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If you’re having difficulty breathing, you want relief. At Genesis HealthCare System, you’ll get advanced care and treatment for a wide range of lung conditions and disorders. You benefit from a team including board-certified pulmonologists who’ll provide you an exceptional healthcare experience.

LiveWell Patient Story: Robotic Technology Makes Hard-to-Reach Lung Biopsies Possible

Doctors intended to use Shelly Grafton’s abdominal CT scan to discover the root of her stomach pain. While the results led to a hernia repair surgery and the removal of her gallbladder, the image also revealed something unexpected: a suspicious, small spot on the lower lobe of her left lung. 

“When I learned about that spot on my lung, I felt devastated. I wanted the best and quickest help I could get, and that’s what I received at Genesis,” Shelly said. 

Shelly’s tiny abnormality measured only 3 mm at the time of the CT scan (slightly wider than the tip of a crayon), which is too small to biopsy, but over a year, it grew to 10 mm (the size of a pea), the minimum size to biopsy. So, Emily Brawner, D.O., F.C.C.P., Pulmonary/Critical Care Medicine at Genesis HealthCare System, recommended gathering more information using the Monarch robotic-assisted bronchoscopy. This advanced technology allows physicians to access small lung nodules in hard-to-reach places. 

“The Monarch platform provides more stability and better visualization and precision. So, not only do we have a better chance of accessing hard-to-reach areas within the lung, we have a better chance of getting information and answers for our patients,” Dr. Brawner said. 

Lung cancer ranks as the deadliest cancer. The sooner and more accurate the diagnosis, the earlier treatment can begin, and the better prognosis for patients. With that in mind, Genesis invested in the innovative Monarch platform, becoming the second hospital system in Ohio to offer patients the technology. 

"Dr. Brawner held my hand and helped me feel safe like whatever happened, she would take care of it. She was very compassionate.”

Dr. Brawner used the Monarch technology in conjunction with another advanced bronchoscopy platform to perform two bronchoscopy techniques to assess Shelly’s lung. The Monarch electromagnetic navigational robotic-assisted bronchoscopy helped Dr. Brawner access and take nodule samples. At the same time, an endobronchial ultrasound (EBUS) allowed for lymph node samples from the chest. For Shelly, biopsies from this combined procedure revealed cancer. 

“I was nervous and upset when I learned the diagnosis. However, Dr. Brawner held my hand and helped me feel safe like whatever happened, she would take care of it. She was very compassionate,” Shelly said. “After the diagnosis, Dr. Brawner sent me to a medical oncologist and a radiation oncologist at the Genesis Cancer Care Center. Everyone is wonderful there. You don’t feel like you’re being treated for cancer. You feel like you’re there for an appointment.” 

At the Genesis Cancer Care Center, Shelly underwent chemotherapy five days a week for six weeks and then radiation therapy three times a week for another six weeks. For the next year, she’ll undergo a monthly immunotherapy session. Shelly says the treatments have shrunk and shriveled the tumor, and she feels grateful for such incredible close-to-home care. 

“For me, Genesis was the only place to go. It’s near enough to my home, the facilities feel light, bright and cheery and so are the nurses and everyone who works there. I had always heard the treatment was good there, and it is.” Shelly said. 

The Monarch robotic-assisted bronchoscopy technology allowed Dr. Brawner to perform a minimally invasive procedure to access small lung nodules in hard-to-reach places. This advanced technology helps patients like Shelly diagnose and treat their lung cancer.

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Pulmonary Rehab Transplant Success

100-pound weight loss achieved

It was 2014, and Martin Angler, a truck driver from Philo, was unloading boxes from the back of his truck. “It was just a normal day, and the work wasn’t that hard,” Martin said. “But when I got back in the cab, I felt like I was having a heart attack.”

He soon found out he was developing chronic obstructive pulmonary disease (COPD). Martin began treatment to help with his breathing, but the problem worsened. And not long after, he realized he needed to quit work.

It's time to take action

Several years passed, and Martin’s health continued to decline. His doctor told him a lung transplant could help him – but to be accepted into the lung transplant program at The Ohio State University Wexner Medical Center (OSU), he would need to lose 100 pounds. That meant there was hope. Even so, he felt discouraged knowing how much weight he had to lose.

“Then one day I woke up and decided I needed to do this,” Martin said. “So, I went on a strict diet and spent over a year working to lose the weight.”

Early in 2018, he reached his weight loss goal and called his doctor at Genesis, Emily Brawner, D.O., FCCP, Genesis Pulmonary/Critical Care Medicine, to share the good news and find out the next steps.

“It’s critical for patients to be as healthy as possible before they undergo transplant surgery,” explained Dr. Brawner. “Martin took this seriously and did the hard work of losing the weight. The next step was for him to undergo additional testing with his surgeon, as well as participate in the pulmonary rehabilitation program we offer at Genesis. We’ve developed a close relationship with the lung transplant and rehab team at OSU, which helps ensure the best outcomes for our patients.”

The testing for the transplant needed to be completed at OSU, which was over an hour away from Martin’s home. Fortunately, the pulmonary rehabilitation program at Genesis was just a short 15-minute drive away.

