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HYPERBARIC OXYGEN THERAPY AND STROKE
By Dr. Ted Cole, MA, DO, NMD, FAAIM
Hyperbaric Oxygen Therapy (HBOT) has been around for a while.
The first chamber used to treat patients was constructed in 1662
by Henshaw. And yes, that date is correct, making it almost 350
years old. Oxygen was not added to the chambers until more recently,
but in the 1700’s and 1800’s chambers were being used
as surgical suites due to the higher rate of positive outcomes.
In more recent times, HBOT has been mainly used by the military
and diving industry. As a result, there has been reluctance on
the part of the medical community to accept it for many conditions.
However, there is a great deal of scientific information available
on this procedure, and stroke is one of the conditions that it
treats very well.
But first, let's describe HBOT and what it does. HBOT treatments
proceed by placing you in a chamber, and then increasing the atmospheric
pressure. During the treatment you breathe pure concentrated oxygen.
This saturates the tissues with oxygen, and reverses any areas
of hypoxia (low oxygen levels). As a comparison, the average person
breathes in about 6 pounds of oxygen a day. During a single hour
of HBOT, a person will take in about 3-4 pounds of oxygen, which
increases the oxygen content of the tissues by a factor of 10-15.
This has some dramatic and extremely beneficial effects, not only
for stroke, but also for a wide variety of conditions.
Some of the effects are to promote the growth of new blood
vessels, decrease swelling and inflammation, deactivation of toxins,
increases the body’s ability to fight infections, clears
out toxins and metabolic waste products, and improves the rate
of healing. In stroke, the practical effects are to help heal
any damaged brain cells around the site of the stroke (this is
known as the penumbra). It helps get rid of free radicals caused
by the stroke, reduces swelling and pressure on the brain, helps
stop bleeding if present, and helps stimulate the growth of new
brain cells. This translates into improvement or recovery of speech,
strength, coordination, memory, cognitive skills, walking, and
other areas that might have been damaged.
Recovery from stroke can be dramatic, and we have seen patients
become fully functional. The sooner HBOT is started after the
stroke the better, but we have gotten good results even after
15 years post-injury. Results for each individual are unpredictable,
and depend on a large number of factors, such as severity of the
stroke, location, length of time since the stroke, etc. We also
use a number of other therapies that complement HBOT, which provide
even better results than HBOT alone. Like other conditions, a
multi-therapy approach is best.
We typically treat each person 1-2 times a day for 1 hour each
treatment, for a total of 40 treatments. Before further treatments
can be given, the patient must wait at least 4-6 weeks. Then,
another set of 40 treatments can be given. After this point, we
usually limit treatments to 20 at a time. Some people will respond
well to one or two sets of treatments, but most can count on getting
from 100-200 total treatments for best results. We follow each
patient’s progress, and determine therapy based on his or
her response.
There are two types of chambers, multi-place and mono-place.
In the multi-place, more than one person can be treated at a time.
In addition, the atmosphere inside the chamber is air, and oxygen
is delivered through a hood. In the mono-place, only one person
can be treated, and the entire atmosphere is oxygen, so no hood
is required. There is no difference in results between the two,
and the main reason to have both is patient mobility. One simply
lies down on a cot for the mono-place, and it is much easier to
get into than is the multi-place chamber. There is a wide variety
in quality and comfort between chambers. Some indications about
the chamber can be the following: ask about the age of the chamber,
if they’ve been bought second hand or salvage, and if they’ve
been reconditioned before being able to be used.
The main safety consideration is fire. Remember, this is an
oxygen environment, and there are strict rules about using the
chambers. We require that all people entering the chambers be
wearing 100% cotton clothing, with no jewelry or other items on.
You should be given a list to follow before having a treatment.
The main side effect is due to ear and sinus problems. You must
be able to “pop” your ears, or damage can occur due
to the pressure. It’s much like going up in an airplane.
If you’re unable to clear your ears, steps can be taken
to remedy this. All in all, HBOT is extremely safe and well tolerated
with very few complications. It also should be a comfortable experience,
both inside and outside of the chambers. The person administering
the therapy should be a Certified Hyperbaric Technician, and I
recommend that you use a center with a physician on site. The
best way to find out if there is a chamber near you is to do a
web search, using either “HBOT” or “Hyperbaric
Oxygen” as your search word.
When all is said and done, the best place to be after a stroke
is in an HBOT chamber. If I should ever suffer one, that’s
where you’ll find me.
Read patient testimonials.
Dr. Ted Cole, MA, DO, NMD, FAAIM
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