Dru’s story: mapping out a great life with pulmonary fibrosis

Reston resident Dru Smith, 59, is a geodesist with the National Oceanic and Atmospheric Administration and a married father of two. His work focuses on understanding the Earth’s gravity field, a critical science that underpins GPS technology. He is grateful to Inova’s Interstitial Lung Disease Program for helping him chart a course to living well with lung disease.

When Dru fell during a soccer game in 2011, he received a shoulder X-ray that revealed scar tissue in his lungs. Dru had interstitial lung disease, which was affecting the space between his lungs and his chest wall. His lung function was at 80%, and Dru took up running, in part to support his lungs. However, after several years of stability, Dru started feeling deeply unwell in 2020.

“I was getting sicker and sicker. Although every COVID-19 test I took came back clear, I was tracking 17 new symptoms, head to toe. I felt like I was dying,” he remembered.

Dru had developed an autoimmune disorder called microscopic polyangiitis (MPA) that was attacking his lungs. In the process of diagnosing and treating this new disease, it was found that he had increased scarring – called pulmonary fibrosis – and his lung function had decreased. His pulmonologist referred him to Christopher King, MD, Associate Medical Director of the Advanced Lung Disease and Transplant Program and Pulmonary Fibrosis Foundation Center Director at Inova Schar Heart and Vascular.

Comprehensive care for interstitial lung disease at Inova

“There are over 200 different interstitial lung diseases,” said Dr. King. “Here at Inova, we are equipped to provide multidisciplinary care across the full spectrum of conditions.”

Inova’s program, of which Dr. King is a part, is the only center in the Washington, DC, region accredited by the Pulmonary Fibrosis Foundation. The team includes interstitial lung disease physicians, a pulmonary pathologist, thoracic radiologists who specialize in interstitial lung disease, advanced practice providers focused on interstitial lung disease patients, respiratory therapists, and other lung disease experts.

The program connects patients with Inova’s comprehensive pulmonary rehabilitation program, as well as subspecialty clinics, such as a combined rheumatology and pulmonology clinic for patients with interstitial lung disease. It also works alongside pulmonologists, so patients can keep seeing their regular lung doctor while taking advantage of the specialty care Inova offers.

Inova is a leader in clinical research on lung diseases including pulmonary fibrosis. Steven Nathan, MD, Schar Chair, Advanced Lung Disease and Lung Transplant and Medical Director of the Advanced Lung Disease and Lung Transplant Program at Inova Schar Heart and Vascular, recently chaired the steering committee for the global TETON trial, testing a new pulmonary fibrosis treatment. The trial’s results have provided a compelling case for approval of a fourth drug for idiopathic pulmonary fibrosis, for which existing treatments provide only modest benefit. Two articles featuring the findings were recently published in the New England Journal of Medicine, with Dr. Nathan as the first author and Dr. King as a contributing author.

Groundbreaking research such as this benefits Inova’s patients like Dru, who is participating in a spinoff trial called TETON PPF.

Navigating pulmonary fibrosis successfully – as part of a team

Today, Dru is continuing to work closely with Inova’s interstitial lung disease team – and is continuing his fight against pulmonary fibrosis. He has replaced running with speedwalking and exercises six days a week, alternating speedwalking with lifting weights. He doesn’t use supplemental oxygen, and he is determined to keep his current lung function steady, so he can keep doing his daily activities without disruption.

“My goal is to live a long, healthy life,” Dru said.

“One thing that is special about our program is the amount of time we spend with patients. It’s a life-changing disease, and we feel that our patients should get adequate time to have their care addressed in a holistic manner,” Dr. King said. “Our people are a real strength of the program. The physicians are certainly part of it, but what patients talk about the most is how great the nurse coordinators are. They are so responsive when patients have a need or concern.”

Dru agrees. He gave two examples of team members who truly above and beyond. First is Brandy. She administers spirometry tests, which can be anxiety-inducing for advanced lung patients. “She is one of the most empathetic people I’ve ever known,” Dru said. Her supportive demeanor turns a difficult test into a manageable one.

When Dru began experiencing gastrointestinal issues while taking a new medication, Dr. King connected him with Anastasia, a registered dietitian on the advanced lung disease team. “She was a miracle worker. She kept following up, giving me new things to try until my GI issues subsided,” Dru noted. “The fact that she is on staff speaks to the excellent level of multidisciplinary care Inova offers.”

“We see patients frequently in the outpatient setting, so the team builds a relationship and a rapport with patients over time,” said Elsa Girma, RN, one of the program’s nurse coordinators. “Seeing them regularly helps us tend to their needs better, and it’s my favorite part of the job.”

The goal of Inova’s Interstitial Lung Disease Program is to stabilize patients’ lung function, stopping or slowing the disease down so patients can live full and abundant lives.

“What we focus on here is quality of life. We’re dedicated to supporting patients to live the best possible life while going through all these different changes,” said advanced lung disease nurse coordinator Julie Torres, RN.

Learn more about Inova’s Interstitial Lung Disease Program.