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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@kcbarker

9 weeks ago I had 1/3 of my top right lung removed because of a spot on my lung. After surgery I was having a lot of trouble breathing. The doctor did a sniff test and found that my right diaphragm was not functioning. The doctor would do nothing and said I would have to wait 6 months and see if the diaphragm would start working on it’s own. Well I’m really struggling with this. Medicare won’t pay for me to have oxygen because my oxygen level has to be under 89% before they will give me a tank. I’m trying to do all the things that will supposedly help me but I still struggle for breath. Any suggestions on how I can help my situation?

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I really recommend you join the facebook page for people with paralyzed diaphragms. Fortunately I don't need supplemental oxygen with my left paralyzed diaphragm, but many of the people in that group do. They would share their tips on how they cope with breathing and dealing with Medicare and the insurance companies to get the oxygen supplies they desperately need. Most doctors don't know much about this rare condition, and I've learned so much about it and gotten amazing support from people there. Best wishes!

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@cindyhikes

I was diagnosed with paralyzed left hemi-diaphragm a few months ago. But it is likely something I've had for a very long time and been able to compensate enough until recent other health issues made it harder for me to breathe. (Long story)

It didn't take long for me to feel good about plication surgery. Recent studies/analyses point to secondary health risks such as strain on heart, etc. that I'm pretty sure have been impacting my life for years. Plication surgery is an especially good option now that robotic techniques are more common. But even the VATS minimally invasive plication surgery is safer and more effective than older "open" plication techniques.

Can you share with us other options you think are worth considering? And is there a reason you are choosing Cleveland Clinic (which is definitely a top tier medical facility)? I've been looking at the University of Utah which appears to be working on becoming a top tier robotic plication surgical center.

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The three main ways to treat paralyzed diaphragms are plication, nerve graft, and diaphragm pacing. I don't know anything about the center at the University of Utah doing plications, which is why I would go to a center like the Diaphragm Center at Columbia Medical Center in NY, the Cleveland Clinic or the Mayo Clinic, where doctors have decades of experience doing successful plication surgeries. The Utah Center says it has 100% success rate. What does that even mean? No one died? I know there are dozens of qualified skilled thoracic surgeons around the country doing plications, and I'm sure some of them are at the University of Utah. If I had the option, though, I would go to one of the three places listed above.

As I'm sure you know, there are two main ways plication surgeries are done: a full thoracotomy where the surgeon opens your chest cavity or minimally invasive VATs surgery with robots. I asked my prospective thoracic surgeon who diagnosed my PD and specializes in minimally invasive thoracic surgery if he could guarantee he would do my plication using minimally invasive techniques, and he said he could not. He would decide once he started the operation how he would proceed depending on how well he could see. Scar tissue seems to be a big issue impacting plication surgeries. I only mention this because I think patients who want plication surgery assume they can have it done with minimally invasive techniques, where this might not be the case. It is definitely something to ask your thoracic surgeon about. Best wishes as you figure out your next steps!

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I’m thinking about contacting Dr. Kaufman in NJ to have my paralyzed Diaphragm repaired. According to what I’m reading he has a 80 to 90% success rate. I really don’t want to wait 6 months to see if the Diaphragm will come back. It looks from what I’ve been reading it is not very likely to come back, even my pulmonary doctor was not encouraging, he told me not to expect it to come back. So which is better or safer? The Plication surgery or the Diaphragm repair surgery? My insurance is going to be a problem also because some doctors won’t take my supplementary insurance, only Medicare.

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@kcbarker

I’m thinking about contacting Dr. Kaufman in NJ to have my paralyzed Diaphragm repaired. According to what I’m reading he has a 80 to 90% success rate. I really don’t want to wait 6 months to see if the Diaphragm will come back. It looks from what I’ve been reading it is not very likely to come back, even my pulmonary doctor was not encouraging, he told me not to expect it to come back. So which is better or safer? The Plication surgery or the Diaphragm repair surgery? My insurance is going to be a problem also because some doctors won’t take my supplementary insurance, only Medicare.

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My understanding of what Dr. Kaufman is most known for is a nerve graph. He takes a functioning nerve from your calf and grafts it onto the nonfunctioning phrenic nerve. If the graft takes, the renewed phrenic nerve will start working, which means the diaphragm will start working again. From what I understand, he has an age limit and doesn't accept patients over 67, I think it is, for doing the nerve graft. He probably does other procedures too. You can contact his office to find out more information. Every surgery is risky, which is why it's important to find the best most experienced surgeon and facility you can. Best wishes as you figure out your next steps!

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