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Dear :

Thanks for placing Dr. Neubauer Summary Statement regarding HBO for Strokes

due to Thrombosis.

My wife,' Orie Lee Manson, closely parallels the case 3A 7 3B on page 2 of

the post. It summarizes the results of an 85 year old patient who was able

to get HBO after a CVA attack 6 months previous.

My wife was refused HBO by Dr. Titus and DR. Roy Myers, both highly

regarded HBO physicians. She was refused therapy on the basis there was no

scientific or medical basis for allowing it, no justification. She was only

8 or 10 days into the stroke when Dr. Titus said no.

Bit I knew better as I had attended the HBO stroke conference at the Sheraton

in and heard Drs Neubauer, Harch, , Barrett, Van Meter and others

stating they had cause to believe itHBO would help, not cure perhaps, but

help. Dr. john Stauch at ndale had a monoplace chamber and had offered

from the start to treat my wife if I could get her to the chamber.. She was

unable until I bought a specially equipped van with an access chair. Thus

on March 3rd Lee began her HBO, 11 months after her stroke. Now she has

completed 92 treatments, the same as reported in cases 3A and 3B.

My wife is much improved. She walks by holding her hand to help stabilize.

She has taken 27 steps without any assistance. She helps me decide what to

put on the Salmon to poach it and measures with her finger how much water to

use. She still doesn't talk, except sometimes spontaneously a few words, but

never responds by asking her to say something. She knows her home, all her

surroundings and goes out on the lake with me quite often. She remembers all

her CNA's and knows her family and is currently working with a speech

therapist who has her practicing symbols to communicate. This is still

difficult but she is getting much better with symbols and plays Solitaire

with about 60% recognition of each play. I have kept a daily journal for the

first 60 or so HBO's She did have a couple of falls that set her back and

we are temporarily halting at 92 as we have noted a few mood shifts, late

in the afternoon and she gets agitated with one of the CNA's Can't decide if

its toxicity from HBO or personality problem with the CNA. But we plan to

resume HBO in another 3 or 4 weeks. I'll try to keep you posted.

Manson

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  • 11 months later...

I had a similar experience 4 years ago and a portion of my left leg is still

numb. Dr. Cheney said it was probably because my blood was too alkaline

(later confirmed by test) which can cause arteries to spasm. I have not had

any similar problems since beginning his protocol which includes whey

protein, hydroxycobalamin, Somatomed..... Steve Bullock

Stroke

>

> Ken,

>

> About two years ago, (five years into CFS) I was laying on a large

> tank lid, with my head and upper torso inverted down in the tank.

> When I got up, I realized the whole outside of my right thigh was

> numb on the surface. This gradually resolved itself over the period

> of about 18 months. At the time it worried me, but the best

> explanation I could come up with was that I pinched a nerve somewhere

> while I was leaning over. Now after reading what you said about

> stroke, could that have caused it I wonder.

>

> Any comment? I am still waiting for a doctors appointment in December

> before I can get any coagulation testing.

>

> Matt

>

>

> This list is intended for patients to share personal experiences with each

other, not to give medical advice. If you are interested in any treatment

discussed here, please consult your doctor.

>

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Matt: I'm pretty sure 1000 mcg = 1 mg. You need to take at least 5 mg/day

of hydroxycobalamin to get any benefit. I started at 1-2 mg/day with little

affect. I get my hydroxy from Wellness Pharmacy via air-mail overnight

shipped in ice. It comes in small vials with 10 mg. of hydrxy each in a 1

cc vial. Steve B.

Re: Stroke

>

> That is interesting, Steve. This is not a symptom I have seen

> associated with CFS before, and it is nice now to be able to find out

> about someone else with the same experience AND hear DR. Chenny's

> evaluation. I am working on the below mentioned protocol. If I can

> just get someone to prescribe me B12. So far I have only gotten

> 2cc/month of hydroxy 500mcg/ml. Does anyone know what mcg is? I guess

> it means micro????????

>

> Matt

>

>

> > I had a similar experience 4 years ago and a portion of my left leg

> is still

> > numb. Dr. Cheney said it was probably because my blood was too

> alkaline

> > (later confirmed by test) which can cause arteries to spasm. I

> have not had

> > any similar problems since beginning his protocol which includes

> whey

> > protein, hydroxycobalamin, Somatomed..... Steve Bullock

>

>

>

> This list is intended for patients to share personal experiences with each

other, not to give medical advice. If you are interested in any treatment

discussed here, please consult your doctor.

>

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That is interesting, Steve. This is not a symptom I have seen

associated with CFS before, and it is nice now to be able to find out

about someone else with the same experience AND hear DR. Chenny's

evaluation. I am working on the below mentioned protocol. If I can

just get someone to prescribe me B12. So far I have only gotten

2cc/month of hydroxy 500mcg/ml. Does anyone know what mcg is? I guess

it means micro????????

Matt

> I had a similar experience 4 years ago and a portion of my left leg

is still

> numb. Dr. Cheney said it was probably because my blood was too

alkaline

> (later confirmed by test) which can cause arteries to spasm. I

have not had

> any similar problems since beginning his protocol which includes

whey

> protein, hydroxycobalamin, Somatomed..... Steve Bullock

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Real difficult to say -- I assume that you were likely working on the Abrams and

thus many things could have been happening... for example

muscle contraction around blood vessels which could have cut off/reduced

blood flow (ie. " a foot felling asleep " ) and potentially a minor blockage formed

which resolved over time. The simplest practical definition of a stroke is a

" reduction of blood flow that produced symptoms due to coagulation, or for which

coagulation is a significant factor " (thus stress producing Adrenalin,

tightening blood vessels, inducing a stroke qualifies).

The catch is that the usual stroke detection techniques generally do not work

for PWCs because scans shows abnormal results usually....

M Lassesen, M.S.

ex " Dr.Gui (MSDN) " , " Dr. VB "

cv: http://www.folkarts.com/kenl/ KenL@...

Phone: 360 297.4717 Cell: 360 509.8970 Fax 520 832.6836

----- Original Message -----

From: Matt Hoppe

Now after reading what you said about

stroke, could that have caused it I wonder.

Any comment? I am still waiting for a doctors appointment in December

before I can get any coagulation testing.

Matt

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on 9/02/00 6:02 AM, Matt Hoppe at hoppe@... wrote:

> About two years ago, (five years into CFS) I was laying on a large

> tank lid, with my head and upper torso inverted down in the tank.

> When I got up, I realized the whole outside of my right thigh was

> numb on the surface.

I find this very interesting, this business about Transient Ischemic

Attacks, because I believe that I've had at least one before. Now that ken

has refreshed my memory as to the common signs and symptoms of TIAs, I

believe it even more than I did just after the event. In fact right after

the event I read a book written by a neurologist, who described TIAs in his

patients, and I was convinced that that is what had happened.

This is what happened to me:

I had recently begun an exercise program consisting of jogging up the road

of a huge hill, on top of which sat an Astro-Physical Observatory. The

observatory hill was a beautiful place to walk or jog and few cars passed

by. On about the 3rd day of my daily jogging routine, I quite suddenly

noticed that my right jaw was painful and that my right side was also

painful--very much like a 'stitch' in the side or a pinching sensation. I

slowed down at once to a walk and the acute pain in my right rib cage

subsided but I was left with the most uncomfortable feeling in my

jaw--that's hard to explain: sorta stiff, numb and tingling.

Since my father suffered from angina, I thought that's what was happening to

me. As I returned home, my right arm from about the wrist up to the

shoulder became excruciatingly uncomfortable. It was sorta numb and

'frozen', but I couldn't stand the feeling, nor could I identify it. And

I'm familiar with what a pinched nerve feels like. I figured I was having

cardiac ischemia.

So I went to the hospital by cab and waited in the ER for nearly 3 hours--in

major pain, laying down on my left side across 3 chairs. When the intake

worker took my history, I foolishly told them that I have a history of

anxiety problems--not panic disorder, but social anxiety. After that, I

could tell that I had been written off as a " panic attack case " and I was

seen last. When the doc saw me, he gave me an ECG and told me I was fine.

told me to keep up the jogging...

One thing that seemed to play into the situation is that I had been a daily

marijuana smoker up until about 1 week before the incident. I now think

that the cannabinoids had had a positive effect against TIAs. The recent

development of Dexanibinol (a cannabinoid derivative) as a pharmaceutical to

be used for stroke victims, provides support for this.

Anyhow, I wouldn't want to repeat the whole experience.

Hud

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  • 2 months later...

Thanks for that snippet from the Chiropractic Review, Larry. I can't agree that rotation is fine, however. Rotation is what appears to trigger or exacerbate the intimal tear that ultimately leads to the stroke. Manipulative techniques described by Darald that don't involve rotation as well as instrument techniques that do not involve rotation are inherently less risky. As long as we continue to believe that there is nothing that can be done to prevent this kind of tragic result of a manipulation the factions in medicine that want to call chiropractic dangerous and unwarranted (although nauseatingly hypocritical, as Vern as very nicely pointed out) will have an ear in the popular media and elsewhere. We are the ones who have to recognize and address the problem.

