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Landon Bartel, 18, who had double-lung transplant in 1991 and again in 1996, is set to graduate high school on Saturday


June 24, 2005

It was a hot day, which automatically meant trouble for Landon Bartel, and when his high school ecology class went outside for a bird-watching exercise in a swampy area, he knew he could not go.

He didn't have to explain that climatic conditions probably would cause his sinuses to close and trigger a coughing attack. He simply asked to be excused, and the teacher, knowing Bartel's background, complied without question.

No big deal, really, but typical of the problems that have plagued the diminutive 18-year-old all his life.

"I handle things as best I can," he said. "There's no choice."

Which is why high school graduation, a milestone for most teenagers, is particularly meaningful for Bartel. For the approximately 500 other seniors at Sachem North High School, receiving a diploma tomorrow will be something to celebrate. For Bartel, it will be something to marvel at.

He not only has survived two double-lung transplants, but also has maintained a relatively high quality of life, an achievement of only several dozen other patients.

"I'm very lucky," Bartel said recently as he spent an early summer afternoon working on a computer in his room and playing with his dog in the backyard of his Lake Ronkonkoma home. "My situation could be very different."

His transplants were necessitated by a congenital lung disease -- interstitial pulmonary fibrosis -- that restricts breathing and hampers oxygenation. If not beaten back, the disease, which made Bartel feel and look like an anemic old man, probably would have been fatal.

After getting his first transplant in 1991, when he was 5, things generally were fine for several years. But the same troubles resurfaced in 1995, when he again began to feel tired and have trouble breathing.

Bartel's frail body was rejecting the foreign set of lungs, forcing him to decide upon another transplant. "I'm tired of being tired," he said, in 1996 after the operation.

Although the transplants saved his life, the patient paid a high price: A daily regimen of anti-rejection medication has compromised his immune system, making him highly vulnerable to germs and climatic changes.

Bartel, who is 4 feet, 10 inches tall and weighs 78 pounds (doctors attribute his small stature to longtime medication), has been hospitalized twice with pneumonia in the past two years. Sickness also has kept him home for weeks at a stretch.

"The doctors warned us about this," said his mother, Ronda, 46. "But we thought it would develop much later on. We were wrong. It's happening now."

Compounding her worries is the constant fear of her son rejecting his second transplanted set of lungs.

"Whenever he comes down with something," she said, "there's always that terrible question -- is it just an infection, or is it the start of a rejection process? This fear will never leave us, particularly because there won't be a third transplantation. Doctors simply will not try it."

The odds of rejection, pulmonary specialists say, are relatively small for one double-lung transplant; but they increase dramatically -- up to 65 percent after 10 years -- with a second transplant.

"Landon is a miracle," said Sheila Sherrod, 43, a licensed practical nurse who handles pediatric cases in St. Louis, where Bartel had both transplants. Nearly a decade after helping to treat him, she was to come here today for his graduation.

"He is a very special person," said Sherrod, who developed a similarly close relationship with only one other patient during her 15-year career. "This is the kind of kid that grabs your heart."

While excited by the prospect of seeing his nurse, Bartel, who turns 19 next week, is stoical about his condition.

"I'd rather not have it, of course," he said. "But I do. That's the bottom line."

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