Testimonials
A Breath of Fresh Air
By JO CIAVAGLIAThe shocked look on his doctor's face scared James Haas. The Bristol Township man had just started a wound-care treatment that was considered a last resort, hoping to save his badly burned foot. A few weeks before, a bolt of high-pressurized steam burned a golf ball-size hole almost completely through Haas' foot. He described what was left as resembling a chicken carcass pulled from a soup pot. Other medical interventions weren't working, and concern grew that limb-threatening gangrene could set in. Haas' foot doctor suggested a remedy commonly used for scuba divers with decompression sickness from surfacing too fast.
The treatment is gaining mainstream medical credibility as an effective treatment for extreme burns, chronic wounds and catastrophic crush injuries. After Haas spent three sessions in a hyperbaric chamber, his doctor removed the bandages and what he found stunned him: new skin growing over two bones that were exposed days earlier. He told Haas he'd never seen anything like it in his medical career. “I can't believe how well this has healed,” Haas said. “Something is working. I couldn't tell you for certain what did it, but something.” It's something as common as the air we breathe.
The practice of hyperbaric medicine, treating a disease or injury in an environment of higher than normal atmospheric pressure, dates from the 1600s, historical accounts say. Despite a checkered history, the therapy is seeing renewed interest, especially for wound care, vascular diseases, and other conditions that might benefit from increased oxygen exposure. Lower Bucks Hospital in Bristol Township, where Haas is being treated, has joined a growing national network of healthcare providers using hyperbaric oxygen therapy. Three other local community hospitals — Abington Memorial, St. Luke's in Quakertown and Warminster — also have hyperbaric oxygen chambers, but none are as cutting-edge as the recently opened one at Lower Bucks. The $900,000, 10-person chamber designed and built by Hyper-Ox is one of the largest on the East Coast, according to the company. It received state approval to treat patients March 19. The first week, 18 patients started the standard treatment course of 106 minutes in the chamber for 20 days. With an increasingly older population in which diabetes and circulatory problems are more common, Lower Bucks Hospital considers the addition of the hyperbaric chamber a natural extension of its wound-care services, CEO and president Austin Cleveland said. A chronic wound can take weeks or months to heal in patients with vascular or circulatory problems. Reducing that recovery time benefits the patient's health, and it reduces hospital stays and related healthcare costs, too, Cleveland said. Cleveland participated in a 106 minute “dive” in the new chamber and afterward described the experience as amazing. “You feel really refreshed. You don't know you're being pressurized,” he said. “One of the guys in the chamber with me said, "I haven't felt this good in years.' He started doing push-ups.”
FRESH AIR BENEFITS The normal air that humans breathe has far less oxygen (21 percent) than nitrogen (78 percent), with about 1 percent carbon dioxide. Inside hyperbaric chambers, patients breathe 100 percent pure oxygen that is pressurized, a combination that appears to speed the healing process. Hemoglobin, the molecule in the blood that carries oxygen, can load itself with more oxygen under the conditions in the chamber. Pressure forces the oxygen into the blood system and cellular levels. The blood can then deliver more oxygen to the wound tissue, which encourages healing from the inside out. The older, mostly one-person chambers work by filling the compartment with pressurized pure oxygen that the patient breathes. Lower Bucks Hospital's chamber, though, uses compressed room air. When the chamber reaches the correct atmospheric pressure, patients breathe oxygen pumped in through separate masks. The larger chamber means many people can be treated for different conditions simultaneously. At Lower Bucks, most patients so far have been treated for slow or non-healing diabetic foot ulcers, said Dr. William O'Brien, Hyper-Ox's medical director. But one patient trying it has macular degeneration, which causes blindness. The interior pressure of the Hyper-Ox chamber is increased to the equivalent of about 45 feet underwater; patients spend about 106 minutes inside breathing the oxygen, O'Brien said. Patients can be treated in their street clothes. The most noticeable side effect during pressurization is ear popping similar to what's experienced on an airplane. “It's a lot like flying,” O'Brien said. “It's unbelievable technology.”
Scientific studies suggest that if used earlier on wounds, rather than as a last-resort treatment, hyperbaric oxygen therapy could provide faster, better healing results, said Lisa Hill, the wound program coordinator at Abington Memorial Hospital. Abington's wound-care center has seen an increase in patient volume in its three, single-person hyperbaric chambers. It sees an average of five patients a month; last fiscal year, it provided 1,599 treatments. Hill said the center has seen remarkable results among cancer patients with radiation soft-tissue injury. Two years ago, doctors presented their outcomes at a national conference, showing that among 102 patients treated, 100 percent healed and did not experience wound reoccurrence, she said. The patients also reported less bleeding and pain. “It's really exciting,” she added.
“QUACK” REPUTATION The resurgence of hyperbaric medicine is no small feat, given its checkered history, which is largely that the mainstream medical community has been slow to accept it, said Don Chandler, executive director of the Undersea and Hyperbaric Medical Society, a trade group. In the past, the therapy has been touted as a cure for everything from ingrown toenails to baldness. Many people remember the infamous 1986 tabloid photo of pop star Michael Jackson sleeping in a hyperbaric oxygen chamber allegedly in an effort to slow the aging process. But early hyperbaric chambers used only compressed air, not pure oxygen. In 1939, the Navy began successfully treating divers with decompression sickness using compressed pure oxygen. Clinical trials in the 1950s uncovered a number of beneficial outcomes from exposure to the chambers. More recently, the American Board of Medical Specialties in 2000 approved undersea and hyperbaric medicine as a subspecialty of emergency and preventive medicines. The federal Food and Drug Administration also has approved it as an advanced treatment protocol for problem wounds. Four years ago, the Centers for Medicare and Medicaid Services added chronic diabetic ulcers of the lower extremities to its list of health conditions approved for treatment with hyperbaric oxygen therapy. Consequently, United States wound-care centers are adding hyperbaric oxygen chambers in record numbers. In 1970, 30 were located in medical settings but now the number is 800, Chandler said, and those figures don't count chambers used in private homes and nonmedical-associated centers. While practicing doctors are showing more interest in hyperbaric oxygen therapy, there are still those who consider it “quack medicine,” Chandler said. There is no scientific proof that pure oxygen prevents wrinkles, he added. No hard data show that it enhances athletic performance, or that its use helps people with autism spectrum disorder, multiple sclerosis, cerebral palsy or asthma. But that hasn't deterred people from pursuing the use of hyperbaric oxygen therapy for these conditions, despite a lack of objective evidence of its benefit, Chandler said. There are new medical studies under way that explore the therapy's effect on autism, stroke and traumatic brain injury. Little is known about the outcomes of these informal trials because private money is paying for the treatments instead of research grants, which require strict research controls, data gathering and documentation. However, more research dollars for such trials could mean higher profile and increased scientific credibility, which, in turn, generates medical support for expanding the treatable conditions that private and public insurers would reimburse, Chandler said. “We get frustrated in our society because we can't get that evidence,” he said.
Mr. Norman Bell's thoughts on his hyperbaric treatment experience
Hyperbaric Oxygen Treatment has made me feel both physically and mentally better. I have had a significant decrease in pain and I am showing signs of further improvement.