Re: [MedicaidforHDOT] Inflatable chambers & O2

June 29, 2003

Hi Rita, You can use O2 with the inflatable chambers, either

bottled or an O2 concentrator. To review a study of the

inflatable chamber used to treat brain injury go to

http://www.ihausa.org/newsletter/htm/dec_2002/page_1.htm

Lucinda

rdbadge@... wrote:

>As a parent of a son with CP who has done 125 HBO treatments. I would love

>to hear these answers. I have always wonder how these inflatable chambers

>could help my son. I was told at several conference that I have went to that

had

>the chambers on display that they do not use medical oxygen. So I have to ask

>how can they help our kids by using the air that is floating around us? I

>have been to the 2 HBO conferences and have heard from lots of people. So I

>really would like to hear from you all that have these chambers at home. I

think

>the questions are great and thanks for asking them.

>

>Thank

>Rita

>

June 29, 2003

You can use O2 in inflatable chambers, but that doesn't mean you should!

KP Stoller, MD, FAAP

Assistant Clinical Prof, UNM HSC Dept Pediatrics

Simply Hyperbarics

www.simplyhyperbarics.com

> Hi Rita, You can use O2 with the inflatable chambers, either

> bottled or an O2 concentrator. To review a study of the

> inflatable chamber used to treat brain injury go to

> http://www.ihausa.org/newsletter/htm/dec_2002/page_1.htm

>

> Lucinda

>

> rdbadge@... wrote:

>

>>As a parent of a son with CP who has done 125 HBO treatments. I would

>> love to hear these answers. I have always wonder how these inflatable

>> chambers could help my son. I was told at several conference that I

>> have went to that had the chambers on display that they do not use

>> medical oxygen. So I have to ask how can they help our kids by using

>> the air that is floating around us? I have been to the 2 HBO

>> conferences and have heard from lots of people. So I really would

>> like to hear from you all that have these chambers at home. I think

>> the questions are great and thanks for asking them.

>>

>>Thank

>>Rita

>>

June 29, 2003

Greetings,

I think that whatever works for your loved one is what you should

use, and the mild chambers can be used safely with or without 100%

oxygen.

There is an intern at the teaching hospital we go to that keeps on

pressuring me to put my daughter on Zantac, simply because she thinks

every child with a Nissen Fundoplication is on it. I have explained

to her many times that my daughter reacts negatively to Zantac. She

cannot believe it, because it is supposed to be a relatively safe

medication. And of course, it is standard protocol. Zantac has a

licorice base to it and the licorice base is tweaked chemically so

they can patent it and make more money than if they just used natural

licorice. However, my daughter has an adrenal genetic disorder that

prevents the absorption of the licorice chemical as well as the

licorice natural. Her body tweaks it all by itself and she gets very

irritable and tired. It took me 8 months of studying naturopathy and

herbals to find out what our endocrinologist and the interns should

have known, but aren't taught in med school. I don't know if the

average pharmacist knows it or not either, but a compounding

pharmacist would. The intern and endo. were willing to keep my

daughter irritable and overly tired and blame it on her brain injury.

I told you that story to point out that what works for the norm

(allopathic medicine philosophy) doesn't work for the chronically

ill. Each persons body has their own chemical make-up. This factor

is more intense with the chronically ill. One person may be

deficient in Calcium, another doesn't absorb the Vit B from his

veggies, so he needs to take it in nutritional supplement form. Your

average allopathic Dr. will give him a drug to treat the symptoms of

either deficiency instead of actually finding out the reason why he

doesn't absorb his Vit B or why he's deficient in Calcium. And we

Americans trust that. Totally amazing and anecdotal!

