Take a deep breath and exhale a slight amount.
Now try taking another deep breath. Gerard Criner, chief of pulmonary and critical care medicine at the Temple Lung Center, said that’s how breathing feels with advanced emphysema, a degenerative disease that makes the lungs “too big” for the chest.
Temple Lung Center became the first in the mid-Atlantic region and the third in the nation to perform the biologic lung volume reduction procedure. BLVR uses a biodegradable gel applied directly to the lung to remove diseased tissue and improve patient’s breathing.
According to Criner, BLVR is a non-invasive
procedure in which a bronchoscope is inserted through the patient’s airway and into the lung. A liquid medicine is applied through a catheter to multiple parts of the diseased tissue, which becomes a chewing gum-like consistency on contact. After a period of weeks, the tissue becomes a scar and shrinks, reducing the volume of the lung.
The purposeful scarring of the tissue is as beneficial to the patient as having it surgically removed, Criner said.
“It’s as if you have a sponge, if you want to make the sponge smaller,” Criner said, “you could cut the sponge in half, or you could wet the sponge and let the sponge collapse. This would be the sense of making the sponge stiffer, reducing its size.”
Betty Zindel, a 71-year-old retiree from National Park, N.J., was the first patient in the region to undergo BLVR treatment, which was performed on Aug. 15. Zindel was diagnosed with emphysema in 1996 after a bout with pneumonia and relied on oxygen for two years.
“The treatment was a lifesaver for me. I thought there was nothing that could be done,” Zindel said. “Now I go to the food store and push the shopping cart around. I make dinner and clean up the kitchen. I’ve come a long way.”
Six patients received the BLVR procedure
at Temple Hospital, which was part of a Phase 1 trial.
“We looked at it in terms of safety,” Criner said. “How long it lasts, how durable, is it best? That’s still unknown.”
According to Criner, no side effects are apparent except for a slight temperature 12 hours after undergoing the procedure. Criner also said that there is no risk of the medicine traveling to different parts of the lung because the gel turns solid within seconds of contact with the tissue. Alternate treatments for advanced emphysema include oxygen therapy, open surgery to remove the damaged tissue, and lung transplant.
BLVR takes 20-30 minutes, and patients who’ve undergone the procedure returned home after spending two days in the hospital.
The procedure can be performed more than once on the same patient. Susan Morris, a 50-year-old resident of South Philadelphia became the third person to undergo the procedure in September.
“I was on the lung transplant list,” Morris said. “I had it done six weeks ago and everything’s changed. I’m not on oxygen. I take less medications. I’m back to doing the things I love.”
Vicky Thomas can be reached at firstname.lastname@example.org.