A
year and a half ago, Jodi Pliszka began feeling short of breath. Over
time, normal daily activities like climbing stairs, walking and even
talking left her out of breath. Initially diagnosed with asthma and
allergies, Pliszka tried various medications and inhalers with little
relief.
"I sounded
like Darth Vader," Pliszka says of the high-pitched wheezing that
accompanied her breathing. "I was literally struggling for
breath."
Then in January,
Pliszka visited Dr. Jon Bock, an ear, nose and throat physician at
Froedtert & the Medical College of Wisconsin, seeking treatment
for her snoring. A fiberoptic scope revealed a significant narrowing
of her airway. Bock diagnosed Pliszka with idiopathic subglottic
stenosis (ISS), a rare disorder that affects the tracheal area
directly under the vocal chords.
The exact cause
of ISS is unknown. The disorder affects middle-aged women almost
exclusively— in six years of treating patients with ISS, Bock has
only had one male patient.
Pliszka admits
that right after her diagnosis she was angry and upset.
"I was
upset because I had lived with this for over a year," she
explains.
But this wasn’t
the first time Pliszka had been diagnosed with a rare condition.
Nearly 30 years ago, Pliszka learned she has alopecia, an autoimmune
disease characterized by the complete loss of hair all over the body.
"Having
alopecia helped me," says Pliszka. "There are certain things
I can’t control, but I can control how I react to my disease and how
people treat me."
After losing all
of her hair to alopecia three decades ago, Pliszka became an outspoken
advocate for those living with the rare condition. Now she’s doing
the same for people affected by ISS. She started a support group on
Facebook (www.facebook.com/groups/IdiopathicSubglotticStenosisSupport),
which drew nearly 200 members in under a month. In February she and
her daughter developed a video, "Strangled From Within:
Idiopathic Subglottic Stenosis," about her struggle to find a
diagnosis for her breathing problems. In its first week on YouTube,
the video had more than 1,300 views.
"I don’t
want someone else to go through what I did," Pliszka explains.
Three weeks
after her ISS diagnosis, Pliszka underwent surgery to remove the ring
of scar tissue that was constricting her trachea and affecting her
ability to breathe freely. Bock performed a laser dilation — the
most common procedure used to treat ISS. After inserting a scope into
her trachea, Bock injected a steroid to soften the scar tissue, then
made a laser incision to remove the scar tissue. Finally, a balloon
was inserted and inflated to re-expand the affected area.
Although the
results of dilation are immediate, the downside is that it’s not a
cure. The scar tissue always returns — within years or months of the
procedure.
"One of the
most rewarding things for people is that they wake up from the
procedure like they never had difficulty breathing," says Bock.
"The problem is that it slowly recurs again."
A new
alternative to dilation is the injection of steroids into the tracheal
band to soften and resolve the ring of scar tissue. But for the
treatment to be effective, patients must have the steroid injections
every four weeks.
For those with
severe ISS or who have had multiple dilations, a tracheal resection
may be considered. This major surgery involves removing the affected
area of the trachea, then reconnecting the healthy trachea back
together. It commonly requires a temporary tracheostomy below the
resected airway and a stay in the intensive care unit following
surgery.
Although there’s
no cure for ISS currently, Pliszka remains positive. And since her
surgery, she’s breathing freely again.
"I feel so
much better," she says.
"I can walk
up the stairs without getting winded." M
Local
Study Aims
to Help Children Suffering From Asthma
By
Craig McCarthy
A five-year
study is underway in the City of Milwaukee to try to reduce
irritant exposure in the homes of children who suffer from asthma.
Funded by a $1.25 million grant from the Greater Milwaukee
Foundation, the study is a joint effort between Children’s
Hospital of Wisconsin and the nonprofit organization Fight Asthma
Milwaukee (FAM) Allies.
"We’ll
be looking specifically to measure our clients’ exposure to
irritants in their homes," says Erin Lee, program manager at
FAM. She also helped write the grant.
Some common
home irritants include cigarette smoke, dust mites, pets and
animals, pollen and mold. Leading the study is Dr. Mitch Grayson,
an allergist/immunologist in Milwaukee. He’s the medical
director at FAM, an associate professor at the Medical College of
Wisconsin, and author of the proposal on asthma research for which
the study is based.
"What
we really want to do with this study is, first, focus on the idea
of measuring what is actually in these homes in the Milwaukee
area, and then say, ‘OK, now once we know what’s in the home,
what can we do to
reduce the exposure?’" says Grayson.
Once
eligible homes with a Milwaukee ZIP code have been identified,
members of FAM will conduct several visits and follow-up phone
calls with the residents over a six-month to one-year period.
Families will receive asthma education and be provided equipment,
such as bracelets that pick up and identify airborne irritants and
an air-quality monitor. The monitor measures the changes in
particulate matter from room to room.
There’s
also a blood draw, which is required as part of the study. The
blood will be analyzed for genetic markers — markers that may
help researchers predict who’s going to respond to irritant
reduction.
A total of
50 subjects will take part in the study. Grayson says the goal is
to not only provide immediate assistance and relief for those
asthma sufferers enrolled, but to gather data that can then be
used to have a much broader and long-term impact on
society and improve the overall health care system. M |