I told you that to demonstrate this. You need to find what type of

HBOT works for your loved one. Does he/she do better in a multi-

chamber with a hood? My daughter doesn't sit up on her own so she

couldn't wear a hood and you can't take a wheelchair in that chamber,

not big enough. My daughter was even given a treatment in an old

Vickers clam shell mono-chamber, she loved it until she kicked her

knees up and they hit the top and she had bruise upon bruise. It

promised to be a very fun experience for her until she started crying

from the bruising. It was also 1 1/2hrs from my home. The 18 place

chamber 5 min. from my home won't allow her in (It's off-label, you

know). The nearest free-standing clinic is 1 1/2 hrs by car, I have

3 other children and a husband to take care of. We tried the

inflatable chamber in a Dr.s office w/ 100% oxygen pumped in the

chamber and she loved it and responded well, but again the office was

1 1/2 hrs from my house. So we got a chamber and an oxygen

concentrator and for a while she was doing well, but then her

temperature controls went haywire and she would spike a temp every

time I gave her a treatment. I talked to our phys. friends and we

tried, over a period of 8 mo., different combinations. It resulted

in the fact that my daughter responds best to the 1.3 ATA of ambient

air. Less is more in her case.

Get what your loved one needs.

With Much Respect,

Marlena Orndorff

she had some problems with her temperature control

-- In medicaid , " P Stoller MD "

<kstoller@p...> wrote:

> You can use O2 in inflatable chambers, but that doesn't mean you

should!

>

> KP Stoller, MD, FAAP

> Assistant Clinical Prof, UNM HSC Dept Pediatrics

> Simply Hyperbarics

> www.simplyhyperbarics.com

>

> > Hi Rita, You can use O2 with the inflatable chambers,

either

> > bottled or an O2 concentrator. To review a study of the

> > inflatable chamber used to treat brain injury go to

> > http://www.ihausa.org/newsletter/htm/dec_2002/page_1.htm

> >

> > Lucinda

> >

> > rdbadge@a... wrote:

> >

> >>As a parent of a son with CP who has done 125 HBO treatments. I

would

> >> love to hear these answers. I have always wonder how these

inflatable

> >> chambers could help my son. I was told at several conference

that I

> >> have went to that had the chambers on display that they do not

use

> >> medical oxygen. So I have to ask how can they help our kids by

using

> >> the air that is floating around us? I have been to the 2 HBO

> >> conferences and have heard from lots of people. So I really

would

> >> like to hear from you all that have these chambers at home. I

think

> >> the questions are great and thanks for asking them.

> >>

> >>Thank

> >>Rita

> >>

June 30, 2003

Philip:

Knowing a static charge is possible with a chamber filled with 100% O2 is

something that causes my nerves to stress. Yes, I know there must be a

source of ignition, but I just can't see myself ever feeling comfortable

using that set-up except in an emergency. None of the bags licensed in the

USA are permitted to be pressurized with 100% O2 or even have it piped in

(if I am correct). I know one can pipe in O2, but that violates their

license - a minor point to be sure, but I like to control the unexpected

when I am responsible for others, and perhaps I am needlessly over

cautious, but that is how I feel.

KP Stoller, MD, FAAP

Assistant Clinical Prof, UNM HSC Dept Pediatrics

Simply Hyperbarics

www.simplyhyperbarics.com

> On 29 Jun 2003 at 15:22, P Stoller MD wrote:

>

> You can use O2 in inflatable chambers, but that doesn't mean you

> should!

>

> Dear Ken

> We use two plastic chambers everyday and use pure oxygen to pressurise

> them. The design has been in use since about 1959 and the only time

> there has been a problem has been when patients have taken a source of

> ignition into the chamber. I can generate static inside using my hand

> against the plastic but I know that there is not enough energy to cause

> a problem. A conservative estmate is that there are about 5000 in use

> around the World.

> Best wishes

> Philip

>

> Prof Philip B

> Wolfson Hyperbaric Medicine Unit

> University of Dundee

>

> _._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.