D FreemanMailing address: 2480 Liberty Street NE Suite 180Salem, Oregon 97303phone 503 763-3528fax 503 763-3530pager 888 501-7328

Stroke

I found one of the articles I base my last E-mail on. I will continue to search. The Chiropractic Report by Chapman July 1999 Vol13 No.4 published an excellent review of cervical adjusting. Haldeman's article published in Spine was included. I highly recommend it. Some of the key conclusions were and I quote ...

" Cerebrovascular accidents from vertebrobasilar artery dissection (CVAs) can be an unexpected and devastating case of stroke. However they are on 1.3 in 1000 cases of stroke." ... "43% of the 367 reported cases follow no known precipitating event and are thus labeled 'spontaneous. Of those with identifiable trauma 16% are trivial, involving normal sporting activities, walking, household chores, turning the head while driving, coughing, ect. "..."accordingly 6 in 10 (59%) of CVAs have a trivial cause. The other 41% of the cases have been attributed to cervical manipulation (31%) and major trauma (10%) motor vehicle accidents, significant sports injuries, lifting injuries, ect. The facts of various individual cases make it plain that manipulation can be the proximate case of CVA. Haldeman et al suggests that it may not be the underlying cause, or even the cause, in many cases where it is assumed to be. Patients may have had a spontaneous dissection from a minor trauma, and consulted a practitioner with the resulting symptoms of neck pain or headaches. Spinal manipulation is then " administered to patients who already had spontaneous dissection in progress".

This conclusion is supported by a compelling argument. If the primary case of CVA was cervical manipulation, or indeed any specific head position or movement or trauma, "considerably more cases would be anticipated". There are about 250 million office visits to chiropractors in the US each year and millions of whiplash injuries, falls and other activities causing violent movements to the head and neck, but few CVA's. This suggests that there may be "some unique factor that causes certain people to be at risk."

"All of this amounts to good and bad news. They good news is that in chiropractic practice you can use any cervical adjustment technique you deem appropriate, since the best evidence is that no position or technique carries additional risk. Additional studies from North America and Europe report that pre-manipulation test of vertebral artery function are invalid and unnecessary.

The bad news is that rare patients are CVA's waiting to happen. No one knows why. They cannot be screened in advance, competent and skillful practice will not protect you, and a CVA can happen in your office tomorrow. Fortunately the is risk is remote. Most persons turning to reverse their car out of a driveway will not have a CVA, and most chiropractors will never experience one in a lifetime of practice.

What should you be doing about this? The answer, in terms of patients rights, law and ethics, is be disciplined and responsible about getting informed consent. In the words of the current US national guidelines for chiropractic practice:

"Patient consent to treatment is always necessary, it is often implied rather than expressed. However, where there is risk of significant harm from the treatment proposed, this risk must be disclosed, understood and accepted by the patient. Such informed consent is required for ethical and legal reasons. The best record of consent is one that is objectively documented (e.g. a witnessed written consent or videotape)."...

"If a patient of yours were to suffer serious consequences from a CVA caused by cervical adjustment, wouldn't you sleep more soundly at night knowing you had disclosed this very rare but foreseeable risk of your treatment?"

The article can be condensed into the sub title: ROTATION IS FINE, PRETESTING IS OUT, BUT GET CONSENT"

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In the courses I teach, when we cover this topic after covering all the info., I suggest the adjustment very much described by Les and probably taught the best by the Motion Palpation folk. That being a little long axis extension, a slight amount of lateral bending and rotation, just enough to bring the joint to tension, then an " impuse " thrust. As instead of the old rotatary break! I just love that name, " rotatary break " sounds so good in court, don't ya know!

Vern

Re: Stroke

Thanks for that snippet from the Chiropractic Review, Larry. I can't agree that rotation is fine, however. Rotation is what appears to trigger or exacerbate the intimal tear that ultimately leads to the stroke. Manipulative techniques described by Darald that don't involve rotation as well as instrument techniques that do not involve rotation are inherently less risky. As long as we continue to believe that there is nothing that can be done to prevent this kind of tragic result of a manipulation the factions in medicine that want to call chiropractic dangerous and unwarranted (although nauseatingly hypocritical, as Vern as very nicely pointed out) will have an ear in the popular media and elsewhere. We are the ones who have to recognize and address the problem.

D FreemanMailing address: 2480 Liberty Street NE Suite 180Salem, Oregon 97303phone 503 763-3528fax 503 763-3530pager 888 501-7328

Stroke

I found one of the articles I base my last E-mail on. I will continue to search. The Chiropractic Report by Chapman July 1999 Vol13 No.4 published an excellent review of cervical adjusting. Haldeman's article published in Spine was included. I highly recommend it. Some of the key conclusions were and I quote ...

" Cerebrovascular accidents from vertebrobasilar artery dissection (CVAs) can be an unexpected and devastating case of stroke. However they are on 1.3 in 1000 cases of stroke. " ... " 43% of the 367 reported cases follow no known precipitating event and are thus labeled 'spontaneous. Of those with identifiable trauma 16% are trivial, involving normal sporting activities, walking, household chores, turning the head while driving, coughing, ect. " ... " accordingly 6 in 10 (59%) of CVAs have a trivial cause. The other 41% of the cases have been attributed to cervical manipulation (31%) and major trauma (10%) motor vehicle accidents, significant sports injuries, lifting injuries, ect. The facts of various individual cases make it plain that manipulation can be the proximate case of CVA. Haldeman et al suggests that it may not be the underlying cause, or even the cause, in many cases where it is assumed to be. Patients may have had a spontaneous dissection from a minor trauma, and consulted a practitioner with the resulting symptoms of neck pain or headaches. Spinal manipulation is then " administered to patients who already had spontaneous dissection in progress " .

This conclusion is supported by a compelling argument. If the primary case of CVA was cervical manipulation, or indeed any specific head position or movement or trauma, " considerably more cases would be anticipated " . There are about 250 million office visits to chiropractors in the US each year and millions of whiplash injuries, falls and other activities causing violent movements to the head and neck, but few CVA's. This suggests that there may be " some unique factor that causes certain people to be at risk. "

" All of this amounts to good and bad news. They good news is that in chiropractic practice you can use any cervical adjustment technique you deem appropriate, since the best evidence is that no position or technique carries additional risk. Additional studies from North America and Europe report that pre-manipulation test of vertebral artery function are invalid and unnecessary.

The bad news is that rare patients are CVA's waiting to happen. No one knows why. They cannot be screened in advance, competent and skillful practice will not protect you, and a CVA can happen in your office tomorrow. Fortunately the is risk is remote. Most persons turning to reverse their car out of a driveway will not have a CVA, and most chiropractors will never experience one in a lifetime of practice.

What should you be doing about this? The answer, in terms of patients rights, law and ethics, is be disciplined and responsible about getting informed consent. In the words of the current US national guidelines for chiropractic practice:

" Patient consent to treatment is always necessary, it is often implied rather than expressed. However, where there is risk of significant harm from the treatment proposed, this risk must be disclosed, understood and accepted by the patient. Such informed consent is required for ethical and legal reasons. The best record of consent is one that is objectively documented (e.g. a witnessed written consent or videotape). " ...

" If a patient of yours were to suffer serious consequences from a CVA caused by cervical adjustment, wouldn't you sleep more soundly at night knowing you had disclosed this very rare but foreseeable risk of your treatment? "

The article can be condensed into the sub title: ROTATION IS FINE, PRETESTING IS OUT, BUT GET CONSENT "

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The article I posted quotes from were with out any of my own editorial elaboration. My intent was only to give a snapshot of the current literature. As long as you asked for my opinion, and I'm sure you did this, I'll give it to you now. I grew up in the Mt Horb Wisconsin area and studied at the Gonstead clinic. I graduated from NWCC and at that time, Gonstead was the predominant influence on the core adjusting curriculum. We were never allowed to perform master cervicals. Rotatory moves would not get you a passing grade in technique class. Personally I found rotatory moves to be crude and painful. My formative years and technique were forged from Gonstead, , Pettibon, Meric, SOT and Activator. I do not know of any literature that is sympathetic to Gonstead or Pettibon methods producing fewer CVA's. I would like to believe that this is true and that careful application of our art with competent clinical caution would produce more expeditious outcomes. The literature however does not support this. For my patients, I'll continue do a good history, take vitals, do a good physical exam, identify the pain generator or upstream events, make a diagnosis, and arrive at a treatment plan. At this point, I'll continue to avoid rotatory maneuvers as I have for the last 21 years. However, it sounds like the suits say I need to add a standard consent form with a PARQ note. So , you see, I never disagreed with you.

Stroke

I found one of the articles I base my last E-mail on. I will continue to search. The Chiropractic Report by Chapman July 1999 Vol13 No.4 published an excellent review of cervical adjusting. Haldeman's article published in Spine was included. I highly recommend it. Some of the key conclusions were and I quote ...

" Cerebrovascular accidents from vertebrobasilar artery dissection (CVAs) can be an unexpected and devastating case of stroke. However they are on 1.3 in 1000 cases of stroke." ... "43% of the 367 reported cases follow no known precipitating event and are thus labeled 'spontaneous. Of those with identifiable trauma 16% are trivial, involving normal sporting activities, walking, household chores, turning the head while driving, coughing, ect. "..."accordingly 6 in 10 (59%) of CVAs have a trivial cause. The other 41% of the cases have been attributed to cervical manipulation (31%) and major trauma (10%) motor vehicle accidents, significant sports injuries, lifting injuries, ect. The facts of various individual cases make it plain that manipulation can be the proximate case of CVA. Haldeman et al suggests that it may not be the underlying cause, or even the cause, in many cases where it is assumed to be. Patients may have had a spontaneous dissection from a minor trauma, and consulted a practitioner with the resulting symptoms of neck pain or headaches. Spinal manipulation is then " administered to patients who already had spontaneous dissection in progress".

