Bronchial thermoplasty offers hope to asthma patients

On bad days, even a short walk can be a struggle for Sankaran Lakshmi. The software programmer and mother of three, has suffered from severe asthma for more than 20 years.

"I can't get up from the bed, I can't walk, I can't climb up the steps," says Lakshmi.

So Lakshmi has turned to a cutting-edge technology being used at El Camino Hospital in Mountain View. It's called bronchial thermoplasty. Over a course of three procedures, Ganesh Krishna, M.D., will attempt to treat the interior walls of Lakshmi's lungs.

"Bronchial thermoplasty uses a heat energy. It's a radio frequency energy that is converted into heat, and what it does is decreases the bulk of smooth muscles that are underneath the surface of the breathing tubes," says Krishna.

First, a camera guided catheter is inserted into the patient's bronchial tubes. Doctors then run a probe, with a specialized tip that delivers the radio frequency energy. As shown in an animation provided by the manufacturer, the heat penetrates the wall of the bronchial tubes, to shrink the surrounding muscle. By weakening those muscles, doctors say they're able to lessen the severe tightening that forces the airways closed during an asthma attack.

"It doesn't cause damage or scarring on these muscles, it just decreases the bulk. Therefore the constriction that is caused by these muscles is less vigorous," says Krishna.

To avoid putting stress on the patient's lungs, doctors divide the treatment into three procedures, treating each of the lower lobes separately, and then the top lobes in a third visit. Lakshmi still has that final treatment ahead, but says her breathing already feels improved.

She's hoping the final result will allow her to cut back on steroid treatments and a host of other asthma medications she currently relies on, but most of all, she's hoping to breath normally.

"I need to be able to jog, I need to be able to spend more time with the kids. And I should be able to get back to the life, the life which I'm dreaming for," says Lakshmi.

To be clear, bronchial thermoplasty is considered a long-term treatment for the symptoms of asthma, but not a cure. Patients do typically stay on some medications, though Krishna says patient improvements have lasted at least seven years in follow up studies.

Written and produced by Tim Didion

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