November is COPD Awareness Month and on Nov. 20, Burke will be recognizing World COPD Day. For the past several years, we have had a one day symposium at Burke as a service to COPD patients. Our intent is to enhance the knowledge for the patients that already know us and introduce ourselves to those in the community who may not yet be aware of the services we offer to COPD patients and their families.
The symposium will consist of lectures, discussions and an exhibitor’s area with vendors (both private and non-profit). There is no fee for the program and lunch will also be provided free of charge.
This year we have a special guest speaker. William Bulman, M.D., is an assistant professor of clinical medicine in the Division of Pulmonary, Allergy and Critical Care Medicine, and director of bronchoscopy at Columbia University Medical Center. His clinical interests include interventional bronchoscopy, advance chronic obstructive pulmonary disease and acute respiratory failure. He also is a research investigator in a clinical trial involving bronchoscopic treatments for emphysema.
This clinical trial is part of the large Lung Volume Reduction Coil Treatment in Patients with Emphysema (RENEW) Study that will involve at least 315 patients at 30 research centers in the U.S. and Europe. The first study in the U.S. began in February at University of Pittsburgh Medical Center.
RENEW tests whether the insertion of small coils can collapse diseased lung areas and improve lung function and exercise tolerance among patients with advanced emphysema. The coils are implanted non-surgically through the use of a bronchoscope—a tubular device about half an inch wide and two feet long used to see the inside of the airways and lungs. Although it can be flexible or rigid, a flexible bronchoscope is almost always used.
California-based PneumRx developed the coils, which are small, super-elastic and have shape-memory. Typically, each patient is implanted with ten coils in one lung and four months later, up to 10 more coils are implanted in the other lung. The procedure takes about an hour each lung. Once set, the coils pull in the damaged, over-inflated lung areas so that the remaining healthy lung tissues can inflate and deflate more effectively. This improves airway function and breathing at rest and during exercise.
Before this non-invasive approach, similar treatments to help slow the progression of the disease required major surgery. Emphysema is an irreversible, incurable condition where the air sacs in the lungs are progressively destroyed, causing shortness of breath and difficulty breathing.
The 109 patients involved in the initial European study showed significant improvement at the six-month and 12-month marks after implantation in their:
- forced expiratory volume or FEV1, which measures the maximum amount of air that can be exhaled in one second;
- the residual volume or RV, which measures the volume of air remaining in the lungs after a maximal exhalation; and
- six-minute walking distance or 6WMD, which estimates a person's ability or capacity to exercise.
The patients also indicated improvement in their quality of life.
These are exciting developments that I hope you will find very interesting and informative. I know you will be as taken with Dr. Bulman as I was when I saw his presentation in September.
Please call Pamela Jones, PT, at 914-597-2483 to register for this event.
—Richard Novitch, M.D.
Director, Pulmonary Rehabilitation Program