Asthma Treatment Gives Back Quality of Life
25
August

By Adem Lewis / in , , , , , , , , , , , , , , , , , , , /


[ Silence ]>>So asthma is a disease
that is characterized by airway inflammation and
bronchiole constriction or bronchiole reactivity. So, these patients
have inflammatory cells in the breathing tubes and have
muscles underneath the surface of their breathing tubes
that get bigger and bigger, and they start constricting
and causes trouble with air flowing
out there lungs. So, that causes them significant
amongst are shortness of breath and interferes with there
activities of daily living. It also occurs in some
patients predominantly at night interfering with their
sleep and their quality of life. So, asthma is airflow
obstruction causing disease. Yeah. Asthma occurs
in various degrees of severity in different people. For someone with moderate
persistent asthma, they have, despite being on medications, they would have airway
obstruction causing them not be able to exercise, limited in
terms of shortness of breath and not be able to sleep. They wake up wheezing, they–
it interferes with their work. They will lose different days
of work because they had to go to emergency room, doctor’s
offices, urgent care centers. They tend to sometimes get
treated with steroid medications that would cause
them to gain weight, raise their blood pressure, and
cause sometimes to be diabetics. So, they become overweight and
all of those things interfere with their life in many ways. The conventional therapy for
asthma is inhaler medications and they focus on
suppressing the inflammation that the asthmatics have
and also provide them with some dilatation of their
breathing tube facilitating better breathing. Bronchiole thermoplasty is a
catheter-based treatment option that is done through a
bronchoscope that is introduced into the patients
breathing tubes. What it does is, as
I mention earlier, these patients have smooth
muscles underneath the surface of their breathing tubes that
become bigger and bigger. And as they get bigger they
constrict more vigorously crossing the airflow
obstruction to be more severe. The catheter that we introduce through the bronchoscope
decreases the bulk of these muscles and thereby
making the airflow easier. Yeah. The procedure is
done in three stages. We use thermo-frequency waves
to de-bulk the smooth muscles. So it’s a heat based
to treatment option. So we don’t want to apply
the heat to all the areas of the lung at the same time, and therefore we
do it in stages. The first stage is
one of the lower lobes and three weeks later, we
do the second lower lobe on the opposite side. And then three weeks later, we do both the upper
lobes together. So it is done in three stages. And before and after each stage,
we measure their lung function with the lung function study to
assess their treatment response. The procedure itself, each stage
takes about 40 to 45 minutes. Sometimes it takes
less than that. But this is probably
the maximum amount and it’s done under anesthesia. It can also be done
under moderate sedation. It all depends on the
patient’s preferences. Some people like to be
anesthetized for the procedure and some people may not but
it could be done in both ways. And the recovery
time is fairly short. It’s an outpatient procedure. Patients tend to go
home the same day. We do observe them after the
procedure for about four hours, because having a bronchoscope down the breathing tubes
can sometimes aggravate their asthma. So, in order for– and
typically when that happens, it happens in the
first few hours. So, we monitor them for four
hours after the procedure so the patients typically spend
about half a day on the hospital and then go home,
and then they’re back to their normal activity, baseline activity
the following day. Yes. The, you know, the procedure’s recently
approved by the FDA. The studies that have
been done have shown that this procedure decreases
the severity of asthma, it decreases severe asthma
exacerbations by 122 percent, it decreases hospital
admissions by 73 percent, and decreases emergency room
visits by about 82 percent and this is certainly
not a cure for asthma. And so I always tell my patients
to have realistic expectations, but it certainly decreases
the vigor of asthma and makes it more livable with
asthma especially in terms of quality of life and time
lost from work and time lost from social activities. Yeah. The patient that I
recently did, did quite well. She’s a young nurse who
actually had lost her job because of frequent
asthma exacerbation. And after the procedure she
did very well, and she was able to go out shopping
with her daughter which she was unable to do. She was able to walk from the
parking lot from my office to my office, which is
a considerable distance. She was able to walk
with, walk very easily which she was unable
to do before. She had to always stop
and catch her breath. She is looking forward
to going back to work and she’s done extremely well. And we anticipate her
going off her prednisone. She actually lost 21 pounds
just by being more active after the procedure and she
had gained significant amounts of weight because
of her inactivity, because she was always
short of breath as well as the prednisone
she was taking. Yeah. The candidate for
this procedure is someone who has moderate
persistent asthma or above and if the patient or
their physician thinks that the patient is a candidate
for bronchial thermoplasty, they can contact my clinic and my staff can facilitate
missing the patient and evaluating them for
candidacy for the procedure as well as tolerating
anesthesia. And they can contact my
office at 650-934-7144. And Dinesh Prasad
[phonetic] is my nurse and he will facilitate
the appointment. They can also contact James
Canfield at El Camino Hospital in the respiratory medicine
section who can facilitate this. Right, it is a fairly unique
procedure that’s offered at El Camino Hospital
and, you know, the procedure is not available
elsewhere in the Bay Area except for one of the other medical
center which is a UC Davis. And so we are in
a unique situation because of our international
pulmonary program and a spectrum of procedures that we offer,
we have been one of the sites for offering this procedure. [ Silence ]


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