Asthma Attack: The "heat" is on

Trouble breathing, coughing, stuffiness and more and 60-million people suffer from allergies and asthma. There's no cure, but now doctors have a new weapon to help these people attack the annoying symptoms.

Karen Ecker lived the last five years a prisoner inside her own home.

"I couldn't have the windows open at all,” explains Karen Ecker a severe asthma sufferer. “My daughter would be playing outside and I'd get to watch her."

One day she was fine, the next was a different story.

"All the sudden I couldn't breathe," says Ecker.

Suffering severe asthma, simply leaving her house was dangerous.

"My lips would turn blue and I would just cough uncontrollably," says Ecker.

Anti-allergy medication, even steroids-did nothing to help. Then the FDA approved bronchial thermoplasty. It uses radio-frequency energy to heat up problem areas.

"It seems to reduce the thickness of the smooth muscle, which may reduce the spasming," says Sumita B. Khatri, MD, MS Co-Director Asthma Center Cleveland Clinic Respiratory Institute.

A catheter goes through the nose or mouth, into the lungs, and delivers thermal energy to the airways.

"And this basket has four metal struts on it, which is used to apply heat to the airways of the lung," says Dr. Khatri.

It's not a cure, but it's given Karen a chance to start crossing things off her bucket list.

"The first one on the list was a picnic with Steph outside," says Ecker.

She also checked off, a trip to the zoo, fireworks, a family vacation, going out to dinner, and her celebration thermoplasty garden.

"It's just a symbol of freedom just to be outside,” says Ecker. “At first I would stand at the window and look at it and dream of the day I would be standing out here."

Enjoying what most of us take for granted for the first time in years.

Lifestyle changes, steroid inhalers and nasal sprays are a first line of asthma defense.

Bronchial-therapy is only used for severe asthma sufferers and has been shown to improve the quality of life by reducing asthma symptoms, lessening the severity of flare-ups, and reducing the number of emergency room visits.


REPORT: MB # 3507

BACKGROUND: Asthma is a chronic lung disease that inflames and narrows the airways. It causes recurring periods of wheezing, chest tightness, shortness of breath and coughing. The inflammation can be trigged by a number of internal and external factors, but the exact cause is not known. The airways then swell and fill with mucus, making it difficult to breathe. Because asthma causes resistance, or obstruction, to exhaled air, it is called an obstructive lung disease.
Asthma is one of the most common and most costly diseases in the world, and presently, it has no cure. More than 20 million American have asthma, and managing asthma costs as much as $18 billion each year. In the U.S. each year, asthma attacks result in almost 10 million outpatient visits and 2 million emergency room visits. It also accounts for 500,000 hospitalizations and 4,000 deaths each year. TREATMENTS: Treatments for asthma can be divided into long-term control and quick-relief medications. There are two major groups of medications used in controlling asthma: anti-inflammatories and bronchodilators. Anti-inflammatories reduce the number of inflammatory cells in the airways and prevent blood vessels from leaking fluid into the airway tissues. Bronchodilators work by increasing the diameter of the air passages and easing the flow of gases to and from the lungs. Regular follow-up visits (at least every six months) are important to maintain asthma control and to reassess medication requirements.
BRONCHIAL THERMOPLASTY: Bronchial thermoplasty is the first device-based asthma treatment approved by the FDA. It's performed through the working channel of a standard flexible bronchoscope that is passed through a patient's nose or mouth, into their lungs. The tip of the small catheter is expanded to contract the walls of targeted airways. The thermal energy is then delivered to the airway walls to reduce the presence of excess airway smooth muscle that narrows the airways in patients with asthma. By decreasing the ability of the airways to constrict, this new treatment has been shown to help patients with severe asthma gain substantially better control over their disease.
According to a study in the American Journal of Respiratory and Critical Care Medicine, the patients treated with bronchial thermoplasty saw their quality of life improve. They saw a 32-percent drop in asthma attacks, an 84-percent reduction in emergency room visits for respiratory symptoms, a 73-percent drop in hospitalizations for respiratory symptoms and a 66-percent reduction in days lost from work or school or other daily activities due to asthma. Doctors stressed that this device does not cure asthma, but it helps improve the patient's quality of life. There's little risk since there is no incision, but patients may suffer from worse asthma symptoms the days immediately following the procedure. (Source: American Journal of respiratory and Critical medicine)


Kelynn Brewer, RN BSN Clinic Coordinator The Asthma Center, Cleveland Clinic Respiratory Institute (216) 444-0582

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