LIST OF TREATED CONDITIONS
Stroke
Stroke is caused by a sudden loss of blood and oxygen to a specific area
of the brain, which kills off a central core of brain cells. With the
death of these cells and the swelling this causes, blood and oxygen are
further isolated from the surrounding cells, which also then swell... and
the cycle tends to repeat itself. These surrounding cells - rather than
the central core itself - can cause much of the stroke patient's
disability. If these marginal (viable, but not functioning) cells can be
revived with sufficient oxygen, substantial and sometimes dramatic
recovery may result.
HBOT can aid in the stroke victim's
recovery in a variety of ways, including:
-
Relief of hypoxia (lack of
sufficient oxygen)
-
Cerebral edema and spasticity
-
Extra vascular diffusion of oxygen
-
Improvement of micro-circulation
In a review of many studies,
more than 1,000 patients who sustained cerebrovascular disease and were
treated with HBOT showed improvement in quality of life.
Coma
Coma is defined as a state of profound unconsciousness caused by
disease, injuries, or poison. Coma may last up to four years causing
severe incapacitation, financial burden, and distress to the family. In
most cases, the patient has been in a coma over three months and has
fairly regained his or her physical abilities. The Ocean Hyperbaric
Center has treated a number of patients with long standing coma, even up
to 12 years, who have shown varying degrees of improvement including a
return into society. This is the unusual case, but frequently a lessening
of care, removal of PEG tube, and tracheotomy may be accomplished using
intensive HBO therapy. This is validated again with sequential SPECT
imaging before, during, and after coma. Some of these patients may
require up to 300-500 HBO treatments. All modalities of physical therapy,
occupational therapy, speech therapy, and ancillary types of therapy are
used. Dr. Neubauer has reported an overall 50% success rate in the
treatment of long-term coma.
Multiple Sclerosis
Multiple Sclerosis (MS) patients with Kurtze category less than
five respond very well to hyperbaric oxygenation. Currently there are
12,000 MS patients being treated at 110 centers in the United Kingdom.
The results are the same as was published by Dr. Neubauer in 1978 and 1980
in the Florida Medical Journal:
1) It is not a cure.
2) It is dose sensitive.
3) It requires long term follow up treatment.
4) It alters the natural history of the disease in a
favorable
fashion.
MS is a demyelinating disease of the central nervous system (CNS). It is
characterized by exacerbations, remissions, and stability. It is
aggravated by any type of stress whether it be an automobile accident, an infection
or other
types of trauma, even emotional. When the disease is erratic, remissions may
last for years. This is a debilitating disease and during exacerbation or in
rapidly deteriorating patients, they may be wheelchair bound for the rest of
their lives only several years after the diagnosis. There have been hundreds
of treatments for MS. In fact, there has never been any disease in which so
many treatments have been tried. Unfortunately, some of these treatments
produce disastrous results. Of all the treatments ever tried, hyperbaric
oxygen is the safest, most effective, and most cost effective.
In an initial study by this center, we were able to show that lesions
occurring within the brain stem demonstrated by MRI would disappear with
one hour of treatment of hyperbaric oxygen, thus reducing any swelling
around the lesions. Should Dr. Philip James of the United Kingdom be
correct with his embolic theory, this would be a very specific type of
treatment for the central nervous system problems of multiple sclerosis.
Lyme Disease
Lyme Disease is an infectious disease following by a tick
infestation with the Borrelia burgdorferi (Bb organism). The disease may
remain quiescent for years. When frequently diagnosed, the early signs and
symptoms are arthralgia, weakness, fatigue, flu-like symptoms, muscle
aches, joint pain, rash (referring to as erythema migrans) and occasional
CNS symptoms. Its primary treatment are tremendous dose of intravenous
and oral antibiotics in an attempt to eradicate the parasite.
The
effectiveness of any treatment is characterized by a
Jarisch-Herxheimer reaction, which occurs when the Bb organisms are somewhat
destroyed. The toxic products cause a reaction of fever, chills, and
weakness in the patient. The diagnosis remains obscure for a number of
years, but recent tests such as the polymerase chain reaction (PCR), the
ELISA, or the Western-blot test help to make the diagnosis.
A complicated
case of lyme disease is an encephalopathy, or an inflammation of the blood
vessels of the brain. This is very well demonstrated with SPECT imaging.
We have treated a number of patients with lyme disease who continued
intravenous antibiotics, but took hyperbaric oxygenation to help reduce
the Bb organism infestation. A herxheimer reaction has been produced and
many patients have done well. The original work by Dr. Fife indicated the
usefulness of hyperbaric oxygenation in this condition. It must be
pointed out that this organism is not an anaerobe but is unable to grow as
rapidly in a high oxygen environment.