This conclusion is supported by a compelling argument. If the primary case of CVA was cervical manipulation, or indeed any specific head position or movement or trauma, "considerably more cases would be anticipated". There are about 250 million office visits to chiropractors in the US each year and millions of whiplash injuries, falls and other activities causing violent movements to the head and neck, but few CVA's. This suggests that there may be "some unique factor that causes certain people to be at risk."

"All of this amounts to good and bad news. They good news is that in chiropractic practice you can use any cervical adjustment technique you deem appropriate, since the best evidence is that no position or technique carries additional risk. Additional studies from North America and Europe report that pre-manipulation test of vertebral artery function are invalid and unnecessary.

The bad news is that rare patients are CVA's waiting to happen. No one knows why. They cannot be screened in advance, competent and skillful practice will not protect you, and a CVA can happen in your office tomorrow. Fortunately the is risk is remote. Most persons turning to reverse their car out of a driveway will not have a CVA, and most chiropractors will never experience one in a lifetime of practice.

What should you be doing about this? The answer, in terms of patients rights, law and ethics, is be disciplined and responsible about getting informed consent. In the words of the current US national guidelines for chiropractic practice:

"Patient consent to treatment is always necessary, it is often implied rather than expressed. However, where there is risk of significant harm from the treatment proposed, this risk must be disclosed, understood and accepted by the patient. Such informed consent is required for ethical and legal reasons. The best record of consent is one that is objectively documented (e.g. a witnessed written consent or videotape)."...

"If a patient of yours were to suffer serious consequences from a CVA caused by cervical adjustment, wouldn't you sleep more soundly at night knowing you had disclosed this very rare but foreseeable risk of your treatment?"

The article can be condensed into the sub title: ROTATION IS FINE, PRETESTING IS OUT, BUT GET CONSENT"

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  • 3 weeks later...

Dear Corny,

- Cayenne pepper to clean out the arteries.

- Homozon to clean out the colon.

- Liver cleanse to clean out the liver.

- Black tea (decaffeinated) with lemon juice 4 times per day

to strengthen veins and arteries.

-Brewers yeast, IP6 and sublingual B12 to reduce homocysteine,

and aid in cell repair.

Best of Health!

Dr. Saul Pressman, DCh

stroke

> My dear aunt has been having stroke symptoms for several days. Tingling

> and numbness in arms, neck and face. She is approx 65 and eating poorly

> and too much all her life. She may finally be ready to accept some

> alternative advice.

>

> I am suggesting needed diet changes and am wondering what others have

> experienced with supplements, therapies and techniques that will help her

> avoid the serious symptoms that will likely soon follow.

>

> Thanks, Corny

>

>

> OxyPLUS is an unmoderated e-ring dealing with oxidative therapies, and

other alternative self-help subjects.

>

> THERE IS NO MEDICAL ADVICE HERE!

>

> This list is the 1st Amendment in action. The things you will find here

are for information and research purposes only. We are people sharing

information we believe in. If you act on ideas found here, you do so at your

own risk. Self-help requires intelligence, common sense, and the ability to

take responsibility for your own actions. By joining the list you agree to

hold yourself FULLY responsible FOR yourself. Do not use any ideas found

here without consulting a medical professional, unless you are a researcher

or health care provider.

>

> You can unsubscribe via e-mail by sending A NEW e-mail to the following

address - NOT TO THE OXYPLUS LIST! -

> DO NOT USE REPLY BUTTON & DO NOT PUT THIS IN THE SUBJECT LINE or BODY of

the message! :

>

> oxyplus-unsubscribeegroups

>

> oxyplus-normalonelist - switch your subscription to normal mode.

>

>

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Allow me to send you information on Stroke and HBOT

Were does your aunt live

Please send your address

stroke

> My dear aunt has been having stroke symptoms for several days. Tingling

> and numbness in arms, neck and face. She is approx 65 and eating poorly

> and too much all her life. She may finally be ready to accept some

> alternative advice.

>

> I am suggesting needed diet changes and am wondering what others have

> experienced with supplements, therapies and techniques that will help her

> avoid the serious symptoms that will likely soon follow.

>

> Thanks, Corny

>

>

> OxyPLUS is an unmoderated e-ring dealing with oxidative therapies, and

other alternative self-help subjects.

>

> THERE IS NO MEDICAL ADVICE HERE!

>

> This list is the 1st Amendment in action. The things you will find here

are for information and research purposes only. We are people sharing

information we believe in. If you act on ideas found here, you do so at your

own risk. Self-help requires intelligence, common sense, and the ability to

take responsibility for your own actions. By joining the list you agree to

hold yourself FULLY responsible FOR yourself. Do not use any ideas found

here without consulting a medical professional, unless you are a researcher

or health care provider.

>

> You can unsubscribe via e-mail by sending A NEW e-mail to the following

address - NOT TO THE OXYPLUS LIST! -

> DO NOT USE REPLY BUTTON & DO NOT PUT THIS IN THE SUBJECT LINE or BODY of

the message! :

>

> oxyplus-unsubscribeegroups

>

> oxyplus-normalonelist - switch your subscription to normal mode.

>

>

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Allow me to send you information on Stroke and HBOT

Were does your aunt live

Please send your address

stroke

> My dear aunt has been having stroke symptoms for several days. Tingling

> and numbness in arms, neck and face. She is approx 65 and eating poorly

> and too much all her life. She may finally be ready to accept some

> alternative advice.

>

> I am suggesting needed diet changes and am wondering what others have

> experienced with supplements, therapies and techniques that will help her

> avoid the serious symptoms that will likely soon follow.

>

> Thanks, Corny

>

>

> OxyPLUS is an unmoderated e-ring dealing with oxidative therapies, and

other alternative self-help subjects.

>

> THERE IS NO MEDICAL ADVICE HERE!

>

> This list is the 1st Amendment in action. The things you will find here

are for information and research purposes only. We are people sharing

information we believe in. If you act on ideas found here, you do so at your

own risk. Self-help requires intelligence, common sense, and the ability to

take responsibility for your own actions. By joining the list you agree to

hold yourself FULLY responsible FOR yourself. Do not use any ideas found

here without consulting a medical professional, unless you are a researcher

or health care provider.

>

> You can unsubscribe via e-mail by sending A NEW e-mail to the following

address - NOT TO THE OXYPLUS LIST! -

> DO NOT USE REPLY BUTTON & DO NOT PUT THIS IN THE SUBJECT LINE or BODY of

the message! :

>

> oxyplus-unsubscribeegroups

>

> oxyplus-normalonelist - switch your subscription to normal mode.

>

>

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Corny,

There is some other good advice being offered, but if it was me, I'd

also start immediately on either piracetam, hydergine or pramiracetam to

protect brain cells in case she is having minor strokes & to protect her

if she has a major cerebral accident. If one should have a stroke,

having one of those already in the bloodstream can make a major

difference in the outcome. My personal choice would be piracetam, since

it has no known drug interactions or toxicity.

jim :)

Mike E Cornwall wrote:

>

> My dear aunt has been having stroke symptoms for several days. Tingling

> and numbness in arms, neck and face. She is approx 65 and eating poorly

> and too much all her life. She may finally be ready to accept some

> alternative advice.

>

> I am suggesting needed diet changes and am wondering what others have

> experienced with supplements, therapies and techniques that will help her

> avoid the serious symptoms that will likely soon follow.

>

> Thanks, Corny

>

>

> OxyPLUS is an unmoderated e-ring dealing with oxidative therapies, and other

alternative self-help subjects.

>

> THERE IS NO MEDICAL ADVICE HERE!

>

> This list is the 1st Amendment in action. The things you will find here are

for information and research purposes only. We are people sharing information

we believe in. If you act on ideas found here, you do so at your own risk.

Self-help requires intelligence, common sense, and the ability to take

responsibility for your own actions. By joining the list you agree to hold

yourself FULLY responsible FOR yourself. Do not use any ideas found here

without consulting a medical professional, unless you are a researcher or health

care provider.

>

> You can unsubscribe via e-mail by sending A NEW e-mail to the following

address - NOT TO THE OXYPLUS LIST! -

> DO NOT USE REPLY BUTTON & DO NOT PUT THIS IN THE SUBJECT LINE or BODY of the

message! :

>

> oxyplus-unsubscribeegroups

>

> oxyplus-normalonelist - switch your subscription to normal mode.

