U of I Hospital offers treatment for lung disease
November 1, 2012

By Karen Garvey

Roberto Machado, MD, calls her a Christmas miracle. The young woman, barely into her 30s, had lupus and a potentially deadly complication of that autoimmune disease: pulmonary hypertension—high blood pressure in the arteries of the lungs.

Pulmonary hypertension causes the lungs’ arteries to narrow or become blocked. Because the heart must work harder than normal to push blood through these narrowed arteries, this disease can lead to heart failure.

When the woman arrived at the University of Illinois Hospital & Health Sciences System just before Christmas 2011, she could not walk a step. She was barely able to breathe. Her prognosis was grim. Machado and his multidisciplinary team started an advanced and comprehensive course of treatment in the hospital’s intensive care unit, including powerful intravenous medication. After two weeks of care by pulmonary and critical care doctors, cardiologists, rheumatologists, nurses, pharmacists, and others, she went home — able to walk and breathe and with an infusion medication to keep her breathing.

“We have not cured her, but we really changed her quality of life and improved her overall prognosis,” Machado said. Without the treatment she had at University of Illinois Hospital, “I think she would have not survived,” he added.

Improving lung health: Dr. Roberto Machado, director of the Pulmonary Hypertension Program, and other UI Health pulmonary experts are working hard to raise awareness and improve diagnoses and treatments for lung diseases.

Nationally recognized

That kind of state-of-the-art therapy, coupled with cutting edge research, makes the University of Illinois Hospital’s pulmonary program a nationally recognized leader in treating lung disease, including pulmonary hypertension and the more common chronic obstructive pulmonary disease (COPD).
The hundreds of thousands of people with COPD know its symptoms all too well: shortness of breath, especially with physical activity, and coughing with a lot of mucus. They also know that, without proper treatment, COPD will get worse and can keep them from leading active lives and doing the things they love.

Smoking causes the vast majority of COPD in the United States, said Min Joo, MD, director of the COPD program at the University of Illinois Hospital & Health Sciences System.

That makes personalized treatment to help patients overcome nicotine addiction a priority for the pulmonary clinic and one of the elements of care that sets UI Hospital apart.

“We sit down with patients to talk about their habits—’when do you smoke, why do you smoke?’” Joo said. “Because if you’re not ready, not willing to quit, none of the rest will be helpful.”

Medications can help snuff out the urge to smoke, but helping patients understand why they smoke is key to helping them stop, Joo said. Some may smoke to handle daily stress because cigarettes seem therapeutic, while others enjoy the pleasurable feelings nicotine produces. Getting to each patient’s “why” takes time and personal attention that many other physicians do not have the resources to provide. “It’s not as simple as saying ‘you have lung disease, you need to stop smoking,’” she said.

COPD is not reversible, but when patients do stop smoking, getting proper therapies can prevent it from getting worse, Joo said. In fact, stopping smoking at any stage of the disease can help patients live longer.

Tailored plan

Every COPD patient at UI Hospital’s pulmonary clinic gets a thorough evaluation, followed by individual treatment that likely includes inhalers, an exercise plan tailored to the patient’s abilities, and education about the disease. “We’re not just passing out medications,” Joo said. “We have the expertise, time, and resources to provide comprehensive care for COPD patients.”

That holds true for patients with other lung diseases such as asthma, bronchiectasis, sarcoidosis, and pulmonary hypertension. Joo and other COPD experts at UI Hospital continue to be involved in research studies to discover therapies to improve life for those with COPD. Studies include STAT Cope, which investigates the role of statins in COPD treatment, and LOTT, a trial to help improve quality of COPD care in the primary care setting.

Pulmonary hypertension can affect people of all ages and often results from another condition such as scleroderma, heart disease, or lung blood clots. Despite being known as “high blood pressure” of the lungs, clinicians cannot diagnose it with a blood pressure cuff. In fact, diagnosis can be complicated and often involves invasive procedures, Machado said.

“It’s a deadly disease and probably more common than we think,” he continued. “It’s progressive, and for people with other underlying diseases, it can make their lives far worse. We need more
awareness of that.”

Because pulmonary hypertension often is misdiagnosed or diagnosed late, when it is harder to treat, the Pulmonary Hypertension Association has designated November Pulmonary Hypertension Awareness Month. The group urges physicians to look for the disease when patients experience shortness of breath or fatigue.

“Back in the early ‘90s there were no FDA-approved therapies,” Machado said. “The median survival was about two and a half years. Now we have new therapies, and patients are living better, living longer. We’ve made incredible advances, but we haven’t found a cure.”

Machado and other lung disease experts at UI Hospital are working hard to find one, though.

Evidence points to a strong genetic component to pulmonary hypertension, so Machado and others at UI Health System are involved in a large research study of how genes affect risk for developing pulmonary hypertension and how gene expression could help identify persons more likely to respond to certain medications. The results could help medical personnel better understand pulmonary hypertension’s causes, personalize treatments for individual patients, and understand why and how
medications work, Machado said.

Results also could lead to promising new treatments.

Eventually, Machado hopes, a complete cure will be found for his Christmas miracle patient.

For information, call (866) 600-CARE.