Patients who require medical therapy can take advantage of the Pulmonary Rehabilitation Network, which consists of 32 regional centers that follow rehabilitation program guidelines established by the University of Maryland and Kernan Hospital.
Since establishing its Emphysema Program in 1994, the Division of Thoracic Surgery has evaluated over 700 people with emphysema to determine their best course of treatment.
Patients who require medical therapy take advantage of the Pulmonary Rehabilitation Network, which consists of 32 regional centers that follow rehabilitation program guidelines established by the University of Maryland and Kernan Hospital. If necessary, patients can also undergo lung volume reduction surgery or, in select cases, lung transplantation.
People with emphysema can expect to proceed through the steps listed below if they are evaluated by our team:
You will undergo a series of tests that will help the staff define your illness and determine the extent of the problem. These tests typically include:
Your test results will be presented at our weekly multi-disciplinary conference, which is attended by members of the thoracic team. Based on the information, the team may recommend nonsurgical medical management, which involves medication and rehabilitation; lung volume reduction surgery; or, in special cases, lung transplantation. You will be contacted by phone five to seven days after the conference.
You will attend pulmonary rehabilitation sessions two to three times per week for a minimum of eight weeks. These sessions may take place at Kernan Hospital or a center closer to your home, and they typically involve an exercise regimen as well as education and counseling about the disease. The program is designed to help you retrain your breathing muscles, manage your shortness of breath, and conserve energy. If you attend faithfully and follow the therapist's recommendations, you can expect to improve by at least 25 to 50 percent, although many patients improve even more dramatically. While the program lasts for only eight weeks, it asks you to make a lifetime commitment to exercise. If you stop exercising, your symptoms are likely to return and gradually worsen. Moreover, if you go on to have surgery, the procedure is less likely to benefit you and your recovery will be much more difficult.
You will be scheduled to see the surgeon again shortly after you complete your formal rehabilitation. Before that visit, you will undergo some of the same tests that you had before. You also may need to have a VQ Scan, which shows how well the blood vessels and airways in the lungs communicate. You will be asked to breathe in a material which "highlights" the lungs when viewed by a special camera, and you will be injected with a drug that illuminates the blood vessels in the lungs. After these tests, the surgeon will re-evaluate you and decide on further treatment, which might include surgery, continued rehabilitation, or additional medical therapy.
If lung volume reduction surgery is recommended and you decide to go forward with it, you will be asked to sign a consent form and then schedule an appointment for pre-operative laboratory testing. The surgeon often will want to see you the week before your surgery is scheduled for an additional evaluation. During this time, you must stick to your prescribed exercise program and report any changes in your condition.
If you are interested in participating in the Emphysema Evaluation Program, we recommend that you first discuss it with your primary care or family physician. For more information, please call 410-328-6883.