What the *Bleep!* is Going on With Hyperbaric Oxygen Therapy?

Screamby Xavier A. Figueroa, Ph.D.

When I meet with friends, relatives and work colleagues, I get asked about what I do. When I explain my job, I always get asked, “Does hyperbaric oxygen therapy really work for traumatic brain injury?”

I know many of those who are reading this blog have the same question in mind. It’s a pretty important question for a person that has a TBI.

So – does it work or not?

In my opinion, yes.

But opinions are like belly-buttons, everyone has one. What you really need are facts and studies that support your opinion (if you are impatient to find them, jump HERE). Now, me saying that HBOT can help treat a TBI will probably raise a few eyebrows. Let’s face it, neurologists, psychiatrists and researchers have been going after this problem for decades. Me saying that a pressurized gas can heal the ravages of a traumatic brain injury may sound far-fetched. But you don’t know what I know… and neither do a lot of highly-trained doctors.

You see, doctors are the problem. And the solution to getting HBOT as a therapy approved.

After finishing a 4-year baccalaureate program in college, medical school takes another 4 years to complete. In school you sample different specialties (family medicine, emergency medicine, etc.) and it then takes another 3 – 7 years of residency/fellowship to complete a specialty. On average, doctors are exposed to 3 – 4 days of education of hyperbaric medicine in their general training. This training does not include the current research, only the well-established treatments. In all, not much exposure or education is given to doctors-in-training for hyperbaric medicine.

After graduation, a doctor needs to maximize the number of patients and billable procedures’ he or she can accomplish. Med school started getting really expensive in the 1980’s. This means that doctors are busy people and specialized in the area of medicine that they practice and keeps them employed.    

abstractsDoctors keep current in their specialty by joining general medical societies (The American Medical Association) and societies that cater to their specialties (American Academy of Neurology, for example). The amount of information out in the medical research journals is humongous, even within specialties.

And it just keeps growing.

A lot.

The graph on the right shows the growth rate for the past 30 years for medical and scientific papers. And it is not going to slow down any time soon. Separating the metaphorical chaff from wheat isn’t easy, either.

Finding the time to read, let alone keep up, is a daunting and time consuming task. So doctors, like most of us, rely on experts and opinion leaders to keep them informed. Usually they gather at conferences to discuss the burning issues and emerging problems that affect their specialty.

Doctors and patients are also relying on comments and opinions from trusted sources. Comments on research, such as the one below, are normally provided by trained medical providers, who are non-experts in the field of hyperbaric medicine and have a passing knowledge of the research literature:

NEJM HBOTI’m sure that Dr. Silver is an excellent Psychiatrist (the New England Journal of Medicine has a reputation for selecting excellent doctors), but his specialty or training is not hyperbaric medicine (although he does do research on TBI and pharmaceuticals). The details and nuances of hyperbaric oxygen play a big part in understanding technical information and getting the right conclusions out of data. This will become very relevant when we discuss the Department of Defense sponsored studies.

More importantly, the impact that a specialty has depends on the size of the membership and what illness it treats. So, let’s see what the different populations of doctors in each specialty are in the US. The chart below is the number of active physicians (MD’s and DO’s) as of 2012 in each of the specialties below (the data was compiled from the Henry J. Kaiser Family website and the American Academy of Neurology website).  The largest single group is Psychiatry, which coincidentally is the specialty that handles the majority of TBI management. At the extreme end is Hyperbaric Medicine, with about 2,000 active specialists in the US.

statsHyperbaric medicine is a very small specialty compared to any of the other specialties. It mostly focuses on wound treatment, skin burns and difficult to treat infections. They have no lobbying arm in Congress and the average NIH budget for HBOT research is less than $2 million/year. Alzheimer’s disease averages $450 million and TBI research average $90 million (information was from the NIH website).

So, why don’t you hear about HBOT in a positive light?  Those who have the membership (and money) have bigger bullhorns and access to funding institutions. Hyperbaric medicine is tiny and underfunded.

What A Little Digging around Shows

The biggest complaint that is tossed around by many physicians is the lack of data showing the effectiveness of HBOT for traumatic brain injury. Point granted…but only if you ignore the literature.

