Unique asthma therapy helps woman breathe easier

When Wendy Paige's cough and shortness of breath didn't go away, she knew it was more than just a cold. That was nearly 10 years ago, but she remembers the experience well.

As a nurse technician working with hospice patients, Paige, now 57, was keenly aware of health issues – both hers and those of her patients.

Initially diagnosed with bronchitis, the Detroit resident was put on short term steroids to help ease her symptoms, but she quickly realized she needed something more.

"I wasn't getting any better," said Paige, who had been physically active her entire life. "I had been going to the gym six days a week," she said, noting that aerobic exercise, swimming and walking were part of her rigorous routine.

Getting the diagnosis

But her exercise soon came to a halt as her "symptoms went on and on," said the grandmother of 11. "I finally went to an urgent care where I learned I had asthma and was put on an inhaler."

Asthma is a chronic inflammation of the airways that can lead to restricted airflow into the lungs. Symptoms include wheezing, shortness of breath and coughing.

Paige said her asthma was described as mild to moderate, and was likely exercise-induced. Despite various types of treatment, she felt her condition was worsening with each passing year.

"I was put on all types of steroids, which helped for a while. But eventually, I would end up in the hospital."

With little hope she'd ever feel well again, Paige's doctors recommended she consult with specialists at University of Michigan Health, one of only a few hospitals in the country offering unique expertise in a procedure known as bronchial thermoplasty.

"Their program was rated the best in the area," said Paige, who met with U-M Health pulmonologist Njira Lugogo, M.D., to be evaluated. "She said she knew she could help me."

An innovative therapy

Bronchial thermoplasty is a novel therapy that reduces the thickness of the smooth muscle in the airways of the lungs. The goal is to improve a patient's breathing capacity by opening up the airway to allow better airflow.

The procedure is performed during three sessions scheduled approximately three weeks apart. Two separate treatments focus on the left and right lower lobes of the lung followed by treatment for both upper lobes. During the procedures a bronchoscope — a thin, flexible tube-like instrument — is guided through the patient's nose or mouth and into the lungs where thermal energy is delivered to the airways.

"Patients have demonstrated promising results such as a reduction in the number of flareups and fewer emergency room visits," said Lugogo. This includes Paige, who had very severe asthma not controlled well with inhalers, oral steroids or biologic injections, which block the activity of specific proteins that can cause inflammation in the airways of asthma patients.

Although relatively rare, Lugogo said she recommends bronchial thermoplasty for patients like Paige who have failed all other treatments, but stresses the procedure must be performed by a highly trained team with specific expertise.  

Paige's bronchial thermoplasty sessions, performed by pulmonologist Jose De Cardenas, M.D., were initially scheduled for May 2020, but were delayed due to Covid. Undeterred, she finally underwent treatments in July, August and September 2020.

"My condition was very severe, so I was hospitalized for the treatments," Paige said, noting that it took a few months after the final session for her to experience a noticeable improvement.

This, according to Lugogo, isn't uncommon.

"There is often a delay in a patient's recovery because the procedure aggravates the lungs, but the benefits after the recovery period are significant for most patients."

Breathing easier

Paige is a prime example: Now on a low dose of prednisone, she admits to feeling much better, with no wheezing or other major symptoms.

"Perfect control is my dream for her," said Lugogo.

Paige said she's happy to be back to working out and embracing a healthy lifestyle and "would love to go back to taking care of patients again," but for now, she's focused on her own health and not taking a single breath for granted.