--

-----

carpe diem, carpe pecunia, carpe femina. -- Jim Lambert

jlambert@... http://www.entrance.to/madscience

http://www.entrance.to/poetry

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Rapid Recovery Hyperbarics

CHRONIC STROKE REHABILITATION

With the injury to the brain, blood vessels are damaged or destroyed. The

tissue that surrounds the area of outright necrosis has had its circulation

compromised and may be only receiving a fraction of the blood flow and

oxygen that it needs for optimum health. Thus a disruption in structure

creates immediately a change (decrease) in function. This decrease in

function remains for months or years and the neurons in these areas are said

to be in " hibernation " or " sleeping " . Hyperbaric oxygen treatments when

given daily stimulates a process called " angiogenesis " or the formation of

new blood vessels. New blood vessels form in the vicinity of the damaged

tissues as a result of certain chemical signals (e.g. angiogenin) that are

produced by the newly re-energized neurons, endothelial cells and

macrophages and are then secreted into the surrounding tissues. These

signals stimulate new blood vessels which slowly reconnect to the damaged

tissues and within 60 days of daily treatments, the " sleeping " neurons wake

up and resume their normal functions as the proper structures return back in

place. The hyperbaric oxygen induced blood vessel repair results in a

permanent structural change in the blood vessels that re-supply the

previously damaged and nonfunctioning nerve tissue which was occurring due

to diminished and inadequate blood flow. These new blood vessels improve the

blood flow and oxygen delivery to the damaged brain tissues and this results

in permanent improvements in the stroke and traumatically brain injured

person. Clinically, what you see is the return to life of a previously

paralyzed and useless limb or limbs, improvement in swallowing, speech,

thinking (cognition), memory, etc. Quite obviously not all of the

disabilities disappear since there was a central core of dead tissue that

can not be revived. However, after the two months of therapy, these people

may continue to improve for at least two years after their treatment with

hyperbaric oxygen especially if they continue with physical therapy. This

all occurs in patients who may have not seen any improvement in their

conditions for years after their stroke even with the use of any and all

other therapies indicating that the brain’s milieu intérieur has been

altered for the better since the neurons are able to slowly re-establish

their lost connections in ways not possible before hyperbaric oxygen.

Outcome in stroke may be predicted to some degree by the volume of tissue

affected. Comparative functional volume obtained by single photon emission

computerized tomography (SPECT) often indicates a larger region of

recoverable tissue than CT.(Mountz, JM 1990) This functional volume of the

infarct size can be demonstrated to decrease after one to several hyperbaric

oxygen treatments (Neubauer, 1990,

1992) and this increase in blood flow to the area of infarction that occurs

as a result of hyperbaric oxygen can serve as a clinical test to determine

if there is

salvageable neurons still present in the penumbra. Presumably, if the test

(SPECT first, then HBO then repeat SPECT) is positive, the person should

receive benefit from the use of a series of hyperbaric oxygen treatments

because of the revitalization of the ischemic penumbral tissues.

This is a good test if the test is positive since we are generally assurred

that the person will experience improvement with hyperbaric oxygen. However,

what if the

test is negative? Since the literature and clinical experience predicts that

between 80 to 90 percent of stroke victims will be helped by hyperbaric

oxygen, perhaps the

SPECT scan may be missing some other fundamental mechanism by which

hyperbaric oxygen is helping these people improve. For example, when rat’s

forebrains are made ischemic for 10 minutes and then after 1, 2, 3 weeks and

3 months their cerebral glucose utilization is measured, generalized

reductions in glucose utilization is found throughout the majority of gray

matter indicating that widespread alterations of functional activity prevail

in postischemic brains beyond the selectively vulnerable regions. (Beck T,

et al 1995) Following acute, localized lesions of the central nervous

system, arising from any cause, there are immediate depressions of neuronal

synaptic functions in other areas of the central nervous system remote from

the lesion. These remote effects result from deafferentation, a

phenomenon known as " diaschisis " . (Von Monakow C. 1914)

After an interval of time, which will vary directly with the severity of the

lesion, functional recovery may occur to some degree due to synaptic

reactivation of neurons. This is favorably influenced by rehabilitation.

Diaschisis most

commonly manifests itself by such neurological signs as impaired

consciosness or cognitive impairments including dementia, dyspraxias,

dystaxias, dysphasias, incoordination and sensory neglect. The nature of

diaschisis has been demonstrated by widespread depressions of local cerebral

blood flow and metabolism extending far beyond the anatomical lesion. Von

Monakow pointed out that development

of diaschisis is enhanced by latent circulatory disorders in both the

affected and unaffected areas of the brain.

Recovery of function is associated with recovery of local perfusion and

metabolism. (Meyer, JS,et al 1993)

More recently PET scans have shown that diaschisis does not independently

add to the clinical deficit in human cerebral infarction but represents part

of the damage done by the

stroke. (Bowler JV et al. 1995) " Diaschisis is a functional phenomenon that

correlates with both stroke severity and infarct hypoperfusion volume "

(Infeld B; et al.1995)

In another PET scan study of 31 patients with infarcts involving the frontal

sensorimotor cortex, 23 had persistent diaschisis up to 5 years after onset

while the remaining 8

had the diaschisis recover without recovery of oxygen metabolism in the

infarcted area (implying that tissue in the ischemic penumbra did recover

and this is what allowed for recovery of the diaschisis). (Miuura H; et

al.1994.) Thus if functionless ischemic penumbral tissue can be

" re-activated " and be made to function again, a coresponding

amount of the areas of diaschisis will be returned to normal with normal

blood flow and function returning.

In a number of studies in normal dogs, monkeys and Man, hyperbaric oxygen

has been shown to diminish cerebral blood flow from 1 to 29% (average 14.7%)

which some people have claimed to be detrimental to a stroke or brain

injured patient. All of these studies were done in normal non-brain injured

subjects while the studies that were done in brain

injured patients all showed an increase in cerebral blood flow (Jain, 1996

page 239). Dr. K.K. Jain states, " Vasoconstriction and reduced cerebral

blood flow do not produce any clinically observable effects in a healthy

adult when pressures of 1.5 to 2 ATA are used. ..The effects of HBO are more

pronounced in hypoxic/ischemic states of the brain. HBO reduces cerebral

edema and improves the function of neurons rendered inactive by

ischemia/hypoxia. The

improvement of brain function is reflected by the improved electrical

activity of the brain. "

stroke

>Thanks everyone for all the good advice. Now it's up to me to impress

>upon auntie the importance of the advice. Her good " doctor " has

>suggested a couple aspirin per day as the immediate remedy. (Hippocrates

>would be spinning in his grave....)

>

>, please send that info to me at 5801 e cambridge ave, scottsdale,

>az. 85257. Auntie lives in southern Wa, nearest city is Portland, Ore.

>

>Thanks, Corny

>

>

>OxyPLUS is an unmoderated e-ring dealing with oxidative therapies, and

other alternative self-help subjects.

>

>THERE IS NO MEDICAL ADVICE HERE!

>

>This list is the 1st Amendment in action. The things you will find here are

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RESEARCH

IN

HYPERBARIC OXYGEN AND STROKE

GENERAL ARTICLES

Moon, R.E. et al. " Hyperbaric oxygen therapy: From the nineteenth to the

twenty-first century. " RESPIR CARE CLIN N AM, 5(1):1-5; 1999.

Hyperbaric oxygen technology now occupies a legitimate place in modern

medical practice, and the number of clinically active hyperbaric facilities

has grown. The authors estimate that more than 200 monoplace

(single-patient) chambers and over two dozen multiplace facilities are

pesently active in the United State. Nevertheless, the majority of patients

suffering from syndromes amenable to HBO therapy are treated in hospitals

devoid of such modalities. This situation stems in part from the significant

cost of appropriate facilities, the relative scarcity of trained personnel,

and the difficulties in obtaining appropriate compensation in an era of

rapidly changing reimbursement paradigms. The demonstrated efficacy of HBO

as an important part of the treatment of certain acute disease processes,

however, justifies the facilities and skilled personnel necessary for the

care of critically ill patients in a hyperbaric environment.

STROKE ARTICLES

Akimov, G.A. et al. " Assessment of the Efficiency of Hyperbaric Oxygenation

Therapy in Early Forms of Cerebrovascular Disorders. " NEUROSCI BEHAV PHYS,

l985; 15: 13 - 16.

We present results of the assessment of the efficiency of hyperbaric

oxygenation therapy in 104 patients with cerebrovascular diseases. Of these

patients, 32 had chronic cerebrovascular insufficiency and 72 showed

transient disturbances of the cerebral circulation. A good effect was noted

in 74 patients, a satisfactory one in 22, and a doubtful one in 8 patients.

It is concluded from clinical, electro-physiological, psychophysiological,

biochemical, and ophthalmoscopic examinations that hyperbaric oxygenation

therapy is quite efficient when used as part of a combined therapy and as a

means of prompt therapy of acute cerebrovascular crises. Observations over

three to five years of patients repeatedly receiving the hyperbaric

oxygenation therapy at 6 month intervals allows us to recommend it for the

prevention of cerebral strokes.

Berrouschot, J. et al. " Hyperbaric oxygen therapy (HBO) after acute focal

cerebral ischemia. " NERVENARZT, 1998, 69(12): 1037-44.

For a large number of patients with stroke, no therapeutic option can be

offered, even after approval of thrombolytic therapy for treatment of acute

ischemic stroke in the U.S. In cerebral ischemia local anoxia and energy

failure lead to further cellular damage and finally to complete stroke. All

therapeutic concepts try to salvage structurally intact tissue which is at

risk for irreversible damage (so-called penumbra). Hyperbaric oxygen (HBO)

treatment has been reported in animal models of cerebral ischemia, and in a

few clinical reports. In general, the results of these studies have been

promising.