There are several papers (some are case reports, other are observational studies) that show the effect that HBOT has on diagnosed traumatic brain injury. All are uniformly positive, many with long-term maintenance of recovery and with mild to no side effects from the treatments on humans. These reports are listed below:

  1. Shi XY, Tang ZQ, Sun D, He XJ. Evaluation of hyperbaric oxygen treatment of neuropsychiatric disorders following traumatic brain injury. Chin Med J (Engl). 2006;119(23):1978-82.
  2. Hardy P, Johnston KM, De Beaumont L, Montgomery DL, Lecomte JM, Soucy JP, et al. Pilot case study of the therapeutic potential of hyperbaric oxygen therapy on chronic brain injury. J Neurol Sci. 2007;253(1-2):94-105.
  3. Lin JW, Tsai JT, Lee LM, Lin CM, Hung CC, Hung KS, et al. Effect of hyperbaric oxygen on patients with traumatic brain injury. Acta Neurochir Suppl. 2008;101:145-9.
  4. Wright JK, Zant E, Groom K, Schlegel RE, Gilliland K. Case report: Treatment of mild traumatic brain injury with hyperbaric oxygen. Undersea Hyperb Med. 2009; 36(6):391-9.
  5. Harch PG, Fogarty EF, Staab PK, Van Meter K. Low pressure hyperbaric oxygen therapy and SPECT brain imaging in the treatment of blast-induced chronic traumatic brain injury (post-concussion syndrome) and post traumatic stress disorder: a case report. Cases J. 2009;2:6538.
  6. Sahni T, Jain M, Prasad R, Sogani SK, Singh VP. Use of hyperbaric oxygen in traumatic brain injury: Retrospective analysis of data of 20 patients treated at a tertiary care centre. Br J Neurosurg. 2011.
  7. Stoller KP. Hyperbaric oxygen therapy (1.5 ATA) in treating sports related TBI/CTE: two case reports. Med Gas Res. 2011;1(1):17. PMCID: 3231948.
  8. Paul G. Harch, Susan R. Andrews, Edward F. Fogarty, Daniel Amen, John C. Pezzullo, Juliette Lucarini, Claire Aubrey, Derek V. Taylor, Paul K. Staab, and Keith W. Van Meter. A phase I study of low-pressure hyperbaric oxygen therapy for blast-induced post-concussion syndrome and post-traumatic stress disorder. J Neurotrauma. 2012 Jan 1;29(1):168-85.

From these eight reports, a total of 396 human subjects were enrolled. Some studies did only 2 treatments of HBOT. Other did over 100 treatments. All used 1.5 atmospheres in pure Oxygen. The studies are designed around two types of testing systems: 1) split study subjects into groups that received standard treatments for TBI or standard treatments for TBI plus HBOT; 2) Measure performance before HBOT and then after HBOT in study participant with long-standing TBIs (greater than 2 years). All saw improvements that were statistically significant.

Trial GraphAt this point, the usual chorus of “but these are not randomized, placebo or sham controlled clinical trials (RCTs)” comes up (if you need a definition for a randomized, controlled trial, click here). All true, except that other drugs or treatments have been accepted into the medical mainstream without placebo/sham RCTs. Penicillin is just one example. In any event, randomized placebo controlled clinical trials are not the end-all, be-all in medical research. Plenty of clinically relevant data can be gotten with a cross-over RCT, such as the one below.

  1. Boussi-Gross R, Golan H, Fishlev G, Bechor Y, Volkov O, Bergan J, et al. Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury – Randomized Prospective Trial. PLoS One. 2013;8(11):e79995. (CIVILIAN) )(ISRAEL)

Trial Graph2The study by Boussi-Gross (depicted above) showed a statistically significant difference before and after treatment for the HBOT group after forty, 1.5 ATA treatments. A total of 32 study participants were in the HBOT treatment group, while 24 study participants were assigned to the wait group. In total, 56 study subjecst were treated with HBOT. The wait group showed no statistically sigificant changes in their test results during the 2 months that the HBOT group was treated.  After thewait group was treated with HBOT (or crossed-over to the treatment), the wait group improved as much as the HBOT treatment group.

Pretty clear cut. HBOT works for the treatment of mTBI at 1.5 ATA.

The Other Results

But what about all those Department of Defense (DoD) funded studies!?  I  mean, these are big budget, well controlled and thoroughly vetted studies done by the Armed Forces medical and research division of the United States of America. Those are REAL studies, sham RCTs!  And they showed that HBOT does not help with TBI.

