Cleveland Clinic Team Helps Florida Patient Breathe Easier After Complex Lung Surgery

The 80-year-old is a retired firefighter and paramedic from Cleveland who now lives in Bonita Springs, Fla. Although he has dealt with asthma his whole life, he has always been active and fit, even running three miles each day with his dog. 

A few years ago, though, he began to feel short of breath. He went to a walk-in clinic and was treated for a virus with antibiotics and steroids, but his breathing did not improve. So, he went to see a pulmonologist (a healthcare provider who specializes in conditions that affect the respiratory system). Prior to scheduling a routine test, John became so short of breath he had to go to an emergency room where scans revealed that he had a pulmonary embolism, a blood clot that travels to the lungs from somewhere else in the body and causes a blockage. He was treated and released but remained under the care of a cardiologist and pulmonologist. 

Over time, routine scans revealed that John’s heart had become enlarged. He also developed swelling in his legs, which was presumed to be from high salt intake. However, the swelling eventually got bad enough that his skin blistered. He again went to a walk-in clinic and was given medicated cream and referred to his primary care physician.

Although his skin eventually healed, John, was certain more needed to be done, so he went back to see a wound-care doctor. 

“I was thinking there was still an issue with my veins, so I asked for a referral to a vascular surgeon,” John says. “The doctor said: ‘Your veins are fine. The problem is in your chest, your heart or your lungs.’"

Because he was familiar with Cleveland Clinic, he went to the emergency room at Cleveland Clinic Weston Hospital. 

“I was more than happy to drive the two hours to go to Cleveland Clinic Weston Hospital,” John says of the distance between his home in Bonita Springs and Weston Hospital in Weston.   

He went to see Jinesh Mehta, MD, a pulmonologist at Weston Hospital, first. Testing done by Dr. Mehta revealed that John had pulmonary hypertension (high blood pressure in the lung arteries), which was being caused by the blood clots obstructing the circulation in his lungs. He was put on medication and watched closely. 

“I felt better but still compromised. I couldn’t carry anything heavy,” John says. “I was frequently short of breath just going to the mailbox.”

Additional scans showed there were still four significant clots in his lungs. It was then that Dr. Mehta suggested John consider surgery, which was his best option since medication had not been completely successful. 

The procedure John would need was pulmonary thromboendarterectomy (PTE), a complex surgery to remove blood clots and scar tissue from the lungs. It is for people who have blockages in the lungs that can’t be treated with medication and are caused by the rare condition that John had, called chronic thromboembolic pulmonary hypertension (CTEPH).   

Many patients are eligible despite the procedural complexity. Cleveland Clinic Weston Hospital has a multidisciplinary team including cardiologists, imaging specialists, interventional radiologists, pulmonologists specializing in the care of patients with pulmonary hypertension and, most importantly, cardiac surgeons who review each case and decide on the optimal management for each patient. Although he was concerned about his age, he was reassured to hear that patients even older than him had successfully undergone the surgery. 

So, in December of last year, a coordinated team of Cleveland-based and Florida-based Cleveland Clinic physicians including Nicholas Smedira, MD, a cardiothoracic surgeon at both Cleveland Clinic main campus in Cleveland and Cleveland Clinic Weston Hospital in Florida, performed the procedure on John. 

He recovered in the hospital for a week afterward and said that he did not experience any pain. He has been doing physical therapy over the past few months and says his condition has been steadily improving. 

“Now I feel pretty good, almost normal,” John says. “I can walk at a pretty good pace now.”

He says he is back to walking his dog and can walk a few miles a day without getting short of breath. 

Follow-up testing has confirmed that all four of the major clots have been successfully removed.  John will remain on medication and continues to go for follow-up appointments at Weston Hospital.

“One of the things I like the most about Cleveland Clinic is they make every effort to accommodate you,” he says. 

He said he appreciates that he was taken on time for all his appointments and he was able to schedule several appointments and procedures on the same day, including blood draws with results the same day. The results of blood draws, X-rays and other tests were forwarded to the physicians almost immediately.

“It’s nice to go to one place to get everything done, especially when you are coming from a farther distance,” John says. 

“I’m happy,” he adds. “I tell everyone: if you have health concerns, be your own advocate. I’m glad I was and that I chose Cleveland Clinic.”