Learn About Hyperbaric Therapy for Healing Diseases

Hyperbaric oxygen therapy (often referrer to as HBOT) involves breathing pure oxygen while lying in a sealed, oxygen-rich pressurized chamber.

Hyperbaric Oxygen Chambers (HBOCs) have an oxygen concentrator that "scrubs" the air and removes the hydrogen and other gases, delivering 100% pure, pressurized oxygen into the chamber.  Thus, owners of HBOTs do not need to purchase oxygen.

HBOT provides the human body with up to three times the normal atmospheric pressure with 100% pure oxygen.

Hyperbaric Oxygen Therapy as Conventional Medicine

Human body tissues require an adequate oxygen supply for normal functioning.  Surviving and recovering quickly and completely from injuries requires even more, and that is where HBOT becomes so helpful.

HBOT increases the amount of oxygen the blood can carry, which raises or temporarily restores normal levels of blood gases and tissue function, promoting healing and fighting infection.

In a healthy human, oxygen is transported throughout the body only by red blood cells. Using HBOT, oxygen is dissolved into all of the body's fluids, the plasma, the central nervous system fluids, the lymph, and the bone. This allows it to be carried to areas where circulation is diminished or blocked. Oxygen can reach all of the damaged tissues allowing the body to support its own healing process. The increased oxygen greatly enhances the ability of white blood cells to kill bacteria, reduces swelling and allows new blood vessels to grow more rapidly into the affected areas. It is a simple, non-invasive and painless treatment.

Benefits of HBOT?

Many illnesses and injuries occur, and often linger, at the cellular or tissue level. Cases such as: circulatory problems; non-healing wounds; and strokes, adequate oxygen cannot reach the damaged area and the body's natural healing ability is unable to restore the normal function properly. Hyperbaric oxygen therapy provides this extra oxygen naturally and with minimal side effects.

Hyperbaric oxygen therapy improves the quality of life of the patient in many areas when standard medicine is not working. Many conditions such as stroke, cerebral palsy, head injuries, and chronic fatigue have responded favorably to HBOT.

How Hyperbaric Oxygen Therapy is Performed

HBOT is performed with the patient in an enclosed chamber. Monoplace chambers are for use with one patient while multiplace chambers can deliver this therapy to several individuals at one time. In multiseat chambers, the oxygen is given through a mask or a hood. The first few minutes of therapy can be noisy. Patients are encouraged to relax. This can involve listening to music and, in some cases, watching movies or television during the therapy session.

HBOT is a treatment that has been utilized with increasing popularity in the last 50 years. It is a simple, non-invasive treatment that is often covered under insurance and can help to improve the health and functioning of individuals who have certain conditions.

There are some cases of side effects with this therapy. They have included barotraumas to the ears and sinus. These are a result of the environmental pressure changes and amount to the inability to equalize the pressure in the middle ears while the pressure in the chamber increases. A similar sensation occurs when individuals are in flight and the airplane is descending.

There are simple techniques that medical professionals can instruct the patient to perform to alleviate these symptoms. Near-sightedness can also be a temporary side effect, but normally is no longer an issue within a couple of months after therapy is discontinued.

The duration and amount of treatments usually depends on the condition it is being used for.

What conditions does HBOT treat?

Insurance and Medicare consider  the following conditions for HBOT to be covered for payment:

• Air or Gas Embolism
• Carbon Monoxide Poisoning
• Compartment Syndrome/Crush Injury/Other Traumatic Ischemias
• Decompression Sickness (Bends)
• Diabetic and Selected Wounds
• Exceptional Blood Loss (Anemia)
• Gas Gangrene
• Intracranial Abscess
• Necrotizing Soft Tissue Infection
• Osteoradionecrosis and Radiation Tissue Damage
• Osteomyelitis (Refractory)
• Skin Grafts and (Compromised) Flaps
• Thermal Burns

The following conditions are off-label which may or may not be covered by insurance or Medicare:

