Phrenic nerve damage

[Chelle911]

I had an accidental severance of my superior vena cava during leadwire extraction. My phrenic nerve was damaged and the right diaphragm is paralyised. We are unsure if it is severed or damaged. I am very symtomatic with this. My general practioner says he believes a neurologist my be able to help. He does not know of any place that specializes in this. He referred me to the best neurologist he knows in this area. I am willing to travel anywhere to receive relief. Any suggestions?

Thank you for any help!
Michelle

[Abhijeet Deshmukh, MD]

Hello.

There is always a risk of damage to the phrenic nerve during mediastinal surgeries. What is more important now is to prevent further complications from paralysis of the diaphragm.

When one part of the diaphragm is paralyzed, the abdominal contents (organs) tend to push it easily upwards into the chest. This is especially when you are lying flat.

The paralyzed part can be surgically fixed so that the diaphragm is not pushed up. You will also have to take extra care of the respiratory system. There is going to be a reduced oxygen supply to some parts.

Regards

[Chelle911]

Thank you for your response!
Do you know anything about the phrenic nerve grafting? Pros? Cons? The new process of grafting without a thoracotomy? Nerve grafting for diaphragm paralysis verses plication? I am searching everywhere for a solution to my problem and would greatly appreciate your views on these procedures!
Thanks again!

[Abhijeet Deshmukh, MD]

Hello.

I am not sure if you found this article. They have reported a successful phrenic nerve grafting. This article also discusses the benefits over plication.

http://mmp.cjp.com/pipermail/openheart-l/2005-November/004495.html

Regards

[Chelle911]

Again, Thank you for your information! I read the information you directed me to, decided to have the nerve grafted, then the pulmonologist told me that this diaphramatic paralysis would not cause the oxygen drops, fluid in my lung, and pluerisy. He sent me back to the cardiologist for an echo. It showed 2 holes in my heart that was shunting a lot of blood. I then completed a TEE and was then told that I only have a PFO and he recommended nothing other than an aspirin a day. He suggested it was the phrenic nerve issue again.
I honestly believe the pluerisy is from the open heart surgery. I have a hard time healing bones. But this does not explain why at 7 months after surgery I am having oxygen level dropping on exertion and fluid in my lungs and shortness of breath. BTW...when I say exertion I mean walking across the room at a regular pace. Where do I go from here? Who do I ask to help me? I am 38. I should not be setting at home on oxygen!!! Please understand I am not asking you to diagnose but asking for a direction.

Thank you!
Chelle

[JOEY1943]

I AM HAVING A DIAPHRAMATIC PLICATION ON MONDAY 5/12 COULD YOU RELATE TO ME WHAT I SHOULD EXPECT. MY SURGEON AND PULMONOLUGIST HAS BEEN THOROUGH WITH INFORMATION BUT I THOUGHT YOU MIGHT BE ABLE TO TELL ME AN ACTUAL CASE AND WHAT TO EXPECT UNDER NORMAL CONDITIONS. I AM 65 YRS OLD AND 2/3 OF DIAPHRAM IS PARAYLIZED. MY GEN'L HEALTH IS NOT GREAT DUE TO CROHNS AND A SIGMOID COLOSTOMY AND COLECTOMY,WHICH I HAD IN 2004 AND 2005 I THEN HAD BLOCKAGE SURGERY IN 2005 AND EXPLORATORY BOWEL SURGERY IN JUNE OF 2006 AT THAT TIME THEY FOUND THE SMALL BOWEL WAS ATTACHED TO MY PELVIC BONE WHICH WAS SEPERATED WITHOUT DAMAGE ,I HAVE BEEN LEFT WITH CHRONIC LOWER ABDOMINAL PAIN I TAKE UP TO 14 30MG MSIR A DAY FOR ONE YEAR.