Peggie Donowitz, an advanced practice nurse at U.Va., works with a team of physicians, nurses and physical therapists to help patients with emphysema find a higher quality of life.

August 22, 2005 -- Peggie Donowitz loves her job as an advanced practice nurse at the U.Va. Health System. She gets to see chronically ill patients come here searching for a better quality of life– and finding it.

Donowitz, R.N., MSN, works closely with Jonathon Truwit, M.D., head of the Division of Pulmonary and Critical Care Medicine, to help patients with chronic obstructive pulmonary disease (COPD) access the most advanced medical and surgical treatments. Emphysema is a common form of COPD, a group of lung diseases affecting 3 to 4 million people and the 4th leading cause of death in the United States. Often, these patients come to U.Va. carrying oxygen tanks and struggling to walk a few feet. Donowitz follows them through their first clinic visit at U.Va., several weeks of physical therapy, surgery, and more weeks of physical therapy. In the end, her reward is seeing them do things they didn’t think possible – like walking on a treadmill for 30 minutes. Donowitz particularly delights in watching lives like Brenda Wilson’s dramatically transformed.

“I have the pleasure of being these patients’ consistent contact through the course of their procedure,” Donowitz says. “I think our patients are incredibly brave. It’s a big decision to have surgery. Most of them fortunately do really well and are very appreciative. That makes the job very rewarding.”“ And I hear from them,” she adds.

A patient she met a decade ago still sends Christmas cards. Another patient recently got in touch to say he was doing what he loves most.“ He called to say he had just finished his 10 weeks of rehab (after surgery) and his first 18 holes of golf in ten months, and he got a bogey on the last hole,” she shared, smiling.

Another aspect of her job that Donowitz loves is working with responsive and highly skilled physicians.“ Dr. Truwit is on top of his game – he’s quick and he’s fast. It’s a
lot of fun to work with him,” she says. The thoracic surgeons who perform surgery on her patients– Thomas Daniel, M.D., David R. Jones, M.D., and K. Robert Shen,
M.D., – are great to work with too.“ The surgeons have all been receptive to working with me. The’re very good with the patients. Very kind. They certainly take time to answer all their questions and try to allay their fears.”

Over the past decade, Donowitz has helped 70 emphysema patients go through lung volume reduction surgery (LVRS). (See more about LVRS in the article Surgery at U.Va. Transforms a Woman’s Life.”) She has also been an accessible resource for cystic fibrosis patients and lung transplant recipients. She looks forward to seeing many more patients have LVRS now that U.Va. is approved by Medicare to perform the procedure. The coming year promises to be an exciting time. She’s helping Truwit oversee an early phase clinical trial of a treatment for
severe emphysema that gives an alternative to surgery. In this procedure, a one-way valve is implanted in select regions of a patient’s bronchial tree using a minimally invasive flexible bronchoscopy. Once in place, the valve limits the flow of
air into the diseased portion of the lung and gradually reduces lung volume, helping improve lung function.Over the next year, U.Va. plans to enroll 10 patients in the trial.

“I’m very excited about this trial,” she says. “We’re hoping this device will achieve the same results as surgery while reducing the risk of complication. U.Va. is one of only six centers in the country trialing this new valve. And only about 40 people nationwide have undergone this procedure.”

She adds: “I’m very proud to be part of a team of physicians, nurses, physical therapists and referring physicians, working together to give options to patients who come here desperate for help and many times, to their surprise, find the energy to enjoy life again.”