Asthma is serious business in Tennessee, and the record heat we've been having literally leaves some gasping for air. 3 of the top 10 worst asthma cities across the U.S. are right here in the Volunteer State. Nashville only this year moved out of the top 10. Tonight, a possible breakthrough for the state's worst asthma cases. Carla Byram is hoping Vanderbilt's new bronchial thermoplasty procedure, the first of its kind in the Midstate, can restore her daily function.

"You hear so many people say it's like a fish out of water and truly that's a good explanation," says Byram. "And you feel like you're grasping for every bit of air you can get."

Byram is being tested to make sure her lung function is strong enough to be put to sleep for the surgery.

"Once you have it, you won't need it again ever," says Vanderbilt Bronchoscopy Director Dr. Otis Rickman.

Bronchial thermoplasty works, doctors say, a lot like a microwave, delivering radio frequency energy to the affected airway.

"It basically warms up enough to destroy the smooth muscle that causes the constriction in asthma, but not enough to burn or char anything," says Dr. Rickman. "But the right amount at the right time."

Byram has been suffering with the chronic disease since her teens, and has now maxed out on every medicine and therapy that's available. This makes her a perfect candidate for this breakthrough procedure, reserved for the very worst cases of asthma.

"It's a constant problem," says Byram. "I'm attached to my nebulizer at home and O2 at night. On days like this I have to stay in the house because going outside smothers me to death. It's impossible. There's no real quality of life right now. It's pretty miserable."

She's gotten to the point where she's willing to try something that's brand new, that's only been studied 7 years.

"That was one of the main concerns is will this scar my airway and I'll have a problem later on?" says Dr. Rickman. "Well, at least for 7 years we know that is not the case."

With this breakthrough treatment, trips to the emergency room for those in the study dropped 84% and sick days at work dropped 66%.

"It's an outstanding opportunity to hopefully not fix me, but make me better so I can have quality of life," says Byram.

The procedure requires 3 treatments under sedation, and many patients may still require a daily maintenance medication for asthma.SPECIAL REPORT: Vandy Asthma Treatment