Department of Defense Brain Injury Rescue and Rehabilitation
SCIENTIFIC BACKGROUND AND OVERVIEW
The Use of Hyperbaric Medicine in Acute Trauma
By
Paul G. Harch, M.D.
Clinical Asistant Professor and
Director, Hyperbaric Medicine Fellowship,
Louisiana State University School of Medicine
New Orleans, Louisiana

Hyperbaric oxygen therapy (HBOT) is the use of greater than atmospheric pressure oxygen as a drug to treat basic disease processes and ther diseases(1).  In the simplest terms HBOT is a pharmaceutical or prescription medication similar to the thousands of medications routinely prescribed by physicians everyday throughout the world.    The key differences with HBOT, however, are that it is a drug that treats basic disease processes that are common to every disease, that it acts as a repair drug in these processes, and that it replaces an essential element of life for which there is no substitute, oxygen.  This effectiveness in treating basic common disease processes explains the ability of HBOT to act in a generic beneficial fashion to a multitude of diseases, including and esprecially traumatic injuries to all areas of the body.

HBOT has both acute and chronic drug effects.  HBOT exerts these effects by obeying the Universal Gas Laws, the most important of which is Henry’s Law (2).  Henry’s Law states that the concentration of a gas in solution is proportional to the pressure of that gas interfacing with the solution.  For example, the amount of oxygen dissolved in a glass of water is directly proportional to the amount of oxygen in the air.   Similarly, the amount of oxygen dissolved in our blood is directly proportional to the amount of oxygen we are breathing.  According to Henry’s Law, there is a very small amount of oxygen dissolved in the liquid portion of the blood when breathing air (21% oxygen) at sealevel.  The remainder and majority of oxygen is bound to hemoglobin in the red blood cells giving a 98@ saturation of hemoglobin.    As we increase the amount of oxygen in inspired air by applying a nasal cannula or facemask of pure oxygen the final 2% of hemoglobin is quickly bound by oxygen.  All of the remaining available oxygen interfaces with and is dissolved in the liquid portion of the blood.  Once we reach 1.5 liters/minute of supplemental  oxygen by a tight fitting aviator’s mask or non-rebreather mask we have reached the maximum amount of oxygen that can be dissolved in blood by natural means.  However, this is not the absolute limit.  By placing a patient in an enclosed chamber,  increasing the pressure above ambient pressure, and giving the patient pure oxygen we can cause an increase in dissolved oxygen in blood in direct proportion to the pressure increase.

At the point of three atmospheres absolute of pure oxygen (3 ATA), just slightly more than the amount the U.S. Navy has used for 50 years in the treatment of divers with decompression sickness, we can dissolve enough oxygen in the plasma to render red blood cells useless.  Under these conditions as blood passes through the tiniest blood vessels tissue cells will extract all of the dissolved oxygen in the blood without touching the oxygen bound to hemoglobin.  This amount of dissolved oxygen alone can exceed the amount necessary for the tissue to sustain life.  In other words, you don’t need red blood cells for life at 3 ATA of 100% oxygen.   This physical phenomenon was proven in a famous experiment in 1960 and published in the first edition of the Journal of Cardiovascular Surgery by Dr. Boerema of the Netherlands (3).  Dr. Boerema anesthetized pigs, removed nearly all of their blood, and replaced it with salt water while he compressed them to 3 ATA.  At 3 ATA in a hyperbaric chamber pigs with essentially no blood were completely alive and well.  This phenomenon has been proven effective in other experiments and is the basis for clinical use in extreme blood loss anemia (4).  The best examples are Jehovah’s Witness patients who have lost massive amounts of blood and because of a religous proscription are unable to receive blood transfusions.  These patients are kept alive over weeks with repetitive HBOT until their blood system is able to naturally produce enough blood to sustain life.  This ability to maintain life without blood has obvious potential to battlefield casualties awaiting transfusion.

