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I Have an Elevated and Paralyzed Right Diaphragm (1 Viewer)

Johnny Angell

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If you were forced to have a condition that contained paralyzed in it's description, according to my experience, this is the one to pick. I am a runner (or was) and in late October of 2015 I started becoming unusually and extremely breathless. This seemed to happen overnight.

My primary care physician sent me to a cardiologist and within a week it was determined this did not involve my heart. That was the last thing that happened quickly in my search for a diagnosis. I think it was March of 2016 when it was determined my right diaphragm was raised (breath out position) and paralyzed. The phrenic nerve was damaged by something. Surgery in the area can damage it but I had had none. The default cause is then considered to be a virus of some sort.

Whatever the cause, it is permanent. There is no cure and it is not common so I doubt there is any research occurring. Besides, nerves typically don't come back to life. There is a surgery called Imbrication of Diaphragm. Think of the diaphragm as shaped like an arch as it crosses the thoracic cavity under it's lung. The surgeon puts pleats crossways into the diaphragm which shortens it which causes it to lower. This means it will no longer press up on the lung or least press up on it less. The lung will expand more and process more air.

I consulted with two surgeons, neither does this procedure using the laprascopic method. A rib will be removed and the others spread to gain access to the diaphragm. Then he puts in the pleats. Yes I'm having a tailor do the surgery. :) I will be in the hospital 5 days maybe more. I will have an epidural that will be feeding me kick-a-poo joy-juice while in the hospital and pain meds to take at home for another 1-2 weeks. Recuperation is 6 weeks and after that I imagine I will still be a bit slow for a while.

When my pulmonologist diagnosed me after he first diagnosed asthma, he briefly described the surgery and recommended I not get the surgery. He referred to to a surgeon to discuss it so I get get it out of my head. Dr. Burnett described what would happen, and not guarantee positive results, and said it's surgery, so it's a risk. He said if it was him (he's going to retire very soon), he wouldn't get the surgery. But, he added, I don't want what you want.

That last statement really gets to the heart of the matter. I don't want to be what I am now, a person who can't run, who gets breathless by being over, or gets breathless with just a bit of effort, for the rest of my left. At least not without trying to improve the situation.

From several sources I have heard that Dr. Burnett is one of the best thoracic surgeons in the South, not just this AR. A person my wife knows at work used to work in his office and comment he had a region wide reputation. My veterinarian (yeah, my vet) knows of him said he's the best. My primary care doc said that he's going to leave a void in the state when he retires. He also says I couldn't do better. My primary care doc told me this morning that he'd asked a heart surgeon who also has done the surgery, that some patients get significant improvement and some don't. I did consult with two surgeons and both were consistent in description, attitude, and prognosis.

At the start I kind of belittled this condition. That's because it's probably not going to shorten my life and I can still be active. If I wasn't a runner, maybe I wouldn't want the surgery. I want to run again, so I'm getting the surgery. It will be the 26th of May in Baptist Hospital in Little Rock.

Wish me luck.
 

Josh Steinberg

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Johnny - wishing you nothing but the best of luck. Please let us know how you're doing when you're able to.
 

David_B_K

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Wow, Johnny, that sounds like one of those surgical procedures that I am surprised to hear even exists. However, I doubt they would have come up with it if it wasn't needed. If it were me, I would have to be very confident in the doctors and hospital before I would do it. It sounds like you are, so I wish you the best!
 

Johnny Angell

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Wow, Johnny, that sounds like one of those surgical procedures that I am surprised to hear even exists. However, I doubt they would have come up with it if it wasn't needed. If it were me, I would have to be very confident in the doctors and hospital before I would do it. It sounds like you are, so I wish you the best!
Well, I was surprised that the condition existed. Then I surprised myself by choosing to have the surgery. My pulmonologist recommended against it, but after talking with the two surgeons it became evident that he didn't fully understand the surgery. He also thought it was so rarely done that I would have to go out of town for it.

Every time someone talks to be about Dr. Burnett, it's positive. No negatives. He also has more experience with the procedure than the other surgeon.

Thanks to all the well wishes. I've never used my iPhone to post on the HTF, so it's likely that starting with the 26th and until I come home, you won't here from me.
 

David_B_K

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Johnny, have you had surgery before? I have had 8 surgeries since 2002. I was quite nervous before the first one. After that one, they don't really scare me at all. I have actually become sort of blasé about having surgery now. One piece of advice I always give is this: don't worry if you cannot sleep the night before. You don't have to do anything the day of surgery except show up, and you won't be driving anyway. So, feel free to stay up late, watch TV, read, or do whatever relaxes you.
 

Johnny Angell

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Johnny, have you had surgery before? I have had 8 surgeries since 2002. I was quite nervous before the first one. After that one, they don't really scare me at all. I have actually become sort of blasé about having surgery now. One piece of advice I always give is this: don't worry if you cannot sleep the night before. You don't have to do anything the day of surgery except show up, and you won't be driving anyway. So, feel free to stay up late, watch TV, read, or do whatever relaxes you.
Lets, see...I've had two bunioneictomies, a procedure to remove kidney stones, gall bladder removal, and a procedure called a TURP to reduce the size of my prostate (biopsy showed no cancer). Only the TURP required an overnight in the hospital. This is all in the last 10 years. As you know, extra mileage vehicles require for maintenance. :P

Your advice about the night before is well advised. I shall follow it. My preference is to sleep a much as I can, but will be ok if I can't. I find my attitude is one of excitement and nervousness, the nervousness is at a moderate level. This will be the most invasive surgery I've ever had and will be the first time to stay in the hospital more than one night.
 

Clinton McClure

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Best wishes for a full and speedy recovery Johnny. I had my tonsils removed at Baptist when I was a kid, my brother had coronary angioplasty there seven or eight years ago (I don't know who did the surgery) and my wife had a hysterectomy there about five years ago. Good hospital. Like everyone else has said, keep us updated when you feel like it.
 

Dr Griffin

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Everything is going to be fine Johnny. I had a surgeon with a similar reputation perform spinal surgery on me 35 years ago and I never had another problem. Best wishes for a smooth recovery.
 

Dheiner

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Johnny, I wish you the best. May your surgery be uneventful, and your recovery brief and complete.
As a side-note, you might want to take a tablet in with you. I've found a Kindle type to be a great time eater while laid up.
 

ChristopherG

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Wishing you a speedy and full recovery. Btw - it's really easy to post to HTF from your iPhone. I'm doing it now from tapatalk. You can also do it from safari quite easily.
 

Johnny Angell

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Johnny, I wish you the best. May your surgery be uneventful, and your recovery brief and complete.
As a side-note, you might want to take a tablet in with you. I've found a Kindle type to be a great time eater while laid up.
I will have at least my Kindle.
Wishing you a speedy and full recovery. Btw - it's really easy to post to HTF from your iPhone. I'm doing it now from tapatalk. You can also do it from safari quite easily.
I plan on learning how to do it before the day arrives. I wonder if I can post pics to HTF using my iPhone?

Thanks for best wishes.
 

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