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A Breath of Fresh Air:
Lung Transplant Recipient Feels BlessedAt age 68, Robert Wehrly never imagined that he would be able to restore old houses. Nor did he imagine he would be promoting organ donation to the public, or running and swimming in the biannual U.S. Transplant Games. In fact, Robert never imagined being able to do anything.
Robert, now retired, ran his own contracting business for 30 years. He and his wife, Judy, live on a 20-acre farm in Burlington, Wisconsin. They have seven children, all of whom have worked in the business at various times.
At age 40, Robert was diagnosed with chronic obstructive pulmonary disease (COPD), a term that describes two lung diseases, chronic bronchitis and emphysema. COPD is characterized by obstructed airflow that interferes with normal breathing.
Robert’s emphysema was caused by smoking, which accounts for 80 percent to 90 percent of COPD cases. At his doctor’s urging and with the help of his wife, he was able to quit. But once a person develops COPD, the disease is irreversible and continues to progress.
Emphysema develops gradually and affects the air sacs, which become thin and fragile. The lungs become less able to transfer oxygen to the blood, leading to shortness of breath. The lungs also lose their elasticity, which is needed to keep the airways open. Most people with advanced COPD need supplemental oxygen.
When Robert was diagnosed, his lung capacity was 42 percent. Normal values for lung function are based on a person’s age, height, ethnicity, and sex. A value is usually considered abnormal if it is less than 80 percent of the predicted value for that person. For people with COPD, a less than 70 percent obstruction of lung function is considered mild, and less than 35 percent obstruction is considered severe.
As time passed, Robert found it increasingly difficult to work. “One day, after carrying shingles up to a roof, I was really short of breath and had to stop and rest,” he recalled. Under the care of a local pulmonologist, he was taking up to 55 pills a day.
“COPD is a progressive disease, and I could tell it was getting worse,” Robert said. “I was getting pneumonia more often — at least two or three times a year.”
Robert started using supplemental oxygen. In order to do minor chores on the farm, he breathed through a 150-foot-long hose connected to an oxygen tank in his house. “I was at a point where life wasn’t worth living; my quality of life was gone. I was sucking on an oxygen bottle all of the time,” he said.
Robert’s physician had referred him to an out-of-state healthcare facility to monitor the progress of his disease. He learned that he wasn’t a viable candidate for lung reduction surgery because the disease was prevalent throughout his lungs. (Lung volume reduction surgery aims to remove the least functional part of the lungs in order to improve airflow.) At 55, Robert inquired about a lung transplant at the facility, but was told that he was not considered a good candidate. “I thought, I’ll just do the best I can,” he said.
A lung transplant is usually the last resort treatment for people with lung failure. According to the American Lung Association, about 3,500 people in the United States waited for a lung transplant in 2005, but only 1,000 of them received a transplant.
A Friendly ReferralA friend of Robert’s, whose son had a double lung transplant at Froedtert & the Medical College of Wisconsin, suggested that he talk to the lung transplant coordinator at the campus. At age 59, Robert contacted the coordinator, who arranged for him to come to the Pulmonology Clinic at Froedtert & the Medical College of Wisconsin for testing.
In the clinic, Robert came under the care of Medical College of Wisconsin pulmonologist Stephen Dolan, MD. Dr. Dolan also specializes in critical care medicine. Robert also saw Medical College of Wiscosin pulmonologist and critical care specialist Kenneth Presberg, MD. “I’ve been blessed with some very nice physicians. I’m here today because of them,” Robert said.
“In addition to having severe COPD, Robert was also afflicted with microbacterium avian complex, a slowly progressive infection that is very difficult to eradicate,” Dr. Dolan said. “This is a fairly common complication of severe obstructive lung disease.”
Following weeks of extensive testing, Robert was determined to be a good candidate for a lung transplant, and was placed on the Wisconsin Donor Network transplant list. “The average waiting time for new lungs is 720 days,” Dr. Dolan said. “Because of this, we need to identify patients who can live at least two years even though they are in respiratory failure.”
Robert was lucky. After seven months, he got the call that donor lungs were available. “I got to the hospital in one hour,” he said.
In any type of organ transplant, the donor tissue must be matched as closely as possible to that of the recipient to reduce the odds that the transplanted tissue will be rejected. Fortunately, the lungs were a good match for Robert.
Once a candidate is chosen, time is critical. The lung must be transplanted into the patient receiving the organ within four to six hours. Depending on the recipient’s need, a single or double lung transplant may be performed.
On January 8, 2001, Robert received two lungs during a 10-hour surgery performed by Medical College of Wisconsin cardiothoracic surgeon George Haasler, MD. “Because Robert had an underlying lung infection, he needed two new lungs vs. one,” Dr. Dolan said. “If he received just one lung, the infection from the remaining infected lung would have spread throughout his body.”
Robert spent the next seven weeks in the hospital, followed by care at home with a visiting nurse and a physical therapist.
Robert’s new lungs came from a 61-year-old woman, a fact that Robert wants to emphasize. “Many people think they’re too old to donate their organs, but they may not be,” he said. “Everyone should sign the back of their driver’s license and inform their families that they wish to be organ donors.”
Because the body’s immune system considers the transplanted organ as an invader, and may attack it, Robert needs to take anti-rejection medication for the rest of his life. The medication suppresses the body's immune response to reduce the chance of rejection. He also continues to see Dr. Dolan for follow-up visits.
“He’s done very well in managing his health post-transplant,” Dr. Dolan said. “He follows his homecare regimen, takes his medications and keeps his follow-up appointments. He’s had an excellent quality of life in the last few years and can do many things he couldn’t do before.”
As “payback” for his good fortune, Robert eagerly promotes organ donation through the Wisconsin Donor Network at trade shows and the Wisconsin State Fair. “I’ve been so blessed. Without the transplant, I would be sucking on an oxygen hose and not be able to talk much — if I was still here. Five years out, life is good to be able to do all these things. I feel there are no limitations.”
Now, he continues to restore old houses. Most of all, Robert simply enjoys each day.
Author: Marla Fraunfelder Last Review Date: Aug. 21, 2006 Online Editor(s): Christopher Sadler |
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