Joliet hospital offers new procedure to help control severe asthma

JOLIET – Living with severe asthma has been likened to trying to go about daily activities while breathing through a narrow paper straw. The condition can be incapacitating at times, deadly at others.

Debbie Durham of Plainfield knows only too well what it’s like to go through life with asthma.

“Sometimes, it’s difficult for me to walk even 4 feet,’ ” Durham said. “I get so winded, even singing in the church choir.”

But now, Durham’s pulmonologist Dr. Phillip Leung is recommending she undergo a new procedure designed to greatly reduce asthma in those who have severe cases. Durham is on the waiting list to receive it and is just waiting for insurance issues to clear up.

Pulmonologists at Presence Saint Joseph Medical Center are the first in the area to begin using bronchial thermoplasty to give relief to the most severe cases of asthma sufferers. The procedure uses radiofrequency thermal energy to permanently reduce the smooth muscle mass in the airways of the lungs and has been shown to make breathing significantly easier for those patients.

“This is revolutionary,” said Dr. Diane Doeing, a Presence Saint Joseph Medical Center pulmonologist. “It’s the first procedural-based therapy ever used for asthma.”

Doeing stressed the procedure won’t cure asthma, as there is no cure for it. But it does help control asthma.

“These patients will require less hospitalization and have a better quality of life,” Doeing said. “It’s all about living a better quality of life.”

For Durham, many things can trigger an asthma attack. She’ll feel the tightening in her chest begin when she vacuums, uses cleaning products, comes down with a cold virus, goes out on a windy day and breathes in cold air.

She lost a job because her desk was under an air conditioning vent, and the cold air set off her asthma. A change in seasons, especially going from spring to summer, particularly perturbs her sensitive lungs.

Durham was diagnosed with asthma when she was just a baby, but she said it only became apparent about 15 years ago, when she was 37.

“I was so sick and coughing and couldn’t catch my breath,” Durham said. “I didn’t think it was asthma. The doctor asked if I was using my inhaler, and I said, ‘Doctor, I don’t have asthma.’ She said what I had just experienced was an asthma attack.”

Durham was placed on steroids almost immediately, which helped, but also caused her to gain 100 pounds in just six months. She also takes other medication, uses inhalers and takes breathing treatments.

For a time, Durham also received regularly scheduled injections at the hospital but had to discontinue them after developing an allergic reaction.

“I’m always in the hospital from asthma,” Durham said.

Before bringing bronchial thermoplasty to Presence Saint Joseph Medical Center this year – where she and colleague Dr. Kristopher McDonough are using it – Doeing had performed the procedure several times at a previous medical center.

Limited insurance coverage has interfered with scheduling, Doeing said, and the group has performed only one of the procedures so far, but several patients are currently in the approval queue.

“This is for people over the age of 18 that have severe asthma that is not controlled well by inhaled steroids or long-acting bronchodilators,” Doeing said. “We do have a population of asthmatics who have horrible quality of life. They’re admitted to the hospital emergency room frequently.”

Bronchial thermoplasty is a surgical procedure for adults with severe asthma, Doeing said. The procedure uses radiofrequency waves at temperatures of 149 degrees Fahrenheit inside the lungs to heat up the airways. The result is that muscles there stop constricting as much when asthma triggers hit them.

“It’s about the temperature of a warm cup of coffee,” Doeing said.

The thermoplasty is done on an outpatient basis in three procedures separated three or four weeks apart. Patients are not under general anesthesia, Doeing said, but are put on monitored anesthesia care similar to what is used during a colonoscopy.

During the procedures, a bronchoscope with a light and camera is inserted through the mouth into the airways, where the radiofrequency thermoplasty is then administered from the lower lobes to the upper ones. There are no pain fibers in the lungs, Doeing said, so patients feel no pain, although they may experience coughing or throat pain over the next 24 hours.

“Sometimes, you also see a worsening of asthma in the next week because of the inflammation,” Doeing said.

Bronchial thermoplasty is not a total remedy for asthma symptoms.

“The patient will still need to be on some kind of medicine,” Doeing said.