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biparadoxial diaphragmatic paralysis


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My name's Jared Brown, I've marched SW and Madison for a few years, and a few months ago I went to the doctor and got some interesting news. I posted this on the Scouts' forum a little while ago and am pasteing it here too to hopefully get a little more info about it:

so 2 weeks ago my right shoulder started hurting and I couldn't inhale more that 50 or 60% of my lung capacity or it started hurting a lot more. I figured I just slept funny, but I was still hurting over a week later so Thursday I went to the doctor. He moved my right arm around and concluded it wasn't my shoulder that was the problem. But when he listened to my breathing through my back with his stethoscope, he couldn't hear any breathing sounds coming from the lower part of my right lung.

After a stock x-ray and a real time x-ray thing (basically a video x-ray instead of just a picture) it showed that when I breathed, the right side of my diaphragm, the muscle below your lungs, didn't even budge. It's supposed to move up a few inches when you inhale, and back down when you exhale. Turns out that what I was mistaking for shoulder pain was actually upper lung pain (I'm not real sure why the upper part of my lung hurts instead of the bottom near the diaphragm; the doctor explained it, but I forgot what he said). Anyway, the doctor and the radiologist concluded that I have "diaphragmatic paralysis". The right side of my diaphragm is paralyzed, probably from an injury. I'm kinda rough on on my body with working out and Capoeira and, you know, drum corps and all, so it doesn't surprise me.

Now as most of you brass players know, your diaphragm is kind of important for proper breathing and playing. With only about 50% of my lung capacity it's kinda hard to play trumpet. There's no cure for paralysis yet, so I'm stuck with half of my lung capacity and a daily diet of four Motrin at each meal for the pain and inflammation.

My doctor said that he's only had two other patients ever have diaphragmatic paralysis, and the other two were elderly. Luckily, I'm getting my degree in chemistry, not trumpet performance, so my future career isn't in jeopardy, but my main hobby and passion is. So my question is, has anyone ever heard of this? Anyone here have it or ever know anyone with it?

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I don't know anything about your condition unfortunately but just wanted to leave a message saying thoughts are with you and hope everything turns out to be ok. Take care and best wishes/prayers!!!!

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Wow. My heart goes out to you dude. Are you marching this year/have you aged out? I wish you the best either way.

Just as long we're talking about odd performance related problems, I've heard of percussionists that develop huge problems by practicing too much. Not sure what it's actually called though.

Trumpet players often have bad eyesight because of the pressure of playing through a "pea shooter".

Then there's skin disease and back problems from carrying a horn/drum out in the sun for 10 hours a day...

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Jared. first the obvious. Take care of yourself. I know you thought that with all the healthy activity you've practiced over the years it couldn't happen like this but then ... Hey, I had a stroke in February and I'm still in the hospital recovering. Please take it from me, you've got to concentrate on yourself. And believe me all your Drum Corps brothers and sisters will be pulling for you.

BTW at 58 years old I can't wait to get out of here so I can continue my Capoeira as you might guess I am well past the time where I can negotiate the Aú but basics like ginga and corcorinha or negativa where I can keep my feet on the floor should be easy enough, still. I just hope to be able to play again and you should, too.

Take it easy but don't take it lightly.

Puppet

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ditto on taking care of yourself Jared. Hopefully he has given you some indication of how to improve your situation.

I am not a doctor, but -

I've seen this before, mostly on traumatic patients and especially on ones who have taken a strike either to the chest or the neck. The diaphragm is controlled by the Phrenic nerves which are rooted on both sides from the C3-5 (neck) spinal area - you indicate that you woke up with pain in the upper shoulder right side, and your paralysis is affecting the right side diaphragm. that could be significant, might indicate a localized problem with the root stem on that side only, and could hopefully indicate that this is a temporary situation. the pain could be from irritating the nerve (likely treatable), or it could be that your upper lung is working extra hard, also causing the discomfort.

I'd be curious to hear how you are doing with this. Remember, there is a reason they call it 'practicing' medicine....

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Try and Google it. I did and most of it is highly technical, but it might help you out. All the best.

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Wow, talk about a body blow. As a trumpet player I can sympathize with the prospect of suddenly not being able to play, at least not in the way you're used to. Here's hoping JohnZ's conjecture is correct and it turns out to be temporary. Sure sounds logical and reasonable. I'm no expert either, but FWIW, the body may find a way to compensate over time as well. Best wishes man.

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Yeah, buddy, deep sympathies, for the pain and the loss. It hurts to be told you can't do something that's a key part of you.

I'm not familiar with this condition. BUT... you've gotta take this one day at a time. Just because one doctor made this diagnosis and told you "there is no cure" does not mean that your life path has been set in cement. You don't know what the future holds. Consider consulting another specialist. There have to be some doctors who know a lot about this besides the one you saw. New medical treatments come along every day, and maybe there are promising treatments available outside the realm of traditional medicine.

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