Hyperbaric Oxygen Therapy (HBOT)
Hyperbaric Oxygen Therapy (HBOT)
Hyperbaric oxygen therapy has the extraordinary ability to improve your quality of life when standard medicine is simply not working or as a supplement to traditional medicine. Simple, effective and lifesaving, HBOT can be your answer to recovery. New Life Medical Group is one of the only freestanding facilities that has the matchless ability to provide hyperbaric oxygen therapy in conjunction with other treatments for a more cohesive, effective and long-term result.
Hyperbaric oxygen therapy (HBOT) is the only non-hormonal treatment approved by the FDA for biologically repairing and regenerating human tissue.
In addition to commonly approved FDA conditions, New life Medical Group in Jackson, TN, serving Nashville, TN, uses hyperbaric oxygen therapy to treat the following conditions: closed head injury/concussion, stroke, cerebral palsy, autism, Lyme disease, swelling (edema), joint-related issues, peripheral neuropathy syndromes/diabetes, poor circulation, reflex sympathetic dystrophy, complex regional pain syndrome, chronic fatigue syndrome, osteoradionecrosis, crush injuries, brain edema, near drowning, acute hearing loss, radiation myelitis, certain liver disease, and recovery following cosmetic surgery.
Autism is a neurodevelopmental disorder characterized by impairments in social interactions, difficulty with communication, and restrictive and repetitive behaviors.
Many research studies have demonstrated that those with autism have hypoperfusion (decreased blood flow) to several areas of the brain. Depending on the affected area of the brain, different clinical presentations may be seen. For example, hypoperfusion to the thalamus is reflected in repetitive, self-stimulatory and unusual behaviors. Hypoperfusion of the Werniche’s and Brodmams’s areas is reflected by decreased language development and auditory processing problems. Hypoperfusion of the temporal and frontal lobes is reflected by decreased IQ.
Mental exercise in children is associated with an increased in blood flow to the above mentioned areas of the brain. This increased blood flow has been shown to be impaired in children with autism. Another common finding in autistic children is that they have higher levels of inflammatory markers in the brain, as well as in other organs of the body. (For example, in the bowels it can cause abdominal distention.)
Hyperbaric oxygen therapy (HBOT) can overcome the effects of cerebral hypoperfusion by providing more oxygen to the brain and potentially halting the deleterious effects of lack of oxygen. HBOT also has been shown to help in diseases that are due to inflammatory processes.
In a randomized multi-center trial on autism (Daniel A Rossignol, M.D. et al) published in The Journal of Pediatrics in 2007, it was demonstrated that after 40 sessions of HBOT, 80% of children in the study showed clinical improvement. Some showed “very much improvement,” some were “much improved,” and 20% had no change.
Since not every child battling autism will show improvement after HBOT, baseline examination is necessary to determine potential benefit of HBOT. After a series of 40 HBOT sessions, re-evaluation should be done to determine improvement. In children with autism, HBOT is used at 1.5 ATA to 1.7 ATA, which has been found to be safe and efficacious.
Cerebral Palsy (CP) is a descriptive neurological and physical problem originating from defects in motor cortices. Collectively these are labeled as cerebral palsy.
Cerebral Palsy is non-progressive, non-contagious, permanent neurological abnormality. The location and size of the lesion will determine what deficit the child will have. The abnormalities occur in utero, during or after birth up until age five. The affected individual is influenced by genetic and environmental factors as well. Cerebral Palsy is associated with a perinatal hypoxic event (tight nuchal or prolapsed cord), placental abnormalities , prolonged labor, or infection transmitted during delivery.
There is no known cure for cerebral palsy, and there is no standard therapy. Early treatment gives a child a better chance to overcome disabilities. Therapy for the cerebral palsy child integrates physical, occupational and speech therapies, complemented with psychological, social and educational therapies. Many medications are often needed to help with associated cerebral palsy symptoms such as muscular spasms.
Two alternative therapies include neuromuscular electrical stimulation and hyperbaric oxygen therapy (HBOT). HBOT might be beneficial in treating Cerebral Palsy cases that are due to traumatic brain injury caused by decreased oxygen. Genetic or developmental causes of cerebral palsy would not benefit from HBOT.
The theoretical basis for HBOT in CP is that there are areas in the brain next to the CP lesions that are hypoxic due to marginal tissue perfusion. HBOT can increase the available oxygen to these marginal tissues and reactivate the cells to become functional. The number of cells that can be “salvaged” by HBOT cannot be determined. HBOT might cause improvement in motor skills, attention span, visual and verbal commands.