Or did they?

  1. Wolf G, Cifu D, Baugh L, Carne W, Profenna L. The effect of hyperbaric oxygen on symptoms after mild traumatic brain injury. J Neurotrauma. 2012;29(17):2606-12. (DoD) (USA)

Trial Graph3The study by Wolf et al. is one of the few studies to use a sham treatment in HBOT. Also, for the first time a higher pressure regime was used (2.4 ATA) than the traditional 1.5 ATA used for mTBI. Now, a sham is suppose to be a treatment or procedure that does not produce an improvement…it should be flat…unless there is a placebo effect. The only way you can establish a placebo effect is to absolutely rule out that your treatment (or drug) produces a biological activity. That’s a hard thing to do with oxygen, since it is always biologically active. Explaining why oxygen cannot be used as a placebo is a separate blog post (stay tuned for the next post…I promise to make it fun…really…about oxygen).

In any case, both exposures produced changes (improvements) in symptoms measured in the PCL-M (Post-Traumatic Disorder Check List-Military) for these service members.

Which one produced the best outcomes: the 1.3 ATA or the 2.4 ATA?

Out of the 22 symptoms that were measured, 9 significantly improved under air treatment at 1.3 ATA.  The 2.4 ATA treatment produced one significant improvement in a symptom.  If this was a placebo effect (a psychological effect), the number of improvements and the magnitude of the improvements should have been equal across the board for both pressures. Only the sham treatment had such a lopsided improvement for the study participants.

Why would a “sham” produce a better outcome?

The sham increased oxygen concentration anywhere from 28-43% above normal (pressure in the sham were in the range of 1.3ATA to 1.2 ATA). Any increase in dissolved oxygen in the body can produce (under pressure)  a measurable biological response (I’m saving the explanation for the next blog post…honest). Dosages of oxygen are as real as dosages of pills. Too much of a drug can harm you, too little will do nothing…just right will treat what is ailing you. Oxygen under pressure is no different than a pill.

And the conclusions by Wolf et al. is the following:

The current study in participants with postconcussive syndrome from chronic mTBI demonstrates no efficacy in symptom relief with HBO2 at an exposure pressure of 2.4 ATA for 90 min given once daily for 30 treatments; however, both groups improved more than would be expected greater than 6 months after mTBI. It is recommended that larger, multicenter, randomized, controlled (both sham-control and wait-list), double-blinded clinical trials be conducted at lower total oxygen doses as recommended by AHRQ.

Dr. Wolf is an experienced MD, trained in the field of hyperbaric medicine. He is an Air Force officer  (Colonel) and a careful clinician. He is being a scientist when ascerting the facts of the study. In this case he has drawn conclusion from his two test parameters (1.3 ATA, Air; 2.4 ATA 100% Oxygen)…they were not sufficiently different from one another to reach statistical significance. The improvements seen in both groups were not statistically siginificant when 1.3 ATA was compared to 2.4 ATA. Let that sink in for a minute…both groups improved sufficiently to be statistically significant from their starting (baseline) values, but not different enough between both groups to register as significant.

That was all Dr. Wolf and his colleagues could conclude.

And he acknowledge that the improvements were greater than expected with chronic mTBI study participants. More studies are needed, with better controls in order to reach a solid conclusion.

So, did this study conclude that HBOT is ineffective for mTBI?

No.

Pressurized air (at 1.3 ATA) appears to alleviate more symptoms of a chronic TBI better than pure oxygen (at 2.4 ATA). The statistics from before treatment and after treatment bear it out.

And it showed that HBOT is safe for individuals with a TBI…even at pressures as high as 2.4 ATA.

OK. But What About the Other Studies?

The other DoD studies, which were going in parallel or right after the Wolf study, came to a different conclusion for their results.  The analysis of these three published articles will take quite a while to explain, so I will go into detail on my next blog post (oh yeah…along with how oxygen works you will get a detailed analysis of these three studies…two-for-one…lucky you). But at least these three studies concluded the same thing as the Wolf et al. studies…HBOT is safe for individuals with a TBI.

