Swartling regains life through lungs transplant
By TRAVIS PURSER
Express Staff Writer
Until last fall, Jean Swartling was one of the 67,000
people in the United States waiting for an organ transplant. At age 61,
slowly but surely, her heart was dying due to a rare lung condition.
The disease is called primary pulmonary hypertension (PPH),
a slowly increasing restriction of the blood vessels in the lungs that
over a period of years was making it more and more difficult for her to
breath. The condition, doctors said, would eventually stress her heart to
the point that it would stop working.
What they prescribed was a new set of lungs, fragile
organs that are the least available for transplant. A little reluctantly,
she joined the ranks of those waiting for organ donations, a list that
increases by one person every 14 minutes. Every day, 14 to 18 of those
people die waiting, but Swartling was lucky. Now, after spending a summer
in Salt Lake City for treatment, she’s back in Sun Valley living with,
literally, the lungs of a 30-year-old.
She stands a little more erect than she used to—the
lungs, previously belonging to a southeastern Idaho man, are just a tad
larger than her old set—but otherwise, life is closer to normal than it
has been since she was diagnosed with PPH at age 56.
No longer does she greet visitors at her home with a
50-foot rubber oxygen tube trailing from her nose and a two-and-a-half
pound electric medicine pump strapped to her waist.
Both items were her constant companions—at home, at the Mountain
Express where she worked, in the shower, in bed.
The hose was connected to either an oxygen
"concentrator," a television-sized machine that gleaned oxygen
from regular air, or to an oxygen tank. The medicine pump, connected to a
major blood vessel in her chest by way of a catheter, constantly
administered a "vasodilator," a drug to help expand the blood
vessels around her lungs.
It is not only the reclaimed 10 to 15 years of life that
she now looks forward to, it is also a life unencumbered by machines.
How far ahead does she look? "Oh, not terribly
far," she said during an interview at her home, where she lives with
her dog, Frannie. She still expects her life to be shorter than she once
though it would be, but she’s no longer discounting the future with
thoughts of "Oh, I’m going to die." Having the transplant
"has given me the opportunity to have some plans." There are her
grandchildren, and she’d like to travel and go back to work.
In a sense, the transplant has turned back the clock for
her.
It was five years ago, when she was planning a hiking trip
to Italy that the problems began. She had spent an inactive winter in Sun
Valley, so when spring arrived, she started walking around her
neighborhood to get back into shape. However, she found that she became
exhausted after only walking a short distance. Thinking that she needed
more exercise, "I pushed myself harder and harder," she said,
"but I never got better." Still, she went to Italy,
"thinking all the time that as soon as I get home, I’d better go
see the doctor."
She saw many, first at Magic Valley Regional Medical
Center in Twin Falls, where she underwent tests to determine if she had
clogged arteries, then at St. Luke’s Regional Medical Center in Boise,
where a cardiologist "came into the room and said, ‘I have some
very bad news for you.’" That’s when she found out about the PPH,
"but I’d never heard of it, so I wasn’t afraid." She
initially felt relieved she didn’t have heart disease, even though the
doctor "was basically telling me I was going to die."
Soon, she was traveling to LDS Hospital in Salt Lake City
to undergo more tests and treatment from Dr. C. Greg Elliott, a specialist
in PPH, who has cared for about 200 of the 2 million people in the world
who have the disease, Swartling said. She learned that without a
transplant, she would likely die within two to five years.
"The thought of a transplant to some people is
scarier than hell," she said, "and it just wasn’t to me."
Perhaps because her husband, Dr. Rodney Swartling, who died in 1997, was
an orthopedic surgeon, "I didn’t equate surgery with death."
But getting any organ transplant is about much more than
just overcoming fear. For a number of reasons, there is a restricted
supply of organs that helps create the need for an elaborate system of
criteria for determining who gets a particular organ when it becomes
available.
For lungs, a match depends mostly on blood type and size.
But also, there’s geographical location; because a set of lungs will
only survive for four hours outside the donor’s body, the recipient must
live nearby. And, there’s critical need. "You have to hit that
window of being sick enough to need it and well enough to survive the
surgery," Swartling said. "They want successes," they don’t
want people to die.
To help improve her chances, Swartling moved to Salt Lake
City in July of last year. There, she joined a support group of PPH
patients connected with the hospital and the University of Utah Transplant
Center. A typical wait for a set of lungs there was 18 months, but
Swartling was placed high on the hospital’s wait list, improving her
odds for quicker surgery. Then two died waiting. "That’s one of the
ways I moved up on the list," she said. "That was a little
sobering."
For three months, she kept a packed bag close at hand, so
she could check into the hospital at a moment’s notice, and she did
volunteer work at the transplant center. Then, on Sept. 27, she got the
call while driving to a lunch with her daughter-in-law. She pulled over to
talk. "They said, ‘We have a potential donor for you.’ I told
them, ‘I have to go home and let the dog out.’ "
That was at 2:30 p.m., she remembers; at 3:30 p.m., she
arrived at the hospital.
"I drove myself," she said. "I was a little
apprehensive. I knew this could be the big deal, or that it couldn’t be,
too."
Meanwhile, she waited while Dr. Elliott, perhaps in a
different state, retrieved the new lungs. She read Atlantis Found,
a "kind-of spy novel" by Clive Cussler, and got updates on
Elliott’s work from hospital personnel.
"They finally said, ‘He’s here Mrs. Swartling.
You’re going to have to cooperate with us.’ "
IVs were inserted, and at 8 p.m., she went into surgery.
"I’m sure I was nervous, but they say the better attitude you have
going into surgery, the better recovery you’ll have. So I was trying to
be calm."
The procedure took six hours, and for days after, she
said, "I was pretty incoherent. I don’t have any definite memories
except relief that I did wake."
Afterwards, she spent almost two weeks in the hospital’s
intensive care unit and another two months in pulmonary rehabilitation
walking a treadmill, riding a reclining stationary bicycle and lifting
weights to recover. Sometimes lung recipients must relearn to breathe and
cough due to nerve damage, though Swartling said those things were not an
issue for her.
Today, with the future that her lung transplant has
allowed her to regain, Swartling has become a new proponent of organ
donation. She said she’s amazed at what doctors can do with just one
body.
"One body can save eight or nine different
people," she said. The skin, the eyes, the bone marrow—"it’s
incredible what they can salvage."
Are there enough donors in the world?
"Not even close," she said.
