You’ve just finished a book entitled The Oxygen Revolution, what led you into this realm of medicine?
An accident and a lark. I was plugged into and wanted to be a surgeon and was looking at probably doing facial plastic surgery, and, three weeks into my internship, I had a very bad car accident. I was hit by a car, a very bad car accident; I had a traumatic brain injury, burns, multiple fractures, had amputated toes, and skin grafts, etc., etc., etc.
I was in a pyramid program, meaning you had to cut a certain percentage of people into the second year, and so it was incumbent upon me to get back to work as soon as possible and compete for one of these spots, and I did ! The problem was, I was having a lot of trouble , you know, keeping up and getting excellent reviews and so on, working 110 hours a week and standing on this leg. I had a non-unioned fracture, and grafted burn, etc. I finally took a medical leave at the end of the two-and-a-half years to have additional operations, and, while I was off, I had no source of income, and I had to get a job, and I started working in emergency medicine. I ran into a guy a year later, and had the opportunity to work in hospital-based emergency medicine, just as I had applied and been accepted to take EMT residency training. The position was to work in a New Orleans hospital on an every other week basis, and, in the off weeks, I was writing comedy and pursuing other interests. When I got to New Orleans, after a year, I found myself in a group that did emergency medicine and hyperbaric medicine and was the south-central United States and Gulf States referral area for all diving accidents.
I actually met my ex-wife down here, got married, and finally in ’86 moved from Denver, Colorado. In this group, by 1989, I was seeing these divers, and I took an interest in the ones with brain decompression sickness and started asking questions, specifically, what are we treating? And nobody could answer it. And specifically, we are ninety miles up from the Gulf of Mexico, and so the divers don’t come to us immediately, they’ve got to come in by boat, or be helicoptored in, or travel on land, and that’s if they have serious enough decompression illness to know what’s wrong with them.
Many though, came in days later. My question was, “What are we treating in these divers’ brains?” And the second question was, we would treat them in single-treatment cure which was the rule with the US Navy, and that wasn’t what we were seeing. We were treating them repetitively, sometimes weeks on end, getting incremental improvement, and my questions were “What are we treating two weeks out?” Again, nobody could answer. Finally, I went and researched this in animals and found that the bubbles pass through the brains of these divers within minutes of the accident, and that all these years the US Navy, what they were primarily treating in brain decompression illness was not bubbles but, in fact, was treating the inflammatory reaction in the brain after the bubbles passed through the blood vessels. And once I realized that, there was a whole new appreciation of diving medicine. No longer was this the signature diagnosis upon which everybody assumed we were treating bubbles in divers’ brains. We were treating acute brain injury due to damage caused by bubble passage, which included micro-strokes throughout the brain. Then, all of a sudden, in 1991, out of the blue, comes the Dan Greathouse case. Actually, it was another commercial diver, and this guy had worked for a company for twenty-three years, and, when they used inappropriate almost experimental decompression procedures on him, got him badly bent, and then took him from our control, prematurely returned him to work, and subjected him to the same decompression procedures; he now was severely brain and spinal cord damaged. After we treated him thirty-three times for the acute injury, he was still demented, and so, three months after the last treatment, they cut his worker’s comp off, branded him a “malingerer and a faker”, and he loaded his .357 and .44 magnum pistols and was heading down to the New Orleans McDermott Diving office to kill all of the management associated with the off-shore diving operation.
His brother called him up, told him to hang on, wanted to say goodbye, and they showed up with these attorneys, who then took him and dumped him in my hyperbaric unit and said, “Do something with him because you treated him seven months before.” I got on the phone; I started calling around, and finally reached Dr. Neubauer in south Florida. He told me he’d never treated a diver before, but maybe I could try what he had done with stroke and MS patients. I did so; this guy made a dramatic improvement seven months afterwards. This was untreatable neurologic disease, and I felt that we had made a profound discovery. My colleagues told me, “Don’t you dare report it, you will encounter incredible criticism and resistance; wait until you have a series of them.” And just as we were making the decision, I decided not to report it in that summer of ’91, and Dan Greathouse’s family called me – actually I was called first by my old surgical internship buddy and roommate, who is now an ear, nose, and throat physician in Farmington, and Dan had come into his office to be seen about his injury, and this Dr. _________ called me up and said “I don’t know anything about diving _______, but I know you do, and this guy does NOT have an inner ear problem.
