Kellie has been talking about lung reduction surgery for Stage IV Emphysema/COPD. I thought the Community might want a little background on exactly what that means so that our thoughts and prayers can be more specific in support of our Sister, Kellie! So here goes:
Lung volume reduction surgery is used to improve breathing in some people with severe emphysema, a type of chronic obstructive pulmonary disease (COPD). During surgery, small wedges of damaged lung tissue are removed to allow the remaining tissue to function better. There is a fairly rigorous process to qualify as a candidate for the surgery. After surgery, people often have less shortness of breath and are better able to exercise."By removing the section of lung that is primarily affected with severe emphysema, we can decrease air trapping and consequently the shortness of breath, which can thereby improve the patient's perceived quality of life."
However, LVRS has a small but inherent danger of perioperative mortality."LVRS has risks that patients need to understand and acknowledge," said Dr. Benzo. "In NETT (National Emphysema Treatment Trial), close to five percent of the patients undergoing lung reduction died in the post-operative period. However, once the post operative period is over, the quality of life benefit comes right away."
Q. What are the benefits of lung volume reduction surgery?
A. There are many potential benefits of LVRS. Benefits include:
- Greater ability for the lungs to inflate and deflate properly, which improves breathing
- Many patients report a reduced need to rely on portable oxygen tanks
- The diaphragm (the breathing muscle) and the chest wall are abnormally positioned due to severe emphysema. LVRS provides room for the diaphragm and the chest wall to return closer to their normal positions, which also improves breathing ability.
Most patients who have been selected for LVRS report a great improvement in their overall quality of life. Better breathing means less fatigue and more energy to enjoy life.
Q. Who is a candidate for lung volume reduction surgery?
A. Not everyone with severe emphysema is a good candidate for LVRS. Being a good candidate for LVRS is an important factor for surgical success. A large, nationwide study completed in 2005 found that people with severe emphysema in the upper lobes of the lungs with decreased exercise capacity benefit the most from LVRS. The study also showed that patients who do not meet the criteria would receive little or no benefit from LVRS.
Q. What are the risks associated with lung volume reduction surgery?
A. LVRS is an elective surgery, and as with any type of surgery, there are risks. The benefits of the surgery are not immediate, and may take time to be fully realized. Complications such as pneumonia, infection, and air leaks within the chest cavity can occur. Ultimately, there is no guarantee that the surgery will work.
In the 1990s, LVRS was more common and was performed at many hospitals that did not have the proper framework or expertise to perform the procedure. Over time, it was apparent that some patients who had LVRS were not faring well, so Medicare (the nation's largest health insurance program) stopped paying for the surgery. Medicare initiated a study to determine which people with emphysema are the best candidates for the procedure. The study was completed in 2005 and led to specific guidelines for surgical candidates and reimbursements by Medicare,NETT.
So, as you can see, this is a very major, very emotional decison! I hope this little explanation gives you a clearer picture of her dilemma! I think of you, Kellie, with every single breath I take! My prayers go out for Kellie and for her loving family at this time of intense stress and hope! God Bless Kellie! May her outcome be easy breathing!
