I was born in 1959 in Lisbon. My early years were marked by a typical family life, and we travelled a lot because of my father's work. I completed my schooling until the 12th grade and then started to work. In 1981, I completed mandatory military service at the marines' school.
When I reached my forties, my life changed. I began to feel great fatigue with any task that I performed, everything was difficult for me. I went to the doctor and, after various medical tests, I was diagnosed with high-grade emphysema. When I was diagnosed, I kept thinking about the causes: one of which was easy to determine, tobacco, and another according to my doctor was an alveolar malformation that may have been related to untreated asthma.
I began a treatment routine based on bronchodilators and cortisone and this was my life. Some days were better and some days were worse, for almost 10 years (figure 1).
Manuel prior to his transplant.
One day, my daughter, at the time a cardiac physiologist doing an internship at Santa Marta's Hospital, took me to the hospital where I performed lung function tests. The results were so scary that I was immediately seen by a doctor, Dr Paula Cravo, who then became my regular consultant. The situation worsened very quickly, with my mobility decreasing, my respiratory distress increasing and my blood oxygen levels falling to a considerably low level. I needed oxygen therapy 24 h a day.
During a routine appointment, my doctor told me about lung transplantation. I was a bit confused, I confess, because I was unaware of a transplant being an option. But as my situation was becoming unbearable, I accepted the possibility of having a transplant. I then went to a pulmonary transplant medical appointment, where I was seen by Dr Luisa Semedo. She explained to me what the surgery consisted of, the conditions required to be able to perform it, and the benefits it could bring me.
My first obstacle was getting onto the transplant list. I had to do a set of complementary diagnostic tests and the results were generally positive, apart from my weight. With all my strength, I followed a strict diet and managed to lose about 30 kg. I was also treated for hepatitis B that was detected in a blood test. Finally, I was fit enough to go onto the transplant list. I waited for about a year and a half. During this period, I was called four times about a potential donor, yet was unable to have the transplant.
On October 21, 2016 the hospital phone call we were waiting for arrived and I had the 15-h operation. This went smoothly for my situation. After 2 days, however, there was a complication. My diaphragm tore, and a prosthesis had to be put in, which meant having another 4-h operation.
I was in hospital for 2 months and 1 day. It was a very complicated period, during which I even thought of giving up fighting for my life. But one day I had a conversation with my doctor and realised that it was a second opportunity for me, and that I had a family that needed me and so I decided to keep fighting.
Today, after almost 2 years, I have a much better quality of life (figure 2). I can live and carry out my daily activities independently. I am really grateful for this second life and have the multidisciplinary team from Santa Marta's Hospital to thank.
Manuel 5 months after his transplant.
This article was produced with the help of Associação de Transplantados Pulmonares de Portugal (ATPP), the Portuguese Lung Transplant Association, which is a member of the European Lung Foundation (ELF)’s Patient Advisory Committee.
ELF was founded by the European Respiratory Society, with the aim of bringing together patients, the public and respiratory professionals to positively influence respiratory medicine. ELF is dedicated to lung health throughout Europe and draws together the leading European medical experts to provide patient information and raise public awareness about lung disease.
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