Hart, G.B. et al. " The Treatment of Cerebral Ischemia with Hyperbaric Oxygen

(OHP). " STROKE, l971; 2: 247-250.

The treatment of a patient for three and one-half months, following

occlusion of the right middle cerebral artery with the associated

neurological sequelae, with hyperbaric oxygen combined with methyldopa and

hydrochlorthazide is presented. Treatment scheduled was two and one-half

atmospheres absolute. The treatment was interrupted after 15 treatments to

rule out spontaneous remission for a period of 30 days, and no further

improvement occurred until treatments were reinstituted. The dramatic return

to a near normal state during treatment appears to indicate that he did

benefit from therapy.

Heyman, A. et al. " The use of Hyperbaric Oxygenation in the Treatment of

Cerebral Ischemia and Infarction. " CIRCULATION, Supplement 2: May, l966; 20-

27.

The therapeutic usefulness of hyperbaric oxygenation in cerebral vascular

disease was evaluated in 22 persons with recent neurologic deficits caused

by cerebral embolism, thrombosis, hemorrhage, or arteriographic

complications. Hyperoxygenation produced a significant elevation in content

and tension of oxygen in blood and increased the reservoir of oxygen

available for utilization by neurons. Remarkable and dramatic improvement in

neurologic function occurred in four patients. In two others the neurologic

deficit recurred a few hours after removal from the hyperbaric chamber;

repeated exposure to high oxygen pressures was associated with only

temporary improvement. In six other patients there was some evidence of

clinical recovery immediately after onset of hyperoxygenation, but the

neurologic deficit returned during decompression. The remaining 12 patients

did not improve during hyperbaric oxygenation.

These observations indicate that in some patients neuronal structures remain

viable for some hours after loss of function in acute cerebral ischemia. In

such instances an increase in oxygen delivery may reverse cellular ischemia

and prevent death of cerebral tissues. Hyperbaric oxygenation may provide

supportive therapy in some patients with acute cerebral ischemia, thereby

permitting the removal of the occlusive lesion by surgery or other methods.

Holbach, K. H. et al. " Neurological and EEG Analytical Findings in the

Treatment of Cerebral Infarction with Repetitive Hyperbaric Oxygenation. "

PROCEEDINGS OF THE SIXTH INTERNATIONAL CONGRESS ON HYPERBARIC MEDICINE, Aug.

31 - Sept. 2, l979, University of Aberdeen, Aberdeen, Scotland, pp. 205-210;

DSC, MD (Ed), Aberdeen University Press, l979.

" ...These findings indicate that unilateral occlusion or stenosis of the

internal carotid or middle cerebral artery can lead to distinct focal

neurological deficits and EEG alterations as well as to bilateral reduction

of cerebral function and EGA (electrical brain activity). It also appears

that such ischemic alterations of the brain can be improved by HBO therapy

not only in the acute but also in the chronic post-stroke stage.

Accordingly, we feel that this mode of treatment may be considered as an

additional measure in the management of stroke. "

Holbach, K. H. et al. " Advantage of Using Hyperbaric Oxygenation (HO) in

Combination with Extra-Intracranial Arterial Bypass (EIAB) in the Treatment

of Completed Stroke. " ACTA NEUROCHIRUGICA, Suppl 28: 309; l979.

" ...The evaluation of the effect of HO treatment on post-stroke alterations

of the brain can be helpful in differentiating between reversible and

irreversible changes, and thus response to HBO treatment may be used as a

criterion for the prognosis of the cerebrovascular lesion and also for

selection of patients for EIAB surgery. "

Holbach, K.H. et al. " Differentiation between Reversible and Irreversible

Post-Stroke Changes in Brain Tissue: Its Relevance for Cerebrovascular

Surgery. " SURG. NEUROL., l977; 7: 325-331.

Thirty-five selected patients with chronic stroke were studied. They had

internal carotid occlusion with considerable neurological deficit persisting

for an average of ten weeks. First, hyperbaric oxygen treatment was

administered to each patient. Subsequently extra-intracranial anastomosis

operations were performed on 20 of these patients. These patients were

divided into three groups. Group 1 - 15 of the 35 patients - showed a

significant improvement of cerebral function at the conclusion of the

hyperbaric oxygen treatment. Subsequently an extra-intracranial anastomosis

operation was carried out on each patient resulting in considerable further

recovery of cerebral functions. Group II consisted of 15 patients who showed

only little change in neurological deficit at the conclusion of hyperbaric

oxygen therapy. Extra-intracranial anastomosis operations were not carried

out in Group II. Group III consisted of five patients with little or no

change at the conclusion of hyperbaric oxygen treatment. Subsequent

extra-intracranial anastomosis operations were, however, performed in these

five patients. Although post-operative angiography revealed considerable

filling of the affected middle cerebral territory by the new collateral

channel, there was little change in their status. These findings suggest

that in the chronic post-stroke stage a) hyperbaric oxygen therapy can

improve ischemic alterations of the brain, B) it may be helpful in

differentiating between reversible and irreversible alterations of brain

tissue, c) extra-intracranial anastomosis may result in additional recovery

of impaired neurological functions in those patients who have shown

significant improvement from hyperbaric oxygen therapy and d) response to

hyperbaric oxygenation may be used as a criteria for selection of patients

for cerebral revascularisation procedures.

Holbach, K.H. et al. " Reversibility of the Chronic Post-Stroke State. "

STROKE, l976; 7(3): 296-300.

Forty patients with cerebral infarction associated with occlusion of the

internal carotid artery (ICA) or the middle cerebral artery (MCA) were

treated with hyperbaric oxygenation (HO). EEG analysis were performed

regularly in order to assess the course of the cerebral lesion. Patients in

an early post-stroke stage (IIIB) and patients in a chronic post-stroke

stage (IV) had the changes in EEG analysis and neurological findings

distributed evenly between these two groups.

In 27% of the cases, the improvement was considerable, 53% had moderate

improvement, and 20% showed no change of condition. The improvement mainly

consisted of an increase in alpha-wave and beta-wave activity over the

affected brain region. We were able to show this fact clearly by means of

the EEG-analysis-system applied. The results show that (a) hyperbaric

oxygenation therapy (HOT) has a very favorable influence upon the course of

disease, and (B) simultaneous application of HOT and EEG analysis allows for

a differentiation between reversible and irreversible post-stroke changes in

brain tissue.

Ingvar, et al. " Treatment of Focal Cerebral Ischemia with Hyperbaric

Oxygen. " ACTA NEUROL. SCANDINAV., l965; 41: 92-95.

Four cases of focal ischemia were treated with inhalation of pure oxygen at

a pressure of 2.0 to 2.5 atmospheres ( " hyperbaric oxygen " ) for periods of

1.5 to 2.5 hours. In three of the cases beneficient effects of the treatment

were seen which in two of them could be objectively demonstrated in the EEG.

In one case with progressive ischemic lesions of the brain stem, treated sub

finem, very dramatic effects were seen, which were probably to a great

extent due to the effects of the treatment upon the failing systemic

circulation.

Jain, K. K. " Chapter 17: Role of Hyperbaric Oxygen Therapy in the Management

of Stroke. " pp. 227 - 252; in TEXTBOOK OF HYPERBARIC MEDICINE, Hogrefe &

Huber Publishers, ton, NY, l990.

" HBO therapy should be started in the acute phase of a stroke as an adjunct

to conventional medical management. Rehabilitation of stroke patients should

also be planned during the first few months following stroke. Long-term

follow-up studies are required to determine whether such measures would

reduce the chronic disability from stroke and reduce the incidence of severe

spasticity in stroke patients. The use of HBO may also reduce the need for

some surgical procedures…Animal experimental studies and uncontrolled human

trials have shown the effectiveness and safety of HBO therapy after strokes.

At the Fachklinik Klausenbach (FRG) simultaneous HBO and physical therapies

were used in the rehabilitation of stroke patients. Objective evaluation of

patients during the HBO session showed a 100% response rate (improvement of

spasticity or motor power or both). The improvement was initially transient

but could be maintained, following a course of daily treatments (1.5 ATA for

45 min.) for 6 weeks, in most of the cases " with the evidence available, it

would unethical to carry out randomized double-blind studies in stroke

patients to evaluate the effect of HBO therapy " .

Jain, K.K. et al. " Hyperbaric Oxygen Therapy in the Rehabilitation of Stroke

Patients. " 2nd EUROPEAN CONFERENCE ON HYPERBARIC MEDICINE, l990; Organized

by the Foundation for Hyperbaric Medicine in Basel and the Department of

Surgery of the University Clinic in Basil.

A 100% response rate was demonstrated in 25 patients in sub-acute and

chronic post-stroke stage. In spite of medical management and physical

therapy, these patients had shown no day-to-day changes in their

neurological status. Increase of motor power of the paralyzed hand was

demonstrated by a dynamometer. The improvement was transient initially but

was maintained following a course of daily treatments (1.5 ATA for 45 min.)

for 6 weeks in most of the cases. There was also a significant reduction of

spasticity during HBO treatment and this relief could be extended by

instituting physical therapy in the chamber. In conclusion, we feel that HBO

is a useful adjunctive treatment in the rehabilitation of stroke patients.