> Join the International Hyperbaric Medical Association

> http://www.hyperbaricmedicalassociation.org/forms/Friends_of_IHMA_Join.pdf

>

> Unrestricted downloads of 50+ pdf files on HBOT efficacy

> medicaid/files/ ,

> HDO-documentation/files/ and

> http://www.drneubauerhbo.com/papers.htm

>

> Download your state EPSDT program

> http://www.hcfa.gov/medicaid/stateplan/Map.asp by doing a search on the

> word " ameliorate " . State Medicaid websites

> http://www.medi-cal.ca.gov/RelSites_Oth_States.asp . Medicaid waiver

> programs: http://www.geocities.com/HotSprings/Villa/1029/medicaid.html

>

> Find a hyperbaric clinic http://www.netnet.net/mums/hbolist.htm

>

> HBOT can save billions of dollars and millions of heartaches. Subscribe

> to by sending a blank email to

> mailto:medicaid-subscribe

>

> Unsubscribe? Click here

> mailto:medicaid-unsubscribe .

>

June 30, 2003

Philip:

Technically you are right of course.

KP Stoller, MD, FAAP

Assistant Clinical Prof, UNM HSC Dept Pediatrics

Simply Hyperbarics

www.simplyhyperbarics.com

> Dear Ken

> I understand how you feel but we must be rational - and please note that

> I am just about to go into one of my pure oxygen plastic chambers!

>

> We need to the examine the physics to prevent your nervous stress. The

> issue is related to power. Static cannot generate the power required.

> The late Hounsel who was Head of Research and Development at

> Vickers who built the first acryllic chamber said that it is the

> difference between a spark and an arc.If you step back and think of the

> use of oxygen masks - they usually contain plastic which can be charged.

> The hoods used routinely are made of plastic but we put them over

> patient's heads and do not think twice about it. All the acryllic

> chambers in use around the World are made from plastic. There has never

> been an incident in one due to static. I understand the license problem

> and the fact that vested interests often use scaremongering tactics.

> Without a source of ignition plastic is as safe as steel.

> Best wishes

> Philip

>

> _._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.

> Join the International Hyperbaric Medical Association

> http://www.hyperbaricmedicalassociation.org/forms/Friends_of_IHMA_Join.pdf

>

> Unrestricted downloads of 50+ pdf files on HBOT efficacy

> medicaid/files/ ,

> HDO-documentation/files/ and

> http://www.drneubauerhbo.com/papers.htm

>

> Download your state EPSDT program

> http://www.hcfa.gov/medicaid/stateplan/Map.asp by doing a search on the

> word " ameliorate " . State Medicaid websites

> http://www.medi-cal.ca.gov/RelSites_Oth_States.asp . Medicaid waiver

> programs: http://www.geocities.com/HotSprings/Villa/1029/medicaid.html

>

> Find a hyperbaric clinic http://www.netnet.net/mums/hbolist.htm

>

> HBOT can save billions of dollars and millions of heartaches. Subscribe

> to by sending a blank email to

> mailto:medicaid-subscribe

>

> Unsubscribe? Click here

> mailto:medicaid-unsubscribe .

>

June 30, 2003

Philip,

I believe both of you are correct; it is more a matter of legal systems as

much as it is of technologies and results.

In the US, no matter how slight the possibility for danger, or injury, one

can be easily sued, regardless of precautionary efforts.

For example, power lawn mower manufacturers were successfully sued because

they did not have specific instructions to not use those power mowers to

cut hedges by holding them in the air and passing them over the hedges.

Obviously, no one should do such a ridiculously stupid thing. But, in the

US, there were a few people who had tried that maneuver with the obvious

results. They were able to sue the manufacturer for negligence.

The same is true for the collapsible chambers and the potential for injury

through misuse, no matter how much the provider attempts to protect against

such issues.

The issues fall under a few categories of:

1 Danger (no matter how remote - eg I doubt it will ever happen) of

injury from the chamber itself... as per your discussions

2 Danger of misuse of the chamber - pumping it up beyond it " official

labeled use " of 1.3 ATA to say 2.0 ATA.

3 Danger of misuse for treatments similar, but legally different, I

believe. For example, doing 4 treatments per day instead of 1, or BID.

4 Danger of users treating others.... yes, I believe the chamber

provider could be held liable.... if they have money (the key to US liability!)

