Join me as I delve into another fantastic experience at Okayama Medical Center (OMC), where I received a unique express treatment, including two additional balloon pulmonary angioplastyBalloon Pulmonary Angioplasty Balloon pulmonary angioplasty, or BPA for short, is a technique for widening narrowed or blocked blood vessels in the lungs of CTEPH patients. Small balloons attached to a catheter restore blood flow to areas of the lungs that do not receive blood due to the disease.  When successful, BPA eliminates or reduces shortness of breath, increases exercise tolerance and quality of life, and extends life expectancy. procedures. I went back to Okayama, Japan, for a scheduled follow-up. Several guidelines recommend an appointment three to six months after the initial balloon pulmonary angioplasty (BPABalloon Pulmonary Angioplasty Balloon pulmonary angioplasty, or BPA for short, is a technique for widening narrowed or blocked blood vessels in the lungs of CTEPH patients. Small balloons attached to a catheter restore blood flow to areas of the lungs that do not receive blood due to the disease.  When successful, BPA eliminates or reduces shortness of breath, increases exercise tolerance and quality of life, and extends life expectancy.) treatment [1, 2].

Back at the Center of Excellence

Okayama Medical Center, known for its advanced CTEPHChronic Thromboembolic Pulmonary Hypertension CTEPH is short for chronic thromboembolic pulmonary hypertension, a rare form of high blood pressure in the lungs caused by blood clots or narrowed blood vessels. High blood pressure in the lungs is often also called pulmonary hypertension. unit, is home to one of the world’s most experienced centers for balloon pulmonary angioplasty [3]. OMC’s team, led by Dr. Hiromi Matsubara, is one of the pioneers of modern BPA. Over the past decade or so, they have refined BPA into a highly effective and safe treatment for inoperable CTEPH.

I scheduled my follow-up appointment well in advance to ensure that Dr. Matsubara was available. I really wanted to see my hero again. After all, he turned my life around, and thanks to him, I no longer have to worry much about premature death.

Past Procedures

I underwent my initial treatment (four BPA procedures) during my stay at OMC in October and November 2022. These interventions have significantly improved my condition, and I feel fit for everyday life. My only issue is that my blood oxygen saturationBlood Oxygen Saturation (SpO2) The oxygen saturation (SpO2) of a person's blood is defined as a percentage of the maximum amount (100%) of oxygen it can transport. A healthy person's SpO2 percentage should be between 96% and 99%. - Source: What is oxygen saturation (SpO2)? What is the normal range for SpO2??. Retrieved 11 November 2022, from ihealthlabs.com (SpO2Blood Oxygen Saturation (SpO2) The oxygen saturation (SpO2) of a person's blood is defined as a percentage of the maximum amount (100%) of oxygen it can transport. A healthy person's SpO2 percentage should be between 96% and 99%. - Source: What is oxygen saturation (SpO2)? What is the normal range for SpO2??. Retrieved 11 November 2022, from ihealthlabs.com) tends to drop below 88% with exercise, sometimes as low as 85%. Any improvement in this area would be fantastic.

Related

Read my posts, Why Japan?, and My 2nd BPA Procedure.

Exceptional Express Treatment

Being pressed for time, I received unprecedented express treatment. My medical team squeezed examinations and treatments into just three days.

Exams on the first day:

  • Blood tests, 5 vials
  • 6-Minute walk test (6MWT)
  • Chest X-ray
  • CT scan
  • Electrocardiogram (ECG or EKG)
  • Lung function test
  • Echocardiogram
  • Lung perfusion scan

They performed extensive examinations and tests on the first day, leading to two additional BPA procedures on the second and third days. These interventions further reduced pulmonary artery pressure and vascular resistance. Everything went smoothly and without clinically significant complications.

On the fourth day, I was discharged from the hospital at noon and went directly to Osaka Kansai Airport for my flight home.

At the end of my 6th BPA: Dr. Sato, Dr. Matsubara, and I, still on a the stretcher in the catheter room.
Big smiles! Dr. Kimi Sato, Dr. Hiromi Matsubara, and I are in Okayama Medical Center’s catheter room at the end of a successful 6th BPA. Their work has given me a new perspective on life. – Photo by OMC and published with permission.

