Me and my operation: Op to heat up your lungs relieves asthma attacks

More than five million people in the UK suffer from asthma. Father-of-three Michael Keenan, 49, from Glasgow, a manager for the Ministry of Defence, had a pioneering procedure that has just been approved for NHS patients, as he tells OONA MASHTA…

THE PATIENT

Ever since my brother, Joseph, who was seven years older than me, died from an asthma attack when I was 18, I’ve been on a mission to help doctors find a cure.

I was diagnosed with a severe form of asthma when I was five and since then I needed 12 puffs of my Ventolin inhaler and four puffs of my steroid inhaler a day.

Even with all my medication, the slightest exertion would leave me out of breath. The drugs had side-effects, too — my mouth was constantly dry and I had no appetite.

Heating technique improved patient Michael Keenan's lung capacity by 30 per cent

Heating technique improved patient Michael Keenan's lung capacity by 30 per cent

As a child, my asthma prevented me from doing any sports. I used to save my dinner money and pay friends to give me a piggyback home so I didn’t have to walk.

My asthma was triggered by so many things — dust, dogs, cats and even stress.

At least once a day, I’d have a mild attack lasting up to an hour when I would be gasping for breath, and five or six times a month I’d have a more major attack, where I’d be put on a nebuliser, an oxygen mask on a machine.

As an adult, I’d have nine or ten days off work a month because doctors said I couldn’t leave home when my symptoms were playing up.

Always at the back of my mind was the thought that one of these attacks would kill me, too. So I’ve always volunteered for medical research trials.

In 2006, one of my doctors asked if I wanted to be put forward for a new procedure. I knew people with asthma have thicker muscles in the airways than normal, and that’s why it’s hard for air to get in and out.

In this new op, they’d heat up these muscles so they narrowed. It wasn’t a cure, but you’d have fewer attacks and need less medication.

My asthma had to be monitored for almost a year to make sure I was suitable. I was warned there were possible side-effects such as infections, but I wanted to go ahead. In June 2007, I had the first procedures (I had three over six weeks).

I was sedated with a local anaesthetic so, although I was conscious, I was very sleepy and relaxed. My nose, throat and airways were numb, so I couldn’t feel any pain.

The doctors threaded a flexible tube through my throat into my lungs. When they started, it was uncomfortable and I feared I might choke. Then I fell asleep.

The procedure lasted about half an hour, but I stayed in hospital overnight because I was the first to have it done.

My throat felt uncomfortable when I woke, and I coughed up a bit of mucus and blood, but only for about an hour.

My breathing felt slightly better. /03/06/article-2110804-0057FE4800000258-153_233x361.jpg” width=”233″ height=”361″ alt=”Mr Keenan says he has now virtually stopped using his Ventolin inhaler” class=”blkBorder” />

Mr Keenan says he has now virtually stopped using his Ventolin inhaler

Asthma medicine is usually given via inhalers into the airways. They are designed to keep airways open, but don’t always work for people with severe asthma. Until now, there has been nothing for these patients when they’ve failed to respond to traditional medication.

This new treatment, bronchial thermoplasty, uses radio-frequency energy to heat some of the extra muscle in the airway so it cannot constrict. The treatment was first used in the U.S. and approved there in 2010.

The UK Government’s health watchdog, NICE, recently approved it for the NHS, offering real hope to the 250,000 people in this country with severe asthma that cannot be managed with medication. It is currently available at centres in London, Manchester and Glasgow.

In one clinical trial, the treatment resulted in a 84 per cent reduction in emergency hospital admissions, a 66 per cent reduction in work absence, a 32 per cent reduction in asthma attacks, and a significant improvement in quality of life.

It is performed in three outpatient visits over about three months. The first treats the airways of the right lower lung lobe, the second the airways of the left lobe, and the third the airways in both upper lobes.

The patient is sedated but conscious, and sprays numb the nose, throat and airways. A long flexible tube, a bronchoscope, is put into the mouth and guided down into the lungs using a tiny camera.

We watch the images on a video screen. When the bronchoscope is in position, a thermoplasty catheter, like a tiny metal expandable basket, is pushed through the bronchoscope and into the airway.

It is attached to a machine that delivers the heat.

We expand the basket against the airway, then switch on the machine that fires radio-frequency energy in ten-second bursts.

We then move the catheter a little way along the airway and repeat the treatment until all of the target airways have been treated.

The main risk of the procedure is we will start an asthma attack during the treatment.

Patients also tend to suffer more asthma symptoms in the first week or so after the treatment due to irritation caused by the heat, but this settles down and the asthma is improved.

The procedure costs the NHS about 10,000. For advice about asthma, call 0800 121 62 44 or visit asthma.org.uk