Dean’s breathing easier
MINTURN – Sitting in the pew at Minturn’s St. Patrick’s Parish on the Sunday morning before Thanksgiving, Charlynn Canada knew her husband, Dean, was a dying man.Tethered to a dispenser of liquid oxygen, Dean could move only a few, halting steps before pausing to breathe. His complexion was sallow. He was frail. The lung condition that had progressively ailed him for decades was squeezing the last remnants of vitality from him.At home in Vail’s Bighorn neighborhood, the 63-year-old Canada had even begun writing his final appreciations and expressing his few regrets. When the priest that morning called for the Catholic sacrament for the sick, Charlynn nudged him. He had rarely taken the sacrament. It was, he had usually said, for those who were really sick.This time she told him, “If not you, who else in here deserves this more?”As he took the sacrament, Charlynn issued a prayer, a full-fledged plea for help. “Please, God, take care of Dean,” she thought. It was, she confided later, something she had never permitted herself before.”But I do believe that prayers are answered.”A different lifeA native of Nebraska, Canada had grown up in Denver and then Lakewood before moving to Vail in 1969. Although never athletically gifted, he had been true to the Vail tradition of sweat, sweat and more sweat, most of it outdoors.He swam and played racquetball at the Vail Athletic Club, ran up to Booth Falls after work, and on weekends he loved skiing, hiking up 14,000-foot peaks, and bicycling.In fact, it was on a bicycle trip that he had met Charlynn. They had so many interests in common they decide to get married. That was in 1979. But the Dean she married soon changed. She had to carry the baby when they hiked up mountains. He was out of breath. She couldn’t understand why. Neither could he.”It was about 1984,” Dean remembers. “Being in real estate, I was always on the buzz, running up the steps at the parking structure. I would get to the top and discover that, ‘Wow, I have chest pains. I think I’m having a heart attack.'”A stress test revealed a stout ticker. “You’re doing well,” the doctor said.”But I knew I wasn’t doing well,” Canada says. “I was always out of breath.”A good friend, who had asthma, nonetheless ran in every Memorial Day in the Bolder Boulder. “How can you run in the Bolder Boulder, and I can’t even run down the frontage road,” Canada wondered.Consulting a doctor in Boulder, Canada began an eight-year period when he was being treated as asthmatic. Again, symptoms defied the empirical evidence. X-rays failed to explain why his lung function had dropped from 55 percent of predicted to 45 percent.”I don’t see any emphysema, but it sure acts like it,” the doctor said.Not until a bout with bronchitis in February 1996 did Canada learn the cause of his problem. By then, X-rays were revealing scarring of his lungs that indicates emphysema. But Canada had neither smoked nor worked in dusty conditions or in places laced with chemical fumes, the usual causes of emphysema. Furthermore, the air in Vail is largely unpolluted.In Denver, a respiratory therapist suggested a blood test. A positive result would explain everything. And what if it is? Canada wanted to know. What is the cure?”There is no cure,” replied the therapist. “Only a lung transplant.”
Alpha OneDean Canada is among an estimated 100,000 Americans who were dealt a pair of bad cards, two corrupted genes that produce a condition called Alpha One Antitrypsen Deficiency.This disorder causes the livers of its victims to work improperly. The liver prevents the release of a protein needed for healthy functioning of the lungs. Most victims begin suffering when they are 39 or 40.Another 20 million Americans have a similar but lesser genetic corruption that results in less impairment. Not all of these with the lesser genetic corruption have problems. Those who never smoked and never worked in dusty factories, for example, might survive into old age with no problems greater than lagging a few inexplicable steps slower than their friends on the hiking trail.In the long years until he finally was given his diagnosis of Alpha One in 1996, Canada had found himself occasionally angry. It was an anger borne from frustration. No one could help him. Nothing was working.”It was never, ‘Why me? Why did this happen to me?'” he says. “It was ‘What the heck’s going on here. I used to be able to do all of these things, and now I can’t.'”Among friends and even acquaintances, none was going through the same thing. It was a perplexing, frustrating loneliness. Still, the diagnosis was actually a huge relief. “The not knowing was worse than the knowing.”He also learned about pulmonary hypertension. A frequent consequence of emphysema is that the heart, in attempting to pump blood into the lungs, struggles. In time, parts of the heart can become enlarged. This hypertension was manifested in Dean Canada in shortness of breath, hands turning purple and a lot of chest pain.”I couldn’t walk 5 feet without getting real tight in the upper chest,” he says.Through medical intervention, doctors reduced the pressure that was causing the dangerous pulmonary hypertension in Canada. He also began hearing about Fred Grover, who was said to be an excellent surgeon. He transplanted lungs.Life tethered to tubesAfter his diagnosis, he began using supplemental oxygen, day and night. In Vail, that made him unusual, almost unique.”Here I was in Vail, in real estate sales, and (customers) want to know they are in good hands and with someone who knows what they are doing,” he says. “And here they get a sicko with an oxygen tank. Why would anybody want to buy from me?”But I quickly found out that they really didn’t care. All they cared about was you taking care of them,” he says. “So it disappeared quickly, my image of myself as a pariah. The oxygen tubes blended into the woodwork.”People would usually ask, and if I had an opportunity, I would explain that it is a very, very strange condition. It’s not a disease. It’s a liver condition.”Taking people to show properties with stairs, he would give them the key and invite them to let themselves in while he worked his way up.The experience also caused him to be grateful. From the outset of his diagnosis in 1996, he was weekly administered an extremely expensive substitute protein that manages to slow, but not halt, the effects of Alpha One. Through all this, he was aided by a nurse in Vail, Kathy Robinson, who insisted in helping on her own time – after work, after kids, after many other responsibilities.Even so, his vitality slipped. He last skied in the mid-1990s. He continued to sell real estate into the 21st century. But even that stopped as the small tensions of setting up appointments, getting to a place on time, and finding parking places took their toll.When your lungs are delivering only 25 percent of the oxygen to the blood that you need, it takes very little at 8,150 feet – the elevation of Vail – to create an adventure.
