A Story of Hope
or Never Say Never
Submitted by Erin M. Smith, RN, MS
Manager UCLA Cardiopulmonary Rehabilitation Program

UCLA’s Pulmonary Rehabilitation Program primarily serves adult and geriatric patients with chronic lung disease or who are recovering from lung surgery. Our staff of respiratory therapists, nurses and exercise physiologists team with these patients to help them manage their symptoms and strengthen their muscles to improve their quality of life.

One day I received an unusual request from Karen Nichols, a case manager from the pediatric liver transplant team. She asked if we could help an adolescent girl who had survived two liver transplants and was now suffering from hepatopulmonary syndrome, a complication affecting her body’s ability to use oxygen. Unusual, because we rarely see patients with this condition under the age of 50. Fortunately, Todd Bates, one of our staff respiratory therapists, had extensive inpatient pediatric experience, and we happily approved Karen’s request. Thus began the journey of Caitlin’s rehabilitation.

On Caitlin’s first day of pulmonary rehabilitation, we realized how truly compromised were her lungs: she could barely hold her own weight and needed motorized transportation, she could hardly breathe and her lips were blue. She could not live in her hometown anymore because she couldn’t breathe well at its high elevation, and she had not been able to attend her regular school for the past three years. Caitlin’s goals were simple: return home, go to school and join the dance troupe.

Learning of Caitlin’s wishes yet seeing her fragile state of health was heartbreaking and moved many of us to tears. It looked like she would never attain her goals. Bonding through their mutual admiration for all that is Disney, Todd remained optimistic and determined to help Caitlin. She struggled through tough days, but always showed up for her therapy three times a week. She needed a non-re-breather oxygen mask during exercise to walk at even the slowest possible speed and worked out side-by-side with “older” cardiac and pulmonary patients, who were all cheering for her with every step.

After just a couple weeks, Caitlin’s breathing deteriorated and she was hospitalized for a procedure that hopefully was going to help her. Less than a month later, she returned to our rehabilitation program. After two months, the unexpected happened. Slowly, Caitlin’s blue lips turned pinker and she began to maintain decent oxygen levels on her own. By the end of May, Caitlin was walking on the treadmill without oxygen, performing free-weight routines without guidance and developing bulging biceps! When she spent a weekend at her home, she did not need supplemental oxygen. On her last day with us, Caitlin announced her plans to return to school in the fall.

To celebrate her new health, when Caitlin graduated from Pulmonary Rehab, she wore a cap and gown and ceremoniously tossed her non-re-breather mask from the 200 UCLA Medical Plaza patio as a symbol of her new life (it was later picked up and discarded properly!).

We were moved to tears again.

This is just one of the many success stories that make working at UCLA Medical Center a privilege. These successes come when many disciplines come together and collaborate towards one goal: to improve our patients’ quality of life. Caitlin’s success is the result of many people and I am sure I know only a handful of her cast. Todd and the the pediatric liver transplant team planned Caitlin’s workouts with care, with advise from Sue McDiarmid, MD, Karen Nichols and medical director Ammar Sakkour, MD. Caitlin pursued her rehabilitation sessions with everyone in the Pulmonary Rehabilitation Program: Nancy Owens, RT; Barbara Platt, RT; Steve Arimoto, RN; Lauren Harning, EP; Alison Hagoski, RN; and Erin Smith, RN. Finally, Caitlin’s family and our other patients in our intimate gym never stopped cheering her on.

My experience with Caitlin has changed me both personally and professionally. I will forever think of her when I am offering hope to my patients and helping plan their goals. I know I will think of her whenever I need hope in my own life.

Note: On June 20th, I spoke with Caitlin’s mom, Kelly, and she reported that Caitlin was getting ready to go out on her jet ski! Pretty amazing!