After doctors told her that John, her gravely ill husband of 29 years, was too high of a risk for a lung transplant, Ann Lograsso lay next to him in his hospital bed and together the pair wept.
"Then I said, 'OK. We've had our moment. Now we're going to see what we need to do next because this is unacceptable. We're not just going to sit here and wait for you to die,'" said Ann Lograsso, recalling the moment that ultimately brought her and John to Loyola for a lung transplant on July 2, 2009.
She asked a nurse at the hospital where her husband lay dying for information on the best lung-transplant centers in the Midwest. At the top of the list was Loyola University Medical Center in Maywood, Ill. She called and was told by a procurement nurse that physicians there were willing to evaluate John for a possible transplant.
Encouraged for the first time since her husband medical ordeal began in May, she had John transferred to Loyola. Her mood soared when she saw the words written on the top of the hospital tower's façade that read, "We also treat the human spirit."
"Then I walked into the front doors and see this great waterfall and below it says, 'Only say the word and I shall be healed,'" Ann Lograsso said. "I thought, 'Thank you, God. We're in the right place. We weren't supposed to be over there. This is where we were supposed to be all a long.' Right from the start we were calmer."
Like all organs, the supply of lungs available for transplant is limited. To determine the order that donated organs are offered to candidates a lung allocation score (LAS) is used. The score takes into account a candidate's medical information, severity of illness and the likelihood of a successful transplant. The higher the score, the less likely that a transplant will be successful. The average LAS for patients at the time of transplant in the United States is 43.
When John arrived at Loyola for evaluation, his LAS was 93.5.
"It was one of the highest scores I had ever seen," said Dr. Daniel Dilling, medical director of the respiratory care department at Loyola and part of the transplant team that cared for John. "Lung transplant in a person who was as ill as John is not generally a feasible option."
However, as ill as he was, John had a few things going for him. Though he had had surgery for heart disease in 1996 and 2008, he did have the support and devotion of his wife, who had stood watch over him throughout stays at three different hospitals prior to his arrival at Loyola.
"She undoubtedly saved his life and I've told her that because she asked the right questions and scoured the Internet to find out what else could be done for her husband," Dilling said.
Also, John, 60, was a lifelong athlete who had maintained his physical fitness well. It came easy to him. From 1967 to 1971 he was a starting forward on the basketball team of Millikin University, which inducted him into its hall of fame in 1997. Also, he had coached junior high school basketball and up until he suddenly fell ill in May, he golfed up to six times a week.
"He was such a strong and otherwise healthy man. His athleticism and athletic build was a part of this," Dilling said. "Because he was so robust, we thought a lung transplant might be a possibility."
After a rigorous evaluation, John Lograsso was placed on the transplant list on June 26. On July 2 around 1:30 a.m., word came that a lung was available. By 6 a.m. John entered surgery, which was performed by Dr. Robert Love, vice chair of thoracic and cardiovascular surgery and surgical director, lung transplant, Loyola.
"It was a very difficult surgery. His old lungs looked like a cinder block. That's what Dr. Love told us," Ann said. "My daughter came back the next morning with me and said, 'At least he doesn't look like Shrek anymore.' His swelling had gone down a little bit."
Since his surgery, John's progress has been better than average his physicians at Loyola said. He was released to return home to Decatur on Aug. 11, earlier than had at first been anticipated.
"He was up against big odds but he did very well," said Dr. James Gagermeier, associate medical director, lung transplantation and medical director, bronchoscopy and interventional pulmonology, Loyola. "His lung function has improved dramatically. I see good things for him."
Dr. Charles Alex, another of John's physicians, agrees.
"His outlook should be very good," said Alex, who is medical director for the lung transplant program at Loyola. "He had a fairly uneventful post-operative course. He's very functional and anxious to get back to the normal life he had a short time ago."
Today, back home in Decatur, John admits that because of how sick he was, he doesn't remember much of what happened during much of his illness.
"But I do remember that she (Ann) was my angel looking over me. I wouldn't have been here without her," John Lograsso said.