• Autism
• Cerebral Palsy
• Lyme Disease
• Migraine
• Multiple Sclerosis
• Near Drowning
• Recovery from Plastic Surgery
• Sports Injuries
• Stroke
• Traumatic Brain Injury
• Rheumatoid Arthritis 
• inflamation /scar tissue reduction and illumination 
• Allergy and sinus issues
• infection control
• immune system booster
• many others not specifically listed 

Hyperbaric oxygen is used to treat all conditions which benefit from increased tissue oxygen availability, as well as infections where it can be used for its antibiotic properties. We will go over many different types of conditions in this Learning Center and if you have any questions, feel free to contact me and ask.

Stroke Recovery

Treatment with hyperbaric oxygen therapy (HBOT) can lead to significant neurologic improvements for stroke patients.

Researchers from Tel-Aviv University assessed the efficacy of 2 months of HBOT for 74 patients who had suffered an ischemic or hemorrhagic stroke in the previous 6 to 36 months.

All the patients receiving initial HBOT sustained significant neurological improvements and had a better quality of life after the treatment compared to the start, while no improvements were seen in the control group.

If you have suffered a stroke, you may try HBOT at any stage in your recovery. It does not matter if your stroke was a few months or many years ago; HBOT has the potential to help any stroke survivor at any stage after a stroke.

Brain Injury

Individuals who have sustained an injury to the brain (known as traumatic brain injury or TBI) have been known to have improved functioning as a result of HBOT.

When a brain injury occurs, there is normally tissue that is permanently and irreversibly damaged, but there can also be areas around the permanently damaged tissues that are referred to as dormant. Oxygen deprivation to these areas can result from a decreased flow of blood. Decreased blood flow causes swelling in the tissue. HBOT rejuvenates these brain cells by oxygenating them, which in turn increases the bodily functions lost as a result of this brain area’s dormancy.

Skin Infections and Burns

Thermal burns are great for treatment with for hyperbaric oxygen therapy due to promotion of new blood vessels and tissue growth, and the control of infection(s).

Therapeutic usage of HBOT in burns typically is utilized for second and third degree burns (but can be used to help any type of burn heal quickly). In third degree burns, the initial thermal injury occurs followed by circumferential, widening tissue loss.

When tissue death occurs, the body does not recognize that tissue as its own. This dead tissue becomes a target for the own immune system and "attacks" the dying and surrounding tissues, resulting in even more tissue death.

HBOT given within the first 48 to 72 hours following thermal injury increases the oxygen saturation to the body by up to 12 times(!) that of breathing air at sea level. This can mitigate ischemia re-perfusion injury and the possibility of advanced tissue death beyond the initial area of the burn(s) by giving your body extra oxygen. This can bring the damaged area "back to life."

Beyond 72 hours, HBOT helps by promoting new tissue growth (this encourages healing by helping manufacture new blood vessels). HBOT also reduces the inflammation which inhibits the healing process. Finally, HBOT also offers infection control, as oxygen is the fuel for the body's white blood cells, your weapon to kill bacteria.

How More Oxygen Benefits the Body

The Robert M. Lombard Hyperbaric Oxygenation Medical Center, Inc.

Most living organisms depend on oxygen for survival. Oxygen is the catalyst for a functioning cell to do its work. Different cells in the body have different functions. When sufficient oxygen and nutrients are available, life is sustained at the basic level. Hemoglobin—the red blood cells in the blood stream—normally carries all the oxygen a healthy body needs for survival.

When normal circulation is compromised or obstructed, normal cellular function is affected and some cells may die. If normal circulation is not restored quickly, long-term injury may result.

Other times, the body is compromised by infectious organisms and the immune system simply needs a boost, or a toxic substance, like carbon monoxide, has affected normal respiration.

Hyperbaric oxygenation is proving a useful adjunct to traditional medical modalities for a wide range of conditions and diagnoses.

While it is not possible to cite every physical benefit of hyperbaric oxygenation, outlined below are some of the physiological effects when breathing pure oxygen under hyperbaric conditions.

