<s>[INST] On the right diaphragm is elevate and I took MRI and is look good. The sniff test the right diaphragm show very little downward movement if any. I was informed to see the Dr. in six months for oxygen level which now is 65%. and I was informed the my right phrenic nerve is damaged any suggestion [/INST] Thanks for your question on HCM. Diaphragm is very important muscle of respiration. Perhaps the strongest muscle. And it is supplied by single phrenic nerve.And poor movement of diaphragm is not always caused by phrenic nerve damage, but developmental defect of diaphragm can also cause this. Perhaps this is more common than phrenic nerve damage. Causes of poor hemi diaphragm movement are1. Developmental defect in either muscle or tendons. 2. Damage to unilateral phrenic nerve due to trauma, malignancy,  previous surgery, neuropathy,  snake bite etc.So better to consult pulmonologist and discuss all these. </s>