Modern medicine has made fantasies such as transplanting major organs a reality. Tony Hammes is alive today thanks to a double lung transplant last September at UCHealth University of Colorado Hospital (UCH). Unicorns were not responsible for this fantasy-turned-reality, but they did play their role.
Hammes, 51, never smoked. In November 2010, a cough that stuck around longer than he was comfortable led him to a doctor. The antibiotics didn’t do much; nor would, as the years passed and he moved from Illinois to Wisconsin to Colorado, various rounds of steroids and other treatments. With time, his diagnosis crystallized: idiopathic pulmonary fibrosis.
The “idiopathic” means nobody knows what causes it. The “pulmonary fibrosis” part, as Dr. Joseph Crossno of the UCHealth Comprehensive Lung and Breathing Program describes it, turns the lungs’ air sacs into something like “stacks of red grapes, except the grapes are all raisins.”
That’s how it gradually came to be with Hammes’ lungs. For a long time, it was noticeable but manageable: he might become winded more quickly than in the past, but he could do the things he liked to do: play all kinds of sports with his young son Jonah, enjoy the outdoors with wife Kristin play golf with friends and colleagues, work in the yard. But by 2015, he was having a harder time of things. Shortly before his 20th wedding anniversary that July, he walked into a doctor’s office with an oxygen saturation of 85 percent (94 to 99 percent is normal; below 90 and supplemental oxygen enters the conversation). He walked out with an oxygen tank. He and Kristin laughed about it on the way back to the car.
“Here we are, married 20 years, and you’re with a guy with one of those big old-person tanks,” Hammes told her.
Listed
He continued to travel for work, bringing along the largest portable oxygen concentrator airlines allow in a cabin. But by December 2016, it was clear to Crossno and the UCHealth Comprehensive Lung and Breathing Program that Hammes would need a lung transplant. Hammes had already started pulmonary rehabilitation; now it was about keeping himself in the best possible shape going into the surgery. His lungs got worse; he ended up moving downstairs to the guest bedroom to avoid the climb.
On the first day of September 2017, after driving Jonah to school, he called UCH Lung Transplant Coordinator Maren Diercks. She suggested he come in. It would be a long, eventful stay.
UCHealth pulmonologists Crossno, Dr. Todd Grazia and Dr. Marty Zamora focused on his case. They stabilized him as best he could, but by September 7, no matter how much supplemental oxygen passed through Hammes lungs, they could no longer do the job. He would need extracorporeal membrane oxygenation, or ECMO. This involves sending blood that would otherwise flow to the lungs for oxygenation and carbon dioxide removal outside the body to a machine that does it. UCHealth surgeon Dr. Muhammad Aftab did the surgery. Coming out of it, half-inch-thick clear tubes resting in part on Hammes’ head carried his lifeblood. Between bites of a peanut butter sandwich, Hammes remarked to Crossno: “This is really cool.”
“I’m like, ‘Tony, this is not cool,’” Crossno recalled.
ECMO is a really cool technology, but Crossno’s concern, shared by the rest of the UCH medical team, was that lung transplant patients must use their lungs or risk being dropped from the transplant list. A lung transplant patient has to be able to expand the chest and walk at least a bit—otherwise they get “deconditioned,” as Crossno put it, and the risk of a failed transplant becomes too great to proceed. From the start of ECMO, the clock was counting down. If the right lungs didn’t avail themselves, Hammes would transition from hospital to hospice.
Surgery
Hammes’ survival hinged on the right pair of lungs arriving in the nick of time. He knew this, but remained positive and, with the exception of the sort of late-night anxiety that can strike those with somewhat lesser concerns, serene.
Hammes looked at it like this. He had for years hoped for, even anticipated, a positive outcome from this lung problem of his. He trusted his UCH medical team. And he told himself this: “I’m not in control of this outcome, but if I’m not meant to be here, that’s OK. I don’t understand it, I may not like it, and I have a desire to be here. But it’s OK.” That applied to the two people he was most concerned about: his wife and son, who, he told himself, “will be strong enough themselves, and have a strong enough support system, to go on without me.”
Such thoughts emerged from a natural optimism that made his room in the UCH Cardiothoracic ICU popular among providers. Unicorns came into play here. Using an app on his phone, Hammes gave doctors, nurses and others unicorn names based on the first letter of their name and their month of birth. Hammes’ unicorn name, “Prince Blueberry,” ended up under his actual name on the whiteboard in his room. To round things out, friends from work brought a unicorn statue to his ICU room.
Lungs arrived just under the wire. UCHealth transplant surgeon Dr. Michael Weyant performed the surgery on September 26. Hammes spent another month in the hospital, the last stop being the rehabilitation unit, where he had two sessions each of occupational and physical therapy a day. In late October, he was home again.
Deep breath
Lung transplant recovery takes time. But by February, with help of concerted pulmonary rehabilitation, he was shooting baskets with Jonah, now 13, and by early April he was working nearly full-time.
“We’re still in the honeymoon period, but he’s doing well,” Crossno said. “We really pulled that one out of the fire.”
Hammes is here, just as he had hoped and, on some level, expected. And he says he’s grateful beyond words – for the donor and his family; for his own family and friends; for his colleagues at O’Neal Flat Rolled Metals; and for the skillful, personally engaged care he received at UCH from the doctors to the nursing staff to the ECMO specialists to the respiratory, occupational and physical therapists.
“I’ll probably get emotional about this, because it’s pretty personal,” Hammes said. “The care was outstanding. And we knew that it would be good. You’re in the safest place you could be. This is the place. This is it. It just doesn’t get any better than this.”
He maintains a sense of wonder about the UCH Transplant team that saved him.
“What happened is incredible. It’s incredible that people have dedicated their lives to learn and become experts at this so people can benefit from it,” he said.
Hammes visits the ICU after most of his outpatient appointments, to say hi, to thank them again. He wears a cold mask as Crossno and colleagues suggest he do. On a recent visit, a certified nursing assistant asked if she could help him.
“I used to live here for a couple of months,” he said. “You might have taken care of me.”
She searched his face, but the mask lived up to its name.
“I’m Tony,” Hammes said. “I’m the unicorn guy.”
Her face lit up. “Prince Blueberry!” she said.