As a result of Henry’s Law HBOT is able to exert a variety of drug effects on acute pathophysiologic processes.  These have been well documented over the past 50 years and include reduction of hypoxia (5,6), inhibition of reperfusion injury (7), reduction of edema (8), blunting of systemic inflammatory responses (9), and a multitude of others (10).  In addition, repetitive HBOT in wound models acts as a DNA stimulating drug to effect tissue growth (11,12).  HBOT has been shown to interact with the DNA of cells in damaged areas to begin the production of repair hormones, proteins and cell surface receptors that are stimulated by the repair hormones (13,14).  The resultant repair processes include replication of the cells responsible for tissue strength (fibroblasts) (15), new blood vessel growth (16,17), bone healing and strengthening (18), and new skin growth.

To best understand the effectiveness and potential of HBOT one must understand basic disease processes, commonly referred to as pathophysiolocic processes.  Every insult or injury to living organisms, particularly human beings, is distinct and different, and can be characterized by the type of force, energy, or peculiar nature of that insult.  For example, a blast force is different from a blunt force, an electrical injury, a toxic injury, a biological injury, infectious injury, thermal injury, nuclear injury, gunshot wound, stab wound , burn, or even a surgical wound.  Regardless of the exact nature and idiosyncratic character of the injury, however, every acute injury has a common secondary injury called the inflammatory process (20).  This secondary injury in fact causes more damage than the primary injury.  Moreover, it is a universal process common to every human being regardless of race, color, creed, size, gender or genetics.  The beauty of hyperbaric oxygen therapy is its ability to powerfully impact the inflammatory reaction and its component processes like no other drug in the history of medicine.

The inflammatory process begins with tissue injury.  The injury can be as innocuous as apposition of tissues that normally do not interface against one another, such as a spinal bony compression of a nerve root due to a degenerative disk.  Most often, however, tissue injury results from much larger forces such as the type seen in military conflict.  Once tissue is disrupted, proteins, fat, other molecules, and disrupted tissue is exposed to the circulation.  In addition, blood vessels are damaged both directly by mechanical forces and indirectly by tissue fragments that interact with the vessel walls.  The net effect is bleeding from broken blood vessels and dilation of the unbroken blood vessels.  As the vessels dilate, blood pressure forces the liquid portion of the blood out of the vessels.  The extravasated fluid, now referred to as edema, exerts its own pressure that collapses blood vessels, leading to a reduction of blood flow.  This compounds the reduction in blood flow already caused by disrupted blood vessels and bleeding.  In addition, white blood cells in the the circulation are attracted to the damaged tissue by molecules released from the damaged tissue.  The white blood cells traverse the blood vessel walls in a process called emigration (21) and disgorge themselves of their digestive enzymes.  These enzymes cause further tissue damage in an attempt to clean up the primary damage, but also cause constriction of blood vessels to limit further bleeding and leakage of fluid.

 

 

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HBOT also has beneficial effects on vasospasm and cellular reperfusion injury.  Multiple studies have shown that HBOT reduces cerebral edema and decreases intracranial pressure (ICP).   A summary of the HBOT/cerebral edema studies in animals is that HBOT has two differenct effects: one reducing brain edema (injured brain), and another producing brain edema (normal brain).  This toxic effect on normal brain causes a breakdown in the protective vasoconstriction of arterioles, resulting in a rapid rise in brain blood flow and deterioration in EEG.

Rockswold in 1992 reported the most exhaustive, rigorous, and important study to date in acute TBI (traumatic brain injury) in an attempt to refute or affirm all of the above animal and human data.  Conducted from 1983 to 1989 the study enrolled 168 patients with GCS or 9 or less in a RPCT design and stratified the patients by age and GCS.  Patients were treated at 1.5 ATA/60 every 8 hours for a maximum of two weeks immediately post TBI or until awake or deceased during these two weeks.  The average patient entered treatment 26 hours post TBI and received 21 treatments.  Overall mortality was significantly reduced 50% in the HBOT group and as high as 56% and 60% in the elevated ICP and GCS 4-6 subgroups.

This reduction in mortality has never been equaled by any therapy in the medical armamentarium except possibly the ambulance, or in the case of the military, the helicopter.  Adding HBOT to helicopter evacuation of casualties should further decrease morbidity and mortality of injured soldiers.  This is the foundation of the DoD-BIRR Project.

