A breath of life

ART AVAILABLE
By SEAN BARRON
VINDICATOR CORRESPONDENT
YOUNGSTOWN -- Ramona Vines remembers her first words shortly after the phone rang at her South Side home around 9:30 p.m. May 22.
"Oh, my God!" she recalled saying with excitement to the person on the other end.
"My kids already knew and were jumping up and down. We were ready for that day, and they knew from the expression on my face. I didn't have to say another word."
Vines, who lives on the South Side, was at home with her three children, Dale Edmonds, 13, Jasmine Brown, 11, and Brianna Robinson, 7, when the Cleveland Clinic called to inform Vines that she would be receiving a new lung.
Right away she called her mother, Thelma Vines, as well as other family members and friends, and packed for the trip to Cleveland for her surgery.
An hour before her operation began at the clinic the next day, Vines, 32, found out that she would be getting both lungs replaced.
Since September 2002, she had been on a waiting list for a double lung transplant. After being misdiagnosed several times, Vines learned from the results of a lung biopsy about four years ago that she suffered from pulmonary fibrosis, an irreversible disease that causes scarring of the lungs and reduces the air sacs' ability to expand and draw in oxygen.
How bad it got
Shortness of breath, persistent coughing spells, extreme fatigue and weakness, muscle deterioration and fevers were among her symptoms.
The disease also made walking, dressing and other everyday routines nearly impossible and, until recently, Vines had to rely on an oxygen machine 24 hours a day.
"I went downhill and got progressively worse," she recalled.
Beginning in June 2002, she made regular visits to the Cleveland Clinic and was told that her lungs would continue to worsen. After treating her with numerous medications, clinic officials put her on the list for a lung transplant, Vines said.
Dr. Gosta Pettersson, a cardiovascular and thoracic surgeon, said that the Cleveland Clinic performs about 40 to 50 heart and lung transplants, about the fifth-largest volume in the nation.
He said that before her operation, Vines needed to be on a heart and lung machine to help reduce the work placed on those organs. The machine also helped to keep her blood oxygenated, he said.
Dr. Pettersson noted that the patient's illness has to be beyond the scope of alternative and other treatments to become a candidate for the operation.
Other criteria include a thorough understanding of the procedures, making sure the lungs fit the patient, having family support and having organs that are strong enough to handle the large number of necessary medications.
Risk factors, such as rejections, lung damage and infections, are less than 10 percent, Dr. Pettersson added. Some patients are discharged from the hospital within two to three weeks after their transplant, he said.
What went wrong
Vines suffered several unanticipated setbacks after her surgery. She remained hospitalized for a month after receiving the new set of lungs, and during that time, she endured memory loss, pneumonia and two weeks of hallucinations.
Vines couldn't speak for several days because of numerous tubes that had been inserted, so she had to write down what she wanted to communicate. "For five days, I didn't know what was going on," she said.
Vines lost 20 pounds, was too weak to sit up by herself and had to have occupational and physical therapy to help her regain her strength.
When she was finally able to bend over, Vines said she "could feel my lungs' heaviness" and had to get used to what it felt like to breathe a normal amount of air.
Other post-operative complications Vines faced included being hospitalized twice, once for anxiety and shortness of breath and a seven-day stay in August because a lobe in one of her new lungs partially collapsed. As a result, doctors inserted a stint to reopen the area that collapsed, but only one-half of that lung now works, she said.
Despite her complications and setbacks, Vines' health and strength slowly improved, and her depression and anxiety decreased.
How she's improved
Vines said her physical strength has increased and she counts among her accomplishments being able to perform household chores, getting in and out of her car without being out of breath, walking unassisted through grocery stores and other public settings and visiting friends.
"I feel almost back to normal," she said. "God got me through this ordeal."
She now takes 30 pills a day. Some are designed to prevent further lung damage, others help her with anxiety, and some are taken to reduce the likelihood of rejections and other potential problems.
Dr. Pettersson said he's happy with her progress and the mental strength she's displayed since her operation. "She had a rocky course," he said. "As a doctor, I've become impressed with people who handle this as well as she did."
Vines said she is thankful that her co-workers are holding her job for her in the medical records department at Forum Health Northside Medical Center. Vines hopes to be back to work within a year.
Vines praised Cleveland Clinic officials and said they, along with daily prayer, helped her deal with many of the difficulties she faced.
"I'm trying to live each day with my kids and my mom," she said. "I feel like I have a lot of time, and I see myself being Ramona again. The kids are doing better, so I feel I have to.
"You have to trust in God and pray. There's nothing else."