  1. Cifu DX, Hart BB, West SL, Walker W, Carne W. The Effect of Hyperbaric Oxygen on Persistent Postconcussion Symptoms. J Head Trauma Rehabil. 2013. (DoD) (USA)
  2. Walker WC, Franke LM, Cifu DX, Hart BB. Randomized, Sham-Controlled, Feasibility Trial of Hyperbaric Oxygen for Service Members With Postconcussion Syndrome: Cognitive and Psychomotor Outcomes 1 Week Postintervention. Neurorehabil Neural Repair. 2013. (DoD) (USA)
  3. Cifu DX, Walker WC, West SL, Hart BB, Franke LM, Sima A, et al. Hyperbaric oxygen for blast-related postconcussion syndrome: Three-month outcomes. Ann Neurol. 2014;75(2):277-86. (DoD) (USA)

Oh… and the DoD funded studies are the few studies that fail to show any improvement of TBI symptoms with HBOT. The majority of civilian studies (from four countries and seven independent civilians clinical groups) have shown positive outcomes.

Parting Thought for Those Affected

I have worked with physicians trained in HBOT, run clinical research with HBOT and seen first-hand the effects of HBOT on people suffering from the long-term effects of traumatic brain injury (TBI). The majority of folks that undergo HBOT improved to a surprising degree. A small minority does not improve…and we don’t know why. We would love to find out.

Now, my opinion on HBOT is that it works to treat neurological injuries based on clinical research I have performed, review of the literature and my training as a Ph.D. (Neurobiology/Toxicology). I have no financial interest in HBOT; it's actually costing me money, time and career advancement to be a proponent, let alone a researcher in this field.

So, why do I do it?  Well, to put it simply, it works. And there are many people that are living better lives because they have undergone treatment with HBOT for a TBI. When there is a treatment that can work for TBI, training TBI victims to cope with a “new normal” as a standard of care is getting very close to malpractice. Unfortunately, there is a lot of information out there that can trip up a well-trained physician but the reliance on authority or experts as a guide to treatment is a poor substitute for firsthand experience.

Fortunately there are a growing number of physicians (MD’s, DO’s, NP’s and clinical PhD’s) that are recognizing the limitations of pharmaceutical, psychological and psychiatric methods for rehabilitation. They are looking for alternatives to help their patients. They are finding positive results with HBOT.

You see, I was not a proponent of HBOT when I first jumped into this field in 2010. Like many medical practitioners and researchers, I thought that HBOT might be useful for only a few things in medicine (decompression sickness, wound treatment and the like) but treating neurological conditions? It’s only a gas under pressure. How could it work?

Glad you asked. We’ll see how in the next blog post, too.

While we applaud good science, there comes a point […] of stagnation as the standard of evidence required for the blessing of organized medicine exceeds reality (where most of us live).

– George Mychaskiw II, DO, FAAP, FACOP,

UHM 2012, Vol. 39, No. 4 – How many deaths will it take? AN EDITORIAL PERSPECTIVE

Definitions:

Placebo: (Science: pharmacology) Any dummy medical treatment, originally, a medicinal preparation having no specific pharmacological activity against the patients illness or complaint given solely for the psychophysiological effects of the treatment, more recently, a dummy treatment administered to the control group in a controlled clinical trial in order that the specific and non-specific effects of the experimental treatment can be distinguished i.e., the experimental treatment must produce better results than the placebo in order to be considered effective. An innocuous or inert medication; given as a pacifier or to the control group in experiments on the efficacy of a drug. An inactive substance given to a patient to satisfy an apparent psychological need. (http://www.biology-online.org/dictionary/Placebo),

Sham: Being a treatment or procedure that is performed as a control and that is similar to but omits a key therapeutic element of the treatment or procedure under investigation. (http://www.merriam-webster.com/medical/sham).

RCT: A randomized controlled trial (or randomized control trial; RCT) is a specific type of scientific experiment, in which study subjects, after assessment of eligibility and recruitment, but before the intervention to be studied begins, are randomly allocated to receive one or other of the alternative treatments under study (http://en.wikipedia.org/wiki/Randomized_controlled_trial).

Cross-over RCT:  Randomized, controlled crossover experiments are especially important in health care. In a randomized clinical trial, the subjects are randomly assigned to different arms of the study which receive different treatments. When the randomized clinical trial is a repeated measures design, the same measures are collected multiple times for each subject. A crossover clinical trial is a repeated measures design in which each patient is randomly assigned to a sequence of treatments, including at least two treatments (of which one "treatment" may be a standard treatment or a placebo) (http://en.wikipedia.org/wiki/Crossover_study).

