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 at http://www.cincinnatihyperbarics.com/patienttestimonials.html
Dr. Ted Cole, MA, DO, NMD, FAAIM
Copyright © May 2003
The Stroke Network, Inc.
P.O. Box 492 Abingdon, Maryland 21009
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