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Can you live with one lung?

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Lungs Health

The lungs are the primary organ of the respiratory system, and the human body typically has two lungs. However, exceptions exist, prompting the question of whether one can sustain life with just a single lung. While this may initially seem uncommon, it’s astonishing to discover that it is indeed possible. Surprisingly, individuals can lead their daily lives with this condition.

Our breathing process involves inhaling air through the nose. This air travels through a series of air passages, such as the trachea, bronchi, and bronchioles, ultimately reaching the lungs. It is in the lungs that the exchange of oxygenated and deoxygenated gases takes place. Subsequently, the oxygenated gas is distributed throughout the entire body.1Skrzypczak PJ, Roszak M, Kasprzyk M, Kopczyńska A, Gabryel P, Dyszkiewicz W. Pneumonectomy – permanent injury or still effective method of treatment? Early and long-term results and quality of life after pneumonectomy due to non-small cell lung cancer. Kardiochir Torakochirurgia Pol. 2019 Mar;16(1):7-12. doi: 10.5114/kitp.2019.82966. Epub 2019 Apr 4. PMID: 31043969; PMCID: PMC6491376.

Why Does Anybody Need to have his/her Lung Removed?

While most individuals would prefer the ease of breathing with two healthy lungs, unfortunate circumstances can arise, leaving no choice but to remove a damaged lung. However, it’s important to note that not every instance of these diseases necessitates complete surgical lung removal. The decision depends on the patient’s condition and the stage of the disease. Nevertheless, in many cases, the definitive solution involves a procedure called pneumonectomy, which involves the complete surgical removal of the affected lung.

Pneumonectomy and Its Indications

It is the surgical procedure of incision of a diseased lung. A study2Gu C, Wang R, Pan X, Huang Q, Luo J, Zheng J, Wang Y, Shi J, Chen H. Comprehensive study of prognostic risk factors of patients underwent pneumonectomy. J Cancer. 2017 Jul 5;8(11):2097-2103. doi: 10.7150/jca.19454. PMID: 28819411; PMCID: PMC5559972. reveals that pneumonectomy is a high-risk surgery that can lead to complications and even death. Several conditions can lead to pneumonectomy, including:

  • Inborn lung diseases
  • Bronchiectasis
  • Severe traumatic injury
  • Severe Lung injury (i.e., trauma)
  • Lung cancer
  • Fungal infections of the lung
  • Inflammatory lung diseases
  • Chronic obstructive pulmonary disease

COPD rarely leads to pneumonectomy unless severe complications arise.3Johns Hopkins Medicine. (n.d.). *Pneumonectomy*. Retrieved from [https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/pneumonectomy]

Lungs don’t Regenerate

Unlike the liver, which regenerates even if we remove 75-80% of the liver, the lungs don’t regenerate, so the lung tissue is not formed again once removed. If a person has undergone the removal of a lung, he’ll have to survive with the other lung only. Fortunately, the remaining lung adapts to perform the function efficiently.

Challenges Faced by Individuals Living with One Lung

While there are no specifically defined health risks associated with this condition, individuals may experience certain limitations and adjustments in their daily lives. Understanding these challenges can help individuals with solitary lung navigate their circumstances effectively.4Society of Cardiothoracic Surgeons of Australia and New Zealand. (n.d.). Pneumonectomy: What is it like to live with this condition? [PDF file]. Retrieved from https://www.scts.com.au/Files/Pneumonectomy-What-is-it-like-to-live-with-one-lung.pdf Here are some common aspects to consider:

Fatigue:

People with this state may experience faster exhaustion during physical activities. Strenuous exertion can lead to fatigue and an increased respiratory rate (tachypnea).5Vainshelboim B, Fox BD, Saute M, Sagie A, Yehoshua L, Fuks L, Schneer S, Kramer MR. Limitations in exercise and functional capacity in long-term postpneumonectomy patients. J Cardiopulm Rehabil Prev. 2015 Jan-Feb;35(1):56-64. doi: 10.1097/HCR.0000000000000085. PMID: 25350720.

Reinfections:

Taking proper care to prevent infections is crucial for individuals with this condition, as any respiratory infection can pose a higher risk.6Schneiter D, Kestenholz P, Dutly A, Korom S, Giger U, Lardinois D, Weder W. Prevention of recurrent empyema after pneumonectomy for chronic infection. Eur J Cardiothorac Surg. 2002 Apr;21(4):644-8. doi: 10.1016/s1010-7940(02)00043-x. PMID: 11932161.

Increased Breathing Rate:

Engaging in activities like mild jogging or running can increase the need for oxygen. Vigorous exercise may be challenging due to reduced lung capacity.

