Chemotherapy. Radiation. Graduate from university.
That was Shilpa Raju’s to-do list in 2007 as a 21-year-old undergrad earning her degree in life sciences. An excellent student who had been accepted to a master’s program in the U.K., Shilpa couldn’t believe it when the unthinkable happened: She was diagnosed with Hodgkin’s lymphoma, a type of cancer that affects the body’s lymphatic system.
Although the cancer was treated successfully, the chemo and radiation took a toll on Shilpa’s once-healthy lungs. Serious damage left her struggling with pulmonary fibrosis and often out of breath. Still, she was determined not to let her health problems stop her. After spending a few months at home recovering, Shilpa travelled to India to work for a non-governmental organization (NGO), but eventually landed in the hospital.
“I think everybody copes differently [with illness],” says Shilpa, now 37 and an epidemiologist. She says of her decision to work while recovering from treatment, “I’m not good at doing nothing when I’m sick!”
The next few years tested Shilpa’s ability to maintain her career ambitions with damaged lungs. She suffered a collapsed lung during air travel back to Canada and was no longer able to fly, meaning that studying in the U.K was now out of the question. Still determined to reach her goals, Shilpa hopped a train to Vancouver to study public health at Simon Fraser University. But by the time she was back in Toronto and working for the Ministry of Health, her lung function had declined to less than 25 per cent.
“This is going to sound silly, but I would get off at the bus stop past my office so I could walk downhill,” she says. “I would be so out of breath.”
Double lung recipient Shilpa Raju.
A selfless decision that changed a life
When Shilpa was just 25 years old, her physician recommended that she use supplementary oxygen and that she be put on the waiting list for an organ transplant.
Currently in Ontario, there are about 1,400 people on the waiting list for an organ transplant. And while 90 per cent of Ontarians are in favour of organ and tissue donation, only one in three have registered their consent to donate at BeADonor.ca despite it taking only moments to complete.
One such donor’s selfless decision changed Shilpa’s life.
Before the end of 2012, she received a much-needed double lung transplant. By then, her health had declined so badly that she needed a wheelchair to get around.
The surgery, which typically takes 8 to 12 hours, didn’t go as planned, however. Shilpa’s lungs were severely scarred, making removal difficult. After 17 grueling hours, the surgery was completed and she was placed on extracorporeal membrane oxygenation (ECMO), a treatment that uses a pump to circulate blood through an artificial lung back into the bloodstream, and a ventilator, until she could breathe on her own.
With her new lungs in place, it was still months before Shilpa could walk and speak above a whisper. To make matters worse, the slow recovery stalled further when she experienced more health complications.
Shilpa developed a dangerous infection, as well as post-transplant lymphoproliferative disorder (PTLD). This complication causes the body to produce too many lymphocytes (a type of white blood cell). In Shilpa’s case, PTLD developed into post-transplant lymphoma, and she ended up back in hospital for four more months of treatment, complications and recovery.
Then, ever so slowly, things started turning around as she got better over the next eight years.
“I was seriously living my best life. I did so much,” Shilpa says. “I never quite recovered full lung function because of all the complications, but I could do a lot more. I could travel. I could fly. I was always challenging myself to do things.”
Those adventures included glacier hiking in Iceland, travelling back to India, hopping a plane to Tanzania for a friend’s wedding, going on safari and hiking several North American national parks with her fiancé, now husband.
“I got married!” she says with a laugh. “That maybe sounds trivial, but when I got out of the transplant operation, I was not even thinking about meeting [a partner]. I just wanted to work, hang out with my friends and travel – that was a successful outcome for me.”
Finding love was the icing on the cake, she says.
‘The little things that make a big difference’
Today, Shilpa’s job as an epidemiologist has given her a new perspective on life as a patient and why public health measures are so important to protect the vulnerable. Having been one of those vulnerable people through the COVID-19 pandemic, she says that screening, monitoring and checkups are important parts of a fully functioning health care system. Organ and tissue donation is too, she notes.
Toward the end of 2020, Shilpa’s health care team discovered she had kidney damage from long-term use of immunosuppression medications to prevent rejection of her lungs. She's now on dialysis and hoping to receive a kidney donation soon.
Despite everything, Shilpa is upbeat and focuses on what she can do now to thrive. This past year she walked five kilometres in Toronto’s waterfront marathon. She was slow, she says, but she didn’t give up.
“These are the little things that make a big difference. I’m getting to live life, and be there for milestones – both mine and those of my loved ones,” she says.
These are things that she couldn’t have experienced if she hadn’t been given the gift of a transplant 10 years ago, Shilpa adds.
This content was produced by The Globe and Mail’s Globe Content Studio on behalf of Trillium. The Globe’s editorial department was not involved.