“I know more about lungs than I ever wanted to,” said Wanda Tunnell, 65. The Tuscaloosa, Ala., resident’s double lung transplant in May 2021 was the culmination of a long journey of unanswered questions and terrifying episodes of breathing trouble.
Diagnosed in 2005 with adult-onset asthma, Tunnell navigated her condition for 14 years with a combination of asthma medications and an emergency inhaler. Then in July 2019, she was hit with a perfect storm. “I’d been working in a storage building that was hot and dusty,” she said. “My emergency inhaler didn’t work, and I couldn’t breathe.”
Lung damage
Admitted to the hospital with a blood oxygen saturation of 62% – far below the normal level of 95-100% – Tunnell was at risk for hypoxia, a condition that starves the body’s organs of oxygen. While there, she had a lung biopsy and was diagnosed with idiopathic pulmonary fibrosis (IPF).
According to Victoria Rusanov, M.D., a physician with the UAB Comprehensive Transplant Institute (CTI), IPF is a chronic disease in which the lungs become scarred. “Pulmonary fibrosis can be caused by exposure to toxins, certain medications, and some medical conditions,” she said. “When we can’t find the cause of the fibrosis, it’s called idiopathic.”
There are medications that can slow down the progression of IPF scarring, but the existing damage is irreversible, Dr. Rusanov said. “Because IPF progresses, the expected length of survival is three to five years,” she said. “Lung transplantation is the only therapy that can prolong the patient’s life while improving their quality of life.”
After her diagnosis, Tunnell went home with medications and supplemental oxygen. “It was a rude awakening,” she said. “I had episodes where my breathing would fall off suddenly, and I never knew when that would occur,” she said.
In 2020, Tunnell’s lung function dropped below 60%, then she turned to the UAB CTI for care. She got the call to come in for her transplant in May 2021. “It was a miracle that I got my lungs on the first call,” she said. Tunnell and her husband, Lewis, had just bought a house, movers were scheduled to arrive the day she had surgery. “Lewis got us moved while I was in Birmingham,” she recalled.
The timing of Tunnell’s wait time and surgery was impacted by COVID-19. Transplant patient support groups were suspended during the pandemic, so she felt alone while waiting for her transplant. “I didn’t have anyone to talk to,” she recalled, crediting her husband with helping her through the ordeal. “Because of COVID-19 restrictions, he had to sit alone at UAB Hospital during my 12-hour surgery,” she said.
Paying it forward
Determined not to let others suffer from a lack of support, Tunnell spends a great deal of time helping other people on their own transplant journey. “I meet them in clinics, I meet them in ICU after surgery, and I have a special connection with them,” she said. She has offered her phone number to the UAB CTI transplant coordinator to share with patients who need to talk, and she speaks with patients who are preparing for a transplant. “I’m drawn to people on oxygen,” she said. “I know what they’re going through.”
Understanding the path others are on is the key to Tunnell’s effectiveness. “Lung transplantation isn’t a cookie-cutter surgery,” she said. “It’s not like getting a new part put in during a knee replacement.” In one case, she shared her post-transplant experience with an Auburn, Ala., woman who also had IPF. “I would visit her in the hospital while I was going to cardiopulmonary rehab,” Tunnell said. “I talked to her about how medications affect you, tips for taking medications, and the year-long process of having your medications tweaked and stabilized.”
Tunnell stands ready to help anyone and everyone, but she’s also clear-eyed about the challenges. “A friend who got his lungs two months after I did died five months later,” she said. Another of her friends was in the process of qualifying for surgery but suffered a small stroke that disqualified him, and he later died. “They have statistics for a reason,” she said. “Some people don’t make it.”
Tackling challenges with pride
Dr. Rusanov is proud of the UAB CTI’s lung transplant program, as well as the team’s resolve in serving a changing patient population. “A high percentage of our patients have connective tissue disease or genetic pulmonary fibrosis and are prone to complications because of other organ involvement,” she said. “Underserved patients who need multi-organ transplants – such as heart-lung, lung-liver, and lung-kidney procedures – are referred to us from Mississippi, Louisiana, and all parts of Alabama.”
Tunnell was 63 years old when she received her double lung transplant, but 65 is the average age of those diagnosed with IPF. The average age at transplant approaches 70. “Because people live longer, stay stronger, and have better medical care, their biological age is younger,” Dr. Rusanov said. “Our ability to perform the surgery and deliver critical care management has evolved and improved, so we get better transplant outcomes in our older patient group.”
Between her transplant and COVID-19 precautions, it took Tunnell a while to return to a new normal. Still, she looks at her glass as half full. Last year, she went to a Mississippi waterpark to swim with her grandson, and she and Lewis have planned an RV trip to Chattanooga, Tenn., and Bowling Green, Ky. “My new lungs have been a blessing from God,” she said.