New asthma treatment offered in Charlotte region
By Karen Garloch, The Charlotte Observer | |
McClatchy-Tribune Information Services |
The change occurred in recent weeks after the 53-year-old Morganton woman came to
It's the first nondrug therapy approved by the
Across the country, about 25 million people, or one in 12, suffer from asthma. For most of them, avoiding allergens and using inhaled medications keeps symptoms under control. But for a minority of patients, like Myers, medication isn't enough.
With normal breathing, the bronchial passages are fully open. But people with asthma have more smooth muscle in those airways, and that constricts airflow and causes difficulty breathing. Those are the patients for whom some pulmonologists are now recommending bronchial thermoplasty.
In clinical trials, including one at
"This procedure does not cure asthma," said Dr.
Bronchial thermoplasty isn't for everyone with asthma. It's recommended for patients over 18 whose asthma is uncontrolled despite taking recommended medicines and who need to use "rescue inhalers" two or three times a week because of asthma attacks.
The procedure is covered by
Dr.
"They're not quite ready to sign off on this," McCrea said. "One lady has been in the approval process for six months. We're trying to make sure that it is approved up front so the patient is not burdened with unexpected cost."
The outpatient procedure is expensive -- about
"I think it will help a subset of patients," McCrea said, "and will get more accepted as time goes on."
Losing her son
Myers first learned about bronchial thermoplasty two years ago from her Hickory doctor, who suggested she sign up for one of the clinical trials in
She declined because she didn't want to travel that far. But then something happened that caused her to reconsider. Her 35-year-old son died from asthma complications.
On
"He probably took his medicine, sat down and fell asleep,"
Although her son had had asthma since he was 2,
"I wasn't sure if she was going to get another breath or not," said her husband,
He got serious about finding a better treatment. And when he researched bronchial thermoplasty on the Internet, he found it was offered at several
Despite her reluctance,
"People don't realize how serious asthma is," she said. "It can be a life-threatening condition."
She also wanted to stay healthy for her family. The Myerses have a married daughter and a 3-month-old granddaughter. They also have an adopted daughter who is 6. "I need to be able to breathe," she said.
Still 'investigational'
In May,
Before Myers scheduled the procedure, Zgoda sent letters to her insurance company,
Although approved by the
The
Despite that,
Myers said it could save money over the long term if she can stop taking some of her medicines. She and her husband spend about
"My deductible always gets met in January because of my illness," she said.
Breathing easier
With insurance approval, Myers' three procedures were scheduled about three weeks apart in September and October. During the first two, Zgoda treated each lower lobe of the lungs. The third treatment was for both upper lobes.
Myers was deeply sedated, and Zgoda guided a bronchoscope, a long flexible tube, through her mouth and into her lungs. An attached camera and light allowed him to view the inside of her airways on a monitor. Zgoda then inserted a catheter with an array of electrodes through the bronchoscope. Then, with the electrodes warmed by radio-frequency energy, Zgoda delivered repeated zaps of mild heat to the smooth muscle.
Each blast lasted a few seconds, accompanied by beeping sounds from the machine. Over and over, he moved the catheter and activated it from 80 to 100 times, until the entire airway was treated.
The difference was visible on the monitor. Before treatment, the tissue was reddish and swollen, with extra mucus hanging like a hammock from the sides of her airways. Afterward, the tissue was red and splotchy. But a few days later, the heat damage had healed, and the tissue looked healthy, a whitish pink, smooth and clear.
After the first treatment, Myers was able to reduce her daily dose of prednisone from 60 milligrams to 10. A month after her final treatment, she is down to 5 milligrams and feeling better than she has in years.
"I can actually go up and down my stairs without stopping to catch my breath," she said. "That sounds small to a lot of people. But believe me, that's huge for me. I called my husband.
"My whole reason for doing this was to get off steroids, but I think it's going to be so much better," she said. "I would have never believed it would (be) this good."
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