FREQUENTLY ASKED QUESTIONS
What is Hyperbaric Oxygen Therapy (HBOT)?
Hyperbaric Oxygen or HBOT is high dose oxygen therapy. At high doses, oxygen acts like a drug, stimulating the bodies own ability to heal itself.
How Does HBOT Work?
During HBOT, a patient breathes 100% oxygen in a hyperbaric chamber in which the pressure is increased up to three times the normal atmospheric pressure. The combination of increased pressure and high concentrations of oxygen causes large amounts of oxygen to be dissolved into the blood and tissues (typically 10 to 15 times the usual amount).
How Does HBOT Force More Oxygen Into the Blood and Tissues?
Blood is made up of three main components: white blood cells that fight infection, red blood cells that carry oxygen, and plasma, the fluid that carries both kinds of cells throughout the body. Under normal circumstances, only the red blood cells carry oxygen. However, because of the increased pressure during HBOT, oxygen dissolves into all of the body’s fluids, including the plasma, the lymph, and the cerebrospinal fluids surrounding the brain and spinal cord. These fluids can carry this extra oxygen to areas where circulation is poor or blocked, either by trickling past the blockages or by seeping into the affected area. This extra oxygen helps in the healing process and enhances the white blood cells’ ability to fight infection. It can promote the development of new capillaries, the tiny blood vessels that connect arteries to veins. It can help the body build new connective tissue, and can also aid in reducing localized swelling or edema.
What are the benefits of HBOT?
HYPEROXYGENATION: provides 10-15 times the oxygen to areas of poor blood flow. This increase in oxygen results in a four-fold increase in the diffusion of oxygen through your functioning capillaries. While this is only a temporary effect it allows tissues to remain viable while a new blood supply is established.
NEOVASCULARIZATION is the development of new capillaries and the creation of new blood vessels. New capillaries and blood vessels help restore normal blood flow to compromised tissue
BACTERICIDAL: the sterilization of microbes causing inhibition and inactivation of toxins in conditions like gangrene and other bone or soft tissue infections. Hyperoxia increases the oxidative killing effect of white blood cells and has shown a synergistic effect when combined with appropriate antibiotics.
VASOCONSTRICTION: The constriction of blood vessels. This is helpful in managing intermediate compartment syndrome and other acute lack of circulation in injured extremities, and reducing fluid retention in tissues. HBOT can also reduce excess fluids and swelling of brain tissues which can increase neurological function for people with brain injury.
STIMULATE COLLAGEN PRODUCTION: Collagen is the connective tissue developed and laid down by fibroblasts, the repair cells of the body. The formation of collagen and hence wound healing/recovery is highly dependent on the presence of adequate amounts of oxygen. The actual production of collagen by fibroblasts is also extremely dependent on oxygen availability. Hyperbaric oxygen therapy markedly increases the oxygen available within the blood. This in turn enables fibroblasts to produce increased amounts of collagen.
IMPROVES BONE REGENERATION: Osteoblasts are the cells responsible for bone formation and osteoclasts are the cells responsible for bone reabsorption. Both of these cells work together to form bones and control the amount of bone tissue. These cells are highly dependent on the presence of adequate amounts of oxygen. The increased levels of oxygen during HBOT allows for increased production of these cells and enables them to conduct bone repair and formation more adequately.
ATTENUATION OF REPERFUSION INJURY: is the most recent benefit to be discovered. Much of the damage associated with reperfusion is brought about by the inappropriate activation of leukocytes. Hyperbaric oxygen prevents this activation and helps save marginal tissues around a wound site that might otherwise be lost to a reperfusion injury, which caused by lack of blood flow.
MOBILIZATION OF STEM CELLS: Hyperbaric oxygen increases stem cell function and synthesis within the body. A typical course of hyperbaric oxygen treatments increases by eight-fold the number of stem cells circulating in a person’s body. Stem cells, also called progenitor cells, are crucial to injury repair. Stem cells exist in the bone marrow of human beings and animals and are capable of changing their nature to become part of many different organs and tissues. In response to injury, these cells move from the bone marrow to the injured sites, where they differentiate into cells that assist in the healing process. The movement, or mobilization, of stem cells can be triggered by a variety of stimuli – including pharmaceutical agents and hyperbaric oxygen treatments. Whereas drugs are associated with a host of side effects, hyperbaric oxygen treatments carry a significantly lower risk of such effects.
What is a monoplace hyperbaric chamber?
