Breathing easier-UTMB is one of only two medical institutions in the state to offer a unique lung volume reduction procedure

Jul 24, 2019, 01:10 AM by Christopher Smith Gonzalez

Dr. Shawn Nishi, professor in the Division of Pulmonary and Critical Care at UTMB, talks with Jimmi Raze following a procedure to insert a one-way valve into one of his lungs.
Jimmi Raze remembers when he would go on long walks—two or three miles at a time—along the Seawall in Galveston. 

A former Houston police officer, Raze also used to enjoy a visit to the gun range and his face lights up when he thinks about how he used to dance. Now retired and living in Galveston, Raze can’t do any of those things since he suffers from the effects of emphysema, a form of chronic obstructive pulmonary disease, or COPD. 

Instead, it has been a struggle to just take a breath. A conversation with a loved one is exhausting. A walk down the hall is like running a marathon. 

“I couldn’t walk as far I was able to walk previously, and I just forgot about going up the stairwell,” Raze said. 

But Raze has a chance at doing some of his favorite activities again thanks to a specialized team of health care providers at UTMB. The team recently installed small valves in Raze’s lung that should make a big difference. 

UTMB, recognized as a Joint Commission COPD Center of Excellence, is only the second center in the state to offer a unique lung volume reduction procedure using an endobronchial valve only recently approved by the Food & Drug Administration. 

There is no cure for emphysema, and COPD kills more than 140,000 Americans each year. With the illness, parts of a patient’s lung will become diseased and not work properly. Air is trapped in damaged areas and the lung becomes hyperinflated, putting pressure on the person’s diaphragm and leading to difficulty breathing. 

“Imagine taking a deep breath in and only letting out like a third of it and then you have to take another breath and can only let out a third of that,” said Dr. Shawn Nishi, a professor in the Division of Pulmonary and Critical Care at UTMB. “Suddenly you feel like you are barely taking a breath in because you don’t have any more room. That’s what these patients are dealing with on a daily basis. They are struggling just to breathe.” 

Nishi leads the interventional pulmonology team at UTMB. Until recently, the only treatments for severe hyperinflation were drugs, surgery to removed damaged parts of the lung or a complete lung transplant. 

Now, patients at UTMB who go through the evaluation process and qualify for the new valve procedure have another option. 

Endobronchial lung volume reduction is a minimally invasive procedure in which the health care team uses a bronchoscope to insert one-way valves into the damaged areas of the lung. The valve allows air to leave the damaged part of the lung but blocks air from entering. This allows healthier regions to expand and function better. 

“If we can induce a controlled collapse on the part of the lung that is not working, we can let the air preferentially be diverted to those areas of the lung that are working,” Nishi said. “Overall, the goal is the patients will feel much better. Their breathing will feel much less like exercise. Hopefully, they can walk a little more and their quality of life is better.” 

Just a few days after his lung volume reduction procedure, Raze was already breathing easier. He was having longer conversations on the phone with family members, eating more and looking forward to getting up and walking around. 

“There is a noticeable change,” Raze said. “I just got off the phone with my daughter in London, England. She said I sound better. Everybody seems to think that I sound better.”