References:

Harch, Paul, M.D., “FEB Scientific Background and Overview,” 2005 (81 scientific references)

Harch, Paul, M.D., “Evidence for Use of Hyperbaric Oxygen Therapy for Acute Traumatic Brain Injury,” 2001

Hyperbaric oxygen therapy (HBOT) is a high-dose oxygen inhalation therapy that is achieved by having the patient breathe 100% oxygen inside a pressurized hyperbaric chamber. The delivery of oxygen to the tissues occurs through respiration because the patient absorbs insufficient oxygen through the skin.

Oxygen is transported by the blood from the lungs into the tissue by two methods: it is bound to hemoglobin in red blood cells, and it is physically dissolved in the plasma. As the chamber is pressurized, the elevated alveolar oxygen tension in the lungs drives oxygen into the plasma, which is then transported throughout the body. Oxygen transport by plasma is the key to hyperbaric oxygen therapy, for even tissue with a poor blood supply can receive oxygen as the hyperoxygenated plasma seeps across it.

While increasing tissue-oxygen levels is a primary therapeutic effect of HBOT, other benefits include reducing edema, modifying growth factors and cytokine effects, stimulating more rapid development of capillary budding and granulation tissue formation within the wound bed, promoting cellular proliferation, accelerating collagen deposition, and increasing microbial oxidative killing.

Damaged tissue can have decreased oxygen levels that reduce the activity of several antibiotics, including aminoglycosides, sulfonamides, and fluoroquinolones. By raising the oxygen in ischemic tissue to normal levels, HBOT may normalize the activity of these antimicrobials. Additionally, HBOT may potentiate the activity of certain antimicrobials by inhibiting biosynthetic reactions in bacteria. HBOT can modulate the immune system response and also enhance oxygen-radical scavengers, thereby decreasing ischemia-reperfusion injury.

Although any therapeutic application of hyperbaric oxygenation is intrinsically associated with the potential for producing mild-to-severe side effects, the appropriate use of hyperoxia is one of the safest therapeutics available to the practitioner.

It is unknown if hyperbaric oxygen therapy will cause congenital defects in horses. In human studies it has not been shown to have adverse effects. In our hyperbaric center, we do not hesitate to treat a mare with HBOT, especially when the benefits outweigh the risks. It is not unusual in our clinic, if treating a foal, to allow the mare in the chamber during treatments to aid in the relaxation of the foal.

Contact: Dr. Nathan Slovis, 859/253-0002; Hagyard Equine Medical Institute; Lexington, Ky.

Hyperbaric oxygen (HBO) is a mode of therapy that systematically delivers 100 percent oxygen at pressures two to three times greater than normal atmospheric pressure.  There is no significant oxygen absorption through the skin or wounds, so dressings stay intact during treatments.

For more information on this therapy, contact Advanced Wound Care Systems, Inc. at 801-964-2008

Hyperbaric Oxygen Therapy (HBOT) New evidence has been accumulated

 By Pavel I. Yutsis, MD and Iosif N. Dimant, PhD

 The concept of putting patients in a decompression chamber and raising the ambient pressure around them for therapeutic purposes was at first without scientific basis.  Perhaps intuitively it “seemed like a good idea” to b British clergyman, Henshaw, who in 1662, build a sealed chamber he called a “Domiciulium.” Chamber pressure was controlled by valves which could either raise or lower pressure.  He felt that acute disease of all kinds would respond to increased ambient pressure whereas chronic diseases were better treated with more rarefied air.

             In 1873 Fontaine, a French surgeon, built a mobile operating room on wheels which could be pressurized.  Over 20 surgical procedures were performed in this unit using nitrous oxide as the anesthetic.  Deep surgical anesthesia was possible because its increased effective percentage accompanied by a higher oxygen partial pressure, rendered it safer.  According to the law of physics, compressed air at low atmospheres gives an effective level of 42% inhaled oxygen.  Hernias were seen to reduce more easily and the patient did not have cyanotic color when coming out of anesthesia.

            In 1891, J.L. Corning, the first physician to administer spinal anesthesia, introduced compressed air therapy to the United States and was the first to operate his compressor with electric power.

