Don Bird's condition is rare and usual affects those who have had a lung or heart transplant when the phrenic nerve has been physically traumatized or as the result of a cervical (neck) injury when the nerve can be compressed, vehicle accidents (seat belt) and neck manipulation. In Don's case he had an operation when he was 17 to remove grade 4 melanoma cancer from Lymph nodes on right side of neck. This operation removed all Lymph nodes and muscle in neck area. Scarring from this has over the years tightened around nerve and this coupled with another event unexplained and unknown has then stopped signals to Diaphragm on the right side.
Further information on the role of the phrenic nerve can be found at: http://en.wikipedia.org/wiki/Phrenic_nerve
In Australia, phrenic nerve paralysis is treated in some cases with the installation of a 'pace-maker' style electronic impulse implant which can force the diaphragm to contract. This implant can improve lung function by 15%, but is not able to restore normal function. Another option, offered in NSW, is diaphragmatic placation which literally ties the diaphragm into place – thereby preventing abdominal organs impinging on the thorax, but also preventing the functioning of the diaphragm.
In the US, Dr Matthew Kaufman has pioneered phrenic nerve transplant. His criteria for surgery are strict and patients must be healthy and in a reasonable state of fitness for him to operate. Dr Kaufman is based at the Institute of Advanced Reconstruction in New Jersey (http://www.advancedreconstruction.com/tag/phrenic-nerve-injuries/). He has successfully treated around 20 patients with phrenic nerve paralysis, providing them with increased lung function that has enabled them to return to a normal and active life.
What happens if Don's condition is not treated?
Well, because of the movement of the abdominal organs into Don's thoracic cavity, his right lung cannot inflate. Its collapsed state makes it susceptible to infection and inflammation, so Don has suffered recurring bouts of pneumonia since the initial infection in August 2010. With winter upon us, Don will be in and out of hospital over the next few months, as the usual spat of winter colds does the rounds. But for Don, an infection means pneumonia and more scarring of his lungs. Eventually, the pneumonia will become untreatable.