Jain, K. K., " Effect of Hyperbaric Oxygenation on Spasticity in Stroke

Patients. " J Hyperbaric Med, l989; 4(2): 55-61.

The effect of hyperbaric oxygenation (HBO) at 1.5 ATA on spasticity of

stroke was observed in 21 patients undergoing rehabilitation. The patients

served as their own controls. HBO reduced spasticity in all the patients, an

effect that was more marked than that of physical therapy, hyperbaric air,

or 100% normobaric air. Initially the effect was transient and subsided

within 24 h after treatment, but by conducting physical therapy

simultaneously with daily, 45 min HBO sessions, lasting results were

achieved after 5 wks and could be maintained by physical therapy alone

during the follow-up, which varied from 6 mo. to 1 yr. The exact mechanism

of relief of spasticity is not known but it is probably due to improvement

of the function of neurons in the penumbra zone of the cerebral hemisphere

affected by stroke. This concept is supported by documented improvement of

cerebral metabolism, EEG, rCBF, and motor function in stroke patients after

HBO therapy. From the available evidence, HBO is considered to be an

invaluable adjunct in the rehabilitation of stroke patients with spastic

hemiplegia. Although the effects were documented in the paralyzed limbs,

spasticity improved in other groups of muscles as well.

Kapp, . " Neurological Response to Hyperbaric Oxygen - A Criterion for

Cerebral Revascularization. " SURGICAL NEUROLOGY, l981; 15(1): 43-46.

Twenty-two patients with cerebral infarction secondary to occlusion of a

carotid or middle cerebral artery were exposed to hyperbaric oxygen at 1.5

atmospheres absolute pressure. Ten of the patients demonstrated improved

motor function during hyperbaric exposure. Seven of these patients had

successful surgical revascularization and no recurrence of neurological

deficit. In 3 patients who were not successfully revascularized, the

neurological deficit recurred. It is concluded that response to hyperbaric

oxygen may be of use in the selection of patients with neurological deficit

who will benefit from surgical revascularization of the brain.

Lebedev, V.V., et al. " Effect of Hyperbaric Oxygenation on the Clinical

Course and Complications of the Acute Period of Ischemic Stroke. " ZHURNAL

VOPR NEIROKHIRNRY, l983; 3: 37-42.

Hyperbaric oxygenation (HBO) was included in the therapeutic complex for 124

patients in the acute stage of ischemic stroke. The effect of HBO on the

clinical course was appraised by comparing the dynamics of changes in the

clinical symptoms and the frequency of complications in patients exposed to

HBO with those in the control group (patients not exposed to HBO). It was

established that the depth of unconsciousness and the motor and aphasic

disorders decreased during an HBO session, but the effect was usually

short-lived. Aggravation of the patients' condition in the first week of the

disease, evidently caused by increase of cerebral edema, occurred much less

frequently when HBO was included in the complex of therapeutic measures. The

number of patients with regression of the neurological symptoms was

practically the same with and without the use of HBO, but the regression of

the neurological defects was most evident in patients exposed to HBO. HBO

prevents the development of recurrent cerebral circulatory disorders in the

acute stage of ischemic stroke and reduces the incidence of some

complications in this period (pneumonia, pulmonary edema, thromboembolism of

the pulmonary artery, etc).

Marroni, A. et al. " Hyperbaric Oxygen Therapy at 1.5 or 2.0 ATA as an

Adjunct to the Rehabilitation of Stabilized Stroke Patients. A Controlled

Study. " PROCEEDINGS OF THE 9th INTERNATIONAL CONGRESS ON HYPERBARIC

MEDICINE, March 1-4, l987; Sydney, Australia, pp. 161-167.

HBO Therapy has been studied by many authors as an adjunctive treatment for

stroke patients. Satisfactory results have been reported for the use of HBO

as a predictive tool for EC-IC revascularization. The questions of the

appropriate treatment pressure has been debated in the literature.

We studied a group of 80 well stabilized cerebral thrombosis patients not

any more undergoing any form of treatment or care. Average age was 59.7

yrs., average stroke age 29.2 months. The patients were divided into 8

groups: A: control group not undergoing any care; B: in water

rehabilitation, 30 sessions, no HBO; C1: 30 HBO sessions at 2.0 ATA; C2:

same at 1.5 ATA; D1: HBO at 2 ATA plus rehabilitation as above; D2: same at

1.5 ATA; E1: HBO and simultaneous rehabilitation in our specially built

Hyperbaric pool at 2 ATA; E2: same at 1.5 ATA.

The Rehabilitation protocol was originally developed at our Center as well

as a quantitized and repeatable Neuromotor Disability Evaluation Scale.

Patients were controlled prior to beginning, every 10 days during treatment,

then 1 and 3 months after.

Obtained data show defined and similar HBO effects on the improvement of

patients' performance at 1.5 and 2.0 ATA, a clear and significant

potentiation of this effect being evident for the Hyperbaric Rehabilitation

groups and especially for the group treated at 2.0 ATA. The obtained results

were still present at the third month after treatment.

Neubauer, R.A. et al. " Cerebral oxygenation and the recoverable brain. "

NEUROL RES, 20 Suppl 1: S33-6, 1998.

Oxygenation is the most critical function of blood flow and a sudden

reduction in oxygen availability is an inevitable consequence of severe

ischemia. The resulting cascade of events may result in the failure of

membrane integrity of some cells and necrosis, but in the surrounding zone

of tissue, less affected by hypoxia, cells survive to form the ischemic

penumbra. The timing of these events is uncertain, but sufficient oxygen is

available to these cells to maintain membrane ion pump mechanisms, but not

enough for them to generate action potentials and therefore function as

neurons. The existence of such areas has been suspected for some time based

upon the natue of clinical recovery, but has now been demonstrated by SPECT

imaging with a high plasma oxygen concentration under hyperbaric conditions

as a tracer. A course of hyperbaric oxygen therapy frequently results in a

permanent improvement in both flow and metabolism. These changes apparently

represent a reversal of the changes that render neurons dormant and the

activity of cells, previously undetectable by standard electrophysiological

methods, can now be demonstrated. Three patients are presented in whom

recoverable brain tissue has been identified using SPECT imaging and

increased cerebral oxygenation under hyperbaric conditions. Improved

perfusion from reoxygenation has correlated with clinical evidence of

benefit especially with continued therapy.

Neubauer, R.A. et al. " Hyperbaric Oxygen and Imaging Techniques in Diagnosis

and Therapy of Stroke. Does the Ischemic Penumbra Alter the Outcome in

Stroke? " INTERNATIONAL SYMPOSIUM: NEUROPSYCHOMOTOR, NEURO-PHARMACOLOGICAL,

PSYCHOSOCIAL AND ETHICAL ASPECTS, Oct. 7-11, l992; Siracusa, Italy. pp. 1-9.

Recovery from stroke (a global phenomena) and predictability of outcome may

be directly related not only to tissue damage, but also the ischemic

penumbra or surrounding zone of idling neurons. The local and global effects

of stroke are well known. Actual recovery or evolution in the neuronal

tissue may go on for months. All events related to recovery have yet to be

elucidated. It is known that recovery of ischemic or hypoxic tissue is more

related to the oxygen content than to blood flow. Utilization of Single

Photon Emission Computerized Tomography (SPECT) with the radiotracer

Iofetamine I123, aids in demonstrating ischemic penumbras (reperfusion

amplitudes) in strokes, thus lending support to the work of Symon, Astrup

and Holbach. SPECT analysis before and after a single exposure of hyperbaric

oxygen at 1.5 ATA for 60 minutes was performed on 15 stroke patients with

strokes ranging in time from 6 hours to 15 years. In all of these patients

marked changes in flow and metabolism were seen after hyperbaric

intervention, even in cases with neurologic defects present for up to 15

years. This causes speculation as to when stroke is really completed or

fully evolved and whether the standard methods of treatment of stroke, and,

by extension, all brain injury, encompass the full understanding of the

hypoxic or ischemic penumbra. Five cases are presented here: 4 showed

varying degrees of improvement associated with a viable halo zone. One

patient demonstrated an absent ischemic penumbra. A new protocol combining

HBO and surface oxygen will be suggested.

Neubauer, R. et al. " Enhancing idling neurons. " letter. THE LANCET, March 3,

l990; 542.

" After HBO there was a sharp increase in tracer uptake in areas showing

hypometabolism on the pre-HBO study...Reduced spasticity, improved

ambulation and speech, and cessation of drolling were noted. "

Neubauer, R. et al. " Stroke Treatment. " (letter). THE LANCET, June 29, l991;

1601.

" Hyperbaric oxygen (HBO) efficiently increases the diffusional driving force

for oxygen, thereby increasing tissue oxygen availability. This overcomes

ischemia/hypoxia and so reduces cerebral edema, restores integrity to the

blood/brain barrier and cell membranes, neutralizes toxic amines, promotes

phagocytosis, scavenges free radicals, stimulates angiogenesis, and

reactivates idling neurons. "

Neubauer, R. et al. " Delayed Metabolism or Reperfusion in Brain Imaging

after Exposure to Hyperbaric Oxygenation - A Therapeutic Indicator? "

PROCEEDINGS OF THE XV ANNUAL MEETING OF THE EUROPEAN UNDERSEA BIOMEDICAL

SOCIETY, Sept. 17-21, l989; Eilat, Israel, pp.1-5.

