I had open heart surgery on 4.1.04 for the replacement of my Tricuspid valve. I've had 3 previous replacement surgeries but this is the first time I experience "paralyzed diaphragm." I think it may be because I had to have 2 liters of fluid taken out of my left lung, but it's my right side of the diaphragm that is paralyzed. I don't know what else could've caused it. Any thoughts? Also I do feel that it has improved, but how much longer will it take, and how will I know when it's back to normal? When I first got out of the hospital I was unable to blow my nose because I couldn't inhale correctly, but now I can. It's now been 2 months and about 2 weeks. I'm on 3 liters of O2 24/7. I also still have a cough, shouldn't that be going away? I don't cough up much phlem anymore, it just feels like something is stuck in my throat. Will my diaphragm ever be "normal" again? I've never heard of "paralyzed diaphragm" after major surgery, is it common? How common, and is it easy to fix? If it doesn't get better in the 6 month window that the doctor gave me what happens? Will I need surgery? Is it complicating? I thank you so much for your help.
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 occur on its own. It can follow surgery, like you had to replace your tricuspid valve on 4/1/04. During the surgery the nerve may have been irritated or cut or damaged. If the nerve was just irritated by the surgery, over time your diaphragm may get better. The improvement that you have noticed may continue for 6 months after the surgery. After this time has passed then you will know if your diaphragm will be
Paralyzed diaphragm after open heart surgery is not common, but we hear about it. First, you need to know what makes the diaphragm work. And that is the Phrenic nerve. Its actually 2 very long nerves that start at the base of the brain, run down both sides of the neck, then down each side of the heart, into the thorax, and onto the diaphragm. There are several things that can cause conductive distruption of the phrenic nerve. The most common being trauma. This would be due to an inadvertant cut along the nerve. In most cases, this is perminant damage. Some other causes are vasculitis. another cause is from cold trauma. During open heart surgery, they will sometimes make the operating room VERY cold or even pour ice chips on the heart to slow down the beating. Over time, this can resolve.
In the meantime, I would advise seeing a pulmonologist to rule out any infections. Keep working on lung excercises like coughing and deep breathing. Also, diaphragmatic breathing is VERY important. If you dont know how to do this, lay flat on a bed and place a small book on your belly. When you inhale, make the book rise. When you exhale, make the ball fall. Try and keep your chest perfectly still. This type of breathing feels VERY akward and you may feel like you're not getting a deep enough breath. This is perfectly normal. With this excercise, you are stretching and excercising the diaphragm and expanding ONLY the lower portios of your lungs. THIS IS EXTREMEMLY IMPORTANT in diaphragmatic rehabilitation.
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