I am contemplating providing collapsible chambers to families here in Sacto

because obviously, not everyone can afford HBOT at clinic rates. Yet,

these liability issues are daunting and cause me to wonder about if

providing them is worth the liability.

But, I know 1.3 air works and helps and I want all kids to have access to

medically valid therapies.

I know you do not have to face these issues.... the issues you face are

more in line with true liability and individual responsibility. But, these

are the differences that lie across the ocean.

I hope this helps.

Warm Regards,

Ed

At 08:32 AM 6/30/2003, you wrote:

>Dear Ken

>I understand how you feel but we must be rational - and please note that I

>am just about

>to go into one of my pure oxygen plastic chambers!

>

>We need to the examine the physics to prevent your nervous stress. The

>issue is

>related to power. Static cannot generate the power required. The late

> Hounsel

>who was Head of Research and Development at Vickers who built the first

>acryllic

>chamber said that it is the difference between a spark and an arc.If you

>step back and

>think of the use of oxygen masks - they usually contain plastic which can

>be charged.

>The hoods used routinely are made of plastic but we put them over

>patient's heads and

>do not think twice about it. All the acryllic chambers in use around the

>World are made

>from plastic. There has never been an incident in one due to static. I

>understand the

>license problem and the fact that vested interests often use

>scaremongering tactics.

>Without a source of ignition plastic is as safe as steel.

>Best wishes

>Philip

>

>_._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.

>Join the International Hyperbaric Medical Association

>http://www.hyperbaricmedicalassociation.org/forms/Friends_of_IHMA_Join.pdf

>

>Unrestricted downloads of 50+ pdf files on HBOT efficacy

>medicaid/files/ ,

>HDO-documentation/files/ and

>http://www.drneubauerhbo.com/papers.htm

>

>Download your state EPSDT program

>http://www.hcfa.gov/medicaid/stateplan/Map.asp by doing a search on the

>word " ameliorate " . State Medicaid websites

>http://www.medi-cal.ca.gov/RelSites_Oth_States.asp . Medicaid waiver

>programs: http://www.geocities.com/HotSprings/Villa/1029/medicaid.html

>

>Find a hyperbaric clinic http://www.netnet.net/mums/hbolist.htm

>

>HBOT can save billions of dollars and millions of heartaches. Subscribe to

> by sending a blank email to

>mailto:medicaid-subscribe

>

>Unsubscribe? Click here mailto:medicaid-unsubscribe .

>

June 30, 2003

Do you have the design or manufacturers contact information for these chambers?

Many thanks.

Best wishes and much love, Ken

Ken Gullan

Institute for Research Integration (IRI)

San Diego, CA 92106-2424

IRI is a 501C(3) non-profit corporation established to help children with

developmental difficulties.

To contact me off-list use kengullan@... or call 619-222-1104

[MedicaidforHDOT] Inflatable chambers & O2

On 29 Jun 2003 at 15:22, P Stoller MD wrote:

You can use O2 in inflatable chambers, but that doesn't mean you

should!

Dear Ken

We use two plastic chambers everyday and use pure oxygen to pressurise them.

The design has been in use since about 1959 and the only time there has been a

problem has been when patients have taken a source of ignition into the

chamber.

I can generate static inside using my hand against the plastic but I know that

there is

not enough energy to cause a problem. A conservative estmate is that there are

about

5000 in use around the World.

Best wishes

Philip

Prof Philip B

Wolfson Hyperbaric Medicine Unit

University of Dundee

July 1, 2003

In a message dated 7/1/2003 11:30:38 AM Central Daylight Time,

nemeth@... writes:

> Thus, I do not think there is much disagreement over the issues. I believe

>

> we all feel 1.5 ATA is a good general and optimal therapeutic pressure, and

> that HBOT, while very safe does present specific medical issues and a

> physician (not a nurse, or someone like me - a parent) should be managing

> and overseeing the child's care.... like all other critical medical

> applications

In some cases 1.5 is fine. After a series of treatments you may wanna look at

going to 1.3 or 1.35 in the monoplace only under a Dr.s Recommendation. When

it comes to the critical children Ed is write a Dr. should be at hand or

monitoring the treatments when using 100% Oxygen. I think only a Dr. in the

field

would recognize true Oxygen toxicity it can happen and it has happened. We

have lowered the pressure to 1.35 for Katlyn in a Sechrist 2500B Chamber and are

noticing more improvements. However Katlyn is monitored by a Dr. on a regular

basis. We also stay in constant contact with Dr. Neubauer as well. Katlyn is

pressurized with 100% oxygen. We know are kid's better than most Dr.s however

there are things a Dr. can see with treating these kids that an untrained eye

cannot.