Hemodynamic Improvements

During this short visit, I had my 5th and 6th BPA, and my mean pulmonary artery pressure (mPAP) is now below 25 mmHg, while my pulmonary vascular resistance (PVR) is below 3 WU. Although these levels are slightly higher than those of a healthy heart-lung system, it is a significant improvement over my first BPA (October 2022), when my mPAP was at 57mmHg, and my PVR around 10 WU. – I couldn’t be happier!

An Impressive Performance

I was very impressed by my doctor’s performance. They managed to do all this without compromising the quality of care. Amazing!

This hurried approach may not be suitable for all patients. Personally, I felt exhausted and a bit drained for a few days. – I know, my doctors were tired too. Thanks for being so accommodating! I am forever grateful and will make it up to you. I promise!

One of my doctors explained that they could do it quickly because I was healthy (with no other diseases), my heart had improved significantly, and I was strong. – I walked 640 meters in six minutes, one of the farthest distances recorded at OMC.

Will It Work?

Will the two extra BPAs improve my blood oxygen saturation during exercise? Perhaps! Only time will tell. My doctors have advised me to wait two weeks before seriously exercising again. My lungs and my body need to recover first from the fatigue caused by two BPAs on two consecutive days.

Conclusion

Even though my stay at Okayama Medical Center was short, it left a lasting impression on me – fond memories of three awe-inspiring days. Despite feeling exhausted, I am grateful for the dedication and expertise that significantly improved my quality of life.

A Promise to Okayama

The magnificent Okayama Castle.
The magnificent Okayama Castle, a historical relic of the city’s feudal past, is just a 10-minute walk from the famous Korakuen Garden, one of Japan’s Three Great Gardens. – Photo Gregor Rasp

Okayama, also known as the “Land of Sunshine,” provides travelers with a range of experiences. Among them are the renowned Korakuen Garden, one of Japan’s most celebrated gardens, and the impressive Okayama Castle, a proud symbol of the city’s feudal past.

Okayama offers an unforgettable journey through the diverse and fascinating world of Japan with its rich historical heritage, breathtaking gardens, and cultural attractions. This city offers a delightful mix of traditional and modern experiences, from an age-old castle to contemporary art.

I’ve visited Okayama twice, but both times were rushed and I haven’t had the chance to fully explore all the wonders it has to offer. I vow to take my time on my next visit and truly immerse myself in all that Okayama has to offer.

References

[1] Humbert, M., Kovacs, G., Hoeper, M. M., Badagliacca, R., Berger, R. M. F., Brida, M., Carlsen, J., Coats, A. J. S., Escribano-Subias, P., Ferrari, P., Ferreira, D. S., Ghofrani, H. A., Giannakoulas, G., Kiely, D. G., Mayer, E., Meszaros, G., Nagavci, B., Olsson, K. M., Pepke-Zaba, J., Quint, J. K., … ESC/ERS Scientific Document Group (2022). 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertensionPulmonary Hypertension (PH) High pressure in the blood vessels leading from the heart to the lungs is called pulmonary hypertension. The arteries in the lungs and the right side of the heart are affected by pulmonary hypertension. If untreated, the right side of the heart will weaken over time, eventually leading to heart failure and death. The WHO has defined five distinct groups of pulmonary hypertension, each with a different cause. CTEPH is a form of PH (WHO group 4). - References: mayoclinic.org and cdc.gov. European heart journal, 43(38), 3618–3731. https://doi.org/10.1093/eurheartj/ehac237

[2] Saia, F., Galiè, N., Matsubara, H. (Eds.). (2022). Balloon pulmonary angioplasty in patients with CTEPH. Springer. https://doi.org/10.1007/978-3-030-95997-5

[3] Ejiri, K., Ogawa, A., Shimokawahara, H., & Matsubara, H. (2022). Treatment of Vascular Injury During Balloon Pulmonary Angioplasty in Patients With Chronic Thromboembolic Pulmonary HypertensionChronic Thromboembolic Pulmonary Hypertension CTEPH is short for chronic thromboembolic pulmonary hypertension, a rare form of high blood pressure in the lungs caused by blood clots or narrowed blood vessels. High blood pressure in the lungs is often also called pulmonary hypertension.. JACC. Asia, 2(7), 831–842. https://doi.org/10.1016/j.jacasi.2022.08.011.