For this treatment, HBOT is used at “low pressure” (1.5 to 1.7 atmospheres absolute), as this has been demonstrated to be optimal pressure that an injured brain can tolerate without toxicity. A common protocol would be 1.5 ATA for at least 60 minutes once or twice a day for five weeks, along with physical and/or occupational rehabilitation therapy. Assessment of improvement should be done after each cycle of HBOT before continuing further therapy.
Complex Regional Pain Syndrome (CRPS), is a chronic neurological disorder that currently has no cure. Symptoms for CRPS include burning sensation, sensitivity to touch, swelling, change in the appearance of skin, and spasm of blood vessels. The main symptom is continuous intense pain that does not improve over time and usually gets worse.
There are two types of CRPS. Type I is more commonly referred to as RSD or Reflex Sympathetic Dystrophy and is characterized by no apparent nerve damage. RSD is sometimes interchangeable with CRPS. Type II is known as causalgia, and is characterized by having obvious nerve damage.
The specific cause is of CRPS is not known but believed to be a malfunction of the central nervous system. CRPS is most closely associated with injury or surgical operation; however, sometimes it begins for no known reason. It can affect anyone at any age, but occurs more often in women and in people in their 20s and early 30s.
Hyperbaric oxygen therapy has proven to be an effective treatment for the pain cause by CRPS. A patient is placed inside a hyperbaric chamber where he/she will breathe pure oxygen at an increased pressure. This allows more oxygen to get into the body’s system and promotes faster healing and reduces swelling.
Patients who have used HBOT to treat their CRPS notice results sometimes as early as their first few sessions. Benefits include reduction in pain without the use of needles or narcotics, improved sleep pattern, lessening depression and overall improvement in quality of life.
CRPS/RDS also is treated with sympathetic blocks and spinal cord stimulation. Both of these modalities work by “blocking” the nerves’ connection between the brain the affected extremity. This allows the re-establishment of normal blood flow to the extremity, which promotes healing. Sympathetic blocks have limited duration of action and have to be repeated. Spinal cord stimulation is a permanent system.
Hyperbaric oxygen therapy, sympathetic blocks and spinal cord stimulation are available at New Life Medical Group. Having all of these treatments in one location allows each patient to explore all options and choose the treatment that is best for him or her.
The efficacy of hyperbaric oxygen therapy (HBOT) in organ failure dates back to the 1950’s when exsanguinated pigs survived by placing them in a hyperbaric oxygen chamber (study by Boirema).
Traumatic brain injury affects 2,000,000 people each year. Of these, 1,000,000 require an emergency room visit, and half are hospitalized and 50,000 die. Multiple drugs, as well as hypothermia trials, have failed to give consistent positive results. HBOT has been shown to decrease mortality rates and improve functional outcome with minimal to no side effects.
The effects of concussion to the central nervous system escalate during the first 24 to 72 hours. Disabling concussions are more symptomatic at 24 hours than at the two- to four-hour window when patients typically are seen in the emergency room.
The National Institute of Neurological Disorders and Stroke is funding studies involving HBOT and normobaric hyperoxia. The San Antonio Military Medical Center and the Air Force are studying the effects of HBOT for brain injuries in soldiers (www.af.mil/news/story.asp?id=123184911 ). The National Brain Injury Rescue and Rehabilitation Projects (www.hyperbaricmedicalfoundation.org) seeks to add traumatic head injury/PTSD as an additional indication to the already 14 approved indications, since there is evidence that some veterans have benefited from it.
More evidence is accumulating that HBOT appears to decrease cerebral edema and stabilize the blood-brain barrier. After a traumatic brain event, there is an energy crisis, changing the normal aerobic metabolism to anaerobic metabolism; this results in lactate (an acid) that damages the brain cell energy machine (mitochondria). At this critical time, there is a decreased oxygen delivery to the brain cells. HBOT delivers oxygen to the critical brain areas and improves the cerebral blood flow balance. It also improves metabolism of substrate and decreases the release of harmful toxins. It decreases the apoptotic cell death, modulates the inflammatory process and improves micro-circulation.
The earlier HBOT is instituted, the greater the benefit. Of course, the benefit needs to be balanced with the effects of oxygen toxicity, which can cause a seizure. HBOT is delivered at a shallow level of 1.5 ATA for 60 minutes.
