Life goes on for pulmonary rehab patient

It might’ve been bronchitis or a touch of pneumonia that led 64-year-old Laura Layland into a walk-in clinic that January day in 2015, but it wasn’t. It was something about her breathing that “wasn’t quite like it should be.”

Today, her breathing still isn’t like it should be. But she’s getting the most out of life and keeping her body in shape at Parkwest Cardiopulmonary Rehabilitation Center at Fort Sanders West. After all, it’s just what her doctors have ordered.

When her breathing failed to show any improvement, she consulted her primary care doctor who referred her to pulmonologist Phillip Nichols, MD. After a pulmonary function test, a six-minute walk test, a CT scan of the Knoxville woman’s lungs and lab work, Dr. Nichols turned to her and said, “I am pretty sure you have idiopathic pulmonary fibrosis, but I don’t want to diagnose you with that because that’s a pretty hefty diagnosis until we know for sure.’”

Idiopathic pulmonary fibrosis (IPF) is a lung disease of unknown origin characterized by the thickening and scarring of lung tissue which causes labored breathing and becomes progressively worse. One recent study suggested IPF affects 1 out of 200 adults over age of 65 in the U.S. with about 50,000 new cases diagnosed each year and causes as many as 40,000 deaths.

There is no cure for IPF, but two drugs introduced about two years ago — pirfenidone (Esbriet®) and the nintedanib (Ofev®) — have proven effective in slowing progression of the disease. Ultimately, however, the only hope for many IPF sufferers is a lung transplant, which is why Dr. Nichols referred Layland to Vanderbilt University’s Idiopathic Pulmonary Fibrosis Center, one of the largest IPF referral centers in the world.

Dr. John Loyd, founder of the IPF Center, in September 2015, performed a lung biopsy on Layland which confirmed Dr. Nichols’ suspicions. Layland was immediately started on Esbriet® and also given a portable oxygen tank for use as needed when exerting herself. “There is no cure other than a lung transplant, but everybody progresses at a different rate and depending how your progression rate is, you may never get to the point where you would need a lung transplant,” she said.

Two months later, she began 15 weeks of pulmonary rehabilitation at Fort Sanders West. It’s a routine that she continues twice a week even today, taking her oxygen tank along with her as she her works out on the treadmill, the elliptical and the arm ergometer.

“The minute I came here, I felt like I belonged,” said Layland. “The staff is amazing. They are very committed to knowing everybody’s name. You can come at any given time and it’s a different group of people, but they know who’s coming and going, they’re aware of the surroundings, they’re aware of everybody’s limitations. The classes they present are very informative, the opportunity to interact in those classes – it’s not just lecture – they have conversations and input from individuals in the class.”

 “This is a totally different type care,” she declares. “I need this. I need this for me, but I also need this because, in order to be considered for a lung transplant, you have to be actively participating in a rehab program. I’ve got to continue to be healthy so that if I do have to have a transplant, that’s an undertaking and quite a long journey.

“You have to stay on top on it. If you were to ask me, based on how I feel, if I have progressed to the point to where I need to be on the list, I would say ‘no,’” she said. “Now, I’ve noticed a few changes: I use the oxygen a little bit more than I was using it, but I still maintain all my normal activities and if I have to use a little bit of oxygen sometimes to do that, that’s OK. The biggest thing that I can say to anybody or is that you’ve got to keep a positive attitude. You can’t walk that path: ‘Poor me! Poor me! Because there are some things that you can control and you can take care of. I can’t control the disease, but I can control how I live my life and I want it to have quality in it, and it still does.”