"Many Americans aren't aware that more women in this country die each year of COPD than from breast and lung cancer," says Dr. Mark Hellreich, pulmonologist from Mission Hospital in Asheville, N.C.
According to Hellreich, an early diagnosis can be a powerful motivator for smokers to quit; the disease progresses twice as fast if patients continue to smoke. Hellreich said diagnosing COPD requires a fairly simple procedure, a five-minute breathing test called a spirometry, that is available in many physicians' offices.
The cause of White's disease was not so clear. When she developed IPF, doctors did not know how or why.
"The problem with my disease is that they have no clue what caused it," White said.
She said she just wanted the opportunity to once again enjoy her life, including spending time with her new husband, her children and her grandchildren.
IPF is a scarring or thickening of the lungs. It is less common, but far more deadly, than COPD. The average time from diagnosis to death for IPF patients is less than five years. Most patients die of respiratory failure within 10 years. But it's a relatively rare condition: An estimated seven to 43 of every 100,000 people in the United States develop IPF.
One common symptom of IPF is a noticeable change in a patient's breathing.
"If one month they are climbing stairs and then next month they are winded doing the same activity, it's cause for concern," said Dr. Phillip Camp, director of the lung transplant program at Brigham. "It's not just old age creeping up on you."
A definitive diagnosis of IPF requires a surgical lung biopsy. But doctors can occasionally diagnose the disease using a high-res chest CAT scan.
Currently, there are no FDA-approved medications available to treat IPF. Due to the aggressive nature of the disease, doctors recommend early referral to a lung transplant center shortly after diagnosing a patient.
For IPF patients, a transplant is the most reliable option.
COPD is the No. 1 disease warranting a lung transplant. IPF is ranked second. The death rate for people on the lung transplant waiting list is highest in IPF patients.
Lungs are a hard organ to come by. Only 15 percent of donated lungs are deemed appropriate for transplant, compared to 88 percent of viable kidneys and livers. One reason for this is because the lungs are more easily exposed to infection or irritants in the environment compared to other organs.
In New England, 65 percent of patients who received lung transplants suffer from pulmonary fibrosis, compared to the rest of the country, where most transplant patients suffer emphysema. Camp, the transplant center director, said researchers are unsure why New Englanders are more likely to have pulmonary fibrosis. Cold weather or industrial jobs are potential contributors.
On the day Bishop and White's lung transplants were to be performed, Dibardino hopped on a plane to a location in New England.
A donor had agreed to give both lungs. DiBardino's job was to harvest the lungs as quickly (and carefully) as possible -- one for Bishop, one for White -- then get them back to Boston and split them. He transported the organs in a cooler packed with ice.
Time is of the essence in a transplant. The less time an organ spends in transit, the greater its probable viability.