The use of hyperbaric oxygen therapy by cosmetic surgeons is on the rise. There are 10 to 12 million cosmetic procedures performed each year in the United States. HBOT can benefit patients of the most popular cosmetic surgical procedures, such as tummy tucks, rhinoplasty, liposuction, facelifts and breast augmentation. Chemical peels and laser resurfacing are non-surgical procedures where HBOT can also prove to be extremely effective.
Patients who receive HBOT recover 30% to 50% faster than those who do not receive the treatment. They see a reduction in swelling, less bruising and less inflammation. It also reduces the risk of infection in the incision site, and scarring is less significant. A considerable reduction in pain allows the patient to return to a normal lifestyle much faster. In non-surgical procedures, patients see the redness associated with the laser resurfacing and chemical peels diminish much faster.
Smokers, people with compromised immune systems, overweight patients and anyone who has pre-existing health problems that will affect their overall recovery are the best candidates for HBOT. Overweight patients have benefited most from HBOT as it decreases complications. In addition to post-opt oxygen therapy, surgeons will often recommend at least one session prior to operation in order to have optimal results.
Lyme disease is transmitted to humans through an infected tick and is most often caused by the bacterium, borrelia burgdorfern (Bb spirochete). In the United States, the black legged tick (Ixodes Scapularis) and the western black legged tick (Ixodes pacificans), are the most common ticks to infect humans. Other ticks that have been found to be infected with the Bb spirochete bacteria are the wood rat tick (Ixodes neotomae) and the rabbit tick (Haemaphysolis porispalastris).
The first symptom of Lyme disease is a local rash (erythema migrans), but it is not always present and it can be overlooked. In the EARLY PHASE (inflammatory phase,) flu-like symptoms, headaches, stiff neck, mild fever, chills, muscles aches and fatigue are seen. These symptoms are very non-specific and mimic other diseases. Lyme disease needs to be considered as a possibility if the flu-like symptoms persist over weeks. The LATE PHASE (intracellular phase) of Lyme disease occurs when the bacterium is in the organ (skin, muscles, eyes, heart, brain, etc.). Symptoms in this phase might include neurological dysfunction, cognitive disorders, sleep abnormalities, muscles aches, cardiac problems, etc. These late symptoms also imitate other illness such as fibromyalgia. These characteristics of Lyme disease have given rise to the term “great imitator” to describe this disease process.
HYPERBARIC OXYGEN THERAPY works by driving oxygen into infected cells, thereby creating a rich environment of oxygen that is not suitable to the Bb spirochete. While at the Texas A&M University, William Fife, Ph.D., treated Lyme disease with HBOT at 2.36ATA (atmospheres absolute). Of 91 patients with Lyme disease, 85% of those treated showed significant improvement. A Jarisch-Herxheimer reaction during hyperbaric oxygen therapy and/or while on antibiotics is a sign that the Bb spirochete is being killed. As with all patients facing a serious illness, Lyme disease patients have learned that they need to be informed about treatment options. Especially if standard antibiotic treatment has not helped sufficiently, patients should explore alternative options.
In the past, migraines were thought to be due to spasms of the brain’s blood vessels. More recent research, however, suggests that there is an area in the brain with a lower threshold for migraines — a migraine generator that is sometimes even related to a traumatic event. This generator could be in the brain-stem, involving serotonergic nerve cells that alter the balance of brain chemicals.
Migraines begin with the aura and aura-like phenomenon. This is the beginning of a series of events that end as migraine headache pain. This pain is part of an inflammatory response of the vessels surrounding the migraine generator area in the brain.
Drugs that combat migraines are generally effective with relatively few side effects. Persons who may benefit from hyperbaric oxygen therapy (HBOT) are those whose migraines have more of a vascular origin, (induced either by imbalance of chemicals or abnormal blood flow to a particular brain area), or those who have side effects or contraindications to standard drug therapy.
HBOT has been shown to change the amount of blood flow in the brain during migraine episodes. Additionally, HBOT can favorably alter some of the chemical levels that induce migraines (serotonin and substance P). Published and unpublished studies show that HBOT is effective in aborting a migraine headache in 80% of patients within 40 minutes of treatment. Effedal et al 2004 found that prophylactic use of HBOT to prevent headaches can reduce the number of headaches. Due to the small sample size of the study it did not reach statistical significance.