Cerebral Palsy
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Reflex Sympathetic Dystrophy
Reflex Sympathetic Dystrophy (RSD) is a disease that consists of
diffuse persistent pain, usually in an extremity, following a likely local
injury. It is diagnosed by a bone scan. This may be frequently
dramatic in origin. It is extremely painful and incapacitating. It may
involve any part of the body and multiple treatments have been used. Many
nerve blocks and multiple pain medications have been given in order to
alleviate some of the distress. We have had limited experience with
several cases and the results have been remarkable. We had one little
girl who arrived in a wheel chair with a chart four inches thick. We were
unable to touch her right lower extremity. After three hyperbaric oxygen
treatments, the patient was out of the wheelchair; after twenty HBO
treatments, the patient was running up and down the beach, and discharged
to go home. Her bone scan had returned to normal. The mechanism of
action here is not totally understood. It is hopeful that this will evoke
more research into the use of hyperbaric oxygen in RSD.
A SPECIAL LETTER. PLEASE
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Carbon Monoxide Intoxication
Carbon Monoxide Intoxication can occur from a variety of factors, the most common in the Western World being
automobile exhaust poisoning. Carbon Monoxide (CO) takes the place of oxygen (O2) in the blood and the resulting condition,
depending on the severity, leads to a lack of oxygenation, or hypoxia.
The Ocean Hyperbaric Neurologic Center has had success treating late stage carbon monoxide poisoning, in which treatment
has been delayed or insufficient. In one case, a patient who had been in coma for over 12 years from carbon monoxide intoxication
awoke after oxygen treatments.
Hyperbaric oxygen helps to treat CO intoxication by diluting the concentrations of carbon monoxide
and saturating the plasma with sufficient levels of oxygen; thereby preventing hypoxia even in high levels of carbon monoxide.
The hyperbaric treatments also will reduce the levels of carbon monoxide in the blood by the large amounts of oxygen; the increase
of oxygen parallels an increase in the corresponding compound with hemoglobin.
In many situations the lack of oxygenation leads to brain insult, which we
specialize in treating.
Traumatic Brain Injury
Cerebral edema (swelling) is the rise of intra-cranial pressure
(ICP) which has serious consequences. This may be frequently associated
with severe head injuries or the anoxic and toxic encephalopathies.
Studies by the OHNC
and others have shown that HBOT, initiated soon after acute closed head
injury, can reduce mortality by more than 40%, and substantially increase
the possibility of the patient's complete recovery. Recently, close
monitoring of cerebral pressure has been extremely effective.
Anoxic Ischemic Encephalophathy
(Near drowning, near hanging)
Every year, more than 150,000 Americans
suffer severe head injuries. Like stroke, head injuries deprive certain areas
of the brain of oxygen. Again, as in the case of stroke, the damage resembles
an atomic bomb blast, with a central core of what is probably irreparable
damage surrounded by a penumbra of lesser damage. It is both the size and the
location of the initial damage, as well as the reversibility of the damage
within the penumbra, that dictates the patient's prognosis. In some cases,
this damage can be reversed by HBOT.
But head injury isn't the only cause of
brain damage. Every year, thousands of Americans suffer brain damage as the
result of near hanging, near drowning, near choking, cardiac arrest, cyanide
and carbon monoxide poisonings, and lightning strikes. This type of brain
damage is known as an anoxic ischemic encephalopathy.
Brain damage often occurs after a head injury because the brain starts to
swell, pressing delicate tissue against the unyielding skull. One researcher
found that 80 percent of patients with serious head injuries had brain
swelling. This swelling leads to a vicious cycle: the swelling cuts off the
brain's blood supply, which leads the accumulation of toxic levels of normal
cell wastes. The wastes, in turn, further aggravate the swelling. Such damage
can lead to coma, a state of deep unconsciousness in which the patient
does not respond to pain or sound, and cannot be awakened. But even under such
circumstances, certain brain cells survive in a dormant state within the zone
between the damaged and the healthy parts of the brain, a zone called the
penumbra.
HBOT can, at times, break this cycle by
constricting the brain's blood vessels, yet delivering more oxygen. This seems
like a contradiction, but HBOT can increase oxygen levels because the
increased pressure forces oxygen into the blood plasma, the liquid part of the
blood that normally does not carry oxygen, and into the cerebrospinal fluid
that surrounds the brain. The plasma and cerebrospinal fluid can then reach
areas that the red blood cells, which normally carry oxygen, cannot penetrate.
With HBOT, oxygen in the capillaries is pushed further into the adjacent
tissues than when oxygen is administered at standard pressure. HBOT can also
stabilize and repair what is called the blood-brain barrier, a
protective layer of cells that keeps many toxins or noxious materials from
reaching the brain. This barrier is often greatly disturbed when a head injury
occurs.
As a result of the extra oxygen that
HBOT provides, the dormant brain cells in the penumbra are awakened and begin
to function again. Giving a patient pure oxygen at normal pressure simply
cannot put enough oxygen into either the bloodstream or the cerebrospinal
fluid to overcome the oxygen deficit. But HBOT can improve this oxygen
deficiency. Often, this increased oxygenation helps to restore the patient to
a conscious state. In certain cases, it also allows the patient to recover
from brain damage after effects such as paralysis and speech loss.