16 comments for “What the *Bleep!* is Going on With Hyperbaric Oxygen Therapy?

  1. Xavier Figueroa
    June 30, 2014 at 1:57 pm

    Dear Mr. Owen,

    Thank you for fighting for our veterans. You grandson is fortunate to have a steadfast and open-minded family member that was able to discover HBOT. More and more of these stories need to be told, so that the evidence and information about this therapy can come out.

    Thank you.

  2. Rainey Owen
    June 16, 2014 at 12:53 pm

    As the grandfather of a Veteran of the Afghanistan conflict who returned after suffering three explosive events resulting in significant TBI, I am working to make this healing treatment available to those Veterans in Texas that can benefit from it – just as my Grandson did. Your efforts in this regard are sorely needed and welcome. At this point there are some 18 counties in Texas that have already approved a Resolution asking the Texas Legislature to do what is necessary to make this treatment available to our Veterans. More counties are seriously considering this, since it is obvious that neither the VA nor Military Medicine will act responsibly. This governmental behavior is tragic and pathetic.

    This is not a magic bullet but it is far more effective than more (black-labeled) drugs and ‘counseling.’ While I am not Medically trained, I can read and I can reason (at least semi-) logically. What Dr. Cifu and his ilk have done – and are doing – is, in my opinion, drastically and (possibly deliberately misinterpreting) and misrepresenting the data that was collected.

    We owe our damaged Veterans much more than that.

    Rainey Owen

  3. William S Maxfield MD
    June 2, 2014 at 1:54 am

    Regarding HBOT in TBI/PTSD: See our data Clinical Nuclear Medicine 35: 659, Aug 2010 and the 3-year followup on the cases 38: 762-763, Sept, 2013.

    I suggest you also check Philip James article on HBOT for MS: IJNN 2(1):45-48, 2005 as in my experience HBOT has been very effective in MS.

    Let me know if you have any questions.

    William S. Maxfield MD

    http://www.hyperbaric-care.com/

    • Xavier Figueroa
      June 4, 2014 at 12:22 am

      Xavier Figueroa

      Dear Dr. Maxfield,

      Thank you for contributing to our blog. Your posted presentations at the 55th and 58th Annual Meeting of the Southwestern Chapter of the Society of Nuclear Medicine are excellent case presentations of individuals that were affected by a TBI and showed improvements (both in SPECT imaging and quality of life).

      I agree that we are just starting to scratch the surface on treatments for neurological conditions.

      Xavier Figueroa

  4. Tom Fox
    June 1, 2014 at 4:51 am

    The effectiveness of hyperbaric oxygen becomes apparent when you look at the improvements consistently reported in all participants of DOD studies. DOD studies are examining two treatment groups. "Evidence-based medicine" is only as good as the quality of evidence being examined.

    Special interests must also be considered. Dr Cifu's participation must be examined. He appears as a second author in a number of studies. He is part of the US Veteran's Administration.You must ask if the widespread manipulation of veterans' lists which caused the head of the VA to resign last week is the only manipulation that has been undertaken by the Veteran's Administration, an agency entrusted with the care of those who have borne the battle.

    Interesting fact: Dr Cifu received a $63 million dollar federal grant to study after "debunking" hyperbaric oxygen.

    Tom Fox

    • Xavier Figueroa
      June 2, 2014 at 6:20 pm

      Dear Mr. Fox,

      Thank you for commenting on our blog posting. Given your service with Army Aviation, experience and involvement in the treatment and training of Army Hyperbaric medicine, your comments are much appreciated (as is your experience in this area: http://www.centrehyperbare.com/en-about.php).

      Your article [www.SOTECH-kmi.com (June/July, 2008, Vol.6, Iss.5)] highlights how long the debate regarding TBI and HBOT has been going on and the knowledge base that existed prior to the publications by the DoD and VA sponsored studies.

      It is a shame that the debate between hyperbaric practitioners and the DoD/VA clinical research has hit a wall when it comes to recognizing the difference between a real placebo/sham and the actual effects of treatment.

