What procedures can be done?

[magicinjoel]

I am a 54 yr old male, who is a Respiratory Therapist. My problem started in the end of Nov. of 2008. I started having trouble sleeping on my back, difficulty breathing..felt like something on my chest. We to Dr.s and had tests done, heart is good, had a pft test done and it showed I had about 32% of ltc. The specialist and the staff of my hospital are baffled as to why. Had a sniff test done and it showed normal diaphragmatic movement. After some other testing, I was referred to the Univerasity of Michigan. I saw a Dr. there and she still thinks it has something to do with the diaphragm. After weeks of getting my insurance to approve an emg of my diaphragm at the Univerasity of Michigan. Which I had done yesterday 3/20/09, an the results showed the left diaphragm barely moving and the right diaphragm only working 50%, also it showed some damage to the thoracic nerve. The Dr. who did the test said there is usually pain associated when this occurs. I had none, My question is what procedures can they do for me? Is there surgery? Could it be a virus? What is a diaphragmatic plication?  Your reply is greatly appreicated.

[Sunny602]

I feel your frustration, it took quite awhile for docs to figure out what happened in my case as well. Actually, they still aren't sure, they have ideas but that is better than nothing. I have bilateral diaphragmatic weakness, I too had similar problems with breathing (docs actually treated me for asthma initially), wound up on O2, BiPAP and finally, the vent. I still am on the vent, but not nearly as full time.
Anyhow, as far as what docs can do for you....for breathing problems, maybe they could try BiPAP especially if you are short of breath and seem to tire out in that department. I know it made a world of difference in my case, at least for awhile until I totally tanked.
Diphragmatic plication is usually done on unilateral paralysis from what my doc told me, but I could be mistaken as so much has happened since my journey began. Diaphragmatic pacing is also something that is becoming more and more evolved from what my specialist in Boston told me. There has been some success in their trials for those who have bilateral diaphragmatic issues...might be worth looking into. I am actually being considered for the trial, so we will see. I know it would be lovely to come off this vent or only rely on it for a little bit.
Oh, plication is a surgical procedure that involves tacking down the affected side so that the floppy diaphragm leaf doesn't migrate up into the chest cavity upon inspiration. It stays put and therefore doesn't crowd the lungs, giving you better expansion.
Causes of nerve damage...yes, it could be a viral cause. My doc considered that with myself as well, they finally have chalked it up to being an autoimmune process, in other words, my body attacked its own tissue and nerve, thinking it was a foreign object.
I am not a doctor, just a former RN who has certainly seen her share of these type of problems. I hope you find answers, keep pushing for them and keep your chin up.
Sunny