Clinics, Patients Turn to Hyperbaric Medicine

Michael Buyze

BROOKE ARMY MEDICAL CENTER, Texas -- --

“We call it the fog. It's like they’ve been awake for a few days straight,” said Col. (Dr.) Michael Richards, 59th Medical Specialty Squadron Undersea and Hyperbaric Medicine section chief.

“His wife had to finish his sentences. He could no longer take care of himself, really. He couldn’t manage his finances, he couldn’t drive, he couldn’t take care of his children. He couldn’t make decisions, even on small things like choosing what kind of milk to buy at the grocery store.”

For this patient, a fighter pilot, suffering from arterial gas embolism, a condition that causes gas bubbles to enter the blood stream and prevent blood flow -  “the fog” was a career ender. Or would have been, without the use of hyperbaric medicine.

When treatment after treatment weren’t having an effect on his mental disorientation, he turned to the hyperbaric medicine unit at Brooke Army Medical Center. After 60 sessions, he has regained the acuity needed to return to the air.

“We brought this patient from the east coast and after about three months of treatment, he left here a completely different person,” Richards said. “That was really gratifying for us, because he really had no other options and we were able to turn him back into the person he was before.

“His father called me in tears.”

As one of two hyperbaric chamber facilities in the Air Force, this one at BAMC gets referrals from throughout the Defense Department, as well as from civilian trauma and burn centers in the San Antonio area. The physicians, nurses and technicians there treat typical hyperbaric patients suffering from post-radiation injuries; decompression sickness; arterial gas embolism; chronic wounds; diabetics with end-organ disease and poor circulation; sensory hearing loss; burn patients and more.

“For example, for carbon monoxide poisoning, [patients] can get treatment under hyperbaric conditions with oxygen to drive off that carbon monoxide,” said Lt. Col. William Hayes, 59th MDSS Undersea and Hyperbaric Medicine flight commander. “Within 24 minutes they can have normal carbon monoxide levels again - better than normal. With arterial gas embolism or decompression sickness, they can get treatment and be resolved less than 24 hours after the incident.”

They’ve also begun treating other patients who may not fit the bill but may benefit from the therapy - with success.

Hayes described one patient suffering from necrotizing, or dying, flesh on the ends of his fingers. The motorcycle rider was experiencing such pain that he couldn’t use his hands.

“It wasn’t something typically treated using hyperbarics, but the mechanism behind what he had is something that we’ve seen respond to hyperbaric treatment,” Hayes said. “So we thought -  let’s give it a shot.”

After several treatments, the patient had a complete resolution.

As the word gets out about the benefit hyperbarics offers to patients, the clinic gets busier and busier. The clinic has begun partnering with dermatology, rheumatology, orthopedic surgery, and infectious disease, just to name a few, adding a tool to aid patients in addition to any treatment they’re already receiving.

“It's the most satisfying job that I’ve ever had,” Hayes said. “It's so unique. They come see us five times a week, sometimes more depending on the condition. We start to know them by their first names, they know us well.

With tears in his eyes, one patient, Gilbert Rojas, coming out of his fiftieth treatment after a service-connected injury, spoke about his experience.

“It blows me away, the technology, but more than that the humanity. I’ve broken down a couple of times, it’s just so overwhelming. When they take care of you it’s from the heart, it’s real.”

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Hyperbarics Oxygen Therapy

HOW DOES HBOT WORK?

Hyperbaric oxygen has a number of potential effects on the body including:
  • Angiogenesis – stimulates growth of capillaries in hypoxic tissue to improve wound healing
  • Hyperoxygenation – high levels of oxygen can help with the repair of cellular function
  • Osteogenesis – HBOT can stimulate the production of new bone cells in compromised bones
  • Microbiological – high levels of oxygen help eliminate anaerobic bacteria
  • Immune Stimulation – increased phagocytosis and natural killer cells
  • Decreased Inflammation – decrease in TNF alpha, cytokines and cyclo-oxygenase
  • Vasoconstriction – oxygen causes the constriction of blood vessels which can reduce oedema
  • Bubble Reduction – increased pressure decreases nitrogen bubbles in decompression illness
  • Tissue Repair – increase in stem cell production may help in tissue repair/regeneration
  • WHAT CONDITIONS CAN BE TREATED WITH HBOT?

    The mainstream and hospital-based uses for HBOT include the following:

  • Lyme disease
  • Cancer
  • Air or gas embolism
  • Carbon monoxide poisoning
  • Acute traumatic ischemia 
  • Exceptional blood loss 
  • Cyanide poisoning 
  • Decompression illness ("bends")
  • Clostridial myonecrosis 
  • Radiation proctitis 
  • Some non-healing wounds
  • Gas gangrene
  • Necrotizing infections
  • Some cases of osteomyelitis
  • Radiation-induced tissue damage
  • Compromised grafts and skin flaps
  • Burns
  • Compartment syndrome
  • There are a growing number of extra conditions that may respond to increased oxygen levels. For many of these the level of scientific proof is limited or anecdotal. These include:hyperbaric chamber

  • Cerebral palsy 
  • Stroke 
  • Multiple sclerosis 
  • Head injuries and concussion
  • Mycoplasma + Lyme disease
  • Before and after surgery
  • Chronic fatigue
  • ADD/ADHD
  • Sports injuries
  • Autism
  • Migraine + cluster headaches
  • Idiopathic sudden deafness
  • Systemic fungal infection
  • Parkinson's disease
  • Trigeminal neuralgia
  • Raynaud's phenomenon
  • Vascular disease
  • Crohn's disease (especially if fistula)
  • Fibromyalgia
  • Decreased immune function
  • Venomous bites
  • Retinal artery occlusion
  • hyperbaric chamber           hyperbaric chamber