Something serious is wrong.” And that started the Dan Greathouse story and the whole future of this.
Children and adolescents seem to be the most vulnerable to head injury, brain damage, and trauma. How can hyperbaric oxygen therapy help them?
Very easily. The literature is already out there with four randomized, prospective, controlled trials showing that hyperbaric oxygen has significant benefit in acute, severe, traumatic brain injury. The evidence is there for acute, severe, traumatic brain injury, and I and others have now accumulated substantial experience treating some acute and chronic brain injury that are now duplicated in the animal model.
Autism, obviously, continues to be a major challenge for parents; it seems to be increasing; can hyperbaric oxygen therapy at least alleviate some of the symptoms or facilitate some improvement?
Unquestionably. The second I thought it was first at the time autistic child in this country treated with hyperbaric was treated in my facility in 1996, and his case is reported in The Textbook of Hyperbaric Medicine as a Cerebral Palsy case. He was actually, he was kind of misdiagnosed. He has CP, if you will, but he scored twenty-nine on the childhood Autism rating scale. Thirty is the threshold for overt Autism, so he’s an Autism spectrum case. What happened after his experience, so began a series of autistic patients I’ve treated, and we’ve got to change your question. This is not just symptom improvement, this is a gross and repair drug, and what we’re doing is repairing some of the organic damage in these children’s brains, so it has a huge potential in Autism, and it’s now been duplicated by multiple physicians around the country, based on what was started here, and then in application using lower pressures and lower oxygen.
Your book discusses the fact that birth injuries continue to occur; there’s prematurity, low birth weight, fetal alcohol syndrome, fetal alcohol effects; can hyperbaric oxygen help in these instances?
Yes it can, and before we answer all these questions, probably what we should do is answer a foundational question what is hyperbaric oxygen?
Hyperbaric oxygen is the use of greater-than-atmospheric-pressure oxygen intermittently as a drug to treat basic disease processes and, hence, the diseases. In the case of birth injuries, it’s an acute, ischemic low blood flow, hypoxic low oxygen insult to the brain, and hyperbaric oxygen treats that low oxygen insult, and, on top of it, if delivered soon enough, inhibits the same inflammatory reaction caused in the divers’ brains by passage of bubbles, in this case, the reestablishment of blood flow and oxygenation causes the secondary reperfusion injury.
So, for the actual birth event, where there is an injury to the child’s brain, a very timely, initial treatment has the potential to inhibit the vast majority of the injury. With more accumulative problems like fetal alcohol syndrome, it’s not going to be a single event. This is something exposed over the course of gestation, and it requires more treatment. So, yes to your question, you’re just treating different pathology.
You talked about this earlier, but Cerebral Palsy continues to be problematic; I know that there are drugs that can help the spasticity, but can hyperbaric oxygen therapy be an adjunct or even a primary treatment?
Unquestionable, yes, it is a primary treatment. Again, getting back to the definition, hyperbaric oxygen is a generic growth and repair drug for generic brain pathology acute, sub-acute, and chronic and, in the case of CP, the first children treated in this country were treated down here in 1992, and what I was doing was investigating the application of this protocol that I was applying to divers and boxers and other traumatic brain-injury patients. I applied the same to the Cerebral Palsy children, and we found that it worked very much the same. Now, the problem with spasticity and it’s due to anatomic considerations and just the nature of what is injured. There are permanent and transient effects of hyperbaric oxygen on spasticity. Could it be synergistic with medications that reduce spasticity? yes, and it is. We’ve added it to patients already on Baclofen, for instance, and it’s effective.
For kids in school, a learning disability presents a major challenge; is there any research showing that hyperbaric oxygen can assist those kids?
