Breaths of fresh air (Case Study)

Jan 14 2014

Breathing is something most take for granted, done with such ease that it is taken care of by our subconscious without even a thought. However this is not the case for someone living with Chronic Obstructive Pulmonary Disease (COPD).

For those suffering from the condition, each breath is an uphill battle, a conscious and laboured struggle. This decline continues gradually until simple daily activities like showering, dressing or making a cup of tea, become an almost impossible feat.

Imagine breathing through a straw while walking up a hill and you might begin to imagine what the one in seven Australians over 40 who suffer from COPD face each day.

Chris Lewis, a devoted mother and grandmother from Greta, began to notice she was finding it hard to breathe seven years ago, shortly after she turned sixty.

“I didn’t think my puffing was a disease at the time, I just thought I was getting old and unfit, but then l began slowing down,” Chris said.
Chris’ symptoms did not go ignored, her daughter Vanessa McDonald noticed her mother’s breathlessness and Chris was diagnosed with COPD shortly after.

Respiratory researcher A/Prof Vanessa McDonald and mother Chris Lewis
COPD is a long-term degenerative disease affecting the lungs causing shortness of breath and is used as an umbrella term for bronchitis, chronic asthma and emphysema.

It is not reversible and there is no cure but it is almost completely preventable. Cigarette smoking is the single largest cause of COPD in the Western World.

A team of respiratory research leaders who belong to HMRI’s asthma and airways research group are working hard to improve the outcomes for those who suffer from the disease. Among them is Associate Professor Vanessa McDonald.

Vanessa’s close relationship with respiratory disease goes back to her beginnings as a specialist respiratory clinician at John Hunter Hospital.
“Whilst I was working as a clinician I always valued the research that informed my practice and the fact that I was able to contribute to research, I think that made me a better clinician,” Vanessa said.

At the same time her mother Chris was diagnosed with COPD in 2006, Vanessa decided to take her experience from the respiratory clinic and focus on COPD research for her PhD.

“With Mum having COPD it certainly provides some motivation to improve outcomes for those living with COPD and to find new treatment approaches to help people,” Vanessa reflects.

“There was this view of COPD at the time that there was not much you could do. It was very difficult to determine if a person had asthma or COPD or both and which guidelines to treat them by.”

It was this gap in distinction between asthma and COPD treatment practices that would become the focus of Vanessa’s research.

“The population is ageing. As time goes on more and more people are being diagnosed with the disease and the trajectory is scary of how many people will have a diagnosis of COPD in the future” she said.

Vanessa’s approach to managing COPD involves developing treatment programs that are specifically individualised to each person. It is this significant change in some established practices that breaks new ground in COPD treatment.

Vanessa is currently working on designing an individualised medication therapy to treat inflammation in the airway and throughout the body. The study measures the inflammatory cells found in the blood or if there is systemic inflammation of the other organs throughout the body and then treats only the areas that are inflamed.

“This is more of a personalised approach to care where we individually treat the problem that exists and that then leads to benefits in inflammation processes, quality of life and a reduction in exacerbations and hospitalisations.”

The results of this study showed enormous improvement in quality of life for those suffering from COPD. So much so, that Vanessa and her team are now working on translating the pilot study into a larger trial to see if they can replicate the results in a larger population.

It seems that Vanessa’s combination of patient experiences, innovative research questions and the motivation from watching her mother manage such an illness has made her an unstoppable force within the respiratory world.

The significant contribution Vanessa has made to COPD was recently acknowledged at the HMRI Awards Night when she received the PULSE Early Career Researcher of the Year award.

“Winning the early career research award was surprising, it is great to have clinical research like this receiving awards,” Vanessa said.

“As a researcher I feel like I can give back to clinical practice by informing evidence based practice guidelines.”

Vanessa’s mother, Chris smiles with delight as she listens to Vanessa talk about her research achievements and it is hard not to notice her quietly oozing pride as she watches her daughter.

At this moment it is easy to forget that Vanessa is a world renowned researcher and instead to see her as a daughter, trying her best to help her mum to breathe a little easier.

Chris leans over and squeezes Vanessa’s hand as she says “Vanessa has a great thirst for knowledge, we were so proud of her…we are always proud of her.”

Vanessa takes a moment, and then replies: “It is great to see the impact that these research trials have on the people that you know, the people that you have been seeing in clinics and the people that you love but there is still a lot that can be done.”

While Vanessa has taken significant and important steps forward for COPD, she has her sights set on some even bigger goals.

“I would love to see a change in behaviour towards smoking, if we could just reduce the rates of smoking in the community we would be winning a huge battle in terms of preventing COPD,” she adds.

“In my lifetime I would like to see this personalised approach translated into all COPD health care guidelines across Australia, and I would like to see each person suffering from COPD receiving personalised therapy…yes, that really would make me very happy.”

HMRI currently has a number of COPD research studies that are recruiting participants. If you would like more information about enrolling in a COPD research study please contact: Brooke Emmett, Clinical Research Officer at the Priority Research Centre for Asthma & Respiratory Disease HMRI, phone: +61 2 4042 0125 or email: brooke.emmett@newcastle.edu.au