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Saved Twice

Posted by on Tuesday, January 3, 2023 in Around the Medical Center, Fall 2022 .


Patient Janet Darnell received a lung transplant followed by treatment for colon cancer. Photo by Erin O. Smith.

The first time Janet Darnell saw her clinicians at Vanderbilt, she was sitting in a wheelchair, on oxygen 24 hours a day, and her lungs were near failure. She couldn’t walk from her chair to her front door.

In a series of events she considers miraculous, Darnell’s life would be saved twice in one year. First, she received a lung transplant in 2020. Just five months later, because of tests required for transplant, Darnell had surgery to remove stage 3 colon cancer. Without the lung transplant, the cancer may never have been detected.

Darnell, 66, of Greeneville, Tennessee, recently walked a mile.

“Sometimes I think I’m a walking miracle,” she said. “I really do. I owe it to the Lord and Vanderbilt. I don’t know what I would’ve done. There’s no other hospital around that I trust like I do them. I go down there, and I just feel comfortable. I feel like I trust those people.”

Darnell had no problems with her lungs until about two years before her transplant. She was seeing her family physician, and he became concerned listening to her lungs. He advised her to get a CT scan.

The results showed she had pulmonary fibrosis, a lung disease that leaves lung tissue damaged and scarred. There is no cure, and her only hope was a lung transplant. Researching the condition, she figured she could live two or three years on oxygen.

One night afterward, she fell asleep on the couch, and her husband couldn’t rouse her. She was rushed by helicopter to a hospital in Johnson City, Tennessee, and was on life support for six days. She had pneumonia, and her lungs had gotten worse.

Darnell saw a specialist in Johnson City who referred her to Vanderbilt for a transplant. Stephanie Norfolk, MD, assistant professor of Medicine, was one of the first of a team of pulmonologists who saw her in clinic. “She was definitely sick enough that without a transplant she would not have survived, I would anticipate, another six months, let alone 12 months,” Norfolk said.

Darnell was advised to build up her strength so she could walk for six minutes. She began physical therapy in Greeneville three times a week. “I kept going, and Vanderbilt kept checking, and one day, praise the Lord, I made the six minutes,” she said.

That was good, but then she had to demonstrate that to her treatment team. She did.

In April 2020, she got the call that her new lung was available. VUMC arranged for Darnell to board a plane at the Greeneville airport in East Tennessee and be flown to Vanderbilt. Her bags were already packed.

Darnell had a successful lung transplant, saving her life. Her life was about to be saved again.

To receive a transplant, all patients are required to receive a series of tests and screenings to ensure they are good candidates for transplant. Darnell had several colonoscopies both before and after her transplant. That’s how a suspicious polyp was detected, leading to a surgery in September 2020 when much of her colon was removed. “It is the only way to get the cancer out and to figure out what stage it is,” said her surgeon, Ben Hopkins, MD, who, coincidentally, is Norfolk’s husband.

“The confluence of events that occurred was lifesaving,” Norfolk said. “Having the lung transplant was what enabled her subsequently to get through surgery for her next diagnosis of cancer.”

Darnell is now on surveillance to ensure the cancer doesn’t return, said Hopkins, associate professor of Surgery. Five years after the cancer was removed, she will be declared cancer free.

The cancer screenings were “critically important,” Hopkins said, adding that American Cancer Society guidelines now say anyone 45 or older should get a colonoscopy, not age 50 or older, as was recommended until 2021.

Darnell’s oncologist, Cathy Eng, MD, said Darnell’s case shows how a multidisciplinary institution such as Vanderbilt can coordinate complex medical care — in Darnell’s case, two major medical issues. As a result, “she is 100% healthier than when she started,” said Eng, professor of Medicine, David H. Johnson Professor of Surgical and Medical Oncology and co-leader of the Gastrointestinal Cancer Research Program at Vanderbilt-Ingram Cancer Center.

Today, Darnell said she feels great.

“I’ve got more energy now, believe it or not, than I did before I found out I had pulmonary fibrosis,” she said. “I’m just amazed.”