The monoplace chamber is designed to house a single patient. It features a pneumatic control system and an acrylic shell. Full 360-degrees vision is maintained, as well as two-way communication with the operator. The chamber is normally pressurized with 100% oxygen thus relieving the patient from wearing an uncomfortable and cumbersome mask or hood for the entire treatment. During treatment the patient remains lying comfortably on a specialized contoured bed.
What is a treatment like?
Once a patient is in the chamber and the door is closed, the oxygen begins to circulate. This starts a gradual increase in pressure — called compression. The oxygen circulation produces a relaxing sound much like the wind blowing through trees. The Chamber Operator remains by the chamber throughout the treatment to adjust the rate of compression according to patient tolerance and to coach the patient on relieving the full sensation in the ears. You may feel fullness in your ears as your eardrums adjusts to the change in the chamber pressure. This is very similar to the feeling you experience when you are in an airplane. Compression generally lasts 10-15 minutes depending on how effective one is at clearing their ears.
When the interior of the chamber reaches the prescribed pressure, the fullness sensation in the ears will cease and the patient is free to rest or sleep. The chamber environment remains at room temperature. The patient may also use their personal entertainment system which includes a flat screen television monitor, DVD, CD, and MP3.
Near to the end of the treatment, the Chamber Operator will gradually decrease pressure that was added at the beginning. This is decompression, which generally lasts 10 minutes. During decompression, there may be a slight “popping” sensation in the ears as a result of the changing (decreasing) pressure. This “popping” is a normal adjustment, similar to what happens when driving up a mountain or ascending in an airplane. It is usually much easier to equalize ear pressure during decompression than during the compression phase.
How often are treatments given?
The length and frequency of treatments will be individualized for each patient and their condition. For most conditions patients are treated once or twice a day — Monday through Friday — and treatments may last 60-90 minutes. Some emergency conditions will require only one or two treatments. In most cases of healing support, the effects are gradual and 20 to 40 treatments may be required.
Is HBOT Safe?
The most common potential side effect during treatment is barotrauma to the ears and sinuses caused by pressure changes. To minimize this potential side effect, patients learn techniques to promote adequate clearing of the ears during compression (similar to clearing your ears on an airplane). Other side effects are rarer, but may include oxygen toxicity which affects only 1 person in 10,000. After a large number of treatments some changes in vision may be noticed by a few patients. Any changes usually return to pre-treatment vision levels in a 6 week period. Some patients may experience claustrophobia which can be resolved with relaxation techniques or mild medications. In addition, a few patients report a “popping” or “cracking” sensation in their ears between treatments. This sensation can be relieved using the same techniques that patients use to clear their ears while they are in the chamber.
What can be taken into the chamber?
Since patients are enclosed within 100% oxygen environment, multiple safety precautions are followed to promote safety. Items NOT allowed in the chamber include;
- Cigarette lighters
- Nylon Wigs
- Petroleum ointments
- Hearing aids
- Synthetic clothing (Patients are provided 100% cotton scrubs to wear during treatment)
- Hard Contact lenses
- Paper products
Why haven’t I heard of HBOT?
You very seldom hear of anyone being treated in a hyperbaric chamber because they are fairly unusual in American hospitals. Medicine in the United States is pretty much a get a pill, have a surgery or get a radiation treatment proposition. HBOT, other than the FDA approved uses, is considered alternative medicine and “experimental”, so few doctors ever consider this very effective treatment. Doctors are a product of their training and experience. Since HBOT is not taught in most medical schools and is not available in most teaching hospitals, their training and experience lack an HBOT background unless they specifically seek training on their own. Most doctors only hear about HBOT in conjunction with scuba diving accidents or carbon monoxide poisoning, and seldom use it for anything beyond the FDA approved uses for a hyperbaric chamber.
How well does HBOT work with other therapies?
HBOT is an adjunctive or add-on therapy that enhances many other therapies. You should continue all other physical, occupational, speech, wound care therapies. Other therapies will retrain your body and brain as they recover with the help of HBOT. You will progress more with all your therapies when you add HBOT to your treatment program.
Is HBOT covered by private insurance or Medicare?
Yes. and MOSTLY NO. HBOT is covered by Medicare and some private insurance companies only when it is used to treat the FDA approved medical conditions (See “Conditions” page for a list). Any other use is considered “experimental” and will not be covered. This is another reason that hospitals only treat the FDA Approved conditions. HBOT is paid for totally by the patient in most cases. However, the accelerated healing promoted by HBOT shortens recovery time enough to save on additional hospital costs, medication costs and lost wages.