Plication

[MedicInTheAir]

I am a flight medic both in the military and on the civilian side.  

Any thoughts on how the plication of a unilateral paralyzed diaphragm would affect my ability to fly?

I am currently SOB upon exertion.  X-rays and CT scan show that I have a severe mediastinal shift to the right and about 60% of my normal lung capacity due to this shift and the elevation of my diaphragm.

Thanks!

[National Jewish]

For diaphragmatic paralysis, plication of the diaphragm is being done more in adults, with good results.  If you decide to have it done, insist that it be done by a thoracic surgeon who has had a lot of experience with the procedure.

After this surgery people have had less shortness of breath with increased lung and exercise capacity.  This is most likely to happen with a severe mediastinal shift and decrease in lung capacity, as you have described your condition.

[aadams]

I was in the hospital for diaphragmatic plication for two weeks in April, 2006.  I am not familiar with physical fitness standards for flight crew members.  But I assume shortness of breath associated with exertion would compromise your ability to remain on flight status.

To my experience, surgical plication would not make you any LESS able to function as a flight crew member.  In fact, this procedure may provide some degree of improvement in respiratory function.

The paralysis you describe is sometimes self correcting. My response to dsgksg on 09/22/2006, may be of interest.