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Suggest treatment for phrenic nerve injury

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Posted on Tue, 11 Nov 2014
Question: My husband has had a phrenic nerve injury as the result of open heart surgery to repair his mitral and tricuspid valves. His diaphragm shows on activity on the right side - only a little on the left side. Where do we go from here? The Dr that performed the EMG on the phrenic nerve said there is really nothing that can be done. We just have to wait to see if the nerves come back

His surgery was long - he was on the heart/lung machine for over 6 hours - he did have an issue with the placement of the lead into his heart to monitor his valve repair - so he had to go to the XXXXXXX lab to have it placed. He came out of surgery at about 3 in the afternoon, came off the ventilator the next morning - was only off it for a few hours - than had to be re intubated. He was on the ventilator the second time for almost 5 days. His lungs still show that the bottom half have not re-expanded. He is now on a bi-pap machine at night for some relief. He has to sleep in a sitting up position, becomes extremely short of breath with little activity, eating,...
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Answered by Dr. Muhammad Ali Rauf (4 hours later)
Brief Answer:
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Detailed Answer:
Hello

My name is Dr Muhammad Ali Rauf & i will look into your problem.

I have gone through you query and will be happy to assist you. Nerve injury in most of the cases is difficult to treat. On the other hand in some cases nerve regenerates itself with the passage of time to regain some of its function. Few trials have been carried out at high level reconstruction center where doctors tried to treat the injury and restored some functions but that to is in trial phase. One of the reconstruction unit is "Institute for Advanced Reconstruction in New Jersey" where doctors tried and achieved results. I would suggest you to contact them with all the documents you have and discuss the issue. They will then guide you in detail about the prognosis and further workup.

Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it. Wishing him good health !!
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Muhammad Ali Rauf (32 hours later)
What are the long term effects of not having the diaphragm working and the lower portion of the lungs not inflating?
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Answered by Dr. Muhammad Ali Rauf (1 hour later)
Brief Answer:
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Detailed Answer:
Hello

Thank You for writing back. Long term effects include:

a. Diaphragm

> Breathing Difficulty
> Difficulty in inspiring air which will cause decreased oxygen in blood
> As a result he will hyperventilate(increased breathing)
> Unable to do heavy/sternous activity
> Frequent shortness of breath spells

b. Lungs:

> Lower portion will gradually become decreased in size because of disuse atrophy. If remaining lung remains healthy then it will not cause prominent symptom.
> There will be increased chances of chest infection so he will be needing extra care.

Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you both good health !!
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Muhammad Ali Rauf

General & Family Physician

Practicing since :2013

Answered : 1313 Questions

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Suggest treatment for phrenic nerve injury

Brief Answer: Please see description Detailed Answer: Hello My name is Dr Muhammad Ali Rauf & i will look into your problem. I have gone through you query and will be happy to assist you. Nerve injury in most of the cases is difficult to treat. On the other hand in some cases nerve regenerates itself with the passage of time to regain some of its function. Few trials have been carried out at high level reconstruction center where doctors tried to treat the injury and restored some functions but that to is in trial phase. One of the reconstruction unit is "Institute for Advanced Reconstruction in New Jersey" where doctors tried and achieved results. I would suggest you to contact them with all the documents you have and discuss the issue. They will then guide you in detail about the prognosis and further workup. Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it. Wishing him good health !!