Giving back: once a lung transplant recipient, now a surgical nurse
Nurses are known for being kind, caring and sympathetic, but Brianna Fogelman brings an uncommon empathy to her nursing job at Johns Hopkins Medicine in Baltimore.
Fogelman, 27, underwent a double lung transplant last year to treat a rare lung disease and returned this fall to work in the same hospital where she received her life-changing surgery.
"I understand how it feels to have your ability to breathe taken away from you in just a couple of days," she said.
Though she had always planned to become a nurse, it wasn't until after her transplant that it felt like more of a calling, Fogelman said.
"My interest and passion spiked tremendously after I became a patient," she said.
The former high school track and field athlete was in her third year of nursing school when she was diagnosed in the spring of 2019 with hypersensitivity pneumonitis. It's a rare disease that causes inflammation that can lead to irreversible lung scarring.
The condition is caused by inhaling specific environmental allergens—in Fogelman's case, feathers. As a child, she had parakeets as pets and eventually developed an allergy to all types of feathers, including those in pillows, blankets and jackets. As a result, her lung condition worsened.
She and her doctors tried everything to improve her breathing, including immunosuppressants and steroids to reduce inflammation, and Fogelman said her lungs were "decent" for a while.
Then, in 2018, she developed an infection that would be pivotal for her health. "I had six to eight lung collapses from 2018 to 2019," she recalled.
Despite that, Fogelman managed to continue her nursing training at Wesley College in Dover, Del.
But soon after graduation, she got pneumonia and lost all remaining lung function. She was placed on the emergency transplant waiting list.
On June 24, 2019, after a couple of disappointments, she received her new lungs.
It was the 100th transplant surgery at Johns Hopkins for her surgeon Dr. Errol Bush, who is thrilled to have Fogelman back at Hopkins—as a nurse.
"She is an amazing nurse because of what she has been through," said Bush, surgical director of Hopkins' advanced lung disease and lung transplant program.
Fogelman's transplant surgery was a success, though it had an unexpected wrinkle: The lower lobe of her new right lung had to be removed during the operation so it could better fit in her small chest cavity.
Though she is not directly treating patients with COVID-19 or other infectious lung diseases, the hope is that she will see more lung transplant patients once the pandemic is under control. The medications she takes to prevent organ rejection make her more susceptible to infections like COVID-19.
Fogelman is one of the lucky ones, Bush said. Many donor lungs are too damaged to transplant safely due to underlying disease or time spent on mechanical breathing machines, he said.
"She knows how it feels to be intubated and waiting for lungs," Bush said. "We went through multiple donors and letdowns when lungs weren't good."
It all gives nurse Fogelman a special sensitivity to patients.
"She can answer questions like, "Is it painful?" and help relieve anxiety and offer support in ways that the rest of our care members aren't able to do," Bush said.
Waiting for new lungs was hard, Fogelman added.
"I empathize with patients who feel helpless and don't see the light at the end of tunnel," she said. "You are always getting bad news, and that's how I felt for so long."
All the time in the hospital waiting for new lungs left her a bit out of shape, but Fogelman feels "really good," she said.
"I can do everything," she said. "I can run and walk upstairs."
She is vocal about the benefits and importance of organ donation.
"Overall, it's very important that people try to understand that organ donation is so important and should try to get to know people who have benefited," Fogelman said.
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