Milwaukee VA leads the way in advanced pulmonary care with Interventional Pulmonary Program

“I can’t do as much as I used to,” he said. “I get worn out, tired.”

Desjardin, a resident of Sturgeon Bay, began receiving his medical care through VA when the Milo C. Huempfner VA Outpatient Clinic opened in Green Bay in 2013. He is a retired Vietnam Veteran and the primary caregiver for his wife, who has multiple sclerosis. COPD has made it harder for him to provide the care she needs.

“She used to fall, and I used to pick her up and get pretty winded,” he said.

Through the Milwaukee VA’s interventional pulmonary program, he learned about options available to improve his quality of life.

On March 11, Desjardin became the first Veteran at the Milwaukee VA, and the first within the VA Great Lakes Health Care System, to receive bronchoscopic lung volume reduction (BLVR) therapy at a VA facility in the catchment area. This is a novel treatment that helps patients with COPD and shortness of breath even after maximal medical therapy. By placing one-way valves using a bronchoscope, the damaged portions of the lungs are isolated, allowing healthier parts of the lungs to expand and function more efficiently.

This new offering was introduced by Dr. Uzair Ghori, who brought interventional pulmonary program to the Milwaukee VA in 2022. The Milwaukee VA is the only medical center in the VA Great Lakes Health Care System to offer comprehensive advanced pulmonary procedures which include the following in addition to BLVR:

• Rigid bronchoscopy: This is usually performed by cardiothoracic surgeons to reduce the size of tumors or place stents to maintain open airways. This is now offered by the Milwaukee VA Interventional Pulmonary team.
• Cryobiopsy: This procedure uses cryoprobe to freeze and remove larger tissue samples during bronchoscopy. This has allowed patients with interstitial lung disease to receive diagnosis without undergoing surgery for lung biopsy.
• Robotic navigation bronchoscopy allows pulmonologists to biopsy hard-to-reach areas of the lungs with high accuracy and improved patient safety. “Think of it as the F-35 of the pulmonary world,” as per the pulmonary team. The Milwaukee VA was among the first VAs to adopt this system and has already performed more than 50 procedures. The other core proceduralists that support this program are Dr. Amit Taneja, Dr. Kavita Ratarasarn and Dr. Andreea Anton.
• Ghori and cardiothoracic surgeon Dr. Paul Linsky have also introduced a new technique to locate and remove small, difficult to find pulmonary nodules, which are small growths in the lungs. The interventional pulmonary team places a “beacon” at the nodule using robotic bronchoscope. The surgeon then uses a special “firefly mode” light to zero in on the nodule during surgery and removes it.

Most advanced pulmonary procedures at the Milwaukee VA are performed on an outpatient basis, allowing patients to return home the same day if no complications arise.

Strong collaboration from the endoscopy suite, respiratory therapy, anesthesia, operating room, and Intensive Care Unit teams has greatly contributed to the success of the advanced pulmonary procedures program. Michelle Musha, a registered nurse who is the procedure coordinator, serves as the orchestra conductor, skillfully synchronizing the efforts of various healthcare teams participating in delivery of care.

“I think the speed of service and the various types of services we are providing our Veterans, especially at the Milwaukee VA, is exceptional,” Ghori said. “We keep most of it in-house, and I think we do personalized health care.”

Desjardin, now back home caring for his wife, expressed his appreciation for the doctors, procedure team and nurses who tended to him before, during, and after his procedure.

“Oh, the care — the care here is great,” he said. “I’d recommend it.”