diaphragm paralysis

[Grand Pa News]

My father is 82. He is on a ventilator. This is the second time within a four week period he has almost died because he cannot breathe.  The first time they discovered a systemic infection.  None of the doctors (cardiac, pulmonary, or neurology) can tell us why he cannot breathe. The cardiac and pulmonary doctors tell us that his heart and lungs seem fine.  The neurologist  do not see anything. His diaphragm is not functioning properly and so when he tries to breathe on his own his body begins to poison itself due to the high level of Co2  build up. Recently, his blood pressure drops to 60 unless regulated by medicine. ( pressure behind his heart was rated a 6)  My huge concern is that in January 2003 he had a pacemaker implanted. Since that operation we have noticed a steady deterioration in his health, increased fatigue, heaving, difficulty swallowing, severe back pain (directly behind the area of the pacemaker), falling down occasionally. Is there any sort of relationship between the pacemaker operation, the marked decline in health following the surgery, and now this “mysterious” illness keeping him on a ventilator? Could heart or blood pressure medicine play a role? We are desperate because we know his body changed after his pacemaker operation and we do not know why. He’s never been sick. Is there any possibility an infection could exist in the pacemaker and it is not being detected or that the surgery set off some pre-existing disease or that something was damaged in the surgery?

[National Jewish]

The phrenic nerve makes the diaphragm move so that the lungs can fill with air and empty.  Diaphragmatic paralysis is a condition where this nerve is not working properly.  In many instances the cause is never found.  It can follow chest surgery, like your father had when the pacemaker was implanted in January 2003.  It can occur on its own.  There could be something along the phrenic nerve’s path to the diaphragm causing the problem.  As an example the position of your father’s pacemaker may be keeping the nerve from working properly.  A CT scan may be helpful in seeing if this is the cause.  Since your father is 82 years old and recovering from an infection, the paralysis of one side of his diaphragm could make the ventilator necessary so he can get the carbon dioxide (CO2) out of his lungs.

It would be important to check with your father’s heart doctor to be sure there is no infection and the pacemaker is working properly.

[bdw]

A related discussion, treatment for diaphragm paralysis in an adult male was started.