Home ventilation for respiratory failure: Jacquie’s story

When Jacquie Eubanks was born, her doctors weren’t optimistic. She was very small and faced several congenital conditions, including a cleft palate and severe scoliosis—a spinal curvature so pronounced it compromised both her movement and her ability to breathe.

Eubanks’ early life was marked by frequent relocations. Her father served in the U.S. Air Force, moving the family around the world before settling in a quiet town near Dover, Delaware. Despite her medical challenges, she grew up in a supportive neighborhood surrounded by lifelong friends.

Her scoliosis was not just visible, it was debilitating. “I only weighed about 60 pounds and I was the size of a 10-year-old,” Eubanks said. “The curvature in my spine was almost like a candy cane. It compressed everything in my chest.”

That compression would eventually cause more than discomfort. It would push her into early chronic respiratory failure.

A long road to diagnosis

In junior high school, Eubanks underwent spinal fusion surgery to stabilize her spine. The procedure required weeks in traction followed by 10 months in a full-body cast. Despite the physical toll, she was determined to live fully. She went to college, got married, and became a mother to two healthy children.

For 25 years, Eubanks has worked as a neonatal intensive care unit (NICU) nurse at ChristianaCare Health System. It’s an incredibly demanding role, both emotionally and physically.

“Sometimes I work 80 hours a week, running around the hospital. I’m not one to call out or take a lot of sick days,” she said.

But then something changed. One morning, Eubanks became severely short of breath just walking from the parking lot to her unit—something she’d done for years without issue. A specialist initially suspected pulmonary hypertension, and Eubanks underwent a cardiac catheterization.

The procedure caused complications, and Eubanks felt the diagnosis didn’t match her symptoms or clinical experience. She began searching for answers elsewhere.

The right team at the right time

Eubanks turned to Penn Medicine, making an appointment with Kerri Akaya Smith, MD, at the Penn Medicine Pulmonary Hypertension Program. After reviewing Eubanks’ tests, Smith recognized the real problem wasn’t her heart or lungs. It was respiratory insufficiency likely caused by her scoliosis. She referred Eubanks to John Hansen-Flaschen, MD, at the Fishman Program for Home Assisted Ventilation.

At her first visit, Hansen-Flaschen ordered comprehensive pulmonary testing. The results were sobering: Eubanks’ breathing muscles were significantly weakened, and her body was retaining high levels of carbon dioxide—a key indicator of chronic respiratory failure.

A sleep study confirmed Eubanks’ blood oxygen dropped dangerously low at night. Her chest wall deformity from scoliosis was severely impairing her ability to breathe properly during sleep.

Hansen-Flaschen recommended noninvasive home-assisted ventilation, using a breathing mask at night to give her overworked respiratory muscles the rest they needed.

A new lease on life

The impact was life-changing.

“I feel totally, 100 percent different than when I first went in,” said Eubanks. “Before the ventilator, I was always tired and barely able to get through the day. Now, I sleep seven to eight hours every night and wake up energized.”

Thanks to the home ventilator, Eubanks has returned to the career she loves and the life she fought so hard to live.

“Without it, I probably wouldn’t be able to work the hours I do or do the things I love,” she said.

Preventing a crisis before it happens

According to Hansen-Flaschen, Eubanks’ early diagnosis likely prevented a cascade of health complications. Without intervention, her respiratory muscles would have continued to weaken. The build-up of carbon dioxide could have led to a respiratory crisis requiring emergency hospitalization and possibly a tracheostomy.

“This is exactly what the Fishman Program is designed to prevent,” said Hansen-Flaschen. “Too often, people are misdiagnosed or told their symptoms are due to aging, heart failure, or even dementia, when in fact, they’re in early respiratory failure due to an underlying structural condition like scoliosis.”

Many physicians overlook how musculoskeletal abnormalities can lead to chronic breathing issues. Eubanks considers herself fortunate to have found a team that understood her condition and how to treat it.

“I’m so happy to be involved with Penn Medicine. I owe them my health,” said Eubanks. “They keep me on track, and I’m doing great, thanks to Dr. Hansen-Flaschen and everyone in the Fishman Program.”