Physical Therapist , Good Shepherd Penn Partners, Penn Medicine Transplant Institute

Derek Zaleski PT, DPT

“I describe the lung transplant process as a wild ride with an incredible ending. Patients begin their journey in the worst medical condition you can imagine and they come out the other end breathing easier, now free of oxygen and most of their previous limitations.

I get to see this transformation firsthand as the primary physical therapist for the lung transplant program. There are three main parts to my job. In the morning, I’m in the therapy gym helping post-transplant patients build their strength and conditioning as they recover. In the afternoons, I work with hospitalized patients to improve their mobility, strength, and exercise tolerance ahead of transplant.

The third facet of my day is the pre-transplant evaluations. Along with a respiratory therapist, we give patients a series of physical tests to determine whether they are good candidates for transplant. This is the most challenging part of my job because the transplant team relies heavily on my professional opinion and the outcome of these tests. This evaluation is one of the hard stops to transplant. It’s emotionally hard for me, but we have an ethical responsibility to transplant the appropriate patients. No one person is more deserving of a transplant than another, but it’s a fact that the transplant outcome will not be good based on their level of deconditioning. In some cases, we have to say no, and that’s not easy for any of us.

I definitely form lifelong relationships with my patients- two immediately jump to mind.

The first was a gentleman who was so sick he was receiving upwards of 70 liters of oxygen flow – that’s like a fire hose of oxygen in his face. He was so motivated to get transplanted, but he could only manage 10 minutes of activity a day – he was very limited. But he worked SO hard for those 10 minutes and gave us everything he had. His hard work paid off and he got his lung transplant.  He spent months in the hospital recovering and then more months working with me in the outpatient gym. He now volunteers his time recruiting organ donors for the Gift of Life Program, and he has lectured to Penn’s medical students about his experience. There’s a photo of him hanging in our therapy gym.

I also remember a woman I evaluated as an outpatient; she had advanced COPD with a very difficult journey ahead to make it to transplant. But that didn’t stop her, she was very motivated and eventually got her transplant. While she was waiting, she dyed her hair purple because she wanted to do something she would never normally do. She’s still alive today and keeps a purple streak in her hair to remind herself to live her best life every day.

It’s an incredible honor to be a part of these patients’ journeys.”

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