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New thermal treatment reduces number of severe asthma attacks

Published: Saturday, Dec. 22 2012 11:15 p.m. MST

Trent Aiken has asthma that has been severe enough he needed Life Flight twice.

Eric Betts, Eric Betts, Deseret News

SALT LAKE CITY — Trent Aiken has had asthma most of his life, day and night, and serious enough to need Life Flight twice.

He's twice been on a ventilator, and he's awakened almost every night for the past 42 years with an asthma attack. But not anymore.

For the first time, a Utah hospital is offering a novel heat therapy administered directly inside the bronchial tubes. The treatment reduces — if not stops — the need for steroid medications and trips to the emergency room.

In the procedure called bronchial thermoplasty, interventional pulmonologist James Pearl at LDS Hospital inserted a small bronchoscope through Aiken's nose, feeding a catheter directly into his lungs.

The tip expands, contacting the walls of the affected airways, then delivers precision bursts of thermal energy. The applied heat softens the muscles, reducing the spasms that trigger asthma attacks.

"He should feel much better and hopefully can be off his steroids, which cause long-term side effects," Pearl said.

Aiken's profession with Rio Tinto takes him around the world into remote areas where medical help is not immediately available.

"He'll feel much safer now working in many of these outback locations," Pearl said.

Aiken's asthma should be well under control, and his sleeping pattern has changed dramatically, he said.

"I'm sleeping completely through the night now, where before I wasn't," Aiken said. "Every morning I would wake up needing my medication, and now I'm not."

Pearl said he had a patient who used to come into the hospital every two or three months, but that has changed since she had the treatment.

"She hasn't been in the hospital now for year, and her family says she looks much better," he said. "She's breathing easier. She's off steroids. That's impressive."

Almost 80 percent of those treated with the heat therapy are experiencing a better quality of life, Pearl said. Recent studies show fewer hospitalizations, fewer emergency room visits and fewer lost days at work and school.

And although studies are still under way, the data seems to support a lasting effect — not just one to five years, but perhaps for the lifetime of the patient.

"I was a believer after the first treatment," Aiken said. "I was a believer after the second treatment. And now after this third and last one, I'm convinced it was the right thing to do."

In all three procedures, he was under local anesthetic for only an hour and returned home that same day.

"The thermoplasty appears to treat not just the symptoms of my asthma, but the disease itself," Aiken said.

The therapy is currently FDA approved for those 18 years or older. Studies are under way to see if it may be applicable for children as well.

While bronchial thermoplasty is reimbursable under Medicare, private insurance companies are hesitant to pick up the cost. Aiken is paying the $20,000 for his three treatments out of his own pocket.

Email: eyeates@desnews.com

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