Temple doctor excels at diagnosing, treating tricky TBM

Tuesday, June 9, 2020
Temple doctor excels at diagnosing, treating tricky TBM
Your chronic cough might actually be TBM, a condition that's often misdiagnosed for asthma and getting more common to treat thanks to an innovation in robotic surgery.

NORTH PHILADELPHIA (WPVI) -- Coughs can be signs of many medical different problems. While most are simple, some can be complex.

For one woman, a chronic cough turned out to be a rare disorder.

"It started with a cough that doctors thought was just asthma," recalls Danielle Hong, of Egg Harbor Township, N.J.

However, asthma treatments didn't help Hong.

As time went on, Hong was given stronger and stronger drugs, including high-dose steroids.

Yet the shortness of breath got worse.

"Nothing seemed to get better and my cough sounded like a barking seal," she notes. "I was unable to even tie my shoes or throw in a load of laundry."

Hong was eventually referred to Dr. Charles Bakhos of Temple Health.

He recognized TBM - tracheobronchomalacia.

"It basically means there's a weakness in the windpipe," says Dr. Bakhos. "A lot of people are labeled having COPD or asthma for many, many years, because they have symptoms of chronic coughing, recurrent respiratory infections."

The collapsing windpipe makes it harder to breathe in and out.

And throat secretions can't clear, causing infections that can weaken the windpipe even more.

The cause of TBM is unclear, but doctors see it more in some patients with joint issues, chronic lung conditions, slight obesity.

"We think that smoking is a risk factor, and potentially acid reflux," he notes.

Medications, including antibiotics, may help, but surgery is usually the best option. And robotic surgery gives the best outcome.

"It does involve us going inside the chest with small keyhole incisions, there's no big incision anymore. The goal is to strengthen the back wall of the windpipe," he notes.

Four months after her surgery, Hong is back to activities she missed, like long walks with her dog, even going up steps.

Hong says the high-dose steroids she took might have contributed to her problem.

She's grateful for finding Dr. Backhos, one of the few doctors in the country doing this type of surgery.

"It has been truly life-changing for me" she says. "Every day gets better and better."