Yoga Therapy for Lung Transplant Clients – God’s Gift of Life

by Robin Bourdeau, C-IAYT, ICF-ACC

It would be impossible to share information about Yoga Therapy for Lung Transplant clients without sharing the journey of my “walking miracle.” In March 2022, my husband was diagnosed with Idiopathic Pulmonary Fibrosis (IPF). He had been experiencing increasing shortness of breath over several years, but it escalated to the point that he finally sought medical attention. His Primary Care Physician recognized the clubbing in his fingernails and referred him to a pulmonologist, and so the journey began: blood work, spirometry, biopsies, and more.

If you are not familiar with IPF, the National Institute of Health (NIH) National Heart, Lung, and Blood Institute describes IPF as “a serious chronic (long term) disease that affects the tissue surrounding the air sacs, or alveoli, in the lungs. This condition develops when that lung tissue becomes thick and stiff for unknown reasons. Over time, these changes can cause permanent lung scarring, called fibrosis, making it progressively more difficult to breathe.”

https://www.nhlbi.nih.gov/health/idiopathic-pulmonary-fibrosis

While there is currently no medical cure for IPF, we serve a mighty God who is capable of breathing new life into our bodies, and God saw fit to breathe life into my husband until new and healthy lungs became available to him. My husband continued to work and travel, requiring more and more oxygen as time progressed. He defied the odds over and over - from having COVID to experiencing severe dips in oxygen saturation and becoming unresponsive - and I began calling him my walking miracle. In March 2024, he came home from a trip with Influenza A, which put him in the hospital. This was a turning point, and he was finally ready to consider a lung transplant.

We began a rigorous evaluation and education process before being placed on the transplant list. As part of the education process, Cleveland Clinic provided a list of coping skills, and here is where yoga therapy came in.

Coping Skills (from Cleveland Clinic pre-transplant education program)

· Grounding

· Pursed Lip Breathing

· 4-7-8 Breathing

· Box Breathing

· Visualization/Mindfulness

· Journaling, medication, distraction, etc.

This is all essential information, and it cannot be stressed enough that having a qualified yoga therapist work with pre-transplant clients and their caregiver(s) can have a profound impact. The difference between being provided a list and having a certified yoga therapist is a gap that needs to be filled for lung transplant candidates.

The client and caregivers must be prepared for the physical, mental, and emotional challenges. The road to recovery following a lung transplant is not like other surgeries, and life will never return to normal. New lungs do not automatically just work; the body will forever treat them as foreign objects. The client may require ventilator support as part of learning to breathe again. Other everyday post-transplant experiences include blood pressure variations, atrial fibrillation (A-Fib), gastroparesis, paradoxical diaphragmatic breathing, muscle loss, and tremors (mainly due to anti-rejection medication). Anxiety, depression, delirium, and sometimes vivid dreams or hallucinations also accompany the recovery process. Primary and secondary trauma are unavoidable.

A God-centered, trauma-informed yoga therapist will be able to prepare the client and caregivers(s) with tools to manage the stress and anxiety of the life-altering process of being evaluated, placed on the waiting list, false alarms or “dry runs,” hospitalizations, ICU stays, and the long process of recovery, lifelong medications, regular blood work, and more.

While every journey is different, there are foundational concepts that can be applied to most situations. The following are derived from our journey and that of others we have been blessed to know as we rally together at the Cleveland Clinic. It is important to note that comorbidities can be present in pre-transplant candidates and should be carefully considered when constructing a yoga therapy program.

GROUNDING – Establish a connection with your body and, more importantly, with your Creator. Use a cue or signal that will be a simple reminder to slow down and breathe. Build a firm foundation.

“Everyone then who hears these words of mine and does them will be like a wise man who built his house on the rock. And the rain fell, and the floods came, and the winds blew and beat on that house, but it did not fall because it had been founded on the rock.” Matthew 7:24-25 (NIV)

BREATHWORK – Establish a routine and practice in advance of the procedure. Learning a new skill when trying to recover is significantly more difficult. Conscious and intentional breathwork helps with anxiety and recovery. Breathwork that focuses on the diaphragm can be particularly helpful. Breath prayers can help focus on connection with God.

YOGA – The stronger a person goes into the procedure, the more likely the recovery will succeed. A pre-transplant client will need strength, flexibility, balance, proper posture, and coordination. Depending on the progression of the disease, chair yoga may be a suitable option. Most transplant candidates will be prescribed pulmonary rehab, and yoga therapy is a solid complement to that.

MEDITATION/VISUALIZATION – The mind is a powerful tool in healing our bodies. It is essential to support the client transitioning from a ‘being sick’ mindset to a ‘being healthy’ mindset, from “I can’t” to “I can.”

“As we think, we change the physical nature of our brain. As we consciously direct our thinking, we can wire out toxic patterns of thinking and replace them with healthy thoughts. New thought networks grow and strengthen, increasing our intellectual capacity and healing our bodies.”

~ Dr. Caroline Leaf, Neuroscientist

NUTRITION – The post-transplant diet has many restrictions that may be a significant change for the client and his or her family. Knowing this in advance and working to establish new routines before transplant can reduce the anxiety of such significant changes in lifestyle during and post-recovery. Consider an Ayurvedic approach to support the client’s unique needs. This can also benefit the caregiver(s) whose lives will need as much routine as possible.

HYDRATION – Medications common to transplant clients can have an impact on the kidneys. Hydration is an important focus in recovery and supports a healthier heart rate and blood pressure.

In closing, I wish to recognize the incredible support from the medical staff at the Cleveland Clinic. The care provided for both patients and caregivers is world-class. Shout out specifically to the Physical Therapists, Occupational Therapists, and Respiratory Therapists who shared their expertise so freely.