Not directly, but that question is difficult to answer because of the inexactness of that term “learning disability.” What is a learning disability? A learning disability is a broad umbrella for kids with fetal alcohol, kids who were crack babies, kids who had prolonged labor and a birth insult to the brain, kids who have been exposed to carbon monoxide in infancy, it is learning disability can be the result of just about any organic insult to the brain and so if, possibly even genetic causes and, given the definition I gave you earlier, YES this can help learning disability, and, in fact, this is what Dan Greathouse is so interested in. And I presume you are also!
Certainly! We often hear about kids who have fallen into pools and the like; what emergency procedures should be implemented for those guys?
The first treatment should be a hyperbaric oxygen treatment after initial resuscitation, and this has been done now. In fact, one of the first cases, and one of the only ones I know of in the United States, was a case I had on July fourth weekend of 1998. at a nearby hospital here, which was destroyed by Hurricane Katrina, we had an eleven-year-old who was under water for a minimum of fifteen minutes, eventually retrieved, was in full cardiac arrest, he was taken to the emergency room, and, at that emergency room was an emergency medical doc whom I knew and whom I’d interfaced with years before treating some merchant seamen, who had been rendered unconscious in the hold of a ship and the result for these guys was so good that it was burned in this emergency medicine doc’s brain ! So, when this near-drowning child came in, he contacted hyperbarics; the technician there was one I’d worked with for ten years. She called me up and asked for direction on how to treat this child. We treated him with a single treatment. Two days later, he awakened, and he subsequently went back to school. There is no neurological deficit that anybody can detect, and he made the national magazine cover of Methodist Hospital’s magazine. So we have one case, and I’m trying to think, the Chinese in 1995 reported some cases, I believe, who were grouped in with 336 acute coma cases that they treated in emergency departments.
Asthma seems to be on the increase. Magazines seem to advertise a multitude of medications, drugs; is hyperbaric oxygen indicated or contraindicated?
It’s indicated. The Russians have done this work. We have to remember that Asthma has a few components, one of which is inflammation. Hyperbaric oxygen is immunosuppressive and inhibits inflammation. That’s part of the reaction that we talked about the reperfusion injury of divers’ brains, birth insults, near-drowning, etc.
And so, yes, hyperbaric oxygen has a potential for treatment there. It’s also the treatment in the current case we just talked about of Dan Greathouse’s personal family member, and it’s also the diagnosis, although a little bit different I mean, it goes under the heading of COPD and Emphysema, Chronic Obstructive Pulmonary Disease, which is asthma, bronchitis, and emphysema that was used to treat Dr. Teller’s wife, who was dying of terminal emphysema. So, the answer is yes, it has a place in the treatment of asthma.
The next batch of questions are for the other journal, and I think I can lift from the previous question about what are you currently working on and researching, and how did you first get involved in the treatment of brain injury, and, even number three, what led you into hyperbarics? So we’ve covered those. Number four is kind of personal because I went through EMT back in the nineties, and, even basic EMTs know that oxygen is a drug, yet the medical community seems hesitant to use it. What can account for this?
It’s a matter of how it’s used, and it’s a very complicated medical culture/political issue as to why hyperbaric oxygen is not appreciated and used. Paramedics don’t have hyperbaric oxygen on their vans, and they operate on strict protocols, so, even though they know that it’s beneficial, they don’t know about and don’t have the ability to deliver hyperbaric oxygen. In addition, as I described in the book for the medical profession, why has oxygen and hyperbaric oxygen been lumped together under the same heading? The reason, partly, is that people do not appreciate a difference in dosing of oxygen. When people are put in an ambulance or in the hospital on oxygen, it’s put on, and it’s left on for hours to days, and, when that happens, the body develops tachyphylaxis to the drug effect of hyperbaric oxygen, so you don’t get the types of effects that you do when you apply the oxygen then withdraw it in other words, give it intermittently like the dose of a drug or a pill, and so that’s part of the problem. People think, ‘we will wait a minute, we apply oxygen like this, it doesn’t have all these hyperbaric oxygen effects; what are we talking about? That’s crazy.’ It’s got to do with the intermittency and the way that oxygen in an intermittent dosing signals damaged tissue. Let me just add something. You know, we only got to question number eight in that first segment, and number nine was a critical one:
Are there dangers connected with concerned parents purchasing hyperbaric oxygen chambers and treating their own children?” Unquestionably so; less so with the portable chambers, but we now have I have documented information of three families that put hyperbaric chambers (the hard-shell ones) in their homes and treated these three children, and all three children died. I don’t like this unsupervised application in homes by people who know nothing about this because, in the end, it is still a medical treatment, and with less than pure oxygen it’s not quite as severe an issue, and, at the low, low pressures, meaning the 1.3 atmospheres and below, it’s also not something that causes so much alarm. But once you start getting up in the realm of one-and-a-half atmospheres, and use of these hard-shell chambers, this is flat-out dangerous.
