trials , not to mention implementing a new patient portal that facilitates patient-provider communication , is convenient . But , he says , the center offers much more than that : “ It ’ s access to physicians who have a long experience , not just by themselves but as a team . Now we can all work together and hone our practice .”
DOING RIGHT BY RHODE ISLAND In addition to growing research funding and providing high-end care , Ventetuolo hopes that the CALC will help address unmet patient needs in Rhode Island caused by the state ’ s shortage of pulmonary docs . This can happen not only by attracting pulmonologists to the center , but also by creating a pipeline of future specialists through fellowship training . Starting next year , she says , the CALC will offer cardiology and pulmonology fellows an additional year of training in advanced lung disease . In this way , she hopes , the new center can help reduce the number of people in the region who are still awaiting care .
Klinger is optimistic : “ When trainees see the high level of care in a specialty center like this , it really drives their enthusiasm .”
Martin , who originally wanted to become an interventional cardiologist , agrees . “ There ’ s a saying in pulmonary / critical care medicine fellowship training : ‘ People come for the critical care , but stay for the pulmonary ,’” he says . “ One of the things that attracted me to pulmonary / critical care — and I think this is probably true of other people — is the diversity . In the ICU , we take care of all sorts of stuff , because pulmonary medicine touches a lot of different fields .” Plus , it ’ s an exciting time to be in this field , he adds . “ If you look at cystic fibrosis , asthma , lung cancer , there ’ s an explosion in new treatments .”
Yet while much progress has been made , living with lung disease remains challenging . Pulmonary arterial hypertension has taught Jennifer something she wishes everyone understood : “ Just to breathe is a luxury .” Sarah Baldwin is a freelance writer in Rhode Island .
Breathing For Two
In the early 2000s , shortly after pulmonologist and obstetric medicine specialist Ghada Bourjeily , MD , began working at Women & Infants Hospital , she noticed that some of her pregnant patients with obstructive sleep apnea were also developing preeclampsia , a form of high blood pressure that occurs after 20 weeks of pregnancy . She wondered if sleepdisordered breathing ( a . k . a . snoring ), maternal health , and pregnancy outcomes might somehow be connected .
As it turns out , they are . In 2010 , Bourjeily authored what would become one of many papers that have since shown that sleep-disordered breathing during pregnancy is associated with a slew of negative outcomes . These include preeclampsia and gestational diabetes ; severe complications such as cardiomyopathy , congestive heart failure , and pulmonary edema ; and an increased risk of hysterectomy and admission to the ICU for the mother and pre-term birth and congenital abnormalities for the child . In fact , not only do preeclampsia and gestational diabetes have a harmful impact on the mother , fetus , and newborn , but the diseases also adversely affect women ’ s and children ’ s metabolic and cardiovascular health over the long term . ( Recent research has shown that Hispanic / Latina women who had high-blood-pressure-related complications during pregnancy are , 10 or 15 years later , more likely to have changes in heart structure and function — which in turn can be predictors of heart failure and death .)
“ We know that drops in oxygen level and adrenaline spikes several times a night impact organs like the heart , kidney , or brain in the non-pregnant population . Things that are dependent on those organs ’ function are also likely affected ,” Bourjeily says . “ So when a woman ’ s breathing is disturbed during sleep — which is very common in pregnancy — it may impact her whole biological system . That includes the placenta , which sends nutrients and delivers oxygen to the fetus .”
Bourjeily ’ s current research involves harnessing AI to identify abnormalities in breathing patterns . She is also working with international experts to develop guidelines for obstructive sleep apnea and pregnancy , and on labor , delivery , anesthesia , and pain medication in the context of women with sleep-disordered breathing . Like Corey Ventetuolo , Bourjeily is very interested in how sex and gender impact lung disease , and hopes that more fellows and faculty will develop an interest in the women ’ s-health angle too .
She also hopes to bring sleep services to the center : “ If a patient is here and they have pulmonary hypertension and we suspect they might have sleep-disordered breathing as well , it would be great if we could do the testing and treat them all in one place .” HD @ B
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