The diaphragm is a thin sheet of muscle that separates the chest from the abdomen. Physiologically, it contracts to help with breathing as a major muscle of inspiration. When dysfunctional, it can be abnormally elevated, and associated with lung collapse and shortness of breath.
Common causes of diaphragmatic dysfunction include traumatic injury to the phrenic nerve, which controls the diaphragm, or the diaphragmatic muscle itself. Sometimes, the underlying cause is unclear, but the diaphragm is found to be elevated on imaging, particularly when lying flat. Patients can experience severe shortness of breath as a result of diaphragmatic dysfunction, especially when lying down or after strenuous exercise.
Surgery can significantly improve diaphragmatic dysfunction by flattening or ‘plicating’ the diaphragmatic muscle. Under direct vision, the excess tissue of the diaphragm is sutured and tied using a series of permanent sutures that keep the diaphragm flat. This will in most cases allow the underlying lung to re-expand and improve symptoms of shortness of breath. Professor Christopher Cao specializes in minimally invasive robotic diaphragmatic plication procedures, and performs one of the highest numbers of this procedure in Australasia.
My three year journey, or nightmare, began with a viral infection that triggered an additional autoimmune condition. Literally overnight I went from being a healthy 46-year-old, to being unable to breathe or to walk short distances without feeling short of breath. This feeling was distressing and scary given the quick deterioration of my condition. This was difficult for myself, and my family and work colleagues as they had to pick up the additional workload that I could no longer cover due to my shortness of breath. I also experienced fatigue and absent mindedness constantly throughout the three years of my illness.
It was discovered quite early on that I had a paralysed diaphragm through numerous scans and tests. Being from a small town, the doctors were great and referred me to a variety of specialists that they believed could help. However, due to the lack of knowledge of my condition given how rare it is, the doctors and specialists were unable to find a solution that could improve my quality of life. After three years of worsening symptoms, I visited a different GP who referred me to a specialist that knew Dr Cao. This was the turning point in my journey and the beginning of my recovery. Dr Cao was one of the only surgeons in Australia that had the skills and knowledge to offer a robotic diaphragmatic plication. This was such an easy process for me as the patient. There was always great communication and a very short wait time for the surgery. A surgery that would give me my life back.
The surgery was such a success that the moment I woke up I felt like I could breathe again, and that was the best feeling in the world. This is something I won’t take for granted again. The surgery was performed robotically, which was less invasive, therefore the pain throughout the recovery was minimal and I was able to get up and walking the next day. The recovery was quick and I didn’t need anything more than paracetamol after returning home.
I have since been able to start exercising and have returned to a normal life since the operation. I will be forever grateful to Dr Cao and his team for giving me this second chance to enjoy a full life.