Altitude Concerns with One Lung:

Visiting high-altitude destinations, such as mountain resorts, may become more challenging. Reduced lung capacity coupled with lower oxygen levels at high altitudes can make breathing difficult.

Reduced Respiratory Function:

With the physical reduction of lung capacity, individuals may experience difficulties in activities like climbing stairs or engaging in morning walks due to reduced respiratory function.

Exercise Intolerance:

The decreased ability to supply sufficient oxygen to organs may result in exercise intolerance. It is important to adjust the pace of physical activities accordingly after surgery.
While these challenges exist, individuals with single lungs can lead fulfilling lives by making necessary adaptations and maintaining a healthy lifestyle.7Ilonen IK, Räsänen JV, Sihvo EI, Knuuttila A, Sovijärvi AR, Sintonen H, Salo JA. Pneumonectomy: post-operative quality of life and lung function. Lung Cancer. 2007;58:397–402. doi: 10.1016/j.lungcan.2007.07.008.

Can you still Live a Normal Life with One Lung?

Living with a single lung does not significantly impede one’s ability to lead a normal life. The body can efficiently obtain sufficient oxygen and expel carbon dioxide, allowing individuals with pneumonectomy to generally thrive, much like those with two lungs. To ensure a fulfilling life post-pneumonectomy, consider the following essential steps:

Emotional Support:

Receiving emotional support and surrounding yourself with positive energy are essential factors in leading a fulfilling life with a single lung. Make it a point to spend more time with family and friends, fostering meaningful connections that uplift your spirits.

Choose a Gentle Exercise Regime:

When engaging in physical activity, consider opting for gentle exercises that won’t strain your breathing. You can maintain an active lifestyle while avoiding undue breathlessness by replacing strenuous movements with softer alternatives.

Gradually Enhance Breathing Capacity:

Developing a habit of practicing breathing exercises recommended by your physician can help enhance your lung capacity over time. Consistency is key in building and maintaining optimal respiratory strength.

Heed Professional Guidance:

Following your physician’s comprehensive advice, including dietary recommendations and infection prevention measures, is crucial for ensuring a smooth and healthy life post-pneumonectomy. Regular check-ups and effective communication with your healthcare provider are vital components of your ongoing care.

Prioritize Hygiene:

Maintaining cleanliness and practicing good hygiene habits is paramount in preventing lung reinfections. By ensuring a clean living environment and adhering to proper hygiene practices, you can safeguard your respiratory health.

Minimize Hospital Visits:

To reduce the risk of exposure to infectious environments, such as hospitals, aim to limit your visits unless necessary. Keep supplemental oxygen at home and consider opting for teleconsultations whenever possible, allowing you to seek medical advice and support remotely.

Life Expectancy and Physical Activity With One Lung

The life expectancy of an individual with pneumonectomy varies based on factors such as age, overall health, and occupation.8Ciprian Pricopi and others, Postoperative morbidity and mortality after pneumonectomy: a 30-year experience of 2064 consecutive patients, Interactive CardioVascular and Thoracic Surgery, Volume 20, Issue 3, March 2015, Pages 316–321, https://doi.org/10.1093/icvts/ivu417 While mild physical activity is generally manageable as the remaining lung expands to compensate, it is advisable to avoid strenuous exercises that may strain your respiratory system.
Remember, with the right support, self-care, and medical guidance, you can lead a fulfilling and meaningful life, adapting to the changes brought about by pneumonectomy.

Rehabilitation After One Lung Removal

Following surgery, it is crucial for patients to prioritize self-care, maintain a nutritious diet, and diligently prevent infections to minimize the risk of complications. The recovery process involves comprehensive pulmonary rehabilitation, both during the hospital stay and upon discharge.

Inpatient Recovery:

During the hospital stay, patients undergo various forms of rehabilitation. This includes engaging in breathing exercises and gradually increasing mobility through walking exercises. The goal is to wean off the artificial breathing mask and encourage independent respiration. Additionally, a regular diet is introduced to support overall recovery.

Outpatient Recovery:

Upon discharge from the hospital, the rehabilitation process continues through outpatient care. This phase typically spans 6 to 8 weeks and primarily occurs at home. Patients are encouraged to engage in daily activities that promote strength-building and further enhance their breathing capacity. Gradually, they progress from mild activities to longer walks, enabling them to regain their physical capabilities.

Close coordination with healthcare professionals is vital throughout the rehabilitation journey. Regular follow-up appointments and monitoring ensure that progress is tracked, any concerns are addressed promptly, and personalized guidance is provided. By embracing the rehabilitation process and maintaining a positive mindset, individuals can optimize their recovery and regain a fulfilling life after pneumonectomy.

