Hperbaric oxygen therapy (HBOT) appears to be a safe and effective treatment for Traumatic Brain Injury (TBI), Post-Traumatic Stress Disorder (PTSD) and Depression.  Thanks to the work of the American Association for Health Freedom,  and their petition to Congress,  it looks as though our veterans will soon be receiving this much-needed treatment.

For each of you who took time to write your representatives regarding this issue – Thank you.  The legislation which was passed and signed into law is a start, but this program needs to be funded and sustained.  Please see the link at the bottom of this piece to ask Congress for its continued support of HBOT for veterans.
* From the E-Newsletter, [American Association for Health Freedom]

AAHF Scores a Victory with HBOT for Wounded Veterans

Hope For Traumatic Brain Injury, Diabetic Failure-to-Heal Wounds and More?

On September 30,  President Bush signed into law the FY2009 Continuing Resolution that contains the Defense Appropriations bill.  In doing so, crucial funding became available to complete a scientific study important to all Americans.

Seventeen years ago, Paul G. Harch, M.D., discovered that hyperbaric oxygen therapy at 1.5 atmospheres of pressure  (HBOT 1.5)  could repair a chronic traumatic brain injury (TBI).  Dr. Harch, director of the Hyperbaric Medicine Fellowship at Louisiana State University’s School of Medicine and an AAHF member, has used the therapy on over 700 patients and has taught the technique to hundreds of doctors.

In 2008, Dr. Harch applied HBOT 1.5 to five combat veterans of the current war who have traumatic brain injury and post traumatic stress disorder (PTSD) from concussive blasts.  So far, all of the veterans treated have significan recovery.  Eighty percent no longer have PTSD and all are improved.

During this same year,  Dr. Harch testified in fron to the Surgeon General of the Navy and the Deputy Commandant of the Marine Corps.  He told the stories of the five combat veterans he treated with HBOT 1.5; three of those veterans were in the same room.

One of them, a judge who served as a general in the Army Reserves, endured a year of treatment failures at Walter Reed.  He is now back on the bench, fully recovered in 120 days, after 80 HBOT 1.5 treatments.  The Health Freedom Foundation, sponsored a Marine machine gunner who expreienced seven concussive events from roadside bombs during two tours in Iraq.  Now, after HBOT treatments, his migraine headaches have disappeared, his sleep is restored , his PTSD is gone.  He is now actively employed.  He has his life back, as do other veterans who have undergone HBOT treatment.

At Louisianna State University in New Orleans, under an approved study protocol, Dr. Harch is now treating another thirty veterans of the war who have TBI and PTSD.  AAHF sought funding from Congress for this important study for the past two years. This year, after nearly 200 visitis to members of Congress, funding was finally provided.

In April 2008, the RAND Corporation, a non-profit “think tank” highly respected by the government and NGOs, found that of the 1.6 million veterans of the war, 300,000 have PTSD, 320,000 suffer TBI, and 80,000 have depression.  Current treatment costs for each of these conditions, when treated separately, is more than the cost associated with HBOT 1.5.

HBOT 1.5  one-time cost is US $16,000 (80 treatments at $200 per session) and apprears to treat all three symptoms simultaneously;  the earlier a person is treated, the more effective the recovery, and the fewer the treatments needed.

Hyperbaric oxygen therapy at 2.4 atmospheres of pressure is already used 10,000 times a day at over 900 locations for everything from non-healing diabetic wounds and radiation injuries from cancer treatment, to fourteen other Medicare-reimbursable and FDA-approved indications.  HBOT 1.5 is a dose of HBOT tat clinical experience shows is safe and effective for TBI.

According to Dr. Ted Fogarty, Chairman of Radiology at the University of North Dakota School of Medicine, “Functional neuroimaging shows HBOT revitalizes brain tissues and restores normal brain metabolism in vastly different areas of the brain in ways that other existing treatments cannot.  To leave these injured neurons in our brave veterans to wither on the vine seems criminal when HBOT 1.5 is available and works.”

Today a multi-state coordinated effort is under way to treat vets at 78 locations.  We expect this AAHF-coordinated effort will result in the necessary scientific proof to establish HBOT 1.5 as the standard of care for acute and chronic neurological injuries, and we hope it will secure reimbursement by the VA, Tri-Care, Medicare and civilian insurance.

The body of scientific evidence indicates that modern medicine has overlooked hyperbaric oxygen as a key tool in the treatment of strokes, diabetic failure-to-heal wounds, and conditions like reflex sympathetic dystrophy.  Timely HBOT therapy could reduce the incidence of stroke (the leading cause of disability in the U.S., with over 500,000 reported cases each year) and amputations due to diabetic failure-to-heal wounds.  HBOT has sound science, many years of clinical practice and a convincing reason for all of us to seek access when it can be of help.

Veterans who wish treatment can can contact Teri Rich at 801-964-2008.

