phrenic nerve paralysis exercises

[dyspnicindenver]

Hello im hoping to get some help with some muscle training techniques. Ive been two years now since an acute phrenic nerve and diaphragm paralysis. confirmed via an EMG and treated with a nocturnal Bi-Pap. when i have upper respiratory symptoms i use the bipap with a moutpiece to assist couph aND clearance.
My question is; What exercises and muscle conditioning can i do to increase my lung capacity and quality of life??
The etiology of this condition is unknown though im a life long insulin diabetic thanx Mike

[JoieB]

I also would like to know anything about exercise or any natural remedy to a possible phrenic nerve damage.  Also, has anyone experienced early morning headaches with this problem?  I suffer every morning from 3:00am on, until I get up, they are quite severe and go away slowly when I am in an upright position.  My chest x-ray shows the right hemidiaphragm elevated with eventration.  I'm scheduled for a "sniff test" in 2 weeks along with an exercise test to check the diaphragm.  Is there any info on these horrible headaches or a way to 'exercise' them away?

[dyspnicindenver]

Thanks for your response, of course ive seen a few physicians about this!! I was actually seeking physical conditioning exercises to help to improve my quality of life! I do already know about electical stimulation etc. I just want to know about PHYSICAL stuff i can do to help! Im not ventilated and hope never to be ,a few pounds lost would also help... MIKE

[National Jewish]

The cause of diaphragmatic paralysis is, unfortunately, often not determined.  Respiratory muscle strengthening exercises have not been very helpful.  There has, however, been much interest in electrical diaphragmatic and intercostal muscle pacing, in recent years.  This is a very specialized area.  The best advice we can give would be to contact your nearest hospital for persons with spinal cord injuries and/or your nearest university medical center.  One or more of these techniques may help your situation.

[dyspnicindenver]

Thank you very much for your interest in my case!!
By the way are you a medical professional??
Specifically what i was looking for .IS... as with copd'ers whome use accesory muscles in their upper extremitys when they breath, is there any kind of muscle training and or breathing exercises that may help to expand my volumes??? Ive been doing free weights for the upper extremity and it seems to help some.. My doctor doesnt think pulmonary flows and volumes would be of any use but im going to get a few measurements for a baseline anyway to see whats up and if there is improvement after conditioning... Thanks Mike

[HappyNeige]

If the phrenic nerve is completely paralyzed, you would have no have to voluntarily control the diaphragm and I doubt if any particular breathing exercise will help.  A couple of things can be done about the paralyzed diaphragm, 1) surgical plication of the diaphragm (the diaphragm is sewn down to allow the lung to expand and may improve lung capacity.) and 2) diaphragm pacing. (just like a pacemaker for the heart.)

It is quite difficult to find an expert who does diaphragm pacing and I heard it can be very uncomfortable, if not painful when the diaphragm is 'paced'.  I know of a couple of people who went for the surgical plication and did get some relief after the surgery.  Ask your doctor about more information on this procedure.  It is not a procedure without risk and it is best that your doctor help you decide whether it is right for you.

Good luck,
HappyNeige...

[HappyNeige]

I do have medical background but would like to be discreet about the details. :)  Thanks for asking, though.

I don't think there is any harm in doing arm exercise to improve strength and endurance.  Most indeed believe that with stronger arms, COPD patients may use the muscles around the shoulder blades to improve their lung volumes.  Much less is known for one-sided diaphragm paralysis.  As for the respiratory muscle training, there are 2 ways to do it, one is to hyperventilate and the other is to breathe against resistance at the mouth level.  Both exercises should be done under supervision of the health professionals.  (Usually in the field of pulmonary rehabilitation.)  Again, I am not certain whether these exercises will improve your lung function significantly but they should improve some overall endurance.

Discuss with your doctor about pulmonary rehabilitation program.  Most programs offer arms/leg/respiratory muscles exercises to increase strength and endurance.  They also offer other psycho-social support and it is a good venue to socialize with others with lung diseases.  So you know you're not alone and sometimes the folks have incredibly useful tips to share.

Good luck,
HappyNeige...