Due to the pressure?
And amount of oxygen and the fact that people don’t know what they’re doing, and, in each of these children, they developed seizures and the parents then researched “Oh, wow! Dr. Harch uses it to treat seizures.” Well, yes I do but not like that. And they came across an article that the Chinese have used it to treat seizure disorders, but again, not like that, and so what they did is think more hyperbaric oxygen was good for seizures. They kept treating these children and the seizures got worse and worse and worse, and finally, all three children died. In all three, the diagnosis by the primary physicians was seizure disorder.
So it’s the intermittency of the treatment, and it’s the amount of treatment that’s important.
It is. The dose, which is a function of the depth, the fractional concentration of oxygen meaning 30%, 70%, or 100% the amount of time you spend at depth in the chamber, how deep you go, how long you stay, the frequency of the treatments, and the numbers of the treatments.
So it’s multi-variant.
You’ve got it. It’s dependent upon about seven different things that are involved with dosing.
What’s the best resource for concerned parents seeking hyperbaric oxygen therapy for their children, and where should a parent begin to seek out this therapy?
The best resource this is not just a plug, but it’s my book because of the comprehensive nature and explanation of what it’s about. As I like to say, it’s written for the lay public in terms that even doctors will understand. So I tell people, start with that book. Secondly, I tell them to go to the MUMS network, and that’s one of the places they can get information on sites that offer hyperbaric oxygen. She also, Julie Gordon, the director of this the mother of a Cerebral Palsy child has a whole packet of information that she sends out to parents for, I think it’s twenty dollars, but it’s a substantial collection of information, and that’s a good place to start.
In terms of where to go, go to a place where there is a doctor someone who can oversee, watch this child, coordinate treatment with all the other therapies the child might be getting because, once again, this is a medical treatment just like any other drug.
Is there any promise among the organizations of pediatric doctors coming onboard with this effective treatment?
Yes, for the Autism community. Groups of doctors are talking about DAN Defeat Autism Now this has made it to the level of the executive ‘think tank’ and has been endorsed by them as a therapy. Now we have multiple DAN doctors throughout the United States delivering hyperbaric oxygen to autistic kids, so this is the first group; there are no other pediatric groups that have adopted it. In fact, those that oversee Cerebral Palsy have, I will say, ignorantly rejected it. So, the vanguard is the parent-doctor groups like DAN.
How’s the message of Hyperbaric Oxygen Therapy being spread throughout the various organizations which are concerned with early childhood development?
I don’t know. It’s more a grassroots campaign that is reaching these organizations through parents and parent support groups.
What’s the most formidable roadblock to the acceptance of this therapy?