The Most Overlooked Effective Prescription Drug

by Jamie Deckoff-Jones, MD
GreenMedInfo.com

Oxygen makes up almost 21% of every breath we take. It is fundamental to life. Without it, we die in minutes. It is an odorless, colorless gas that is poorly understood by most doctors, even though it is regulated as a prescription drug in most countries. Many doctors have a visceral mistrust of oxygen due to complicated and erroneous things they were taught in medical school about too much oxygen suppressing the need to breathe in patients with chronic lung disease or causing blindness in premature newborns. Throw in some half baked ideas about sick people having high free radicals and supplemental oxygen inducing free radical formation and voila! The overlooked arrow in the quiver. It comes out of the walls at the hospital, is administered by nurses and respiratory therapists and is generally thought of as an adjunct only, not an important treatment in its own right. Rather, it is more comfortable for the conventionally trained doctor to prescribe ever more dangerous drugs when confronted with a chronically ill patient.

Doctors generally believe that if the oxygen carrying capacity of your blood is normal (O2 Sat), then you don’t need supplemental oxygen, except in a few emergency situations. But many chronically ill people exist in a state of cellular hypoxia, meaning there is not enough oxygen reaching the inside of the cells to fuel cellular machinery. In particular, oxygen is required inside mitochondria to act as a substrate for cellular respiration, the Kreb cycle and oxidative phosphorylation, to produce ATP, the energy currency of the body. Oxygen gets into cells by passive diffusion along a pressure gradient. A simple way to think about it is, if the membranes are gummed up by illness, it requires more pressure to push the oxygen in.

There is a vast literature supporting that HBOT, hyperbaric oxygen therapy, is anti-inflammatory, neuroprotective, anti-infective and promotes healing of injured tissue [1] [2] [3] [4]. However, access is limited by a short list of indications for which insurance companies will pay hospitals exorbitant prices. There is a medical association, the UHMS, or Undersea and Hyperbaric Medical Society, that is the gate keeper. Anything outside of their list of approved indications is off label, legal for a doctor to treat, but insurance won’t pay. There are many private centers around the country that do an excellent job delivering treatments for a small fraction of the cost that hospitals charge. So here we have a powerful treatment that is not patentable, thus no major money to be made, except by treating patients. Doctors and hospitals want to make a lot of money for their time and equipment, so better to keep the present equilibrium with the insurance industry willing to pay a lot for a few, to prevent having to pay for the many who might benefit.

I was a hyperbaricist from ’00-’04. I had a large multiplace chamber in Great Barrington, MA where I treated the late effects of brain injury and other promising but off label indications with hyperbaric oxygen, including neuroinflammatory conditions like autism and treatment resistant Lyme Disease. I witnessed extraordinary benefit in certain individuals in that practice and some improvement in many thought beyond help. There is a small but growing body of literature to support widening the tightly controlled indications list. In particular, Dr. Daniel Rossignol et al have published several very important papers about HBOT for autism and inflammatory bowel disease. The concepts in these papers support the possibility of efficacy in a very wide range of neuroimmune diseases [5] [6] [7] [8].

In the UK there is a network of charity chambers salvaged from the North Sea that treat MS and, more recently, cerebral palsy and other brain injured children for free or a minimal donation. More than a million treatments have been given over a couple of decades. Their experience is completely uncontrolled, but HBOT is not that much fun and people will not keep going unless they are pretty sure it’s helping, even if it is free. Their enormous collective experience has shown it to be a very safe treatment in this setting.

There are two ways to increase the dose of oxygen above room air at sea level. You can increase the percentage of oxygen in the inspired air or you can increase the ambient pressure by using a chamber; both increase the number of oxygen molecules in each breath, so more is carried by the blood to the tissues. Putting the two together, you can deliver very high doses of oxygen with HBOT. I am currently using high flow oxygen by non-rebreather mask, without pressure, to good effect in my practice.

