnosed with a paralyzed left diaphragm last fall and couldn't tell from your posts if that was your diagnosis. I went to the ER because I thought I was having a heart attack and had a lot of tests, etc. My symptoms were chest pain, breathlessness after climbing a flight of stairs, fatigue and no stamina. An x-ray showed my left lung was elevated. After a short stay in the hospital and several more tests, including a "sniff test" to see if the nerve that controls the diaphragm was functioning, I received the diagnosis. It wasn't working, and I had a paralyzed diaphragm. Did you have a "sniff test" — maybe that was the barium swallow test? The thoracic surgeon I ended up being referred to wanted to schedule plication surgery right away, where he would use a robot to sew pleats across my diaphragm to keep it in place and keep my other organs from floating up into my chest cavity. He told me the condition was not life threatening and people could live with it. I'm doing breathing exercises and building up my stamina and hope to avoid needing surgery. I think I got really lucky with the medical care I received from literally walking in off the street and hope you have the confidence in your doctors that I have in mine. It's pretty scary when you can't breathe properly, are dealing with other medical issues, live alone, and can't do everything that needs doing on your ranch. I hope you have people to help you! Is the doctor who recommended and would be doing your surgery a thoracic surgeon? How many of these surgeries has he done? Why does he think you need surgery? I'm sorry if you explained this before, I might have missed a previous post of two. I didn't have an endoscopy so think you must have something different from what I have. I'm really sorry for all you're going through. Since you're dealing with at least two major medical issues, would it be possible to go to a major medical center like the Mayo Clinic to get treatment for both? Please take care…and I hope you'll find out more after the endoscopy. Nancy

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@bill5

I have
COPD type symptoms, shortness of breath, oxygen therapy, just don’t have the lung volume I should. For some time, Drs. have said my left lungs lower lobes were showing little to no activity or movement. I kept prodding Drs. and recently they requested the barium swallow test, this revealed a raised diaphragm, compressing the left lung. The next step is to do a upper GI endoscopic search. Scheduling has that placed out six weeks. I am open to any suggestions, have idiopathic neuropathy also, so suffer multiple directions. There are no outstanding neurologists in my area, have foot pain, causing me difficulty walking. With the lung issues, it has affected my life dramatically, I am a rancher, live alone. Makes life painful, emotional, saddening.

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@bill5– Good morning. My heart goes out to you. I can't imagine having these problems and being a rancher. I hope that you have help! Is there a chance that you might consider going to another city or state for treatment? It could change your life back to being pretty good!

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@nla4625

@bill5 i was diagnosed with a paralyzed left diaphragm last fall and couldn't tell from your posts if that was your diagnosis. I went to the ER because I thought I was having a heart attack and had a lot of tests, etc. My symptoms were chest pain, breathlessness after climbing a flight of stairs, fatigue and no stamina. An x-ray showed my left lung was elevated. After a short stay in the hospital and several more tests, including a "sniff test" to see if the nerve that controls the diaphragm was functioning, I received the diagnosis. It wasn't working, and I had a paralyzed diaphragm. Did you have a "sniff test" — maybe that was the barium swallow test? The thoracic surgeon I ended up being referred to wanted to schedule plication surgery right away, where he would use a robot to sew pleats across my diaphragm to keep it in place and keep my other organs from floating up into my chest cavity. He told me the condition was not life threatening and people could live with it. I'm doing breathing exercises and building up my stamina and hope to avoid needing surgery. I think I got really lucky with the medical care I received from literally walking in off the street and hope you have the confidence in your doctors that I have in mine. It's pretty scary when you can't breathe properly, are dealing with other medical issues, live alone, and can't do everything that needs doing on your ranch. I hope you have people to help you! Is the doctor who recommended and would be doing your surgery a thoracic surgeon? How many of these surgeries has he done? Why does he think you need surgery? I'm sorry if you explained this before, I might have missed a previous post of two. I didn't have an endoscopy so think you must have something different from what I have. I'm really sorry for all you're going through. Since you're dealing with at least two major medical issues, would it be possible to go to a major medical center like the Mayo Clinic to get treatment for both? Please take care…and I hope you'll find out more after the endoscopy. Nancy