The most formidable roadblock is the past misperception and misunderstanding of hyperbaric oxygen, and it starts with the what I call inadequate definition of hyperbaric oxygen. For the last thirty to forty years, it has been ill-defined. In fact, full definition is: “hyperbaric oxygen therapy in which a patient breathes 100% oxygen while fully enclosed in a chamber of greater-than-atmospheric pressure; can be viewed as the new application of an old, established technology to treat certain expensive, recalcitrant, and otherwise hopeless medical cases. Treatment pressurization should be at 1.4 atmospheres or absolute or higher.” Now the problem with that definition is that it’s a therapy defined by the diseases it treats, which is completely backward. If we define it as a treatment to treat certain expensive, recalcitrant and otherwise hopeless medical conditions, then we should be able to group every chronic illness under there since every chronic, human illness is by and large hopeless, recalcitrant, and expensive. We don’t have any curative and any repair drugs for any chronic conditions. So, what happened was, there has now been a list of thirteen diagnoses compiled over the years by a group of hyperbaric physicians that supposedly are supported by scientific evidence. The problem is, half of them are not, and it’s not to mean that hyperbaric oxygen is not effective for them; it’s just that they’re not necessarily supported by the level of evidence that these doctors presumed was there. And this is not my opinion only; it is the opinion of many people who have reviewed this, including myself. The problem is, the list of diagnoses, according to the definition of hyperbaric oxygen, is a disjointed list that no physician or neophyte to hyperbaric medicine can draw conclusions about. We’ve got decompression illness, carbon monoxide poisoning, the flesh-eating bacteria, gas gangrene, exceptional blood-loss anemia; I mean, you can go down the list, and people look at these, doctors look at it, and other specialties, and they raise their eyebrows, and they go, “What? Okay, if you say so.” But, I mean, you can’t connect the dots.
When you take hyperbaric oxygen and define it as a drug that treats basic disease processes and, hence, diseases, you now can identify all the disease processes in these diagnoses, and soon you see this activity, and then it begs the question of ‘why not additional diagnoses with the same underlying patho-physiology?’
What happened, in the past and up till right now, when people used hyperbaric oxygen for things not on that list, the doctors in hyperbaric medicine could not defend it or explain it, and, in the face of criticism, it got discredited, so that, in my generation of doctors as I tell in the forward or the author’s preface of my book, I was a John’s Hopkins third-year medical student walking down the famous _______ Halls of medicine um, _____ Ward and we overheard someone say, “Well, how about hyperbaric oxygen?” And, as we got out of earshot, I asked my resident, who was my superior a full-fledged doctor what’s hyperbaric oxygen? He said, “Oh, it’s a fraudulent therapy. It’s been completely disproved. Don’t even give it another thought. It’s like selling snake-oil, you know, it’s charlatanism.” So, I’m at Hopkins. They’re telling me that this is charlatanism, you bet it is! And that got plugged in my brain. And that has been the attitude that has dominated medicine for my generation of doctors, so, back to roadblocks what’s the biggest roadblock? It is overcoming all of this misperception that has dominated the thinking in an acceptance of hyperbaric medicine for the last forty years.
Is there more HBOT research being done in the United States or abroad?
Good question. Actually, it’s abroad. There is more clinical research abroad, and there’s probably more basic science but the amount of basic scientific clinical research in the United States is surging in just the last three or four years.
How does HBOT help in the treatment of ADD/ADHD?
I don’t know exactly because nobody’s put together a uniform group of ADD/ADHD kids. ADHD is another one of these diagnoses like learning disability.
What’s the cause? It could be carbon monoxide poisoning; it could be a fetal injury; it could be a birth injury; it could be lead, you know, it could be any one mercury maybe it could be any one of a number of things. It’s a constellation of symptoms that has been considered a psychiatric diagnosis, and it needs to be considered an organic brain insult, an imbalance in the brain caused by particular insult. So, depending on the insult, yes it possibly can treat ADD or ADHD.
I’ve noticed that when infants and babies are treated with hyperbaric oxygen, they are usually pictured with an adult inside the chamber. How does the adult typically help such a little one equalize the air pressure in the middle ear during compression and decompression?
This is just a gray question because it touches on a number of things. They’re usually pictured inside with an adult because parents have had a fear of having the children go in the chamber by themselves, and that constituted the main fault of the Collet Cerebral Palsy study done up in Montreal, Canada in 2001. What they claimed was both the control group and the hyperbaric group, who both got hyperbaric doses and showed significant improvement got better because of the parents’ participation effect. The parents brought these kids in, in this highly social environment of good cheer and they went in the chambers with them, and it was just a wonderful quality time experience, and, because of that, these kids improved five to six times as fast in motor function than any other therapy that had been given to them in their lives. And the claim was parent participation. Well, the rebuttal to that is my facility. I’m the one who started this in the U.S., and ninety percent of the children went in the chambers without their parents.