Darin

July 1, 2003

Philip,

RE: At 12:53 AM 6/30/2003, you wrote:

> On 29 Jun 2003 at 15:22, P Stoller MD wrote:

>

> You can use O2 in inflatable chambers, but that doesn't mean you

> should!

>

> Dear Ken

> We use two plastic chambers everyday and use pure oxygen to

> pressurise them.

I too was confused about your statement. I think the issue felt here by us

is the soft walled (collapsible) chambers that are approved to 1.3 ATA,

verses hard walled (whether steel, or acrylic) that can go to 3.0 ATA.

Thus, I do not think there is much disagreement over the issues. I believe

we all feel 1.5 ATA is a good general and optimal therapeutic pressure, and

that HBOT, while very safe does present specific medical issues and a

physician (not a nurse, or someone like me - a parent) should be managing

and overseeing the child's care.... like all other critical medical

applications.

Regardless, we are all committed to kids getting proper HBOT, whether in

FDA approved chambers in an approved clinic, or a collapsible chamber at

home, or a valid home built chamber with all care managed by the family.

HBOT is too generic and too powerful to be denied in any case.

PS AS yo may know, has been treated in Dr. Neubauer's VIckers

chambers which I liked, but also in Sechrist chambers acrylic (3200's) in

Santa , and I am installing the same chambers in Sacramento. I

believe they are excellent for freestanding centers because of the precise

individuality of therapy that can be delivered.

Always, Warm Regards,

Ed Nemeth

J. Nemeth

President, CEO

Spectrum Events

916-856-7044 x 339 Phone

916-856-7040 Fax

July 1, 2003

Ed, you stated:

> Regardless, we are all committed to kids getting proper HBOT, whether in

> FDA approved chambers in an approved clinic,

Exactly what is an approved clinic and who approves them?

Hartsoe

July 1, 2003

Darin, you stated that:

" only a Dr. in the field

> would recognize true Oxygen toxicity it can happen and it has happened "

I'm afraid I will have to correct you. That is a part of the training given

to CHT's. In fact, that would be the training given to Dr's by Dick e

who is a Diver and CHT and Photographer. Also, it has NEVER happened below

2 ATA. Not one single case has been documented. As far as protocol of 1.5

or 1.3 or 1.35, this is guesswork whether it be an MD or anyone else. Until

such time as we develop actual measurements of effectiveness we can only

rely upon experience and speculation. It is true that some MD's have a lot

of experience at judging the needs of a child just from instinct and

experience but so do a lot of chamber operators.

If, in fact, an MD is needed to supervise hbot full time, then you should

not be allowed to have a chamber in your home and noone should be allowed to

have an inflatable. The simple fact is that hbot is so safe that an MD is

not needed. That is what part of the problem is. They are losing control

and they do not like it. So far, we have had 6 MD's personally bring their

children to our center for hbot and all are very comfortable in the fact

that we do not have an MD on the premises full time. If a child or patient

has issues which need to be monitored by an MD, that is totally different.

That is why it is the responsibility of the facility to screen its clients

so they can act responsibly and make certain they do not accept a client who

may need the attention of an MD. We have done over 8,000 treatments and

have never had an MD on hand and have never dialed 911 and have never had to

use emergency protocol. Responsibility is the key issue. Knowing what

your facility is capable of and using proper screening methods. Using the

patients MD along with a good Medical supervisor to make the decisions on

who qualifies for hbot at a freestanding clinic such as ours without an MD

on premise full time is a critical issue. One we take seriously and that

is why our safety record is so good.