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@bill5 I hope I wasn't being too inquisitive or didn't come across too strongly in my previous post. If you do have a paralyzed diaphragm, from what I read it is rare, so not many surgeons have had a lot of experience operating on it. I'm just concerned you get to an expert who knows what he/she is doing. I ended up in the capable hands of the chief thoracic surgeon in a major university medical center who specializes in minimally invasive surgery using robots who has done several plication surgeries. If you read through the thread under lung conditions on "paralyzed diaphragms", one of the posters had a really bad outcome that resulted in him being in pain every day and did not recommend plication surgery unless it was absolutely necessary. I don't know when he had the surgery or if they did his surgery with robots and "minimally invasive surgery", which they are now doing. If you can't travel to a major medical center before you make any decision regarding surgery, I really encourage you to seek a second opinion via video conference from a pulmonologist or thoracic surgeon at Mayo or another big medical center. I think your primary care physician has to refer you to the pulmonary department at Mayo to request a consultation but am not positive. After I get my second Covid shot, I'm going to make an appointment with a fascia expert to try the manipulation Jennifer Hunter recommended to see if that helps me. Anyway, you have people here concerned about you wishing you well in more ways than one. Nancy

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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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Hi Kevin — I'm sorry you're going through this. In addition to the tests scheduled, I'd really recommend a test called EMG which tests to see if the phrenic nerve is working at all and scheduling a visit with a neurologist. My thoracic surgeon didn't do this test as part of diagnosing my paralyzed diaphragm, but I'm going to request it if/when I decide to have plication surgery. It sounds like a pretty tricky test that takes a skilled technician to administer, but I'm sure you could find one. If the nerve is working at all, you have a couple of options on how to proceed. Several people on the facebook paralyzed diaphragm group have mentioned the correlation between viruses — and vaccines which I guess contain viruses? — damage to the phrenic nerve, and a paralyzed diaphragm, so I think there is something to it. Most people look at a paralyzed diaphragm as a breathing/lung issue; but it's being caused by a problem with the phrenic nerve, so it's a neurological issue as well. If the nerve is just damaged, which the neurologist can hopefully tell you, there is a possibility it will heal itself over time…which others in the facebook
group have also experienced…and give you options like diaphragm pacing to kickstart your diaphragm into working again. Please keep us posted on how things go…Nancy

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@nla4625

Hi Kevin — I'm sorry you're going through this. In addition to the tests scheduled, I'd really recommend a test called EMG which tests to see if the phrenic nerve is working at all and scheduling a visit with a neurologist. My thoracic surgeon didn't do this test as part of diagnosing my paralyzed diaphragm, but I'm going to request it if/when I decide to have plication surgery. It sounds like a pretty tricky test that takes a skilled technician to administer, but I'm sure you could find one. If the nerve is working at all, you have a couple of options on how to proceed. Several people on the facebook paralyzed diaphragm group have mentioned the correlation between viruses — and vaccines which I guess contain viruses? — damage to the phrenic nerve, and a paralyzed diaphragm, so I think there is something to it. Most people look at a paralyzed diaphragm as a breathing/lung issue; but it's being caused by a problem with the phrenic nerve, so it's a neurological issue as well. If the nerve is just damaged, which the neurologist can hopefully tell you, there is a possibility it will heal itself over time…which others in the facebook
group have also experienced…and give you options like diaphragm pacing to kickstart your diaphragm into working again. Please keep us posted on how things go…Nancy

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Hi Nancy,
Thanks so much for your feedback. Yes, I'll talk to my pulmonary doctor about the EMG test. She already made an appointment with a local hospital for me to have a "sniff test" and a CT scan on July 6. On the Pulmonary Care Plan she also wrote "Pulmonary Function Test" and "Diaphragm test" but she didn't order them yet.
It's likely that the vaccine caused damages to my phrenic nerve and they affect the diaphragm's functions, but there is another possibility : 2 years ago I fell off a 6 feet ladder and hurt my left rib section. Yesterday I watched a video about "Paralyzed Diaphragm" and a surgeon said that sometimes a fall might cause a tiny crack in the diaphragm then months or years later it widened and allowed part of the stomach or other organs to squeeze thru the crack and partially blocked the diaphragm's movement.
He said that sometimes he had to operate to pull back these organs and fix the hole in the diaphragm. One scary thing he said was : "it's a very risky operation, the mortality rate for those kind of operations is 50%".
I'm a new patient so I still have a lot to learn about "Elevated Lung Diaphragm" and "Paralyzed Diaphragm", but I hope that there will be other alternatives to correct the problem (such as drugs, diet, breathing techniques, physical therapies) so I don't need to go through risky medical operations.
BTW, you also said that : "diaphragm pacing to kickstart your diaphragm into working again". What is "diaphragm pacing" ?
Thanks.
Kevin

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