What’s the beauty of it? If you do go in with your parents, the beauty is mainly if you can sit up with the child. If you sit up, the venous pressure and engorgement of tissues in the nasopharynx where the opening is to the middle ear space are less engorged, and it’s easier for the child to cool his ears, and, in addition, you can even bring some liquid in the chamber in a little container and let the child be drinking and swallowing as pressurization is taking place. When that happens, you know, we’re even using a ‘binky’ a little pacifier when that takes place, as you swallow, they will automatically open the middle ear the Eustachian tube in the back of the throat so, to sum it up, the adults can help the little one equalize air pressure, either reclining or sitting by having them use a pacifier or even drink a little bit but drinking on your back is not the ideal way we like to do that, but the child can be propped up some. If they can be sitting upright, it makes it easier due to vascular factors associated with the middle ear space. That’s being under compression. Decompression is not so much of a problem because the air is expanding and forced out through the Eustachian tube.
What questions have I failed to ask that might be important to the understanding of HBOT?
I think we touched on most of that. I kind of summed up what many of the problems have been in the past; although, I’d add one other thing: the main reason, in my opinion, along with this misperception, the main reason that we have not seen an application to neurology has been two-fold. One, we have a hundred year history of neurology that has been based on the precept of : number one there is nothing you can do for a brain injury, and number two that brain cells, post injury, are either living or dead there’s no intermediate state.
But the equal reason, in the hyperbaric community, has been due to the hyperbaric community itself, and it stems to very ugly, ugly human nature, and what I call medical politics and culture medicine issues. In 1978, Dr. Richard Neubauer, after some Multiple Sclerosis cases had been treated in Czechoslovakia with hyperbaric oxygen, published a letter, a short article in the Florida Medical Journal, stating that he had treated a few Multiple Sclerosis patients, and, lo and behold, they got better. And this was
[anaffola], but what it did was engender a literal hatred for him as an outsider, a non-US Navy doctor, within one of the medical societies, and, because he persisted in applying this to neurological injury, and it was not on this accepted indications list, and he had the nerve to charge one-fourth the hospital rate for it, he encountered the attacks of a group of doctors, and the dislike of him became institutionalized and disseminated throughout the United States Neurological community and medical community to the point where they literally threw the bathwater out with the baby. In other words, in the process of destroying his reputation and trying to discredit him, no one looked at the science of what he was trying to say, and no one in particular ever has refuted the letter to the editor he sent to Lancet in 1990, called “The Idling Neuron Letter,” which fairly clearly, with one case, showed that a woman fourteen years post-major stroke had damaged areas of brain that could be rehabilitated. So this cultural, medical, political problem has held back the application of hyperbaric oxygen to neurology for now almost thirty years.
You’re currently a consulting doctor for integrative hyperbaric centers located in Irvine and Madison.
Actually, I’m not, and, if I’m being listed that way, I should not be. I was going to potentially be associated with them, and it didn’t work out for a number of reasons. Some of them were personal, requiring my time here in New Orleans, and then other just medical issues, so I am not, and, if they are listing me that way, I’ve got to get that corrected.
Currently, what’s the most prevalent neurological condition in children being treated?
Probably Autism.
Could you elaborate on the visual?
Well, yes, Autism nationally. At my facility, it’s been the entire spectrum of pediatric neurological disease, meaning Cerebral Palsy, Autism, genetic disorders, hypoxic ischemic birth injury, cardiac arrest, and a variety of other I mean the whole range of pediatric neurological conditions I’ve treated including learning disabilities.
Could you elaborate on the visual impairments of children if any that are currently being treated successfully with HBOT?
