Quarterly Pulmonary Update Fall 2020

UAB MEDICINE PULMONARY SERVICES FALL 2020 FEATURE STORIES To read these and past stories online, please visit uabmedicine.org/referpulm. NHRA MECHANIC WHO INSPIRED MANY DURING COVID-19 RECOVERY DISCHARGED FROM UAB HOSPITAL Ervin “Jock” Allen spent 32 days in UAB Hospital battling COVID-19, including 24 days on a ventilator. Today, Allen is breathing on his own. The 28-year-old native of Jasper, Ala., is lead technician for the National Hot Rod Association’s (NHRA) Birmingham-based Steve Johnson Racing. He captured the spirits of many across Alabama and beyond since he was admitted to UAB Hospital – because of his own journey and that of his family. His mom, Candace Allen, a health care worker, was admitted to the hospital prior to her son after contracting COVID-19. She passed away on May 18. Allen’s sister, brother, and fiancée also tested positive but have since recovered. “When I get home, I just want to get outside and feel some fresh air,” he said. “It’s been a scary, happy, and sad experience all at once. It’s a blessing that I get to walk out of here and start my new journey.” With Allen’s permission, Johnson has chronicled his teammate’s journey on the Steve Johnson Racing Team Facebook page. Allen has developed a legion of fans and supporters in the tens of thousands who include people in the motorsports community and beyond. The JockStrong.com webpage, complete with #JockStrong-branded T-shirts and masks, was established to help the family. Allen spent a considerable portion of his time at UAB on the Medical Intensive Care Unit (MICU). It is there where the sickest COVID-19 patients are treated and where the majority of them often are on ventilators. Some, like Allen, are ventilated for longer than 21 days – a dangerous threshold for recovery. After Allen was admitted to UAB, he had to be medically paralyzed for several days, and he was proned frequently by UAB’s nursing staff. Allen was also in shock early on in his treatment. When he was finally able to come off of the ventilator, he required a tracheostomy. Allen was weaned off the ventilator in the Special Care Unit, where he spent 10 days recovering and his tracheostomy was removed. “He was in the ICU for about three weeks and very sick for a couple of those weeks,” says Tracy Luckhardt, MD, medical director of the Special Care Unit. “Once he finally turned the corner and his lungs started healing from the coronavirus infection, he’s done really well. He’s been getting very aggressive physical therapy, and occupational therapy has done an amazing job with him. He’s had a very remarkable recovery.” It is not lost on Allen that he is a 28-year-old who battled for his life against a virus that he admits he initially thought was dangerous only for older adults, particularly those with comorbidities. He understands the mortality rates for older adults are much higher than for young adults, but he hopes the severity of the virus and its effects on him will make him an influencer for younger adults to take it seriously. He says he will encourage others to wear masks, practice social distancing, and wash their hands frequently. For UAB staff in the MICU, Special Care Unit, and other critical care areas, watching Allen leave the hospital healthy and with a chance to resume his life lifted their spirits, Dr. Luckhardt says. “Our critical care staff, especially in the MICU, have been working so hard for months,” Dr. Luckhardt says. “We’ve had a lot of really sick patients — way more than we are used to dealing with. These patients take a long time to get better. There are a lot of setbacks. When we have a patient who gets better and is able to leave the hospital, that’s a huge win for us. It feels good for the team, and we really need to rally around those wins because it’s been a long several months with some really sick patients.” “I don’t remember a lot of what happened while I was here, but I do know the staff at UAB took really good care of me,” Allen says. “I can remember being calmed down by a nurse when I was scared in the ICU a couple of times. Then they told me when I first got in that they were going to push me, so be ready. And they did. They always came by and checked on me. They were great.” DR. BHATT EDITS NEW BOOK ON CARDIAC CONDITIONS AND LUNG DISEASE UAB Medicine pulmonologist Surya Bhatt, MD, served as editor for “Cardiac Considerations in Chronic Lung Disease”, published in June 2020. The new book offers comprehensive information on chronic lung disease and cardiovascular disease and their influence on one another, including the epidemiology, physiology, risk factors, pathophysiology, clinical features, diagnostic issues, laboratory and imaging tests, and therapeutic considerations. How the diseases specifically overlap is explored in detail, covering presentation, symptoms, clinical examination findings, diagnostic test results, and a number of important medication interactions. The cardiovascular considerations in this book include left ventricular systolic and diastolic dysfunction, pulmonary hypertension and right ventricular disease, and arrhythmia. The book also addresses extra-cardiac cardiovascular comorbidities such as cerebrovascular disease and peripheral arterial disease. Each chapter includes detailed illustrations, as well as useful pearls and best practices, making this an ideal reference for pulmonologists, cardiologists, and residents caring for patients with increased risk for these comorbidities.