“We discovered big hills where nobody else had noticed,” says Charlynn. “Have you ever noticed how steep it is walking from the Covered Bridge up Bridge Street?”Still, Dean Canada thought he had a high quality of life. Several years ago, when offered a lung transplant, he turned it down. It is not, he says, a completely free gift. The human body will eventually reject a transplanted lung. It’s just a matter of time.But last summer, while visiting Alpha One specialist Dr. Sandy Sandhaus at Denver’s National Jewish Hospital, he began to rethink his first stance against a transplant. As he left the office, Sandhaus’ nurse, Janis Berend, whispered into his ear, “Dean, you’re a chicken if you don’t do this.”Darkening daysCanada decided the nurse was right. But then, it was a matter of a donor.As the days of autumn shortened, the nights becoming longer, Canada’s mind darkened, too. He began evaluating his quality of life against the alternatives. Catholicism in no uncertain terms rejects self-dissolution. Still, the inner debate returned ever more frequently – every hour, every hour, every 15 minutes. As every breath becoming more of a struggle, he couldn’t help wondering if the church was really right in such matters.The darkness flickered at unexpected, inconvenient times, then settling in like dark fog. Always a friendly, joking, non-aggressive man, he turned stubborn, snappish, even belligerent. “I don’t know where the anger is coming from,” he had confined to Charlynn one night in the darkness before sleep.Charlynn didn’t know either – at first. Then she began thinking, and then researching. What she was seeing in this anger and withdrawal were the five stages of death as had been explained by the Swiss psychiatrist Elizabeth Kubler-Ross in her 1969 book, “On Death and Dying.”Dean Canada was dying. He might make Christmas, but not spring, Charlynn thought. His only hope was a lung transplant.The callAlthough Charlynn could never ask that someone else die in order that her husband could live, that was the essential truth. Somebody had died. The person, when getting a driver’s license, had said that his or her organs could be donated in the event of death.The call came three days after Charlynn’s prayer in St. Patrick’s. It was 10 p.m. on the night before Thanksgiving. “We may have a lung for you,” the doctor from Denver’s University Hospital had said. “Are you interested?”Canada felt himself go faint, as if passing out. “Let me call you back in two minutes,” he said. Regaining himself, he did. And within 10 minutes they were out the door.”I’ve had people laugh, I’ve had people cry, and I’ve had people vomit,” replied the doctor, Martin Zamora, “but I’ve never had anybody pass out. I’ll add this to the list.”Who was this person whose lung Dean was to get? Young or old, male or female, Denver or elsewhere? The Canadas were not told for sure. Only that they should get on the highway immediately.As they drove toward the frontage road in Vail, Dean found himself unable to breathe out – a condition common among emphysema patients. “I can’t breathe. I can’t breathe,” he said in panic. “Take me to the emergency room.”
Charlynn recognized it for what it was, anxiety. “Hell, no, we’re going to get a lung transplant,” she replied. As he calmed, they continued east – not that the lung was a sure thing just yet.”Call us from Copper Mountain,” the doctor in Denver had ordered. They did. It was still unclear whether the lung was good. By Silverthorne, though, the surgery was a go. Nurses, anesthesiologists, and surgeons were being assembled. They reached University Hospital at 12:10 a.m. Dean by then was confident, back to looking at the world with a gleam. “Can you give me a nose job while you’re at it, doc,” he told Grover, the chief surgeon.It was, says Charlynn, a rainbow coalition assembled at 3 a.m. for the surgery, faces that looked like they had originated from across the globe to give Dean a new chance at life.Not that it was a sure bet.”‘We may smoke you on the operating table,’ and those are his precise words,” Dean remembers the surgeon telling him. “‘We may leave you worse off than you are now. But there’s also a chance that you might be better.'”Feeling like 23 againThe surgery on Thanksgiving morning was quick for lungs, only five hours. It went unexpectedly well. Within two days, he was hobbling in the hospital hallway – for the first time in a decade with no supplemental oxygen.”They couldn’t hold me down. Once they got my catheter and other tubes out, I was getting up at one o’clock in the morning, walking up and down the hallway,” he says. “I was having so much fun, just walking up and down the hallway.”Given a new lease on life, Canada has found enormous gratification in the most elemental of life’s pleasures. Taking a shower one night, the warm water splashing off his body, became a mystical experience. He receives assistance with the utmost gratification. Most everything has been, to use one of his favorite expressions, two-thumbs up.”You have never been touched by humanity until you have been cared for by somebody who knows how much pain you’re in,” he says, speaking wondrously about the array of aides, many originating from Third World countries, who have cared for him.The recovery was set back briefly by painful intestinal surgery, partly the consequence of his lung surgery. Released within several weeks from the hospital, he has been spending increasing lengths of time in Vail.Offering a photo of himself at age 23, his hair only slightly receding, he proclaims: “That’s how I feel now. Like I’m 23 again.”If statistically his long-term prognosis is not hopeful, his short-term outlook is splendid. He is using his bonus to tell all he can about Alpha One but also the organ donor program.Canada says he has almost no regrets about how he lived his life, except that he did not spend more time with his daughter. “I was,” he says, “in the office until midnight too many nights when I should have been with her.”His final wish – aside from appearing on Oprah Winfrey show to testify to the wondrousness of organ transplants – is to walk with his daughter down the aisle at her wedding, when the day comes that she finds the right man.The way he’s feeling now, Charlynn says he might also just dance with her.Vail, Colorado