Single Photon Emission Computerized Tomography (SPECT) analysis with

Iofetamine I123 was performed in patients with various Central Nervous

System (CNS) dysfunctions before and after a single exposure to hyperbaric

oxygen (1.5 ATA for 60 minutes) as a guide to potential therapeutic

intervention. In CNS disorders current measurements had precluded the

identification of idling neurons or the ischemic penumbra, as most

techniques involved electrophysiological computerized data. Poorly

functioning, yet viable cells, if not electrically active are not

identifiable. These cells, however, given the proper oxygen/glucose ratio

may return to normal function with dramatic results. Increased Iofetamine

I-123 tracer uptake in these ischemic areas (idling neurons) after

hyperbaric oxygen therapy probably reflects reactivation of hypometabolic

neuronal tissue. Unlike MRI or CT, SPECT reflects regional blood flow as

well as grey matter metabolism. The similarity to PET imaging is noteworthy.

A variety of patients with central nervous system dysfunction were studied.

Reactivation of marginal or idling neurons was seen in many disease

entities, the most dramatic being long standing hypoxic encephalopathies.

Demonstrative cases will be presented including hypoxic encephalopathy and

acute and chronic neurologic deficit of stroke. Reactivation of the idling

neuron may be of clinical significance. It is important for the physician to

differentiate between viable and non-viable tissue, both from the standpoint

of treatment and prognosis.

Neubauer, R.A. " Generalized small-vessel stenosis in the brain. A case

History of a Patient Treated with Monoplace Hyperbaric Oxygen at 1.5 to 2

ATA. " MINERVA MEDICA, l983; 74: 2051-2055.

Complete evaluation of older patients with mental changes always leaves us

with a certain percentage whose condition can only be attributed to

atherosclerosis. Little is being done for these patients because this

generalized stenosis of the brain does not reverse with any known treatment.

This writer has treated many such patients with hyperbaric oxygen (HBO), and

presents this case history, along with regional cerebral blood flow (rCBF)

studies, showing the type of changes which frequently occur. This case

initially presented with symptoms of gross mental confusion, memory loss,

both recent and remote, irrational speech and occasional violence. Although

prior complete evaluations were concluded with no recommended treatment, the

initial series of HBO treatment resulted in a well-functioning patient. This

was maintained for four years with intermittent HBO. The patient then

presented with acute stroke, total disorientation and confusion. He again

became functional with HBO. A discussion of the mechanisms of HBO which

might account for the changes is given.

Neubauer, R.A. et al. " Hyperbaric Oxygenation as an Adjunct Therapy in

Strokes Due to Thrombosis. " STROKE, l980; 11(3): 297-300.

Results are reported using hyperbaric oxygenation (HBO) in 122 patients with

strokes due to thrombosis, both acute and completed. HBO is used as

adjunctive treatment and there appears to be justification for a controlled

study to delineate the treatment further. The authors believe it is

essential to treat patients with stroke at 1.5 to 2 atmospheres absolute

(ATA).

Nighoghossian, N. et al. " Hyperbaric oxygen in the treatment of acute

ischemic stroke: an unsettle issue. " ; JOURNAL OF THE NEUROLOGICAL SCIENCES,

1997; 150(1): 27-31.

Therapy for acute ischemic stroke can be approached in two basic ways:

first, by an attempt to restore or improve blood flow in an occluded

vascular territory and, second, via therapy directed at the cellular and

metabolic targets. As local anoxia and energy failure are the initiating

cellular stage in ischemia, the inhalation of oxygen at increased

atmospheric pressures might be effective. Treatment of acute focal cerebral

ischemia with hyperbaric oxygen (HBO) has been reported in animals and

humans. In general, the results of research in animals have suggested a

promising role for the use of HBO. More than 400 cases of human ischemic

stroke treated with HBO have been reported. In about half of the cases,

improvement in status has been claimed on clinical or

electroencephalographic grounds. " It might be speculated that the patients

most likely to respond favorably to HBO therapy are those who have infarcts

related to large vessel thrombosis and surrounded by ischemic penumbra. In

support of this are reports claiming a favorable transient or,less

often,permanent response to HBO in cases selected for demonstrated carotid

occlusion. A large double-blind study might be required in the future. Based

on experimental data, HBO at 1.5 ATA during 1 hour might be proposed, as

neurotoxicity is rare with low pressure and short duration. If HBO treatment

is safe and effective, it could be added to thrombolytic therapy which has

recently shown its efficiency in restoring cerebral blood flow. "

Nighoghossian, N. et al. " Hyperbaric Oxygen in the Treatment of Acute

Ischemic Stroke. A Double-blind Pilot Study. " STROKE, l995; 26: 1369-1372.

Background and Purpose: The effects of hyperbaric oxygen (HBO) therapy on

humans are uncertain. Our study aims first to outline the practical aspects

and the safety of HBO treatment and then to evaluate the effect of HBO on

long-term disability.

Methods: Patients who experienced middle cerebral artery occlusion and were

seen within 24 hours of onset were randomized to receive either active (HBO)

or sham (air) treatment. The HBO patients were exposed daily to 40 minutes

at 1.5 atmospheres absolute for a total of 10. We used the Orgogozo scale to

establish a pretreatment functional level. Changes in the Orgogozo scale

score at 6 months and 1 year after therapy were used to assess the

therapeutic efficacy of HBO. In addition, we used the Rankin scale and our

own 10-point scale to assess long term-disability at 6 months and 1 year.

Two sample t tests and 95% confidence intervals were used to compare the

mean differences between the two treatment groups. Student's two-tailed test

was used to compare the differences between pre-therapeutic and

post-therapeutic scores at 6 months and 1 year in the two treatment groups.

Results: Over the 3 years of study enrollment, 34 patients were randomized,

17 to hyperbaric treatment with air and 17 to hyperbaric treatment with 100%

oxygen. There was no significant difference at inclusion between groups

regarding age, time from stroke onset to randomization and Orgogozo scale.

Neurological deterioration occurred during the first week in 4 patients in

the sham group, 3 of whom died; this worsening was clearly related to the

ischemic damage. Treatment was also discontinued for 3 patients in the HBO

group who experienced myocardial infarction, a worsening related to the

ischemic process, and claustrophobia. Therefore, 27 patients (13 in the sham

group and 14 in the HBO group) completed a full course of therapy.

The mean score of the HBO group was significantly better on the Orogozo

scale at 1 year. However, the difference at 1 year between pre-therapeutic

and post-therapeutic scores was not significantly different in the two

groups. Moreover, no statistically significant improvement was observed in

the HBO group at 6 months and 1 year according to Rankin score and our own

10-point scale.

Conclusions: Although the small number of patients in each group precludes

any conclusion regarding the potential deleterious effect of HBO, we did not

observe the major side effects usually related to HBO. Accordingly, it can

be assumed that hyperbaric oxygen might be safe. We hypothesize that HBO

might improve outcome after stroke, as we detected an outcome trend favoring

HBO therapy. A large randomized trial might be required to address the

efficacy of this therapy.

Raju, GS, et al. " Cerebral accident during endoscopy: Consider cerebral air

embolism, a rapidly reversible event with hyperbaric oxygen therapy. "

GASTROINTEST ENDOSC, 47(1): 70-73, 1998.

A 75 year old male could not swallow solids. During endoscopic dilatation,

the patient became hypoxic and unresponsive. He was mute, could not

understand speech and could not move his limbs on the left side. A CT scan

of the brain showed intravascular air bubbles in the right middle cerebral

artery. Within two hours of the event, he was treated with hyperbaric oxygen

therapy at 3 ata for 46 minutes and at 2 ata for 150 minutes. A follow up CT

scan showed resolution of the air bubbles. That evening he was able to move

his left arm again. Several days later, he was able to walk with minimal

assistance and his speech and comprehension returned to normal.

Veltkamp, Roland. " Hyperbaric oxygen-A neuroprotective adjunct for

hyperacute ischemic stroke? " Letter. J NEUROL SCI, 150, pg.1-2; 1997.

The author writes that though the benefit from HBO therapy is still

speculative, its neuroprotective potential may be greater just after stroke

onset. He suggests that portable HBO equipment be designed for the

initiation of therapy on site by trained personnel before and during

emergency transportation to the hospital. He then states that as soon as the

equipment is available, " the effectiveness of HBOT in combination with other

new hyperactue stroke therapies can and must be(re)explored. "

stroke

>Thanks everyone for all the good advice. Now it's up to me to impress

>upon auntie the importance of the advice. Her good " doctor " has

>suggested a couple aspirin per day as the immediate remedy. (Hippocrates

>would be spinning in his grave....)

>

>, please send that info to me at 5801 e cambridge ave, scottsdale,

>az. 85257. Auntie lives in southern Wa, nearest city is Portland, Ore.

>

>Thanks, Corny

>

>

>OxyPLUS is an unmoderated e-ring dealing with oxidative therapies, and

other alternative self-help subjects.

>

>THERE IS NO MEDICAL ADVICE HERE!

>

>This list is the 1st Amendment in action. The things you will find here are

for information and research purposes only. We are people sharing

information we believe in. If you act on ideas found here, you do so at your

own risk. Self-help requires intelligence, common sense, and the ability to

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hold yourself FULLY responsible FOR yourself. Do not use any ideas found

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or health care provider.

