Asthma is a disease that is very annoying and interferes with daily life, only those who suffer from it know. Constant wheezing, feeling like their chest is constricted, not being able to go anywhere without their inhaler... Things like this make it impossible to do their daily tasks properly, right? This is especially stressful for those who cannot control their asthma even after using the medicine prescribed by the doctor and their inhaler properly. So, today we are going to talk about a special, modern treatment method that can help people with such severe asthma. That is Bronchial Thermoplasty .
Simply put, what is Bronchial Thermoplasty?
Okay, let's put this very simply. Imagine that there is a small layer of muscle around the windpipe (we call it the trachea) inside your lungs. In a person with asthma, this muscle contracts unnecessarily, that is, it tightens. Then that windpipe becomes narrow. Just like when you squeeze a water pipe, it becomes difficult to flow, when the bronchi become narrow, it becomes difficult to breathe. When we have asthma, that's what makes us wheeze and our chest tighten.
Bronchial Thermoplasty is a treatment that applies controlled heat to these stiff, thickened muscles, which helps to relax them. To be precise, this is usually done by a pulmonologist. He or she uses a thin tube to go into your airways and apply heat to the muscles. When these muscles are relaxed, they can't contract as tightly as they used to. This opens up the airways, making it easier to breathe.
The important thing is that this is not a cure for asthma. However, it can significantly reduce the severity of asthma symptoms and the frequency of asthma attacks .
Who is this treatment suitable for?
This is not a treatment for all asthma patients. Bronchial Thermoplasty is usually recommended for people with severe asthma who cannot control it with standard treatments.
Let's look at what is meant by "severe asthma" this way.
| Status | Simple explanation |
|---|---|
| Not controlled by standard treatments | If your asthma symptoms (wheezing, cough, chest tightness) persist despite using your prescribed high-dose inhalers, oral medications, or special injections (biologics). |
| Impact on quality of life | If your asthma is continuously interfering with your daily activities, sleep, work, and exercise. |
| Frequent asthma attacks | If you experience more frequent asthma attacks and difficulty breathing than normal. |
| Having to be hospitalized | If your asthma becomes severe, meaning you have difficulty breathing and need to be hospitalized for treatment. |
If you have a similar condition, you can discuss Bronchial Thermoplasty treatment with your doctor and decide if it is right for you.
How do you prepare before treatment?
Once you and your doctor have decided to have this treatment, there is some preparation involved. The doctor will usually give you instructions like this:
- You will be asked not to eat or drink anything for at least eight hours before the treatment.
- You will be asked to take a steroid pill (e.g. prednisolone) for two to three days before the treatment. This is to control swelling and symptoms that may occur after the treatment.
- Since the treatment is done under anesthesia, you will not be able to drive after the treatment. Therefore, you will be asked to arrange for someone to take you home in advance .
What happens during treatment?
What happens on the day of this treatment is very systematic.
1. First, you will be given anesthesia through a vein so that you will not feel any pain or discomfort. Therefore, you will be asleep throughout the treatment.
2. Then, the doctor uses a bronchoscope.One, a thin, flexible tube with a camera attached, is passed through your mouth into the airways of your lungs.
3. Another special device is inserted through this tube and delivers controlled heat (`radiofrequency energy`) to the areas where the thickened muscles are. This heat causes the muscles to thin.
4. After treating all the necessary areas, the doctor carefully removes the bronchoscope.
This entire process usually takes between 45 minutes and an hour .
After treatment and the entire treatment regimen
After the treatment is over, you will be monitored by doctors and nurses for a few hours until you wake up from the anesthesia. If your asthma symptoms worsen or you experience other side effects, you may need to stay in the hospital that night.
The most important thing is that this treatment is not done in one go. To treat all areas of the lungs, you will need to attend three treatment sessions .
- The lower part of the right lung is treated in one session.
- In another session, the lower part of the left lung will be treated.
- In the third session, the upper parts of both lungs are treated.
There is a gap of at least three weeks between these sessions.
What are the benefits, risks, and side effects of this treatment?
As with any medical treatment, Bronchial Thermoplasty has its benefits as well as some risks and side effects. It is important to have a clear understanding of these.
| Benefits | Risks & Side Effects |
|---|---|
| Reduction in the severity and frequency of asthma symptoms. | Temporary increase in symptoms (cough, wheezing, chest pain) for a few days after treatment (these usually subside within a week). |
| Reduced incidence of asthma attacks . | Small risk of hospitalization due to severe symptoms. |
| Improving quality of life. | Risk of lung infection. |
| Research has shown that the positive results last for at least 10 years. | Very rarely, there is a risk of conditions such as collapse of part of the lung (`atelectasis`) or widening of the airways (`bronchiectasis`). |
When to see a doctor and go to the hospital immediately
After treatment, it is important to know the difference between normal, expected discomfort and serious conditions that require urgent attention.
| Situations to pay attention to | |
|---|---|
| Talk to your doctor: | |
| Talk about any common questions or concerns you may have before or after treatment. For example, "Doctor, I have a slight cough, is that normal?" | |
| Go to the nearest Emergency Department (ETU) immediately: | |
|
Asthma can be a life-threatening condition. Especially if your asthma flares up frequently, you may miss out on some of the most enjoyable things in life. Bronchial Thermoplasty is not a one-size-fits-all solution. However, if you feel that your asthma is severely affecting your life, even after taking your prescribed medications, it is best to talk to your doctor to discuss whether this treatment or other alternative treatments are right for you.
Take-Home Message
- Bronchial Thermoplasty is a specialized treatment for severe asthma that cannot be controlled with conventional treatments.
- This heats the thickened muscles around the airways and makes them thinner, making breathing easier.
- This is not completed in one session, but consists of three treatment sessions spaced about three weeks apart.
- Although this is not a cure for asthma, it can significantly reduce symptoms and the occurrence of asthma attacks .
- As with any medical procedure, there are some risks and temporary side effects.
- You should definitely discuss this treatment with your pulmonologist or your doctor to determine if it is right for you.
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