             Orville J. Cunningham, a professor of anesthesia at the University of Kansas in Kansas City, was a great compressed air enthusiast.  He noted that people with heart disease and certain other circulatory disorders did poorly when living at altitude, but improved on return to sea level.  Taking this concept one step further, he felt that increased atmospheric pressure would be still more beneficial.  During the flu epidemic of 1918, he placed a moribund young resident physician in a chamber which had been used for animal studies, and by compressing him to two atmospheres was able to successfully oxygenate him during his hyposixic crisis, thereby proving to himself that his concept was sound.  He constructed an 88 foot long chamber, 10 feet in diameter, in Kansas City and began to treat a multitude of d diseases.

             Mr. Timkin of the Rollerbearing Company came under his care and apparently had a spontaneous recovery from a uremia while in Cunningham’s chamber.  In gratitude to Dr. Cunningham, Timkin build him the largest hyperbaric chamber ever constructed.  It was a steel sphere six stories high and 64 feet in diameter. T This “steel ball hospital,” located in Cleveland, Ohio, accommodated a smoking room on the top floor, plush carpeting, dining rooms and individual rooms.  It could reach three atmospheres pressure.

             Cunningham felt that some anaerobic-organism “s\which could not be cultured” was responsible for a host of diseases including hypertension, uremia, diabetes and cancer and that compressed air therapy helped inhibit this organism.  The AMA and the Cleveland Medical Society, failing to receive any scientific evidence for his rationale, finally forced him to close in 1930.  Unfortunately, the steel ball hospital was broken up for scrap during World War II.  It would have made magnificent museum.

             Basic and advanced knowledge in hyperbaric medicine was accumulated by Boerema and co-workers in the Netherlands.  During their experiments with pigs they found that life can be sustained in the absence of hemoglobin.  Subsequently, it was established by many researchers that hyperbaric oxygen therapy can provide great beneficial effects in the treatment of chronic refractory osteomyelitis (Perrins), hemmorhagic shock (Cowley), myocardial infarction (Ledingham and others), carbon monoxide poisoning, burns, wound healing, etc.

             It has been suggested by many researchers that the therapeutic effects of Hyperbaric Oxygenation in ischemic processes is based upon adequate oxygenation and improvement of oxygen diffusion and restoration of blood circulation in different tissues and organs, including the brain and its oxygen-sensitive neurons.  In fact, the majority of neurons die within 5-8 minutes of oxygen starvation (anoxia).

             Oxygen plays an important role in (1) regulation of brain metabolism (2) vascular and cellular permeability (3) enzymatic activity (4) functional activity of neuromediators (5) functioning of blood-brain barrier and spinal fluid.  Basic pathogenic factors that determine severity of brain pathology are hypnosis and metabolic derangement caused by circulatory dysfunctions (strokes, thrombosis, brain injuries) followed by brain swelling, infarcts and elevated intracranial pressure.  It is important to point out that restoration of the brain cell tissues are caused by disturbances in brain circulation and can become a long-lasting process.  In fact even in 10-15 years following an acute event, hyperbaric oxygen therapy can still produce a great deal of benefits. It has become obvious that adequacy of brain oxygenation plays a key role.  As it turned out the death of brain cells takes place only in the areas where the blood flow is severely restricted, wherein brain regions of moderately or mildly damaged tissues are not dead but not functional either, and they can remain in such state for many years.  These brain regions with poor blood flow that resulted from stroke or brain injuries are known as the “ischemic penumbra.”  They remain in the “ischemic state” due to inadequate supply of oxygen and nutrients to accumulate enough ATP from both aerobic or anaerobic metabolism to provide nerovasculariztion in the “penumbra.”  Therefore, “ischemic penumbra” will remain ischemic until oxygen delivery from capillaries into the neurons and brain tissues are completely restored.  In the areas of “ischemic penumbra,” anaerobic glycolysis produces only 2 moles of ATP per mole of glucose metabolized, whereas in the normal brain region 36 moles of ATP are formed.

             Hyberbaric oxygen forces oxygen into the plasma.  When the plasma reaches into “ischemic penumbra” it brings enough oxygen to provide for aerobic metabolism (metabolism that utilizes oxygen surges of ATP production while patient remains in the chamber.) As soon as tissues of ischemic penumbra are adequately oxygenated the repair of their “idling neurons,” glial cells and extra cellular matrix begins.

