Lung transplant recipient conquers new heights

August 10, 2021
two men pose next to their bikes on a paved trail
MUSC Health transplant coordinator Jason Ferro, left, and lung transplant recipient John Hoffman are part of a three-man team competing in an adventure race this month. Photo by Sarah Pack

A renewed sense of hope. That’s what his lung transplant gave him, said John Hoffman.

Hope and the determination to do the things that he’d always wanted to do – and maybe even a few things he didn’t know he wanted to do – but that his cystic fibrosis had prevented him from doing.

This Saturday, he’ll be testing those lungs on an adventure race – a 24-hour race in the wilderness of the Ocoee White Water Center in the Cherokee National Forest that incorporates whitewater paddling, biking and hiking. And he’ll be doing so with two people who are very familiar with his medical history – his transplant surgeon, Chad Denlinger, M.D., and MUSC Health transplant coordinator Jason Ferro.

Hoffman got his new lungs in October 2019 at MUSC Health. After that was recovery, and then, of course, the COVID-19 pandemic meant that no one was doing anything adventurous. But 2021 has been quite the year for Hoffman.

“I was at this point in my life where I was like, ‘I'm feeling great. Who knows how much longer I'm going to be on this Earth, so let’s knock out some big things.’ Half Dome was the first one I came up with because I've always wanted to do it,” he said.

Half Dome, an iconic mountain peak in Yosemite National Park, is reached via a 17-mile roundtrip hike that rises 4,800 feet in elevation and concludes, for those with the guts for it, with a 45-degree walk up the granite rock by pulling oneself along via steel cables.

To add to the challenge, Hoffman climbed it in April, when there was still ice and snow on the ground, and the wood ladder-type steps are removed for the season. It was harrowing, but when Hoffman reached the top, he had Half Dome all to himself.

A man climbs up a rocky path with a toddler in a hiking backpack on his back and a young boy ahead of him 
Hoffman and his children in Rocky Mountain National Park this summer. Photo provided

Quite a different setting for a man who had always loved hiking and biking but had started avoiding mountains in the years prior to his lung transplant because he couldn’t breathe.

Hoffman said the cystic fibrosis had slowly but inexorably put a stop to his activities. Cystic fibrosis is a genetic disease in which the mucous that lines organs, like the lungs, becomes thick and sticky. This makes it difficult to breathe and can lead to repeated lung infections.

“I could still go on a short hike and have a good time, but it slowly progressed to where in the evening, I'd be real fatigued. A lot of it was just tiredness,” he said.

For a while, the most that he could do was go to work, come home to his wife and two children and sleep. Eventually, his lung function was so poor that doctors were concerned that the flu or any other respiratory virus could become life-threatening. That’s when Hoffman went ahead with the lung transplant.

Fast-forward to the spring of 2021, and Hoffman sent photos of his Half Dome adventure to the lung transplant team. One thing led to another, and pretty soon, he had agreed to be part of a three-man team, along with Ferro and Denlinger, now with the Indiana University School of Medicine, taking part in the The Hogback, an adventure race that is as much a test of teamwork, orienteering – navigating using a map and compass – and strategizing as it is of physical stamina.

He just had one other thing on the calendar ahead of the race – climbing the Grand Teton in Wyoming. Hoffman returned to Charleston late Sunday from that trip. This time, he hadn’t reached the summit. He and a friend had gotten to 13,000 feet but turned back because of poor visibility. They had reached the point where they would have started using ropes to climb, but without being able to see where they were headed, they decided it was too unsafe.

portrait of a man on a mountain 
John Hoffman climbing Grand Teton in Wyoming. Poor visibility forced him and a friend to head back down once they reached 13,000 feet. Photo provided

But Hoffman doesn’t have time to think about those last 800 feet. On Friday, he’s driving to the race starting point in Tennessee.

This will be Hoffman’s first adventure race, but Ferro has been participating in adventure races for 18 years. He got Denlinger involved about six years ago, and together, they do two or three races a year. Three years ago, they won the Swamp Fox Adventure Race, a similar race that takes place in the Francis Marion National Forest.

“Race” is perhaps not the best description. When the participants arrive, they’ll be given a topographic map with checkpoints marked on it. Once the 24 hours begins, the teams must decide which checkpoints they want to hit and in what order.

“It’s up to you to determine how you’re going to find some of those checkpoints,” Ferro said. Some will be along a road and easy to find while others could be a few hundred meters into the forest. Teams can stay awake and keep going throughout the 24-hour period. In the end, the team that hits the most checkpoints wins.

“Usually, there's more checkpoints than you can get to, so you have to make strategic decisions as to what checkpoints make sense and which ones you should skip,” he said.

And that’s where teamwork and some brainpower come in.

“The great thing about adventure racing is it’s not the team that’s the most fit or the fastest that wins,” Ferro said. “Sometimes it is. But usually, it’s the team that makes the best decisions, maybe slows down to eat when they need to and makes good navigational decisions. Those are the teams that tend to do really well.”

It’s definitely a physical challenge as well. Teammates look out for one another, making sure no one is putting himself in danger, and picking up the slack for each other. Ferro said there’s a sense of camaraderie in these races, and even opposing teams will lend a hand. The races are about more than just a race to the finish, he said.

“You get to know your teammates really well. If you’re going to spend 24 hours with them, you have conversations that are interesting – you get to know people on a fairly intimate level,” he said.

Hoffman looks forward to this aspect of the adventure almost as much as he does to pushing himself mentally and physically.

“I like to push myself. I like to do hikes that I think will be hard because I like to feel that push,” he said.

Now all he needs to do is figure out what challenges he’ll tackle in 2022.