When Gary Cogger was diagnosed with walking pneumonia in December 2010, his doctor at Kaiser Permanente Santa Clara put him on steroids to treat his condition. After more than one year on steroids, he was still having shortness of breath and wheezing—something that baffled and frustrated Cogger, who had recently lost 30 pounds and exercised regularly.
"I had just lost a lot of weight—I should have had an easier time breathing, not a harder time," he says. "And the steroids weren’t helping me feel better. In fact, I felt worse."
Coupled with the undesirable side effects of the steroids—including weight gain and moodiness—Cogger and his doctor quickly started searching for other treatment options. Cogger’s doctor referred him to Ganesh Krishna, M.D., an interventional pulmonologist at the Palo Alto Medical Foundation’s Mountain View Center.
Dr. Krishna—an expert in pulmonary critical care medicine—is one of only a few doctors in the United States who specializes in a minimally invasive pulmonary treatment called bronchial thermoplasty.
Bronchial thermoplasty is a noninvasive procedure that uses radiofrequency energy to heat the smooth muscle of the breathing tubes (airways) of the lungs. When a patient’s breathing tubes are inflamed, the smooth muscles increase in size. This makes the breathing tubes short and small, which causes wheezing and asthma symptoms. During bronchial thermoplasty, Dr. Krishna uses a flexible bronchoscope through the nose or mouth to reach the patient’s lungs. The heat minimizes the bulk of the smooth muscles underneath the mucous membranes, decreasing symptoms and making it easier for patients to breathe.
Gary Cogger is all too familiar with having breathing problems. Throughout his childhood and into young adulthood, Cogger (now in his early 60s) suffered from severe asthma and was even put on life support in his early 20s. Although Cogger’s asthma had disappeared and he had no symptoms for most of his adult life, he began having asthma symptoms again when he was diagnosed with walking pneumonia.
During his first visit with Dr. Krishna, Cogger was immediately impressed. "Dr. Krishna reassured me that everything would be OK," Cogger says. "He was very informative and described the treatment process and made sure I understood everything that was going to happen."
Four weeks after their first meeting, Dr. Krishna performed the first of three bronchial thermoplasty treatments on Cogger—first on the lower right lobe of his lungs, and then the lower left lobe, and finally the two upper lobes. Each treatment was performed in approximately one hour under general anesthesia at an outpatient surgery center.
"My breathing tubes were virtually destroyed as a kid because of my asthma," Cogger says. "It was amazing to learn that the human body has about 300 tubes, and Dr. Krishna had to repair more than 150 of mine!"
Cogger remembers Dr. Krishna standing by his side as he woke up from surgery and reassured him that although he would feel an initial heaviness on his chest, it would go away. (It did, Cogger says.)
The day after surgery, he was back to work with little more than a sore throat—a postoperative symptom that got progressively better with subsequent treatments, Cogger says.
Thanks to bronchial thermoplasty, Dr. Krishna has been able to slowly wean Cogger off of the steroidal medication he’d been on for so long. Cogger reports that his breathing has greatly improved.
"Dr. Krishna is awesome! He has such a great bedside manner!" Cogger says. "I was so comfortable with him from day one—and it’s not easy for me to feel comfortable with someone who is going into the middle of my body. He has a calm and confident presence."