Lung Health : Procedure Reduces Need for Asthma Medication

David Bruce

Sharon Daly used to live an active lifestyle.

The Air Force veteran played softball for years and loved to exercise. But severe allergies worsened into chronic asthma, which sent the 59-year-old Erie woman to the sidelines.

"It's gotten bad. I can maybe walk half a block before stopping," Daly said. "Even getting in or out of bed leaves me short of breath."

Doctors prescribed all types of drugs and inhalers, but Daly's overall condition continued to worsen.

A chance meeting with Kenneth Chinsky, M.D., at the Erie Veterans Affairs Medical Center led Daly to Saint Vincent Health Center, where she has undergone a series of new procedures, called bronchial thermoplasty, which is designed to improve her breathing.

"I was filling in at the Erie VA for my partner when I saw Sharon," said Chinsky, a Saint Vincent pulmonologist.

"I immediately thought she would be a good candidate for this procedure because while she has severe asthma, she is in otherwise good health."

Bronchial thermoplasty is one of the few procedures or surgeries used to treat severe asthma. The Food & Drug Administration approved its use in 2010, and Chinsky said he is the first doctor in the region to perform it.

Each of Daly's three procedures was done on an outpatient basis at Saint Vincent, three weeks apart. Chinsky worked on Daly's lower right lung first, then her lower left lung before heating the main airways inside both upper lungs Feb. 15.

"Her bronchial tubes have developed abnormalities in how the muscles inside those tubes function," Chinsky said.

"We call it excessive smooth muscle."

During each procedure, Chinsky slid a catheter through a bronchoscope and down Daly's throat into her lungs.

At the tip of the catheter was a wire electrode that delivered a 10-second blast of 120-degree heat -- not even as warm as a cup of coffee.

Chinsky used the wire electrode to apply a low amount of heat to the inside of each of Daly's main airways. Applying low heat reduces the amount of smooth muscle inside the airways and widens them.

The most difficult part of the hourlong procedure was guiding the bronchoscope and catheter into some of the curved airways, Chinsky said.

"The device won't allow you to deliver a longer blast," said Chinsky, who uses the Alair system from Boston Scientific. "It eliminates the possibility of human error."

Daly's symptoms worsened for a few days after each procedure, but she said her asthma has improved significantly overall.

"I'd say it's about 50 percent better," Daly said Thursday.

"I don't have those deep coughs from my lower lungs anymore. When I cough, it's more shallow and from my upper lungs," she said.

Bronchial thermoplasty is not a cure for severe asthma, Chinsky said. Daly will continue to take at least some of her medications.

"Our goal is that she feels better, that she doesn't have to visit the ER as often and hopefully take less narcotic cough medicine," Chinsky said. "Perhaps she won't need some of the other drugs she currently takes."

Though doctors have been performing bronchial thermoplasty for three years, many health insurers still consider its use experimental and refuse to cover it, Chinsky said.

The procedure costs about $20,000.

"Sharon is our first patient," Chinsky said. "We have a number of others who are waiting to get insurance approval. It's a major issue."

Daly said she hopes the procedures give her back her old lifestyle. She already has joined Weight Watchers and has lost 7 pounds in just two weeks.

"I know losing weight will also help me feel better," Daly said.

DAVID BRUCE can be reached at 870-1736 or by e-mail. Follow him on Twitter at twitter.com/ETNbruce.

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