Army Veteran’s innovative treatment for severe emphysema

For Veterans with severe emphysema, medication and oxygen therapy may no longer be viable options. Instead, a surgical procedure to either remove the damaged portion of the lung or the entire organ may be necessary. As with all surgical procedures, there are elements of risk as well as extended recovery times.

A new procedure at Truman VA may offer Veterans with this disease a minimally invasive alternative.

For Army Veteran Larry Turner, the symptoms he experienced from emphysema, a form of chronic obstructive pulmonary disease (COPD), severely limited his ability to perform even simple physical tasks.

“I didn’t want to do anything,” Turner said. “I couldn’t do anything because I couldn’t get enough air. Just a walk to the bathroom or to climb into bed was a real chore. Mostly what I wanted to do was just sit. Even then, I was having trouble breathing.”

“Patients with severe emphysema experience life-limiting symptoms from irreversible lung damage,” said Dr. Satish Kalanjeri, Chief of Interventional Pulmonology at Harry S. Truman Memorial VA. “Our lungs are made up of millions of tiny air sacs that, when damaged, rupture and create one big air pocket. The diseased part of the lung then fills with air and as this pocket gets larger, it puts pressure on the healthy section as well as the diaphragm. Those with emphysema typically experience, among other symptoms, constant shortness of breath and chest pain which makes it difficult to perform everyday activities without stopping for air, resting, or needing help.”

New procedure – endobronchial valves

Dr. Kalanjeri and Veteran Larry Turner

VA now has the ability to place endobronchial valves into the lungs via a bronchoscope inserted through the mouth or nose instead of operating through an incision.

By implanting three to five endobronchial valves into key airways of the lungs, doctors can shut off airflow to the damaged portion of the lung to obtain the same results as a lung-reduction surgery without the need for an open procedure.

“The good part of the lung now expands to occupy the space previously taken up by the damaged portion,” Kalanjeri said. “The patient usually does not experience a lengthy recovery, which is common with an open surgery. Instead, after three to five days of monitoring, the patient typically is able to return home and experiences improved relief from their symptoms.”

Excellent results with appropriate patients

“Not every patient with emphysema is a candidate for this procedure,” said Jeremy Johnson, chief of Pulmonology and Specialty Care Services. “Pivotal studies have demonstrated that, when appropriate patients are chosen, excellent results can be expected. We carefully work up potential candidates and have extensive discussions with our Veterans before offering them an endobronchial valve procedure. We believe this process provides our Veterans with an opportunity to achieve the very best outcomes.”

“This procedure was really non-invasive,” Turner said. “It was all done down my windpipe and there was no downtime to it. Once I came out of surgery, I felt great, and I had no pain. It was lunchtime and they brought me a meal and I had a big lunch. I felt great. This procedure has really made things better for me. I go outside now, I walk around, I’ve even been to some stores. I just feel so much better.”

“Team makes me feel like I am number one.”

A more telling example of his improved condition is the return of his ability to travel. A self-described “snowbird,” Turner typically spent his winters living in more southern states to avoid the cold weather. His severe symptoms had prevented his annual migrations until now. This year he is wintering in Texas.

“I’ve been coming to Truman VA for years for my treatments, and it gets better and better every time I come,” Turner said. “The teamwork here is great. The nurses, doctors and technicians really go out of their way to make me feel like I’m number one and they treat me right. Truman VA is the best in the country, and I tell everybody that.”