Mainly they’ve been cortical vision impairments. In other words, damage to the cortex, the visual cortex that controls vision, and we saw this very early on in kids that we were told “were blind.” As we began to treat them, we noticed that these children would begin to see us in their peripheral vision, as we would approach the chamber, so, while they’re inside, they can’t hear anything on the outside due to the white noise of the oxygen whooshing through the chamber, but, as we would come into their peripheral field of vision, while they’re watching, say a video, on the monitor, on the television, they would immediately turn their heads in response to the movement in their peripheral vision, and so we knew these kids were getting back vision. And it’s now been demonstrated a number of times through a group of CP kids treated in Galveston, Texas based on my protocol, and it was reported that one of them, they had done before and after visual invoked potentials and shown an improvement. In fact, it was reported at one of the international symposia in Ft. Lauderdale, Florida.
Basically, what constitutes an integrative approach at the specific treatment centers?
That’s hard to say because it’s unclear exactly what each of them is doing; although, the concept of integrative and what these places are offering, yet the people are applying multiple therapies simultaneously. Ultimately, this has been my goal in neuro rehabilitation. Hyperbaric Oxygen, I’ve spent my career both proving or disproving it’s effective in brain injury, and I’ve done that to my satisfaction. It’s a foundation therapy for repairing biological damage; however, for maximum effectiveness, once you have been able to reestablish function in damaged brain, you now have to get that brain to work and reintegrate. So you need to make all the new connections, and you do that with other simulative therapies, and there are ways to do this. In fact, we are going to be doing this and combining it with a number of other therapies very shortly at a kind of multi-modality center. We’re about maybe six months away from that.
Are there plans for expansion of these types of services throughout the United States?
Oh, yes. The mushroom cloud literally is forming, and we are at the tipping point. There are so many of these types of facilities that are now cropping up across the country to deliver this therapy.
You mentioned the MUMS network in The Oxygen Revolution. Is this organization involved with any movement to raise awareness of HBOT and advocate for reimbursement from insurance companies for successful treatment of neurological disorders in children?
Yes! I think we talked about that, but there’s a very interesting story. This lady, Jewell Gordon, who was a mother of a Cerebral Palsy child, essentially was told to take her child home at birth and do the best she could. And, at the time, twenty-seven years ago, there was nothing for these young mothers on how to take care of a severely brain-damaged child. And so what she did was learned and pulled together resources and decided to offer this to other women. She formed this organization as a “parent-to-parent” matching service to where she puts parents in touch with other parents, worldwide, who have children with the same diagnoses. In 1997, she had become aware that patients were starting to report, or parents were, that their kids had had some hyperbaric oxygen and were showing some improvement, so, in 1998, she called me up, and we had a series of discussions, and she finally sent four mothers to me to assess whether I was a fraud or whether there was merit to this, and, when all four of these children made substantial improvements, she subsequently went and had her daughter treated, and her daughter has just made great strides. She then devoted a significant portion of her newsletter and her efforts to collecting and disseminating information on HBOT. So she has been a primary mover in this. The problem is, she has not interfaced with insurance companies, so her effort has not been directed in that direction. We’re trying to do that through other medical organizations that I’m associated with.
Are there any other organizational movements being mobilized to help make changes in reimbursement for successful medical treatment using HBOT?
Yes. The International Hyperbaric Medical Association that I started, the International Hyperbarics Association started by the portable chamber people that operate the airline and national clinics also are involved with that, and so a lot of us are trying to make inroads. I am very, very heavily involved in the Georgia Medicaid case of David Fields Jimmy Fields attempting to get Medicaid reimbursement for Cerebral Palsy. They are now something like a dozen states that reimburse for CP. So those are the first twenty-two questions, and now I’m going in to the second set.
For what other conditions is Hyperbaric Oxygen used?
Do you mean the standard accepted ones, or do you mean the off-label ones?
As I mentioned before, there’s a list of thirteen (13) indications. You can just access those on the Internet without me. They’re all over the place, if you type in thirteen accepted indications HBOT. In terms of neurological applications, people are applying it to all sorts of different things, and so just the entire spectrum of brain injuries, spinal cord injuries, and other conditions such as chronic liver injury, heart conditions, pulmonary that’s more overseas, though.
When is it contraindicated?
