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For the week of March 7 through 13, 2001

Swartling regains life through lungs transplant

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.


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Copyright © 2001 Express Publishing Inc. All Rights reserved. Reproduction in whole or in part in any form or medium without express written permission of Express Publishing Inc. is prohibited.