Wednesday, 22 June 2016

Lung function test for June.

I had my monthly pfts today, they're back up! Hurray!

Back up from last month when my FEV1 had dropped to 1.33 because it hurt to inhale rapidly. Up to 1.74! Which is higher than where it had been sitting for the past six months (around 1.6) when I had the cancerous nodules in my lungs. Now that those spots are gone, it seems like *hopefully* my lung function is heading upward again. Even if it could get to where it was last August (1.86), that would be amazing.

Overall, if I can get back up to the 1.8's, it's still only around 65% which is quite low compared to a lot of other transplant people. My friend, who recently had a transplant got around a 60% on her first lung function test post-transplant. I'm so jealous. My first one was around 20%. It takes a lot of time for the lungs to fully inflate and for the muscles around the lungs to strengthen so I'm sure she'll be up to 100% within a few months.

I get asked quite a bit why my lung function isn't 100% post-transplant. I don't have a precise answer from any of the medical staff but from what I've been able to figure out, it's because my lungs were not the best match for me. They had to be cut down quite a bit to fit in my body and were 'scrubbed' of any infections pre-transplant. A few years ago, these lungs wouldn't have been considered viable for transplant. Thanks to the doctors in Toronto and the perfusion system, more and more lungs that would have never been used, can be transplanted.

It's great as it means that more people can be transplanted and live but it means that some people, like me, end up with lungs that may not have been a perfect match. Because I was so close to dying, I had no other lungs available and these ones were my best chance of making it. It's better to be alive than have 100% expected lung capacity.

So while of course I wish my lung function was higher, I'm going to be happy with the fact that it's slowly going back up and seems to be recovering nicely from the cancer. 

[The link above is for an article from the Toronto Star about the Perfusion system but here is an excerpt explaining how it works...

Toronto XVIVO Perfusion System (ex vivo means outside the body), which treats and improves high-risk donor lungs so they can be safely used for transplant....

A couple of weeks after the initial interview, Keshavjee allows a reporter and photographer to tag along to see how the system works.

A pair of lungs arrives at the hospital in a blue Coleman cooler at 10:30 a.m. on a Monday. They were harvested from an anonymous donor’s body, somewhere in Canada, six hours earlier...At this point, it’s not certain whether the transplant will even go ahead. The donor lungs are in bad shape, inflamed and full of fluid.

The lungs arrive in operating room 18, the organ regeneration laboratory, on the second floor of the hospital. A team of about six medical professionals is already assembled. They include surgeons, nurses and perfusion specialists who operate the XVIVO system...The lungs are removed from the cooler and placed into a bucket of ice. A tube is attached to the pulmonary artery, which normally delivers blood to the lung from the heart. Another tube is sewn to a vein that normally drains blood out of the lung.

The organs are then moved to a steel table in the centre of the room atop of which sits the XVIVO device. Also known as “the bubble,” it resembles a glass-domed cake plate.

Here, the lungs are hooked up to a circuit that includes a ventilator and heart-lung machine, which pumps a preservation solution into them. The solution, made of low-potassium dextran, was initially developed by Keshavjee and later perfected by others.

As the lungs are brought back up to body temperature, they are healed with a type of anti-inflammatory therapy, also developed by Keshavjee, which makes them less prone to malfunction.

Like something out of a science fiction novel, the lungs eventually begin inflating and deflating. The disembodied organs are alive, breathing on their own. continues on but that's the coolest part...]

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