      Thank you for commenting on this post and we hope to have you back here again.

  5. Bob Fischer Col USMC (Ret)
    May 6, 2014 at 5:57 pm

    Finally, an MD with an open mind who can navigate between the medical specialties when it comes to evaluating a medical alternative that now works and healed some 125 veterans with TBI at the Rocky Mountain HBOT Clinic in Louisville, CO. Narrow and limited mental processes ( zero objective thinking ) is not the sole characteristic and demented domain of doctors who dare not evaluate any innovative new therapy. They are in the majority today. They dare not examine or objectively evaluate evolving therapies and treatments since the mental block and lock in these concrete cerebellums is just as pathetic today as was that of the profound and petulent PhD of the late 19th century who noted the massive technological results of the industrial revolution and exclaimed, "Everything that will ever be invented has already been invented today."

    Today these same mini-minds take a similar position: "What I have already learned and specialized in (narrow and obsolete as it may be), is all I have to know. And for my next patient I will scan my diagnostic checklist, find that set of pills and pablum that match their ancient condition and then I can wallow in my brilliant treatment." Pull that stovepipe down around you, "doctor" so nothing new can ever penetrate the vacuum and then praise yourself inside that hollow chamber. You are practicing this alone in your chosen career field. Today, it is replicated in almost every professional career field and society. The stovepipes are like cornfield stalks… millions of them in all the obsolete, inert professions who refuse to let any light in. Not-invented-here syndrome!

    And now we have 21st century empty noggin MDs who defend their stovepiped "specialties" and reject innovative, promising new therapies – even when they work!!

    Bob Fischer

    Colonel USMC (Ret)

    • Xavier Figueroa
      May 9, 2014 at 4:53 pm

      Colonel Fischer,

      As you have experienced with your attempts to shake up the DoD bureaucracy, any change will be resisted by the system. Doesn't matter where and doesn't matter when. Planck encountered the same resistance by the old-guard in the physics community: "A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it."

      I don't subscribe to Planck's approach, as there are too many men and women who are locked in a condition where hyperbarics could help 70 – 80% of TBI sufferers. Rocky Mountain HBOT and the hundreds of other clinics in California, Florida, Louisiana and Washington have helped our veterans and civilians recover with HBOT. Unfortunately, as the treatments have helped hundreds, the results have gone up in a puff of smoke. The data, the hard numbers that could have been generated to demonstrate efficacy, sit unused and useless. Data is the ammunition we need to educate doctors and wear down the resistance from insurance companies. The real obstacle is convincing the insurance companies and state Medicaid that it is in their best interests to cover TBI treatments with HBOT(or any other therapy that shows efficacy). HBOT is highly underused as an adjunct to multiple therapies. That needs to change… Prions, H. pilori (the bacteria that causes stomach ulcers), MRI and hundreds of other medical discoveries also faced an up-hill battle to achieve acceptance.

      We will get there if we can all pull together…

      Xavier

  6. Jeff Brennan
    May 2, 2014 at 6:35 pm

    Jeff Brennan HBOTAs someone who has gone through an HBOT treatment working with Xavier, I can tell you first hand that I had remarkable results with my cognitive brain function testing after 40 dives. You can learn more about my story by clicking on Kim Justus' link or going to YouTube and typing Jeff Brennan HBOT; you can also follow my story as we start back in the near future with additional dives and brain testing.

    I have TBI and PTSD from nearly 10 years in the Marine Corps and also suffer from high blood pressure, chronic fatigue and fibromyalgia that has been life-changing. With additional HBOT treatments, we're looking forward to seeing more positive results. My hope and dream is that this will help the many that have combat-related TBI and PTSD to help give them a better quality of life!

    Thank you to all who have helped me go through the HBOT treatment and Semper Fi!

     

    SGT Jeff Brennan

    "Once a Marine, Always a Marine"!

  7. Xavier Figueroa
    May 1, 2014 at 11:13 pm

    Xavier Figueroa

    We now have an excellent team in place and we will be launching a solid hyperbaric oxygen therapy clinical trial in the near future.

    Xavier

    • Kerry Mischka
      May 8, 2014 at 7:11 pm

      After surviving a severe TBI in August of 1997, I just went back to life as usual as if nothing had ever happened to me… also known as denial!! This was the worst thing that could have ever happened to me. Immediately, I was placed on antidepressants as depression set in quickly.

