Living with asthma can have a devastating impact on anyone’s life. From sleeping through the night to walking to the bus stop to exercising, asthma can make even the simplest tasks difficult.
Asthma, a disease that affects the lungs, commonly causes persistent shortness of breath, a need to sit or stand up to breathe more easily, wheezing, a chest that feels closed, and the inability to speak in full sentences.
According to the Centers for Disease Control, one in 12 people have asthma. Recent statistics show that there were 1.3 million asthma-related hospital visits to outpatient departments and 1.8 million emergency department visits for asthma in 2010. Though asthma can usually be controlled by taking medications and avoiding triggers such as mold, tobacco smoke, dust mites, and outdoor air pollution — sometimes these interventions do not work when individuals have severe asthma.
A recently FDA-approved, minimally invasive procedure to treat asthma is providing individuals living with the disease a unique way to manage their condition. Bronchial thermoplasty is the first nondrug to ever be used to treat severe asthma and is now being offered at Jamaica Hospital. Patients with severe asthma have excessive airway smooth muscle in their lungs, which, when triggered, causes the airways to further narrow, leading to the onset of an asthma attack. Bronchial thermoplasty uses thermal energy to permanently heat and shrink thickened muscle that surrounds a patient’s airways.
A bronchoscope and the Alair System, which is comprised of an Alair Catheter and Controller, is used during the procedure. The Alair Catheter, which is introduced to the airways through the bronchoscope, has an electrode array that expands to contact the airway wall. Once in its desired position, radiofrequency energy is released and heats the wall of a portion of the airway in a controlled manner.
“This procedure is novel, in that it is the first time asthma is being treated in a physical way,” said Dr. Craig Thurm, director of Jamaica Hospital’s Division of Pulmonary Medicine. “Previously, patients with severe asthma could only rely on medications such as high dose inhaled steroids, bronchodilators and Xolair.”
Dr. Thurm explains that the procedure is generally safe and is broken into three different sessions, each scheduled three weeks apart. The first and second sessions treat the lower lobes of the lungs, while the third session treats the upper lobes. He also points out that a patient’s symptoms may worsen in the days after the procedure but offers potential long-term benefits.
Bronchial thermoplasty is only offered to individuals with severe asthma, who are at least 18 years old and whose asthma is not well-controlled with inhaled corticosteroids and long-acting beta agonists, such as Advair, Dulera, and Symbicort, despite using them as instructed.
“It’s important to understand that bronchial thermoplasty is not likely to cure asthma,” said Dr. Thurm. “It works as a complement to other asthma therapies.” Studies have shown that bronchial thermoplasty can reduce asthma symptoms and asthma attacks, as well as emergency room visits, hospitalizations, and days lost from work and school. Bronchial thermoplasty is currently only offered at three hospitals in the entire state — Jamaica Hospital included.
“We have a high incidence of severe asthma cases in our community,” explained Dr. Thurm. “There is a small group of patients who do not do well, despite our best efforts, including optimizing their medications. They continue to have symptoms and may end up requiring oral steroids, which can have many adverse side effects, such as osteoporosis. We are truly excited to have a new procedure to offer these patients.”
For more information about bronchial thermoplasty, call (718) 206-8776 or (718) 206-7130.