As My Pulmonary Function Declines, the Search for Answers Continues
Weeks after a balloon dilation, columnist Sam Kirton prepares for more testing
Minutes after I’m wheeled into the operating room, everyone stops — a timeout. Lying on my back with an awesome view of the ceiling, the calm and quiet of the room are very noticeable.
I’d been connected to various leads, used to monitor everything from my heart rhythm to my oxygen saturation, as soon as the gurney stopped rolling. A recorder had been started to memorialize the event.
Now, a lone voice takes control of the room, calling on each member of the medical team. The respiratory technician confirms my identity from my hospital wristband, the doctor confirms the plan for the procedure, and the anesthesiologist confirms the plan for my sedation.
I’m instructed to take deep breaths as an oxygen mask is placed over my mouth and nose. The anesthesiologist lets me know when they’ve begun administering the drug to sedate me and asks me to count backward from 100. I seldom make it past 99.
This has all become routine for me.
My first balloon dilation
I recently shared that a bronchoscopy — a routine procedure for post-transplant patients — revealed a noticeable narrowing, or stenosis, of my left bronchial stem. On Dec. 27, I underwent balloon dilation to open the passage.
Balloon dilation is conducted in the same way as a bronchoscopy, involving the insertion of a thin tube into the nose or mouth that’s passed down into the lungs. Once the bronchoscope is in place, a balloon is inflated to stretch the airway at the point where it has narrowed.
One benefit of balloon dilation is the uniform stretching of the airway. The balloons come in various sizes, and the interventional pulmonologist performing the procedure can select the appropriate size to achieve the desired results.
The procedure went well for me. My left bronchial stem was stretched from 7 mm to 11 mm. To provide a frame of reference, 7 mm is only slightly larger than the opening of a standard drinking straw. I experienced no ill effects as a result.
Did it help?
For the first 24 hours after the balloon dilation, I felt the same way I usually do after a bronchoscopy: I had a scratchy throat and a raspy voice, but both cleared up quickly. A week after the procedure, I was walking every other day. I’ve challenged myself to be back to walking at least 30 minutes a day by the end of January.
From my perspective, the procedure helped. I measure my lung function twice a day using a home spirometry device, and the results have indicated improvement. Additionally, some of the symptoms I’d noticed prior to the procedure were gone almost immediately after it.
The plan is for me to return to the pulmonologist six to eight weeks post-procedure to evaluate the width of my airway. In the meantime, I just had a regular clinic visit with my care team, which included a pulmonary function test (PFT) and bloodwork.
What the PFT showed
The results from my PFT indicated a continuing decline in my pulmonary function. The decline was not dramatic. My forced vital capacity, the amount of air I can forcibly exhale after inhaling fully, declined by 0.02 liters. My forced expiratory volume, the amount of air I can exhale during each second of a forced breath, declined by 0.12 liters. Those are not large numbers; however, they become significant when the decline occurred over 29 days and is part of a continuing trend.
While I was sitting in the clinic, my care team, along with the interventional pulmonologist, agreed that a follow-up bronchoscopy should be conducted sooner rather than later. Doctors will examine my left bronchial stem where I had the balloon dilation, take biopsies for testing, and conduct a bronchoalveolar lavage. The lavage involves washing the interior of the lung with a small amount of saline solution and collecting a fluid sample for examination.
Next steps on this journey
I want to clarify that this doesn’t mean the balloon dilation wasn’t a success; in my view, it was, as evidenced by my return to walking. My next bronchoscopy is scheduled for Jan. 31, which also happens to be the sixth anniversary of my diagnosis with idiopathic pulmonary fibrosis. This will be another step on my journey to make every breath count.
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.