Preparing for the transplant

The Genesis Pulmonary Rehab program includes a team of experienced physicians, respiratory therapists, exercise physiologists, a registered dietitian and a licensed social worker who coordinate care for those with lung disease. Tisha Babcock,R.N., MSN, CCRN, CNL, director, Genesis Pulmonary and Critical Care Services, explained the process patients go through when they come to the pulmonary rehab program.

“Patients first meet with the team to discuss their lung disease and challenges they’re facing. We also do testing to get a baseline of a patient’s exercise tolerance, which allows us to set exercise goals,” explained Babcock. “We offer group education classes and support, weight training, balance training, stretching and flexibility, and more, all designed to improve their lung health and overall health.”

Ashlee Noyes, RCP, RRT, CTTS, is a rehab specialist who has worked closely with Martin since August 2019, when he first came to pulmonary rehab. She understands not only the physical and mental challenges patients with lung and breathing problems face, but also how hard it can be mentally, too.

“When Martin came to pulmonary rehab, he was on oxygen,” Noyes said. “Imagine being on oxygen, then someone tells you you’re going to start exercising. That can be a very scary thing when you feel like you can’t even breathe. So, part of what we do is help patients understand that we’re here to help them exercise safely.”

Martin completed the first part of the pulmonary rehab program by early 2019, attending two hours twice a week for 10 weeks. Much of his time was spent on the treadmill, a recumbent bike and a NuStep exercise machine. Martin also met with the team’s registered dietitian for tips and nutrition information specific to his needs to help make sure he kept the weight off.

After these programs were completed, Martin was placed on the transplant waiting list. Fortunately, he didn’t have to wait long; just a few days later, a set of lungs became available. He went in for the surgery at OSU, and the procedure was a success.

“I stayed in the hospital for 13 days. Then on Dec. 13, which is also my birthday, I was released,” Martin said.

Excellent results

After surgery, he continued to work with his OSU surgeon to meet specific goals and milestones. He also continued his pulmonary rehabilitation program at Genesis.

“He’s doing phenomenally,” explained Noyes. “He is hardly winded when he exercises.” Noyes credits Martin’s determination with his excellent results.

Martin finished the first part of pulmonary rehab and is now undergoing the maintenance program that gives patients the opportunity to maintain their health and continue exercising in a supervised environment at the Genesis Pulmonary Rehab Gym. One of the side benefits of the maintenance program is the opportunity to meet other lung disease patients going through similar challenges. The patients get to know each other, share ideas and offer support.

“Going to the pulmonary rehab program helps keep me motivated. It not only helps your strength, but your mental status, too, by talking to other people there,” Martin said.

Martin now lives his life without using supplemental oxygen. He also enjoys gardening and fishing – activities that he hasn’t been able to do for years. And one of the biggest rewards is knowing he’ll be able to play with his grandchildren, including a new granddaughter, who was born in June 2020.

For information about the Genesis Pulmonary Rehab Program, call (740) 454-4718.

Martin Angler Patient Story

Martin Angler was in need of a lung transplant and took action to lose 100 pounds in order to be accepted into a lung transplant program.

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Factory Worker With COPD Now Enjoys Fishing, Gardening

Thanks to pulmonary rehab

David Mummey has suffered from Chronic Obstructive Pulmonary Disease (COPD) for many years. So when his physician, Emily Brawner, D.O., FCCP, pulmonary critical care, suggested he start pulmonary rehabilitation through the Genesis Black Lung Program, he wasn’t sure it would help. David’s mother and brother died as a result of complications from COPD, so he didn’t think the program would improve his condition.

David stopped using tobacco several years ago but figured that 50 years of smoking cigarettes and working in dusty factory jobs had taken its toll on his lungs. Even so, he decided to give pulmonary rehab a try. “I was short of breath and just sat around. I was at the point I couldn’t put out a garden or do anything,” David said.

Give It a Try

He started phase II Pulmonary Rehab in spring 2014 three times a week at the cardiac/pulmonary rehab gym on the Bethesda Campus. The pulmonary rehab program is medically supervised and includes exercises to improve physical fitness, breathing techniques and strategies for managing COPD.

David admits the physical exercises weren’t easy. He didn’t notice an immediate improvement but continued through the program. The respiratory therapists encouraged him to stick with it. “Ashlee Clark is an angel,” he said. “I tended to push myself hard. If I started to struggle, she was right there.” After several weeks, his breathing and stamina improved markedly. “It’s made a big difference in my life. I have been able to do things I wasn’t able to do before.”

A Changed Life

David is able to go fishing with his daughter and grandchildren. He’s also been able to plant a vegetable garden – a task he couldn’t accomplish before starting pulmonary rehab. He completed phase II pulmonary rehab three times a week and is now doing phase III twice a week.

David is grateful for the care he receives through the Genesis Black Lung Program. “It’s changed my life. I’d be afraid to stop now. If I miss one time, I notice a big difference,” he said.

He’s glad he took the first step to enroll in the program. “If I hadn’t started pulmonary rehab, I might not be here today,” David says.

More information

If you have chronic obstructive pulmonary disease (COPD), or other lung issues, we want you to know the treatment you might encounter. Check out our Lung Information You Need to Know (Infographic).

David Mummey Patient Story

David Mummey started pulmonary rehabilitation through the Genesis Black Lung Program.

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