The year 2020 was difficult for most people, but particularly so for Richard Guyer. Richard….struggled….to….breathe. He needed a lung transplant. That decision was reached after a lengthy period of seeing multiple doctors and undergoing many diagnostic tests. During that time, Richard’s lungs were quickly getting progressively worse, and his breathing was only helped some by the oxygen tank he was carting around. Richard suffered a great deal of stress that went along with having no diagnosis or treatment in the near future, especially when he couldn’t breathe.
Richard was admitted to GMHC as an inpatient in late 2020. His symptoms were shortness of breath, a dry cough, and an increase in oxygen needs. Richard’s primary doctor, Dr. Smith, gave him a second referral to the University of Iowa because no diagnosis had yet been reached. Finally, it was determined that he had Idiopathic Interstitial Lung Disease, a rare disease that affects less than 200,000 people a year in the United States. The diagnosis is so difficult because so many disorders fall into this category, the signs and symptoms of many conditions can mimic this disease, and doctors must rule those conditions out before making a definitive diagnosis.
The cause of Idiopathic (unknown or undetermined cause) Interstitial (occurring between the air sacs) Lung Disease, or ILD for short, is unclear. The reality is a shortness of breath that gets worse as the disease progresses. This disease belongs to a group of lung conditions that cause progressive scarring (or fibrosis) of lung tissues, affecting your ability to breathe and to get enough oxygen into your bloodstream. By the time symptoms appear, irreversible lung damage has often already occurred. Medications may slow the damage of this disease, but most never regain full use of their lungs, and the end stage is respiratory failure. Treatment is not always effective in stopping the ultimate progression. A lung transplant is a viable option, as it was for Richard.
Dr. Eberlein (University of Iowa Hospital) put Richard on the transplant list in mid-January of 2021. In December of 2020 Richard went from requiring low flow oxygen to being dependent on high flow oxygen 24/7. Due to the severity of his lung condition, Richard remained as an in-patient at the University of Iowa Hospital until he received his new lungs on March 1, 2021.
Post-operative therapy following a lung transplant is intense and requires close monitoring, so patients remain in the hospital during this first phase of recovery. There were also some setbacks with blood clotting during this period. This proved to be the most difficult time for Richard, as it occurred during the COVID-19 pandemic, which meant that he could have no visitors when he really wanted and needed them. “The pain was really bad, and I just wanted to see my family,” he explained. Richard remained very determined to take care of himself and said, “I had to put the lungs before everybody.” During this phase of recovery, he kept telling the nurses that he was going to walk by the second week… and he did! He replied, “I just convinced myself that I’m going to do it.” Richard also expressed great thanks to Dr. Smith and Dr. Eberlein for the great care they gave him.
After he was able to leave the U of I hospital, he stayed in a nearby hotel during the next level of treatment. Finally, Richard was with his father and received some of the support and family time he had been missing. “It helped a lot to be able to see my dad and stay with him,” Richard commented.
Next came the really good news, Richard could return to his home in Hawkeye, IA! In June of 2021, Richard began pulmonary rehab at GMHC, and although it was a distance to drive, he preferred to continue working with the people who he already knew, and who knew him. When he first arrived, he could only walk for 10 to 12 minutes without needing to stop. Gradually, he kept improving and was then able to walk for 30 minutes without a break. Currently, he is walking on a treadmill during therapy for 25 – 30 minutes… at an incline! He also lifts weights during his therapy sessions, and once a month does a spirometry lung function test along with a nebulized medication. The therapists also monitor his blood pressure and his oxygen saturation during his workouts. Richard said, “I am very grateful for the people who take me to my appointments; I like coming to GMHC for my rehab work, because it is close to home, I am familiar with the therapists I work with and I am comfortable with everyone here. The long struggle with Richard’s lung condition and eventual transplant left him with a fair amount of stress, and he commented, “It is very important for me to have a regular, comfortable place to go for rehab work. It was hard at first, but the therapists here know how to help me stay calm and in my comfort zone.”
Richard visits the University of Iowa every two months for follow-up testing. He enjoys telling others about his journey through his lung-transplant experience, and adamantly relays the importance of becoming organ donors to others. “Without a transplant, I wouldn’t be here!” he concludes. Richard’s goal is to walk in the German Fest 5K and show everyone just how far he has come!
Commented GMHC Respiratory Therapist, Catie Dean, “We started doing pulmonary function tests (determines lung volume) on Richard about a year before his lung transplant. We could see the gradual decline in his lung volume until he was to the point he had to be admitted to the hospital. It is so nice to continue to work with Richard and see the improvements in his health and his attitude since his lung transplant.”