RENEE MONTAGNE, HOST:
And now we turn to a relatively new treatment for asthma. Winter can be an especially difficult time for the millions of people who suffer from asthma. And for some of them the normal round of inhalers and medications is not enough.
Lauren Silverman, of member station KERA, reports on a treatment that uses a heated metal device to widen the lungs' airways.
LAUREN SILVERMAN, BYLINE: If you've ever tried to drink something through one of those little red coffee stirrers instead of a full-sized straw, you know what it's like to breathe with asthma.
VIRGINIA RADY: You just can't get the air in.
SILVERMAN: Virginia Rady, who lives outside Dallas with her husband Nick, has had asthma since she was 2. She's 28, but tests show her lungs are like those of a 65-year-old. If something triggers her airways to twitch and close up, it could be deadly. That means avoiding...
RADY: Cats, dogs, pollen, grass, dust, exercise, stress. If I were to get really emotional and start crying I could actually trigger an asthma attack.
SILVERMAN: Rady tried to go away for college but after a bad flare-up, she moved back home. See, for people with severe asthma, an inhaler isn't always enough. Treating the disease can mean skipping school and work, hospital visits, expensive steroids and breathing machines.
RADY: During a bad exacerbation, I actually will wake myself up. I'll set an alarm on my phone, take my treatment, go back to sleep and it's because if I don't, I'll wake up later not breathing.
SILVERMAN: For decades, a big breathing machine and a face mask lived by Rady's bed. Since last February, they've both been gathering dust in her closet. That's when she had a procedure called bronchial thermoplasty, which involves putting a metal catheter into the lungs airways over and over again.
DR. GARY WEINSTEIN: We go into airways that are three millimeters or bigger and we're heating them up, and it doesn't get that hot, it gets about as hot as a cup of coffee.
SILVERMAN: Gary Weinstein is a pulmonologist at Texas Health Presbyterian in Dallas. He says an invasive treatment to widen the airways might sound like torture, but patients are sedated.
WEINSTEIN: Most people have very little recall of the whole thing except coming into the room and doing a bit of coughing.
SILVERMAN: He's done it on dozens of people, including Rady. And while inhaled drugs offer temporary relief, he says, bronchial thermoplasty attacks the problem at its root - the muscles in the lungs themselves. The procedure is done in three separate visits. Every time the catheter is inserted, it delivers heated zaps of energy that essentially burn off the outer layer of smooth muscle cells. Less smooth muscle means less seizing up.
WEINSTEIN: This seems to be a very good therapy. We found a number of patients who have been stuck on oral prednisone who have gotten off. It seems to be a very helpful procedure that persists.
SILVERMAN: Now, this procedure is really only for the 10 percent of asthmatics who can't control symptoms with medicine. For those patients, one five-year study, funded by the company that created bronchial thermoplasty, showed positive results.
Patients reduced their hospital visits by 70 percent and saw their asthma attacks drop by a third. The biggest downside to the treatment is the body's initial reaction.
RADY: It's like shoving a stick at a hornets nest. You're wheezing, it's not pleasant.
SILVERMAN: But once this temporary asthma flare-up subsides, Virginia Rady says it's life-changing.
RADY: So Nick and I, we've been married for almost a year and a half now. And I'll show you the nursery, it's in pieces right now...
SILVERMAN: Rady, who's a nurse, had been putting off pregnancy because she didn't want to be on steroids, which can cause thinning bones, mood-swings, even type II diabetes. Now, thanks to bronchial thermoplasty, she cut back on medications and is going outside to exercise. Rady is hoping to get pregnant because now she feels she has the stamina to be a mom.
RADY: I can't imagine saying, Nick, the kids are yours now, I've got to do a breathing treatment and then a nap, and that's just the way it would have to be - but hopefully, now I can be kind of normal.
SILVERMAN: Bronchial thermoplasty isn't a magic wand. Don't expect to throw out your inhaler. And while Rady's insurance helped pay the $20,000 bill, many insurers are still not covering the procedure. Doctors agree that's likely to change.
DR. GAETANE MICHAUD: Bronchial thermoplasty, I believe, certainly has its place. I think we just need to understand a lot more about who it is right for.
SILVERMAN: Yale's Dr. Gaetane Michaud has been researching bronchial thermoplasty for more than a decade. She says asthma treatment will eventually become more personalized.
MICHAUD: We have anti-inflammatory options, we have bronchial thermoplasty options, we're starting to develop additional add-on therapies and we just need to figure out which one will work with which patient profile.
SILVERMAN: Now that doctors have another weapon to fight asthma, she says, they just have to settle on when to use it.
For NPR News, I'm Lauren Silverman, in Dallas.
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