             Conclusively, evidence is steadily accumulating that with the use of hyperbaric oxygen therapy the chance for a recovery for patients with chronic neurological disorders is considerably higher than it was previously believed.

             We have analyzed the medical records of 16 patients with chronic neurological disorders (stroke, traumatic brain injuries, multiple sclerosis, ischemic encephalopathy, etc) the completed treatment at The Yutsis Center for Integrative Medicine, Brooklyn, New York, in 1999.  All sixteen patients were treated with hyperbaric oxygen therapy, using pressure of 1.54 – 1.75 ATA.  Prior to the treatment patients had their arterial blood pressure, pulse and respiratory rate checked and their tympanic membranes and pupils were examined.  Patients were placed into the chamber for 60 minute treatments with twenty minutes for descent and ascent.  Neurological examination was done on a weekly basis.  Total number of treatments varied from 30 treatments to 220.  All these patients required a course physical therapy and acupuncture for the best results.  Encouraged by successful results of the treatments, on many occasions patients requested additional treatments in spite of high out-of-pocket expenses.  The majority of the patients reported improvement of different degrees in a number of functions (improvement in speech, memory, motor functions, reading and writing.)  The majority of patients had a brain SPECT done prior to onset of treatment course and upon its completion.  In the cases of acute disturbance of blood circulation, the same efficacy in the treatment was observed.  It is established that efficacy of treatment depends upon severity of damage.

             Conclusively, in our experience, hyperbaric oxygen therapy provides greater benefits for recovery of different functions in chronic neurological conditions in patients.  We have observed improvement in mental status.  The same good efficacy in restoration of speech, reading and writing in 75% of our patients, 25% did not demonstrate any improvement.  The main difficulties in treatment were observed in restoration of motor functions – 75% of our patients improved in different degrees – 25% reported no improvement.

 Here are some case histories:

            Patient S.B – Five months prior to the beginning of his hyperbaric oxygen therapy, S.B a 60 year old male developed CVA (major stroke.)  He was comatose for about one month and a clot was surgically removed from his cerebellum, however patient was left with blurred speech, bad memory, poor balance and coordination and could not ambulate without using a cane.  His hyperbaric oxygen therapy course consisted of 20 treatments of 1.5 ATA and 25 treatments with 1.75 ATA.  Upon completion of 45 hyperbaric oxygen therapy treatments, patient improved 100% in all his functions.

             Patient J.G. – a 35 year old Italian police officer suffered from hemorrhagic stroke (CVA) 4-1/2 years ago, and underwent hematomectomy in the left temporal region.  During his first visit patient presented with sensory aphasia, right sided hemipharesis, poor memory and used a cane for ambulation.  J.G had 40 1.5 ATA and 85 1.75 ATA hyperbaric oxygen therapy treatments (total 125 treatments.)  During his physical examination patient did not need to use his can anymore.  His mental performance has much improved.  His speech became understandable and range of motions in his right upper and lower extremities improved about 40%.  J.G. started playing baseball with his 9 year old son.

             Patient R.Z – a 58 year-old New Jersey pharmacist, a sufferer of hemorrhagic stroke (CVA) 3-1/2 years ago, was brought to our office with difficulties in swallowing and was fed via gastronomy tube.  R.Z had a history of cerebral palsy with mild right-sided hemiparesis and left-sided hemiparesis as a result of the stroke.  Additionally, motor aphasia of a great severity.  Upon completion of 220 hyperbaric oxygen therapy treatments, difficulties with swallowing has been resolved and gastrosomy tube has been removed.  R.Z. discontinued using his wheelchair and is able to walk with assistance.  His speech is partially improved, his mental clarity is improved and his spasicity has decreased significantly.  Finally R.Z can take care of himself.

             It has become obvious that conventional methods of management of chronicle neurological disorders including stroke, head trauma, ischemic encephalopathy and multiple sclerosis are not satisfactory.  Hyperbaric oxygen therapy showed superior results in improvement of different functions in those affected.

             Hyperbaric oxygen therapy is also extremely safe.  A body of medical literature and clinical data clearly proves efficacy of hyperbaric oxygen therapy in acute events and even years after event.

             Our own experience is identical to JAIN’s results at Fraclinic, Clausenbach Germany.  (December 1987 – May 1989,) where improvement in gait, motor functions, speech, writing, reading and mental performance were reported.