You have to be very careful with people with heart and lung conditions. Seizure disorders you have to also be very careful with. Obviously in someone who is brain dead or has no discernible neurological activity, it’s not going to be worthwhile. These are some of the cases I’m frequently called about and wanting to apply hyperbaric oxygen, and I tell people, you know, to assess brain death, and, if it’s there, I would not attempt hyperbaric oxygen.
Are there ever any ancillary medications used? Which ones?
The main ones are vitamins. We use vitamins and anti-oxidants. No one knows if they’re really even necessary, but vitamin C, vitamin E, and a multi-vitamin in combination with hyperbaris with other medications looking for synergy, this has been done somewhat with antibiotics in the past, and it is totally unexplored with neurology.
Can you provide a case example?
If you like, I have to try to decide which one you’d like.
Most physicians associate hyperbaric oxygen with open wounds and sores that refuse to heal. What are the mechanisms involved in the healing process in terms of TBI?
The same mechanisms, we are regulating growth and repair hormones, the receptors for them. In the case of brain injury, we are also metabolically overcoming the metabolic inhibition cause to the cell’s machinery by blood flow and low oxygen insults.
How well has your recent book been received?
Unexpectedly well. It had a small first printing of three thousand and sold out in three weeks, and the publisher was shocked. It’s close to selling out of its second printing, and so they are exceedingly pleased. In fact, they feel that this has the ear markings of a blockbuster book, and they want to market it more now.
Why does there seem to be such stringent research with hyperbaric oxygen prior to acceptance by insurance companies and what can be done to help with the acceptance of it?
I think this goes to the past misperceptions of it, that it was fraud, non-science, voodoo, and disparaging adjectives, and ignorance of it, so people now want to say, ‘Well, we need these mega, randomized prospective trials,’ and they’re wrong. It also goes to this current fascination and fantasy that medicine evidence-based medicine if you will, is the standard of care. In fact, it’s not. We have large, randomized prospective trials for very few things in medicine, and most of them are for antibiotics and other drugs funded by large pharmaceutical companies. So the notion that we have to have this for hyperbaric oxygen is misguided.
Is there any research out there to help show cost effectiveness over institutionalization, traditional medicine, and etc.?
No, not yet. That is one of the plans that we have to collect outcomes through a registry, and that’s going to come, but it’s going to take more time.
You recently from the nation’s lawmakers in Washington, DC to do free hyperbaric treatments for returning war vets, how is the project progressing?
It’s progressing, but we don’t know if we got our request. The budget’s now in; I don’t think it’s in there, but I don’t think it’s final yet. It’s kind of meandering along, but it’s kind of coming to a decision point here very soon. And part of the problem was, when we submitted this, I mean we’ve been working on it six (6) years in Washington, and it was resubmitted again this February, and right after we did, the Walter Reed scandal broke, and people don’t know this, but I went to Walter Reed in 2004, and we offered to treat veterans for free to demonstrate this so the military could begin to utilize it, and it was refused. So when we put this in, then the scandal broke, what happened Bush and Congress each appropriated five-hundred and three-hundred million respectively to research, so now that all the research money is out there, there’s less of an argument to give an appropriation request to an outside party or group of people.
When treating returning vets who have experienced TBI, what would be the baseline for treatment?
Well, it’s going to be their pre-injury level of function. And the problem is that the soldiers usually have some type of entry testing that was done on them, and that can be done to try to repeat it, but there aren’t sophisticated, cognitive tests that are done on every soldier immediately before they go into battle, and then you usually only get it afterwards, so in trying to compare to entry-level of testing and/or look at outcomes. In other words, if you’ve got someone who can’t work and now can return to work, that’s a big plus, and that’s exactly what we’ve got. We now have the very first US traumatic, brain-injured solder from the Afghanistan and Iraqi wars, a US soldier who has been treated with hyperbaric oxygen for a concussion and inability to return to work, and it’s a Brigadier General. He has offered to go public with this. In fact, I’ve got an email here from him here today, and I’m participating in his care now. And what he was finally able to do was get this treatment through doctors that I have known who applied a protocol that I had used to this general, and he is upset that he is the only one who has been able to get this, and he wants to help promote it.