Living with One Lung: Understanding Potential Complications

When living with a single lung, it is important to be aware of potential complications that may arise and impact one’s overall well-being. While many individuals with single lungs lead fulfilling lives, there are certain risks to be mindful of. Here are some of the most common complications associated with having a solitary lung:

  • Respiratory Infections: Due to their reduced capacity for lung defense mechanisms, individuals with this condition may be more susceptible to respiratory infections, such as pneumonia. Preventive measures, such as practicing good hygiene, getting vaccinated, and seeking prompt medical attention for respiratory symptoms, can help minimize the risk of infections.
  • Reduced Exercise Tolerance: A single lung may result in decreased lung capacity, which can affect exercise tolerance. Under healthcare professionals’ guidance, it is important to gradually build endurance and engage in regular physical activity. This can help optimize lung function and improve overall fitness levels.
  • Cardiovascular Implications: This condition can impact cardiovascular health, potentially leading to pulmonary hypertension or arrhythmias. Regular monitoring of heart health and managing risk factors, such as high blood pressure and cholesterol levels, are important for maintaining cardiovascular well-being.
  • Emotional and Psychological Considerations: Adjusting to life with a single lung may bring emotional and psychological challenges. It is essential to seek support from healthcare professionals, family, and friends and engage in activities that promote mental well-being.

By being aware of these potential complications and taking proactive measures to manage one’s health, individuals with single lungs can lead fulfilling lives and effectively navigate any challenges.

Take Home Message

To conclude, Living a normal life with a single lung is possible. However, it has some limitations. Despite these challenges, many people with this condition can live relatively normal and active lives with appropriate medical care and lifestyle adjustments.
Individuals with this condition need to work closely with their healthcare provider to manage their condition and maintain their overall health and well-being.

Refrences
  • 1
    Skrzypczak PJ, Roszak M, Kasprzyk M, Kopczyńska A, Gabryel P, Dyszkiewicz W. Pneumonectomy – permanent injury or still effective method of treatment? Early and long-term results and quality of life after pneumonectomy due to non-small cell lung cancer. Kardiochir Torakochirurgia Pol. 2019 Mar;16(1):7-12. doi: 10.5114/kitp.2019.82966. Epub 2019 Apr 4. PMID: 31043969; PMCID: PMC6491376.
  • 2
    Gu C, Wang R, Pan X, Huang Q, Luo J, Zheng J, Wang Y, Shi J, Chen H. Comprehensive study of prognostic risk factors of patients underwent pneumonectomy. J Cancer. 2017 Jul 5;8(11):2097-2103. doi: 10.7150/jca.19454. PMID: 28819411; PMCID: PMC5559972.
  • 3
    Johns Hopkins Medicine. (n.d.). *Pneumonectomy*. Retrieved from [https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/pneumonectomy]
  • 4
    Society of Cardiothoracic Surgeons of Australia and New Zealand. (n.d.). Pneumonectomy: What is it like to live with this condition? [PDF file]. Retrieved from https://www.scts.com.au/Files/Pneumonectomy-What-is-it-like-to-live-with-one-lung.pdf
  • 5
    Vainshelboim B, Fox BD, Saute M, Sagie A, Yehoshua L, Fuks L, Schneer S, Kramer MR. Limitations in exercise and functional capacity in long-term postpneumonectomy patients. J Cardiopulm Rehabil Prev. 2015 Jan-Feb;35(1):56-64. doi: 10.1097/HCR.0000000000000085. PMID: 25350720.
  • 6
    Schneiter D, Kestenholz P, Dutly A, Korom S, Giger U, Lardinois D, Weder W. Prevention of recurrent empyema after pneumonectomy for chronic infection. Eur J Cardiothorac Surg. 2002 Apr;21(4):644-8. doi: 10.1016/s1010-7940(02)00043-x. PMID: 11932161.
  • 7
    Ilonen IK, Räsänen JV, Sihvo EI, Knuuttila A, Sovijärvi AR, Sintonen H, Salo JA. Pneumonectomy: post-operative quality of life and lung function. Lung Cancer. 2007;58:397–402. doi: 10.1016/j.lungcan.2007.07.008.
  • 8
    Ciprian Pricopi and others, Postoperative morbidity and mortality after pneumonectomy: a 30-year experience of 2064 consecutive patients, Interactive CardioVascular and Thoracic Surgery, Volume 20, Issue 3, March 2015, Pages 316–321, https://doi.org/10.1093/icvts/ivu417

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