Soft portable chambers or Gamow bags were developed to treat mountain climbers who develop altitude sickness. At the time that I was practicing hyperbaric medicine, I was worried about the possibility of an explosive decompression, a potentially lethal event, in one of these chambers, as they are not rated for hundreds of duty cycles. I was opposed to home treatment on that basis, not because of any inadequacy of the treatment, though it is a considerably smaller dose than is generally used in a hard chamber. Since then, my understanding is that there have been more than 10,000 FDA approved soft chambers sold, and the thing I was fearing has not happened. Unless a soft chamber is modified to go to higher pressure than its rating, it should be a safe alternative. The experience has been that if they do leak, they don’t lose pressure suddenly. With some training, mild HBOT can be safely used at home. It a very simple treatment to deliver, once you get the hang of the concepts. I would stick to models that have a track record and FDA approval.

Accumulated experience from the Navy and the diving industry have taught us that repeatedly diving over a long period of time on compressed air causes cumulative damage to the brain and joints from nitrogen bubbles. That’s one of the reasons professional divers use Nitrox, a gas mix with a higher percentage of oxygen than room air. So although soft chambers are approved for use without oxygen, they are probably, in fact, safer over the long haul if used with oxygen, just like diving with Nitrox instead of air. The mild chambers are equipped with a penetrator that allows them to be hooked up to a concentrator, so while the chamber is pressurized with air, the patient can breathe oxygen enriched air through a mask.

Some of the doses reported to be helpful with mild HBOT are extremely low (1.3 ATA with 24% O2) and the equivalent dose can be reproduced without the use of a chamber. It is not known whether there is an independent pressure effect or not. It is a difficult thing to study as there is no suitable placebo for HBOT; patients know if they are being pressurized or not. As you read papers about HBOT, you will find a few important “negative” controlled studies where both the treatment and control groups improved, but without much difference between them. Be aware that a tiny amount of pressure, even with no additional oxygen, is still a treatment, powerful enough in the right circumstances to save a mountain climber’s life. Oxygen starved tissue is exquisitely sensitive to even small increases in oxygen tension. It is even quite possible that for many applications, less is more.

In my current practice, I treat ME or Myalgic Encephalomyelitis (aka CFIDS or CFS), a neuroimmune illness with pathophysiological similarities to autism, Gulf War Illness, chronic Lyme Disease and Multiple Sclerosis. I prescribe a concentrator or tanks to deliver the highest doses of oxygen I can get without a chamber. Some of my patients are completely or nearly homebound. Ease of access is essential for these patients as travel to a chamber isn’t possible.

An oxygen concentrator delivers oxygen through a tube to the patient via a cannula in the nose, a simple mask, or a non-rebreather mask. A non-rebreather mask has a reservoir which holds pure oxygen until the breath is taken; it has one way valves to prevent inspiration of ambient air and to allow exhalation gases out so carbon dioxide is not retained. Tanks are quieter, but at the high flows I’m using, need to be replaced frequently. Concentrators are noisy, but easier to move around and never run out, as they extract the oxygen directly from the air in the room. Concentrators can be portable, but most portables only produce 1-2 L/min (liters of flow per minute). The delivery device needs to match the flow rate. A nasal cannula can be used from 1-4 L/min (more than 2 L/min is hard on the nose) delivering 24-36% depending upon the flow rate and how the patient breathes. Most concentrators go up to 5 or 6 L/min and can be used with a simple mask (delivering up to 40% oxygen). Some concentrators go to 10 L/min and can be used with a non-rebreather mask (delivering >60% oxygen depending upon how the mask fits). A non-rebreather mask should only be used if there is enough flow to keep the bag inflated (>8 L/min).

There is a small amount of literature to support the efficacy that I observe in practice. 100% normobaric oxygen by demand valve has become approved therapy for cluster headache and there are a few papers in the literature supporting the use of normobaric oxygen for other indications, e.g. all cause headache [9 ], trigeminal neuralgia [10 ], mitochondrial myopathy [11] [12] and interestingly, schizophrenia [13]. A few studies show normobaric oxygen to be comparable to HBOT and others suggest it is less powerful, but still with positive effect. [14] [15].

