To continue my story about the iron lung…

The majority of individuals still using the iron lung are polio survivors. Most, if not all, contracted polio in early childhood, during the late 1940s and early 1950s, when the virus was at its heyday.

They’ve been dependent on the iron lung ever since. So you can imagine how terrifying it must be, to be suddenly told that there will no longer be anyone available to fix your machine. That if you need a new part, well, too bad. If your iron lung is making weird sounds, well, live with it.

In all fairness, Respironics will exchange the iron lung for a newer ventilator, and there are a number of devices available. Most ventilators work on the system of positive pressure. These are the ones you see in hospitals, and the ones that the majority of ventilator-dependent people use in the home setting. Unfortunately, positive pressure ventilators are invasive, meaning that you connect to them via a tube down your throat or by a trach. Some of the newest models now offer a connection by mouthpiece, which eliminates the need for undergoing a tracheostomy (hole in the throat).

But the positive pressure ventilators have not worked for many of the polio survivors. Their lungs do not fill up sufficiently, and it is difficult to breathe. And so, they have returned to the tried and true iron lung, which works on the system of negative pressure. Respironics does have a modern update of the iron lung called the Porta-lung, a lighter fiberglass version of the old model. It works on the same principle, and some iron lung users have been able to transition over to it.

However, others can not. Whether the inability to do so is psychological (scary to make a change after all these years, especially if the old system has served you well), physical, or a combination of the two, for this group of individuals who cannot make a switch—their future is very uncertain. What to do if your iron lung stops working? How do you breathe?