Fortunately, common sense along with fact that hbot is safe is why you can

have a chamber in your home to continue to treat Katlyn. Someday, that

option will be available to many others.

Hartsoe

www.miraclemountain.org

> In some cases 1.5 is fine. After a series of treatments you may wanna look

at

> going to 1.3 or 1.35 in the monoplace only under a Dr.s Recommendation.

When

> it comes to the critical children Ed is write a Dr. should be at hand or

> monitoring the treatments when using 100% Oxygen. I think only a Dr. in

the field

> would recognize true Oxygen toxicity it can happen and it has happened.

We

> have lowered the pressure to 1.35 for Katlyn in a Sechrist 2500B Chamber

and are

> noticing more improvements. However Katlyn is monitored by a Dr. on a

regular

> basis. We also stay in constant contact with Dr. Neubauer as well. Katlyn

is

> pressurized with 100% oxygen. We know are kid's better than most Dr.s

however

> there are things a Dr. can see with treating these kids that an untrained

eye

> cannot.

>

> Darin

>

July 1, 2003

Christy,

You asked the group how much; a used hbot chamber might cost and what were

the costs ofoperation. Having gone through all of this about 3 years ago i have

an idea of what is involved.

First your physician's cooperation will prove helpful for he will need to

write a prescription for the liquid oxygen, after your installation is complete.

You may have noted two or three among us sell used chambers. Steve Reimers

sometimes has used chambers as does Spencer per se phone is 815 439 9606.

Steve Reimers phone is 703 866 5490. Steve Reimers s an engineer and

Manufactures chambers. His plant is Springfield, Va.

The prices of used chambers runs from about $15,000.00 to 50,000.00 I paid

Tom Fox $42,000.00 for a lease purchase arrangement and made the mistake of

trying to get it refinanced through an agent in California and wound up

allegedly

owing twice what the chamber cost from Tom Fox in Dothan, Alabama. So

Christy try to be careful with financial work and keep every item in writing.

Too

many of my arrangements were made on the telephone. The fax or e-mail can save

you thousands in case you encounter loan sharks along the way. Every

contract or agreement needs to be in writing.

My transportation cost from Dothan. Alabama to Locust Grove, VA was $800.00

If you get a monoplace such; as mine, a Secrist, you willneed to build a

concrete slab ;on which to place the large liquid oxygen cylinders. This slab

can

be just outside the room where you place the chamber. You will need an oxygen

plumber, the type who installs oxygen in hospitals. This work requires an

expert and they don't come cheap. Someone like Dave Spencer or Steve Reimer can

tell you exactly what you need for the hook up, but it will cost $12,000. to

$20,000. depending on your good fortune with the installers. Not very many

pipes and valves but expensive.

Once you are hooked up with liquid oxygen delivered to your slab, at least

two cylinders but preferably four to keep you running for about 3 weeks. The

oxygen here in Virginia costs about $650.00 with each reload, $450.00 for the 4

cylinders and about $200.00 for rental of the cylinders and delivery charges

and tax.

The you will need a Tech to run the chamber, perhaps someone trained by the

navy Diving School or other military facilities. The Air Force has a great

Tech school in Texas.

All the foregoing are costs for a used monoplace chamber.

Now I am taking a serious look at the portables or milder pressure equipment.

The gamow bags and there are others. They range in price from $10,000. to

$20,000 and hopefully the upcoming Neubauer Conference will sort this all out,

about the portables. I hear the Air Force transported 30 to Afghanistan to be

used for Air Mountain Sickness and I have been told 60 were transported to

Iraq and I'm still trying to verify details. Hope and Trust the foregoing proves

helpful. Captain A. Manson, USN Ret.

July 1, 2003

How easy is it to purchase a used HBO chamber for use in your own home? And if

so what are the costs for maintenance, O2, etc. to run the machine. We had a

neurologist tell us that he sometimes recommends parents purchase used HBO

chambers if their child is going to need numerous sessions.

Thanks for the info.

Christy