             The data presented in this article is based upon our clinical observations and should serve as a challenge to initiate a controlled study as more data will be accumulated and become readily available.  Both physicians and patients will become encouraged to use hyperbaric oxygen therapy in the treatment of chronic neurological disorders.  The good word of this almost miraculous treatment will be spread among American citizens and reach the headquarters of insurance  carriers.  It will finally force major decision makers to at least pay attention to the benefits of hyperbaric oxygen therapy for stroke, traumatic brain injury and other chronic neurological conditions and hopefully create new reimbursement policies to cover hyperbaric oxygen therapy.

 Correspondence:

            For further information, please contact Dr. Neuberger at The Ocean Hyperbaric Center, 4001 North Ocean Drive, Suite 105, Lauderdale by the Sea, Florida 33308 USA, 954-771-4000 or Dr. Yutsis at The Yutsis Center for Integrative Medicine, 6413 Bay Parkway, Brooklyn, New York 11204 USA, 718-621-0900.

Hyperbaric Oxygen Miracles  By Dennis Gersten, M.D.

Nutritional Medicine and Psychiatry, Encinitas, CA

 In June 2002, I underwent a corneal transplant, after struggling for two years with a transplant that rejected and failed. I was blind and in a lot of pain. Three weeks after the June transplant, the new graft began to reject, which means that the body’s immune system identifies the cornea as “foreign” and begins attacking it. I underwent a very familiar treatment to me – high doses of Prednisone to suppress rejection, steroid eye drops and injections of long-acting steroids under the eye.

 The standard treatment failed and several weeks into the rejection, I knew that my time was running out. Within another week or two the cornea was likely to severely deteriorate. I needed an alternative.

After a great deal of research, I began hyberbaric oxygen therapy (HBO) at the Whitaker Wellness Institute in Newport Beach, California, founded by the well-known pioneer in holistic medicine and author of Health and Healing, Julian Whitaker, M.D.

My response was miraculous, and I kept running into other miracles at the Whitaker Wellness Institute.

After a great deal of research, I began hyberbaric oxygen therapy (HBO) at the Whitaker Wellness Institute in Newport Beach, California, founded by the well-known pioneer in holistic medicine and author of Health and Healing, Julian Whitaker, M.D. I had treatments two days in a row, and then saw my ophthalmologist the next day, who told me that the cornea was 50 percent improved. That was great news and was all the information I needed to commit to twice weekly HBO treatments. After a few months of treatment, my cornea is now 85 to 90 percent recovered.

My response was miraculous, and I kept running into other miracles at the Whitaker Wellness Institute. I asked one fellow what he was being treated for, “I used to be quad… I can’t run very well, but I walk pretty great, don’t you think?” It was hard for this conventionally trained medical doctor (me) to understand how a quadriplegic (like Christopher Reeves) could ever possibly have been cured. And then he explained, “Hyberbaric oxygen dramatically decreased edema (swelling) of the central nervous system and spinal cord after injury. It is the swelling that actually leads to the paralysis in most cases.”

I replied “So, what would Christopher Reeves be like today had he begun with hyberbaric oxygen?”

“He would be the same Christopher Reeves he was before his injury,” came the response.

I was sick for ten years. After hyberbaric oxygen therapy, I completely came out of the fog, reconnected to family and friends regained all of my mental faculties. All that is left is some fatigue.”

On another occasion, I asked a 30 year-old man what he was being treated for, “I developed Reyes Syndrome when I was 19 years old and was in a coma for four days. When I finally was able to leave the hospital and return home with my parents, it was as if I were living in a dream. I knew who my family and friends were but I felt no connection with anyone or anything in the world. I was sick for ten years. After hyberbaric oxygen therapy, I completely came out of the fog, reconnected to family and friends regained all of my mental faculties. All that is left is some fatigue.”

And on and on it went with stories like this. I wondered how I could have been so utterly uninformed about this and other oxygen therapies. I became interested in applications of HBO for my patients and for society at large.

