5 Incredible Hawaii Medical Stories


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(page 5 of 6)

A Severe Asthmatic Regains Her Breath, And Life

Relief comes with the help of a bold new therapy and a doctor willing to try it.

Patient Jennifer Purcell and Dr. Warren Tamamoto.
Photo: Rae Huo
 

Jennifer Purcell hated being a sickly grandmother. She hated being in such poor health that she couldn’t take her three young grandsons on outings to the park, the movies or Chuck E. Cheese’s. But her asthma had gotten so out of control in the last decade that doing the simplest things could set off an attack.

She couldn’t even shower anymore without wearing her ventilator, because water vapor would send her into convulsive fits of coughing and wheezing.

It got so bad she would barely leave the house, unless it was for a trip to the emergency room, where she had become a regular. Sometimes even the E.R. docs couldn’t get her tortured lungs under control, and she ended up staying in the hospital, once for three weeks.

The multiple and powerful medications Purcell was on were no match for her twitchy, inflamed airways. Her prognosis was as grim as her daily life had become.

“I felt imprisoned, lonely and frustrated, always gasping for air,” she says.

Desperate for improvement, she ended up doing something that doctors universally abhor: While watching TV she discovered a brand-new therapy that looked like it was made for her.
It’s called bronchial thermoplasty, and it is the first non-drug treatment the Food and Drug Administration has approved for severe asthmatics. Using the heated tip of a catheter, it works by gently burning away a thin layer of smooth muscle lining the bronchial tubes, reducing their ability to constrict during an asthma attack.

At Purcell’s next appointment with her pulmonologist, Dr. Warren Tamamoto, she asked about the treatment. “Right away, he had that look—Oh no, another patient watching those medical TV shows,” she recalls. “He made it very clear that he’s not one to jump on the bandwagon of every new procedure.”

Tamamoto, who is chief of pulmonology at Kaiser Permanente Moanalua Medical Center, knew all about bronchial thermoplasty, including the uncertainty over its long-term safety and effectiveness. “It’s new and very different,” he says.

Before introducing it into his practice, he wanted more evidence that it didn’t produce scarring or some other harm that would only show up years after treatment, leaving patients in worse shape than they started.

Purcell’s timing was perfect. Not long after asking Tamamoto about bronchial thermoplasty, a study was published that followed patients for five years after treatment. It found the benefits of the procedure held up, with no unforeseen side effects. With the five-year data in hand and a qualified candidate eager for the therapy, Tamamoto began bronchial thermoplasty on Purcell in October. “She was the right patient at the right time, with all the indications that she might benefit,” he says.

The treatment is broken into three sessions separated by several weeks. One of its drawbacks is that a patient’s condition may initially worsen. This happened to Purcell, who came down with pneumonia after each of the first two sessions. A couple of weeks after the final session, though, something marvelous happened. “I woke up in the middle of the night, and I was lying there thinking something’s different,” she says. “I couldn’t put my finger on it. Then it hit me. I wasn’t wheezing. It was so quiet.”

Purcell’s quality of life has improved markedly. Although she is not cured, and she must still take medication, her asthma is back under control. She is able to do things she hasn’t done for years. And her grandsons now go on regular outings with their grandmother.

“I didn’t want my grandchildren to remember their grandma as the one who was always sick,” Purcell says. “It’s so heartwarming for me to know that when they see me now, they know we’re going to go out and do something. They know we’re going to have fun.”
 

By the numbers: Bronchial Thermoplasty

2010

Year the FDA approved the use of bronchial thermoplasty for the treatment of severe asthma.
 

2012

Year that Medicare and Medicaid agreed to cover the cost of the catheter used in the treatment.
 

149˚

Temperature the tip of the catheter is heated to, in Fahrenheit. Also, the approximate temperature of a cup of coffee.
 

44%

Average decrease in severe asthma attacks in people who underwent the therapy, over five years.
 

78%

Average decrease in emergency room visits, in the same time period.
 

Bronchial thermoplasty uses the heated tip of a catheter to destroy a thin layer of muscle lining the lung's airways.
Rendering: Courtesy Boston Scientific Corp.

 

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