      Now that I am 44 yrs old, I wonder if HBOT would be able to help me. I still battle on many fronts but finally gave up on psychiatry and pills. It just masks the problems. Exercise works better. Please tell me if I can be part of a study or anything. I am alone and will never have any children (unless I adopt). I am a total advocate for anything that involves oxegen. I mentioned HBOT to my doctor and got a negative response which makes me want to try it even more.

      Thank you,

      Kerry Mischka

      • May 9, 2014 at 12:38 am

        Kerry,

        Your account moves me as another TBI survivor who awakened from a coma in 1996 and was similarly 'blessed' to be placed right back into life with what I called TBI-camouflage to mask challenges and fit in. This journey has been long, difficult and rewarding as I have sought out methods for functional health promotion outside of the typical Rx roller coaster for TBI.

        Since then I have helped to form TBIAlive, a large community organization which is currently becoming a nonprofit corporation to encourage just such opportunities for real health with a survivor-focused perspective. Located in Colorado this group includes a number of participants who have enjoyed remarkable success with HBOT, so any questions that you may have can be directed to me or through one of our developing TBIAlive web forums; we will be happy to connect you with those participants if that is your desire.

        Joel Goldstein is also an excellent resource on this topic, so good luck with everything you are doing and thank you for taking part in discussions here as another survivor.

        Matthew Reilly

        http://www.tbialive.org

        • Xavier Figueroa
          May 9, 2014 at 2:32 pm

          Dear Kerry & Matthew,

          Thank you both for coming to the website and sharing your experience as survivors of a TBI.

          As I keep hearing and reading from survivors, a common thread is how out of step the medical and rehabilitation community are in most communities. In most cases, it is the survivors and family members that have to find solutions to the problems that are "discovered" after a TBI.

          Dr. Maria Romanas will be posting on our site to discuss her experience and how she found real and lasting help using Neuro Rehabilitation Therapy. Her experience was recently published (http://www.medpagetoday.com/Neurology/HeadTrauma/44084) and her recovery has been phenomenal.

          Our purpose here is to help the TBI community to identify and validate whether or not certain therapies can help restore or improve brain function. Although we are focusing on HBOT, there are other therapies that could help in restoring lost function and improving symptoms. Our experience has taught us that the body and brain are much more capable of healing than what we have learned in the past.

          Thanks for commenting and we will update all of you when we start up our clinical trials.

          Xavier Figueroa

    • May 13, 2014 at 1:56 am

      You are awesome! What a testimony and factual data, too.

      Unfortunately, a couple of pieces of information were left out which may have hurt some feelings:

      1. No matter how much data you provide to a doctor, there will never be enough unless it is published in a reputable (usually defined quite narrowly by the physician that you want to convince) journal.

      2. 2-3 days of HBOT during medical school was way too much. Think more in terms of twenty minutes and only if the medical student is in attendance. Most medical students do not attend class because they are 24/7 studying and reading. If they attend class, it is to get answers to questions that they don't understand, to demonstrate clinical skills, or to test. Scary, huh? (Information acquired from doctor daughter.)

      3. Throw out any studies that were not done in the US. We are smarter than anyone else and can't trust studies done elsewhere.

      4. HBOT can't compete financially with pharmaceuticals. It is not a big money maker and even if it was, there aren't enough chambers in the US to accommodate all the clients and diagnoses that would benefit. Sort of a little problem for Medicaid, Medicare and insurance companies, so they choose to not reimburse under the guise of "investigational," "experimental," or "unapproved."

      I loved your article! Keep up the great work!

      Judy Burkholder

      • Xavier Figueroa
        May 13, 2014 at 3:21 am

        Judy,

        Thanks for providing more background information! That sort of engagement with the blog is exactly why we post. You are absolutely correct that HBOT has difficulties competing against more established systems with better financing but we are hoping that if there is enough demand, the medical and scientific community will go forth and fill the need. As for who will pay for the cost of treatment, there is enough money in the private and public insurance groups to enable cost-effective treatments like HBOT. It's all a matter of prioritizing where we spend and how we use those funds.

        As I mentioned in the post, doctors are the problem and the solution. It's all a matter of constant, patient and open-hearted engagement that can effect change.

Comments are closed.