Before going into further scientific explanations, let’s take a “dive” into the hyberbaric chamber. There are a variety of chambers, but a common one is a “three-seater.” It is a twelve-foot long steel chamber with round windows. First, a technician will place an oxygen mask on you. The mask used was the same as those used by Air Force fighter pilots. Next, the chamber door is closed and the oxygen is turned on, and you begin breathing 100 percent oxygen. Then the entire chamber is pressurized to levels between 1.5 and 3 atmospheres, the initial feeling is not unlike begin in an airplane that is either taking off or landing. Most people talk about going for a dive, since the chambers are widely used for decompression illnesses in scuba divers. I personally feel as if I am on a plane going on a vacation.

“Dennis Gersten, M.D., like myself is a conventionally trained physician. However, as a patient at the Whitaker Wellness Institute he received unconventional medical therapy. Like many of our patients, he experienced unexpected and substantial benefits. He was surprised that therapies of such benefit could be completely ignored by conventional doctors. That has disturbed me for over 25 years.”

Julian M. Whitaker, M.D.
President and Founder,
Whitaker Wellness Institute

The duration of the “flight” varies but includes about 10 minutes of pressurization, 60 minutes of treatment, and 10 minutes of depressurization. Now, there is an image to help explain what is happening during HBO. We’ll use an unopened bottle of soda pop to illustrate the process. Before you open the bottle, you can see no bubbles of carbon dioxide (CO2). As soon as you take the lid off, the bottle fizzes, bubbles form everywhere and are clearly visible. They are invisible before opening the bottle because the beverage is sealed under high pressure, causing virtually all of the CO2 to dissolve into the water. As soon as the cap comes off, the pressure leaves, and the CO2 comes out of the solution.

The same principle applies to HBO. You are breathing 100 percent oxygen under high pressure. The high pressure causes the oxygen to dissolve into the blood. As a result, extremely high levels of oxygen saturate your blood and are delivered to your body tissues. As a result of HBO, there is a 10 to 15 fold increases in the concentration of oxygen in the blood, resulting in a dramatic increase in oxygen delivery to your cells. It’s that simple, although one wants to get an HBO treatment center where the staff is well-trained since there is a lot of complexity that the doctors and technicians need to be aware of.

Immediately after the treatment, people often experience more energy, a sense of vitality, and clear-headedness. But that is not the therapeutic effect that is lasting. The true healing impact of HBO comes about after several to many treatments and is explained by several mechanisms.

HYPEROXYGENATION. Supports poorly perfused tissue which helps in wound healing and stroke.

NEOVASCULARIZATION. This means that HBO causes the growth of new blood vessels at a capillary level. If you’ve had a heart attack or are about to, developing increased blood flow, actually growing new blood vessels, via neovascularization could be quite helpful.

ANTI-MICROBIAL ACTIVITY. This is an exciting aspect of HBO, namely its ability to kill bacteria, viruses and mycoplasma. HBO is often used along with antibiotics in treating some bacterial infections and mycoplasma. HBO is often used along with antibiotics in treating some bacterial infections and mycoplasma (a common cause of chronic fatigue syndrome). Viruses cannot live in the presence of oxygen, so it is great news that there are therapies developing that can kill viruses because the anti-viral medications are not a solution to the huge problem that viruses are.

DIRECT PRESSURE. HBO is mainly used in America to treat decompression illnesses in divers, HBO reduces the volume of gases in the bloodstream.

VASOCONSTRICTION. (Constriction of the blood vessels). This occurs without loss of oxygen delivery to the tissues because HBO is delivering highly concentrated oxygen to every cell in the body. This particular mechanism is useful in helping to heal burn wounds.

All five mechanisms are at work during any of the 13 FDA approved indications for HBO therapy.

Carbon monoxide poisoning

Carbon monoxide poisoning complicated by cyanide poisoning

Decompression illness, including air o gas embolism

Gas gangrene (diabetics may develop this)

Chronic osteomyelitis (bone infection)

Radiation tissues injury

Crush injuries and traumatic ischemia

Anemia, including acute blood loss anemia

Intracranial abscess caused by actinomycosis

Necrotizing soft tissue infections

Refractory osteomyelitis (bone infection)

Skin grafts and flaps

Thermal (heat) burns

HBO is being used worldwide for a variety of illnesses and there is tremendous research already supporting these uses. In fact there are more than 30,000 scientific studies. Over the next few years, the documentation will reach the level where the double-blind studies are likely to validate many more treatments.

