Jim Varno is working in his home business, Varno Musical Instrument Repair. He picks up a shiny black-and-silver clarinet with reverence, knowing its worth to its owner, whether that’s a sixth-grade band student or a professional recording artist. This instrument, he says, is someone’s soulmate.
Varno blows into the mouthpiece, gently tapping his fingers along the keys. An ascending scale sounds, the notes fluid because he has fine-tuned the instrument using his 40+ years of experience in delicate repair techniques.
It’s a gesture that many of us take for granted: this exhalation of breath. But for Varno, his struggle to breathe was once so profound that he was prepared to sell his business and give up his life’s passion.
In December 2023, Varno was diagnosed with chronic obstructive pulmonary disease, or COPD, a condition caused by damage to the airways that blocks airflow to the lungs. Even walking across the street to his mailbox at his home in Leland, North Carolina, left him short of breath. Breathing deeply enough to play an instrument was impossible.
Suddenly Varno was faced with a dire reality.
“I’m 66 years old and I thought I was going to have to retire, sitting in a chair and watching TV,” he said. “I thought I wasn’t going to be able to do anything – that this was it,” he said.
But Varno’s Novant Health medical care team had another plan. With the right combination of therapies delivered with support from caring experts, and sheer determination on Varno’s behalf, he reduced his diagnosis from stage 3 (severe) to stage 1 (mild and manageable) in just a matter of months.
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Struggling for air
When Varno began struggling for air, he suspected he was simply “out of shape.” And the only familiarity he had with COPD was from occasionally seeing prescription drug commercials. Although he had been a smoker for much of his life, he had quit more than a decade earlier.
Because COPD is a progressive disease, its symptoms often develop slowly and worsen over time. It affects nearly 16 million U.S. adults, and many more do not know they have it. COPD is a major cause of disability, and it is the sixth-leading cause of death in the United States, according to the National Heart, Lung, and Blood Institute.
“I was miserable,” Varno said. “There’s nothing worse than not being able to breathe.”
Varno visited his primary care physician, Dr. Joana Carnahan at Novant Health Oceanside Family Medicine in Leland. He described her as “wonderful” and “really a godsend.” She’s thorough, too, and she ordered blood work, a heart stress test and an MRI.
Once Carnahan ruled out heart problems, she moved on to check lung function. This included a body plethysmography test, also known as a pulmonary function test, which involves standing in a clear, all-glass box about the size of a telephone booth. This revealed that when Varno was exhaling, it was diminished by 50%. Varno received a rescue inhaler and a prescription medication.
Carnahan, knowing Varno needed a sustainable, long-term solution to improve his breathing, connected Varno with Dr. Carter Childs, a pulmonary disease expert and medical director of the pulmonary rehabilitation program at the Novant Health Heart & Vascular Institute in Wilmington.
Childs conducted more diagnostic tests and based on Varno’s diagnosis of stage 3 COPD, started him on a different medication called Anoro. But it was Childs’ next recommendation that Varno said was truly life-changing: enrolling in the pulmonary rehabilitation program at Novant Health Brunswick Medical Center’s Wellness and Pulmonary Rehabilitation Center.
A life-changing commitment
Pulmonary rehabilitation is a program designed to help those with lung disease through regular exercise, nutrition and lifestyle choices. The program, customized for each individual, can help people manage their symptoms, complications, oxygen and medications, reduce hospitalizations and, most importantly, breathe better and improve quality of life. Key to a successful pulmonary rehab experience is the willingness to fully participate, Childs said.
“You don’t go and absorb it by just showing up,” Childs said. “You’ve got to go and do it, participate and give it some effort.” Varno, he added, was fully committed and “gung-ho.”
Varno attended pulmonary rehab two days a week, 90 minutes a session, for 12 weeks. There he worked with respiratory therapist Mary Wayne and exercise physiologist Keith Murray on exercises to strengthen his vascular system and improve his breathing function, like resistance training with weights and walking on a treadmill. “I’ll be honest with you, they kicked my ass,” Varno said. “I went there to work; I didn’t go there to loaf.”
Each workout ended in a few minutes of quiet relaxation with the lights dimmed. These moments of meditation, Varno said, were both a peaceful way to conclude an exercise session and a helpful way to learn stress management.
A key complement to this exercise regimen for Varno was receiving lessons in nutrition. One important takeaway, he said, was learning to limit his intake of white sugar. Instead of brownies, he now enjoys apples with peanut butter, and he’s learned to limit his portions by paying attention to his hunger cues and drinking plenty of water.
As Varno continued the program, with lots of encouragement from Wayne and Murray, he began to build a foundation that he saw as a “three-legged stool” of exercise, diet and work ethic. “If you kick out one of the legs, you can’t balance on two-legged stool,” he said. Varno became mindful of how he was moving and fueling his body each day, and found that regular exercise also helped him to sleep better at night, in turn giving him more energy to power his work ethic.
Varno began pulmonary rehab with the goal to be able to walk 1 mile without stopping. Within a month and a half, he reached it. “I was amazed, really, by what happened when I started doing what they told me to do,” he said. “It had to be a change in routine starting from when I got up in the morning.”
After 12 weeks, when Varno visited Childs for a follow-up, he learned that he had lessened his diagnosis from stage 3 COPD to stage 1, defined as “symptoms so mild that most people see no difference in their lung function.”
“It’s almost like I’ve been given a second lease on life,” Varno said. “I don’t want to give that up.” Following his completion of pulmonary rehab, he joined a local gym where he faithfully works out three days a week, and he finds that he still has energy to spare for regular walks.
Childs said patients often put off beginning the program when he first recommends it, then regret that they did not start sooner.
“Patients try it and say, ‘I should have done this years ago!’ I hear that all the time,” Childs said.
While months earlier, Varno had identified a buyer and was on the brink of selling his music instrument repair business, he’s now breathing new life into his career. “I don’t need to retire now,” he said. “I’m very happy doing what I’m doing and I’m back in the saddle again.”