The evidence based literature may be meager for many conditions that might benefit from a trial of home oxygen, however, it is an exceedingly low risk thing to try. My patients are canaries in the coal mine. The risk benefit ratio is more favorable by far than for any pill I can prescribe. Oxygen supplementation is a perfect intervention for fragile people who need to start low and go slow with new therapies, as the dose can be easily titrated. The dose does need to be individualized, as a few patients respond to high doses with a “herx” or die off reaction. In my opinion, this is not a positive thing if it is prolonged, but a smaller dose may still be helpful after the reaction clears, and bigger doses may be tolerated after the patient has some treatment under their belt. I prescribe O2 at 10 L/min for up to an hour by non-rebreather mask, once or twice day. I start my patients for 20 minutes at a time. If there are any untoward effects, unlike a pill already swallowed, it can be turned off and it is gone minutes after stopping it.

If it is gone from the body in minutes, why does it work? Like anything, including water, very high doses of oxygen can injure or kill. It takes a chamber to reach lethal doses, but the critical care literature suggests that even continuous high dose normobaric oxygen is damaging and does not produce the benefits seen with periodic treatment [16]. The principle of hormesis explains our clinical observations. It is the same principle that makes exercise good for you, despite stress to the system and free radical production. The right amount of stress activates cellular protective mechanisms, including induction of the antioxidant system. Or, what doesn’t kill you, makes you stronger. So although extra oxygen produces an increase in reactive oxygen species during administration, free radicals kill bugs and changes are induced in the cellular environment that leave it stronger than before the treatment [17] [18] [19]. HBOT has a powerful effect on gene expression involving critical pathways that protect the cell from oxidative stress [20] [21]. Also stem cells are mobilized by HBOT [22] [23].

HBOT, no matter how useful, is difficult and expensive to access, though portable chambers are fairly cost effective over time and can be shared by families. High dose pulsed normobaric oxygen, while probably somewhat less effective over the short run than HBOT, can be continued long term and, for responders, the effects may be additive. It doesn’t help everyone, but when it does help a stubborn condition, it is a great gift. There is little lost by trying it. We are faced with huge and growing numbers of people afflicted with chronic incurable neuroimmune illnesses. How sad, that such a simple, safe therapy as normobaric oxygen is not even on the table for discussion.

Addendum: Relative contraindications to HBOT are seizure disorder, inability to clear ears for pressurization, though this should be able to be handled in almost all cases, without barotrauma, but takes patience on the part of the chamber operator, as well as good communication with the patient. Severe COPD with CO2 retention, is another relative contraindication, although in practice CO2 narcosis only happens in the setting of acute decompensation. Asthma is a concern, because wheezing can cause air trapping and a wheezing patient should not be decompressed as trapped gases will expand and cause barotrauma. Asthmatic patients should be pretreated. Hereditary spherocytosis because of red cell fragility. Pregnancy and cancer are considered relative contraindications because of the unknown, although there are hints that HBOT may in fact be helpful for cancer. Certain prior ear surgeries are a concern and should be discussed with an otolaryngologist. Also some eye problems should be carefully considered. Hyperbaric oxygen may accelerate the maturation of existing cataracts, though if this is true, it takes a lot; HBOT does not cause cataracts de novo, except for a single case report in literature in a patient treated at high pressure. Temporary myopia with treatment is not uncommon. An exam by an ophthalmologist is a good idea prior to embarking on hyperbaric treatment. There have been cases of optic neuritis that worsened with hyperbaric treatments. Implanted devices should be checked prior to treatment with the manufacturer as to whether they are hyperbaric safe. The only absolute contraindications to HBOT is the presence of an untreated pneumothorax (collapsed lung) and recent prior or concurrent treatment with doxyrubicin, cisplatinum, Sulfamylon or disulfiram (Antabuse).

Read the full article here: http://www.greenmedinfo.com/blog/most-overlooked-effective-prescription-drug