New Hope For Life-Threatening Asthma?

Severe. Seriously Severe:

bronchial thermoplasty, severe asthma, reactive airway

Image: New Hope for Severe, Life-threatening Asthma: Bronchial Thermoplasty

If you, or your child, struggles with severe asthma, there is a recent procedure that may hold promise: bronchial thermoplasty.

My clinics tended to attract the children who most physicians had given up on. Or, to be more accurate, the children whose parents had given up on most physicians. They were the kids with severe reactive airways. For most of them, their diagnoses included asthma. Severe asthma. Asthma that was potentially life-threatening. The sort of kids that spent – literally – months every year in the hospital due to their asthma exacerbations. You may know kids like this. Or you may be a parent to kids like this. They all see a Pulmonologist. And, because many pulmonologists are hip to the research data telling us that reflux (gastro-esophageal reflux, or GER) is a common trigger for asthma in children, many of these kids are also being cared for by Gastroenterologists. And, because many of their troubles seem to start in their noses – allergies, or sinusitis – they are also seeing an Allergist; and perhaps an Immunologist. Most of their parents have given up on the majority of these “experts.” Think about it: you’re taking your kid to six different “experts” with Ivy-League credentials, and your kid is still in the hospital for months out of every year because nobody can control their asthma! Every little sniffle seems to trigger an asthma exacerbation in these kids. That’s how they would wind up in my clinic: their Pediatrician or Allergist or Pulmonologist would recognize the connection between their sinus problems and their time in the hospital, and send them to see the boogordoctor.

Sinus Surgery

Most of those children were sent to me expressly “for sinus surgery.” But the goal of virtually all surgery is to correct an anatomic problem. And, based on my experience with sinus disease in children, the underlying problem with their sinuses is not anatomic. So my opinion is that surgery is not the primary solution for sinus disease in most children. I’m delighted to report that the (vast) majority of those patients are better, and without sinus surgery! And, for those rare children for whom surgery was part of the solution (and I emphasize part of the solution), a minimally-invasive approach was used: balloon sinuplasty with great results.

Refractory Asthma

However, there remains a small population of people, including children, who struggle with severe, life-threatening asthma. In medicine, they call it “refractory” when it doesn’t respond to the usual treatments. If you are a parent to one of these children, or you are one of these people yourself, you know about the chronic complications of asthma treatment. You know: life with severe asthma is no fun.

Bronchial Thermoplasty

But bronchial thermoplasty may change all that. It is too early to make reliable conclusions about bronchial thermoplasty; not enough results are out yet from the clinical trials. This is not a remedy to take lightly. This is surgery for asthma!
However, preliminary results suggest that bronchial thermoplasty can provide:

  • an improvement in quality of life,
  • a reduction in the rate of severe exacerbations,
  • a reduction in emergency department visits,
  • and reduced days lost from school or work.

As more results are published from bronchial thermoplasty clinical trials I will report them here. In the meantime, if you deal with severe, life-threatening asthma, and those early results sound good to you, check out this article:

Downloadable PDF of clinical review paper on bronchial thermoplasty, published in the American Journal of Respiratory and Critical Care Medicine, 2012: http://www.atsjournals.org/doi/pdf/10.1164/rccm.201105-0883CI

Also check out various other non-drug remedies that have been proven to help reduce asthma symptoms in good clinical trials – see resources, below.

Resources:

 

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