In 1992, a young mother shrugged off her increasing fatigue, chalking it up to the demands of two young children, one an infant, and a full-time job.
In 2002, a Lehighton man who had worked for years in auto body refinishing and then plastics manufacturing was beginning to find it harder and harder to breathe as he struggled to perform the routine tasks of daily life.
Eventually, both people – Missy Dietrich of Summit Hill and Robert Moser of Lehighton – received organ transplants that saved their lives.
Dietrich received a heart; Moser, lungs.
Their stories, begun more than a decade apart, have converged at the Cardiac/Pulmonary Rehab at Blue Mountain Health System's Gnaden Huetten campus in Lehighton.
There, they build strength and lung capacity under the careful guidance of experienced staff.
The rehab, now in its 17th year, is helping an increasing number of transplant patients.
"After heart or lung transplant surgery, many patients are referred to the rehab program to improve the patient's physical capacity toward functional goals, to improve the patient's quality of life, and to reduce the risk factors for heart and lung conditions," says rehab Supervisor Lisa Pompa.
And their numbers are increasing.
"Patients referred to Cardiac and Pulmonary rehab after heat and lung transplant are becoming more common because organ transplantation is a more common medical procedure today than in the past," says Gary Higgins, director of Rehabilitation Services. "People are living longer, which means that disease has a longer time to damage organs."
The most commonly donated organs are heart, lung, kidney, pancreas and liver, Higgins says.
Both Dietrich and Moser urged people to arrange to have their organs donated.
"And please let your family know you want to donate," Dietrich says.
Moser, who recalls refusing to follow the lead of his wife and daughters when they registered to donate their organs many years ago, is now a believer.
"I said, 'no way. I'm going to the grave with all my body parts,'" he says. "And now look who needed the transplant. I think God was trying to tell me something."
Moser, who has since registered to donate his entire body, is now "always after people to donate their bodies – skin and everything," he says, his voice muffled by the mask he must wear to protect his lungs.
"Donate your organs, because they don't have enough, and people are dying," he says.
The demand for organs for transplants is growing, according to Donate Life Pennsylvania.
More than 104,000 men, women and children across the United States are waiting for organ transplants, according to the organization.
Each day, 18 of them die because an appropriate match wasn't found in time.
In Pennsylvania, more than 7,900 people are waiting for life-saving organ transplants. Thousands of others wait for tissue transplants that would greatly enhance the quality of their lives, Donate Life says.
Dietrich and Moser – and their families – will be forever grateful to their donors. Both take many anti-rejection drugs every day, and work with the rehab staff to keep their bodies – and spirits – going.
Moser, 59, received his new lungs last year – 4 years after receiving his first transplanted lung on Aug. 8, 2005. That one was damaged when his original lung failed and became so swollen it pushed his heart and other organs into it.
He takes about 21 pills a day, a regimen that costs $95,000 a year, all but about $4,000 covered by insurance.
He needed new lungs because he suffered from COPD – Chronic Obstructive Pulmonary Disease. He attributes the ailment to a stint in Vietnam followed by years of working with automotive refinishing and plastics.
"Every year I just kept breathing harder and harder, until one day I just couldn't hardly breathe at all, and I needed oxygen," he says.
Moser's doctor referred him to the Lung Center at Temple University Health System, Philadephia.
There, under the care of Dr. Gerard J. Criner, he received his first lung.
"It worked great for 4 years, and then my other one started killing it," Moser says. "I thought, oh God, not again."
After the he received the double lung transplant last year, doctors let him go home and work with the BMHS rehab.
"This rehab center is very, very good," he says. He credits the staff for his progress. "They know their stuff," he says.
He could barely walk at first, but was back up to speed within weeks.
Dietrich, 43, who worked in physical therapy at Gnaden Huetten's nursing home when her heart problem was discovered, credits rehab director Higgins, then her boss, with saving her life.
Now, 18 years after her heart transplant, Dietrich still comes to the rehab three days a week – for exercise, camaraderie, support and the sense of community and caring.
She takes 28 pills a day – down from the 95 a day she took when she left the hospital.
Dietrich's journey began on Feb. 4, 1992. She was 25, had just had her second child and had hurt her shoulder while walking a patient when her heart problem, cardiomyopathy, was discovered. The condition makes it hard for the heart to pump out blood. It was apparently caused by the flu Dietrich had recently had.
It was Higgins – whom Dietrich calls "my hero" – who insisted further testing be done after emergency room staff sent Dietrich home with painkillers.
"The only symptoms were tiredness and being out of breath," she recalls. "I had just had a baby, and worked full-time" and thought that accounted for the symptoms.
On Feb. 5, 1992, cardiologist Dr. Ronald Stein told her she needed a heart transplant.
"I actually got up from my seat and said you have the wrong girl, and I started walking out," Dietrich recalls. "He said, if you walk out that door, you are going to die in two weeks."
Stein sent her to Hershey Medical Center, where she was prescribed medication that allowed her to function for four years. She started cardiac rehab that March – it had just opened.
Higgins got her a less physically demanding job, and she kept working.
But one day, while in the midst of helping to cook a spaghetti dinner for 80 occupational therapy patients, she knew she was in heart failure, and that the time had come for the transplant.
"It was a Monday, and I called Hershey and said, 'Tuesday at 12 o'clock, as soon as I'm finished, I will be down. Please have a bed ready,'" she says.
She spent a week at Hershey, where she was give more medication that allowed her to go home to prepare her family for what she knew would be a long absence. She cooked and froze meals, bought and wrapped birthday gifts, got her childrens' summer clothes out and ready and made a calendar of must-do tasks for her husband.
Dietrich was admitted to Hershey. Six months later, on June 4, 1996, she received a heart from a 16-year-old Lansdale boy who had died in a car accident.
"I got the transplant just in time," she says.
Her donor, Benjamin Niziolek, had just two weeks before told his parents he wanted his organs donated.
The night before the transplant, Benjamin's parents stood outside a Lansdale hospital, praying out for guidance, when a double rainbow brightened the sky.
A minister visiting Dietrich as she lay dying told her he saw the same rainbow.
Later, the Nizioleks and Dietrich corresponded, and marveled at what both believe was a Heavenly sign.
Now, Dietrich wakes up each morning glad to be alive.
Knowing that her new heart could be rejected at any time despite the many medications she takes, Dietrich has a profound appreciation for every new day.
"Every morning, I am so thankful my eyes open. I can't even explain it," she says. "No matter how I feel, when my eyes open, and it's like, thank you, Lord, because I have another day."