Making quick adjustments when things don’t go as planned

A possible COVID-19 exposure disrupts a post-transplant care routine

Samuel Kirton avatar

by Samuel Kirton |

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Have you ever experienced a period in your life when nothing seemed to go right? While that may seem an odd question for those in the rare disease community, in my case, sadly, it’s not rhetorical.

June has altered some of the best-laid plans, and that trend has flowed into July. Sometimes, sounding the all-clear signal doesn’t necessarily mean that all is clear. June would prove to be the wrong time to let my guard down.

By way of background

When I was diagnosed with idiopathic pulmonary fibrosis (IPF) in January 2017, I suspected the journey would contain a surprise or two. I was correct about the surprises but underestimated their number.

Each of our journeys is likely similar in many ways, but they’re also unique. From the day I was diagnosed until my bilateral lung transplant on July 10, 2021, the process was pretty well scripted. Dr. Steven Nathan and the rest of my care team at Inova’s Advanced Lung Disease and Transplant Center in Virginia knew what to expect. Their experience allowed them to anticipate surprises and quickly make adjustments.

To prepare before my transplant, I received a checklist of all the tests, labs, and vaccinations I needed to make a work-up that the clinic’s transplant committee could use to make a recommendation. The results of those items had two possible outcomes: one would allow an item to be marked complete, while the other might indicate the need for further testing or a different type of test.

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Today, I’m two years plus one day post-transplant. There have been some surprises over the past two years, and in each case, my care team at Inova quickly reacted to protect me and my donor-gifted lungs.

In my post-transplant world, I typically refer to surprises as exacerbations. I had pneumonia last fall and COVID-19 last April. Both required hospitalization and were managed quickly by the team at Inova.

My ongoing issue now is a narrowing bronchial stem. In May, a stent was placed in my left bronchial stem in an attempt to train it to stop narrowing. I was due to have my 16th bronchoscopy on June 27. But that didn’t happen.

What did happen

I live around 90 minutes from Inova. While there are closer hospitals, I have a great relationship with my care team there. On June 27, my wife, Susan, and I were on the way there when we learned that she’d been exposed to a friend who tested positive for COVID-19 on the morning of my appointment.

After consulting with the nurses and my interventional pulmonologist, the decision was made to reschedule the bronchoscopy. While the rate of COVID-19 has declined here in the U.S., the virus is certainly still around.

It was an instant reminder for us IPF patients — and anyone else who is immunocompromised — to remain vigilant about our environment. Everyone in the situation I described above was fully vaccinated and had recovered from COVID-19.


A simple graphic of a yellow diamond-shaped sign that says "Proceed With Caution."

A sign of the times for the immunocompromised patient community. (Graphic by Sam Kirton)

To further complicate the situation, a new circulation pattern for respiratory syncytial virus (RSV) might affect people with chronic illnesses, including lung issues. According to a study shared by the U.S. Centers for Disease Control and Prevention, the seasonal circulation of RSV was disrupted in 2020 with the onset of the pandemic.

It noted, “Although the timing of the 2022–23 [RSV] season suggests that seasonal patterns are returning toward those observed in prepandemic years, clinicians should be aware that off-season RSV circulation might continue.”

My bronchoscopy was rescheduled for today, July 11. Both Susan and I have tested negative for COVID-19. Reaching out to the interventional pulmonology team was the right thing to do. We have a responsibility to protect those caring for us.

This potential COVID-19 exposure reminded me to proceed cautiously and be aware of those around me. Protecting my health while living my best life means I must make informed risk decisions. It’s part of how I make every breath count.

Have you let your guard down lately regarding COVID-19? Please share your thoughts in the comments below.

Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.


Terri Gordy avatar

Terri Gordy

Yep, I let my guard down in April when I flew unmasked to Florida. All those vaccines gave me a false sense of protection. I ended up getting pneumonia but was able to avoid hospitalization. (I've never had COVID.) It was a stupid move, though, as my pulmonary doc says, "You're entitled to live your life on your terms." I just think I'll stop flying altogether since breathing through a mask is so difficult for me. I avoid crowds, concerts, etc. I still take road trips but try to rent houses, condos, etc., where fewer people have stayed vs a hotel room.

Samuel Kirton avatar

Samuel Kirton

Hi Terri,
Thanks for continuing to follow my column and your comments. I find I am most comfortable with a mask on while flying. Don't get me wrong the mask is a bit uncomfortable but I feel more protected. I am with you on your other solutions. Crowds and closed spaces are not for me these days.

Sam ...

Deborah Herbert avatar

Deborah Herbert

Yes, I actually have. In recents weeks, I have stopped wearing a mask everywhere I go. I live in Florida and the weather has been extremely hot and humid. Wearing a mask can be cumbersome. However, after reading your article it is probably in my best interest to continue to wear a mask.

Thanks for sharing.

Samuel Kirton avatar

Samuel Kirton

Thanks for reading my column and your comments. Wearing a mask can be a bit cumbersome but it is better than some of the alternatives. I am up to date on the recommended doses of the vaccine and also have had the Evusheld infusion. When I did get COVID I felt bad but it was not as bad as it could have been. Your priority is protecting you.

Sam ...

Jeffrey Borrell avatar

Jeffrey Borrell

I always have mask at hand because you never know when you'll need it. Whether at the gym or shopping or in any area that gets crowded PUT on your mask. If you hear people coughing around you and can't leave PUT it on , especially if you see them coughing without covering there mouth. Additionally I always wear a mask on a plane. An inconvenience is worth lessening the risk from any air born infection not just covid.
Jeffrey Borrell

Samuel Kirton avatar

Samuel Kirton

Hi Jeffrey,
Thanks for reading my column and for your comments. I am with you on this. I am preparing to fly this week and a mask is a necessity for me. We have to protect ourselves as patients.

Sam ...


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