ARTICLE SOURCE:
HyperMED NeuroRecovery Australia
http://www.hypermed.com.au

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Continuation  of  Previous Entry —

veterans-new

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

I had the opportunity to visit with Teri Rich, the founder of Advanced Wound Care Systems, Inc. located in Taylorsville, Utah located inside the Salt Lake City metropolitan area.

Teri Rich and Dr. Sherman Johnson informed me that Advanced Wound Care Systems has been selected as one of approximately 90 installations around the U.S. for providing a Hyperbaric Oxygen therapy program for veterans.   

For more detailed information, you will need to contact Teri Rich directly at 801-964-2008.  Be sure to mention that you found her through the Hyperbaric Discovery blog.

veterans-new

 Here is the beginning of the overview for this program.  It will be completed in subsequent entries:

Department of Defense Brain Injury Rescue and Rehabilitation Project (DoD-BIRR) Rescue for Blunt Trauma, Crush & Acute Traumatic Brain Injury
Summary of Scientific Backgrounds & Overview
 
 Oxygen delivered under pressure, Hyperbaric Oxygen Therapy (HBOT) is one of the most powerful drugs known to man.  Simultaneously, HBOT delivers the substrate of life, oxygen, for which there is no substitute.  HBOT has profound beneficial effects on injury pathophysiologic processes that are common in military casualties.  Moreover, it has been shown to positively impact traumatic brain injury, compartment syndrome, burns, hemorrhage, and reperfusion injury.  These injuries and injury processes comprise the bulk of battlefield caualties.  With timely intervention of HBOT the morbidity and mortality of injured soldiers should substantially improve as they have in their civilian counterparts.  Past foreign military experience strongly suggests this benefit in extremity wounds and it is our conviction that United States soldiers deserve nothing less.  This is the goal of the Brain Injury Rescue and Rehabilitation Project (Dod-BIRR).

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.

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 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 pathyophysiologic processes.  These have been well documented over the past 50 years and include reduction of hypoxia (lack of oxygen), inhibition of reperfusion injury (immune response to injury), reduction of edema (swelling), blunting of systemic inflammatory responses, and a multitude of others.  In addition, repetitive HBOT in wound models acts as a DNA stimulating drug to effect tissue growth.    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.  The resultant repair processes include replication of the cells responsible for tissure strength (fibroblasts), new blood vessel growth, bone healing and strengthening, and new skin growth.

In the past 12 years scientific research has unequivocally shown that the only drug to completely or nearly completely reverse the reperfusion injury process is hyperbaric oxygen.  This  physiological reaction of the body to trauma is  is a major  source of injury that battlefield casualties experience.  In multiple experiments with different models, different organ systems, different types of blood flow reduction or absence (e.g., heart attack, stroke, cardiac arrest, carbon monoxide, tourniqueting of an extremity, etc.) timely HBOT within hours of reperfusion injury has been shown to completely or nearly completely reverse reperfusion injury.

Simultaneously, due to HBOT’s ability to dissolve large amounts of oxygen in the liquid portion of the blood, oxygen-enriched plasma is able to reach damaged areas of tissue not accessible by normal blood flow and restore oxdative function to those areas.  The net result is a dramatic reduction in the secondary injury process, improved viability of tissue that would otherwise die.

In addition, twenty percent of the wounded in Iraqi experience traumatic brain injury (TBI) a diffuse cerebral insult characterized by primary mechanical disruption of tissue and secondary injury from ischemia, hypoxia, edema, vasospasm, neurochemicals and reperfusion injury.  A review of the medical literature shows that there is substantial data proving a beneficial effect of HBOT on the secondary injury processes of acute TBI.  HBOT has been shown indirectly to improve ischemia and hypoxia in acute TBI by its effect on aerobic metabolism and EEG.  The neurosurgeon authors of the Rockswold study conclude that  “HBOT should be initiated as soon as possible after acute severe traumatic brain injury.”

— TO BE CONTINUED in PART 2

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 TherapyHyperbaric oxygen therapy, or “HBO”, is a medical treatment in which a patient breathes 100% oxygen while increased atmospheric pressure (generally 2 atm) in a hyperbaric chamber. The purpose of breathing 100% oxygen under pressure is to dissolve more oxygen into the bloodstream which accelerates the body’s natural healing process.

  • What Conditions benefits from HBO?
    • Diabetic wounds or ulcers
    • Soft tissue radiation damage
    • Compromised surgical grafts or flaps
    • Brown recluse spider bites
    • Certain infections of bone or skin
    • Crush injuries where intense oxygenation may save a limb
    • Air embolisms
    • Acute Necrotizing Fascitis
    • Gangrene infection

There are many other possible conditions.  Please contact Advanced Wound Care Systems, Inc and Hyperbaric Healing Center in Salt Lake City Utah at 801-964-2008 for a consultation.

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.