Here are some of the more intriguing and essential uses of HBO being used both here and abroad:

Near drowning.

Stroke.

Cerebral edema.

Lyme Disease.

Coma.

Cranial nerve disease.

Peripheral neuropathy, often seen in diabetes.

Delayed wound healing.

Diabetic retinopathy.

Tendon and ligament injury.

Accelerated healing from surgery, including plastic surgery.

Ulcerative colitis.

Multiple sclerosis.

The daughter of a woman working at the Whitaker Wellness Institute has multiple sclerosis and has had a lifesaving and life-changing response to HBO.

In Japan no one is more than 30 minutes from a hyberbaric oxygen chamber. In Europe, HBO is the very first treatment for stroke. Hence, HBO chambers are in most European hospitals. And in Moscow, there is a hyberbaric hospital. In the hospital there are large hyberbaric rooms that can hold 30 to 50 people at a time there are even HBO chambers for cats and dogs.

If HBO is the number one treatment for stroke in Europe, one realizes the tragedy going on in America. I have met people who flew in from Indiana for their HBO therapy because there are apparently very few, or no, chambers in the Midwest.

The more I have researched HBO, have experienced my own clinical response, and have spoken with many others helped or cured of dread illnesses, the more I wonder how many people could benefit from this wonderful modality-oxygen. This is a treatment based on one of our body’s greatest needs for survival, along with food and water. I wonder about all the people with brain disorders who might feel better, might lead healthier lives, if they knew about HBO.

I don’t wonder why there are so few HBO treatment centers in America, because we tend to lag 50 years behind scientific breakthroughs. As a specialist in amino acids therapy, I am well aware that we are now 40 years into this modality but years away from any incorporation into mainstream medicine. So I don’t wonder, but I do regret the lag time and I fell for the people who could experience some relief from their suffering if they had access to ( and knew about) hyberbaric oxygen.

To quote Dr. Julian Whitaker, “Most physicians are only aware of HBO’ best-known use, to treat decompression illness (the bends) in divers. This I a shame. This remarkable therapy should be available to millions of patients who would fare much better with it than the drugs and surgical procedures they’re currently getting. Ask your doctor about hyberbaric oxygen therapy, and suggest that he or she look at the medical literature. Patient demand will likely be the deciding factor in making this therapy universally accessible.”

A final word – Prior to World War II there was a gigantic hyberbaric treatment facility in Chicago. However, it was dismantled so that the metal could be used to help fight the war. No such facility has replaced that one. Nonetheless, one at the time we can climb into these healing chambers, perfuse our tissue with oxygen and recover from a variety of symptoms and illnesses.

The story that leads me to Teri Rich and her Hyperbaric Healing Systems, Inc. and Advanced Wound Care Systems, Inc. which is located in Salt Lake City, Utah actually began several years ago in Newport Beach, California.

I first began to understand what hyperbaric oxygen therapy is by an introduction from Dr. Donald Jolly-Gabriel. Dr. “Jolly” as he likes to be called is the Director of Education and Hyperbarics for the Whitaker Institute and Clinic, located in Newport Beach, California.

I have found Dr. Jolly to be an unbelievable humanitarian and a very caring soul. I was originally called by Dr. Jolly after he found my Alternative Medicine Referral Network. We were both located in Newport Beach at the time, and he suggested we collaborate on how we can help each other and we arranged a meeting.

Our initial meeting was during the holiday season, as Thanksgiving was approaching. I saw a man in a lab coat frantically carrying boxes and directing a few people as I parked in the driveway of the Whitaker clinic. It was my appointment – Dr. Jolly and he was taking some time during his break to make sure food and items got delivered for the homeless at a shelter in Orange county. “Are you going to come with us to feed the homeless on Thanksgiving?” He asked.

Dr. Donald Jolly Gabriel PhD and Denise Hetrick of Clear Mind Center standing in front of a Hyperbaric Oxygen device.
Denise Hetrick of Clear Mind Center and Dr. Donald Jolly Gabriel PhD of Whitaker Wellness Institute, standing in front of a Hyperbaric Oxygen device.