In summary, HBOT is an alternative therapy to abort a migraine headache without drugs and their side effects including sedation, nausea, etc. Complications and side effects of HBOT are rare at pressures less than 2 ATA, and at the conclusion of an HBOT session patients can return immediately to daily activities. Those considering HBOT for migraines/headaches should have a full neurological evaluation to make sure that there are no organic reasons for the headaches (such as mass, tumor, vascular deformities, etc.). HBOT is considered off-label usage, as are many drugs used for migraines.
Peripheral neuropathy (PN) refers to any affliction of the peripheral nerves. Peripheral nerves are those outside the central nervous system that provide signals to skin, joints, muscles and internal organs. The most common symptoms of PN are subtle at first, with tingling and numbness of the toes/skin, decreased sensation, burning, stinging, shoot pain, etc.
Causes of PN can be diabetes, metabolic autoimmune issues, hereditary conditions, infections, toxins, drugs and tumors. Diabetes is one of the most recognizable causes of PN, and PN can begin before diabetes is even diagnosed. Diabetes affects multiple organs because it affects the blood vessels and the peripheral nerves.
These deleterious effects are mediated by decreasing blood flow and oxygen necessary for nerve function/signals. In other words, high blood sugar levels damage the blood vessels that supply oxygen and nutrients to the organs and peripheral nerves. The organs that do not get oxygen and innervation begin to malfunction and do not repair themselves.
Diabetes increases the risk of many serious medical problems: eye complications (blindness), foot problems (ulcers of the skin), heart (heart attack, high blood pressure), hearing loss, gastroparesis (slow bowel function), kidney, brain (stroke) and sexual function (erectile dysfunction in men and decreased vaginal lubrication, uncomfortable/painful intercourse and decreased sexual drive) — all due to damage to nerves and blood vessels.
In summary, several factors are responsible in the development of PN: (1) damage to vessels supplying nutrients and oxygen to organs and peripheral nerves; (2) autoimmune factors causing inflammation such as nerves, etc.; and (3) lifestyle, such as smoking or alcoholism.
Current treatments and recommended lifestyle changes are able to delay the onset of these complications. First and foremost is to control the blood sugar levels in diabetes and to detoxify and boost the immune system. There are multiple medications that can help with symptoms, interventional pain therapies and therapies to potentially slow and reverse the secondary damage. These therapies are all available at New Life Medical Group.
The most visible sign of PN is when a patient develops an ulcer in the foot (diabetic ulcer) that does not heal due to lack of oxygen and blood supply. Medicare approves hyperbaric oxygen therapy for certain diabetic ulcers. As mentioned earlier, diabetes is non-selective and affects every organ. We cannot see the deleterious effects until we have an ulcer, a myocardial infarct, stroke, blindness, sexual dysfunction, autoimmune dysfunction, kidney problems, etc.
HBOT is only approved in the U.S. for severe diabetic ulcers, but in other countries it is used for peripheral vascular disease caused by diabetes and vascular disease. A diabetic ulcer is easy to measure (depth, width, etc.), allowing us to see the progress after HBOT. What is not visible to the eye is that HBOT treats every organ. It re-oxygenates hypoxic tissue by promoting growth of blood vessels that will deliver oxygen and nutrients to organs and nerves. This reduces the risk of complications from diseases like diabetes.
There are numerous medical studies that show the beneficial effect of HBOT with diabetic ulcers. Of course, it is difficult to study the effects on other organs like the brain and heart because they are not easily examined and measured like an ulcer. There is published literature that shows the potential benefits for HBOT as well as other advanced therapies including the use of stem cells. For example, Cihan Top, et al (Internet Journal or Neurology 2002 Vo. 1 #2) showed the beneficial and significant improvements on the automatic system and neuropathy after HBOT. Ning Gu et al (Diabetes Technology & Therapeutics Feb. 2010, 12 (2): 125-133) concluded that HBOT reduces high blood glucose levels, improves oxidative capacities in the skeletal muscles and that these effects are maintained, even after expose to HBOT. Drs. Polydefis and Ebenezer at the Johns Hopkins Research suggest that blood vessels and support cells may be real targets of treatment for diabetic nerve damage (June 2011).
Hyperbaric oxygen therapy is the only non-hormonal treatment approved by the FDA for biologically repairing and regenerating human tissue. HBOT can be used as an adjutant to good blood sugar control and lifestyle changes to delay, and even possibly reverse, the damaging effects of diabetes.