>

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  • 2 weeks later...

Hi a

I understand there is Glen from Rife New Zealand doing some form of ozone

therapy.

This is their address u might want to contact them for detail.

Rife New Zealand Ltd

185 Gills Road,

Albany, Auckland,

New Zealand 1310

Phone : 9 415 6562 Fax : 9 415 6553

Email : rifenz@...

Regards

Reginald

At 05:15 AM 20/12/00 -0000, you wrote:

>HI My first time to the list can anyone help I live in NZ .My mother

>had a stroke two years ago and is institutionalised she can walk with

>the aid of a walker and nurse and she does know her family but she is

>sliding in health and losing interest .Short term memory is not good

>but the hospital insist on feeding her diabetic drink which isnt

>helping, as she is a food controlled diabetic they say she wont drink

>water and has to drink due to recurring bladder infections. Is this

>treatment you have been discussing available in NZ and does my mum

>sound like she could maybe ? benefit from it ,she has lost some use

>of her left arm and foot I would dearly like to hear from anyone who

>can help IN antisipation THANKS a

>

>

>

>OxyPLUS is an unmoderated e-ring dealing with oxidative therapies, and

other alternative self-help subjects.

>

>THERE IS NO MEDICAL ADVICE HERE!

>

>This list is the 1st Amendment in action. The things you will find here

are for information and research purposes only. We are people sharing

information we believe in. If you act on ideas found here, you do so at

your own risk. Self-help requires intelligence, common sense, and the

ability to take responsibility for your own actions. By joining the list

you agree to hold yourself FULLY responsible FOR yourself. Do not use any

ideas found here without consulting a medical professional, unless you are

a researcher or health care provider.

>

>You can unsubscribe via e-mail by sending A NEW e-mail to the following

address - NOT TO THE OXYPLUS LIST! -

>DO NOT USE REPLY BUTTON & DO NOT PUT THIS IN THE SUBJECT LINE or BODY of

the message! :

>

> oxyplus-unsubscribeegroups

>

> oxyplus-normalonelist - switch your subscription to normal mode.

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>

" The problems of today cannot be solved using the same thinking that

created them " . - Einstein

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In a message dated 12/20/00 5:36:14 AM Eastern Standard Time,

saul@... writes:

<< Try and get her some :

3) Methylene blue; or cranberry juice if you can

4) Hyperbaric oxygen treatments >>

Saul,

Can an infant (who suffered a stroke at birth) take methylene blue?

Dotsie

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Dear a,

Try and get her some :

1) Chromium + vanadium

2) Gymnema sylvestre

3) Methylene blue; or cranberry juice if you can

4) Hyperbaric oxygen treatments

Best of Health!

Dr. Saul Pressman, DCh

stroke

> HI My first time to the list can anyone help I live in NZ .My mother

> had a stroke two years ago and is institutionalised she can walk with

> the aid of a walker and nurse and she does know her family but she is

> sliding in health and losing interest .Short term memory is not good

> but the hospital insist on feeding her diabetic drink which isnt

> helping, as she is a food controlled diabetic they say she wont drink

> water and has to drink due to recurring bladder infections. Is this

> treatment you have been discussing available in NZ and does my mum

> sound like she could maybe ? benefit from it ,she has lost some use

> of her left arm and foot I would dearly like to hear from anyone who

> can help IN antisipation THANKS a

>

>

>

> OxyPLUS is an unmoderated e-ring dealing with oxidative therapies, and

other alternative self-help subjects.

>

> THERE IS NO MEDICAL ADVICE HERE!

>

> This list is the 1st Amendment in action. The things you will find here

are for information and research purposes only. We are people sharing

information we believe in. If you act on ideas found here, you do so at your

own risk. Self-help requires intelligence, common sense, and the ability to

take responsibility for your own actions. By joining the list you agree to

hold yourself FULLY responsible FOR yourself. Do not use any ideas found

here without consulting a medical professional, unless you are a researcher

or health care provider.

>

> You can unsubscribe via e-mail by sending A NEW e-mail to the following

address - NOT TO THE OXYPLUS LIST! -

> DO NOT USE REPLY BUTTON & DO NOT PUT THIS IN THE SUBJECT LINE or BODY of

the message! :

>

> oxyplus-unsubscribeegroups

>

> oxyplus-normalonelist - switch your subscription to normal mode.

>

>

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I do not know about Methylene blue, However we have treated five children

with Stroke at birth with wonderful results.

CHT

Rapid Recovery Hyperbarics

http://www.hbot4u.com

Re: stroke

> In a message dated 12/20/00 5:36:14 AM Eastern Standard Time,

> saul@... writes:

>

> << Try and get her some :

> 3) Methylene blue; or cranberry juice if you can

> 4) Hyperbaric oxygen treatments >>

>

> Saul,

> Can an infant (who suffered a stroke at birth) take methylene blue?

> Dotsie

>

>

> OxyPLUS is an unmoderated e-ring dealing with oxidative therapies, and

other alternative self-help subjects.

>

> THERE IS NO MEDICAL ADVICE HERE!

>

> This list is the 1st Amendment in action. The things you will find here

are for information and research purposes only. We are people sharing

information we believe in. If you act on ideas found here, you do so at your

own risk. Self-help requires intelligence, common sense, and the ability to

take responsibility for your own actions. By joining the list you agree to

hold yourself FULLY responsible FOR yourself. Do not use any ideas found

here without consulting a medical professional, unless you are a researcher

or health care provider.

>

> You can unsubscribe via e-mail by sending A NEW e-mail to the following

address - NOT TO THE OXYPLUS LIST! -

> DO NOT USE REPLY BUTTON & DO NOT PUT THIS IN THE SUBJECT LINE or BODY of

the message! :

>

> oxyplus-unsubscribeegroups

>

> oxyplus-normalonelist - switch your subscription to normal mode.

>

>

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Dear Dotsie,

Yes. 3 drops in some water and give it with an eyedropper.

Try and get him/her some time in a hyperbaric chamber. It is

the easiest and most effective treatment.

Best of Health!

Dr. Saul Pressman, DCh

Re: stroke

> In a message dated 12/20/00 5:36:14 AM Eastern Standard Time,

> saul@... writes:

>

> << Try and get her some :

> 3) Methylene blue; or cranberry juice if you can

> 4) Hyperbaric oxygen treatments >>

>

> Saul,

> Can an infant (who suffered a stroke at birth) take methylene blue?

> Dotsie

>

>

> OxyPLUS is an unmoderated e-ring dealing with oxidative therapies, and

other alternative self-help subjects.

>

> THERE IS NO MEDICAL ADVICE HERE!

>

> This list is the 1st Amendment in action. The things you will find here

are for information and research purposes only. We are people sharing

information we believe in. If you act on ideas found here, you do so at your

own risk. Self-help requires intelligence, common sense, and the ability to

take responsibility for your own actions. By joining the list you agree to

hold yourself FULLY responsible FOR yourself. Do not use any ideas found

here without consulting a medical professional, unless you are a researcher

or health care provider.

>

> You can unsubscribe via e-mail by sending A NEW e-mail to the following

address - NOT TO THE OXYPLUS LIST! -

> DO NOT USE REPLY BUTTON & DO NOT PUT THIS IN THE SUBJECT LINE or BODY of

the message! :

>

> oxyplus-unsubscribeegroups

>

> oxyplus-normalonelist - switch your subscription to normal mode.

>

>

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In a message dated 12/20/00 12:40:14 PM Eastern Standard Time,

saul@... writes:

<< Try and get him/her some time in a hyperbaric chamber. It is

the easiest and most effective treatment. >>

Thanks Saul and . I saved your previous post on Methylene blue and I

never thought I could give it to an infant. , I'm still looking into

finding a hyperbaric chamber that is suitable for an infant on the East Coast

with no luck. She would never tolerate sitting alone in a chamber.

Dotsie

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I would never put an infant in a chamber alone, or any child for that

matter, We have treated three month olds that go in with mom, See my

website for trinity who regain the use of her arm after treatment, you will

see a picture of her in the chamber, I have also treated twins at three

months old with stroke. We have treated a child who had a stroke at 6 years

old, all of which when into our Large chambers with the parents, Both

parents and child have full phys exam before any therapy is started to rule

out the contra indications for HBOT.

We have treated adults who have stroked as well. Please send the details

again i.e. age etc.. Call me anytime lets talk about it, 909-889-0517..

CHT

EMT, DMT CHT

Dr. Underwood MD, DO, JD

Rapid Recovery Hyperbarics

http://www.hbot4u.com

Re: stroke

> In a message dated 12/20/00 12:40:14 PM Eastern Standard Time,

> saul@... writes:

>

> << Try and get him/her some time in a hyperbaric chamber. It is

> the easiest and most effective treatment. >>

>

> Thanks Saul and . I saved your previous post on Methylene blue and I

> never thought I could give it to an infant. , I'm still looking into

> finding a hyperbaric chamber that is suitable for an infant on the East

Coast

> with no luck. She would never tolerate sitting alone in a chamber.

> Dotsie

>

>

> OxyPLUS is an unmoderated e-ring dealing with oxidative therapies, and

other alternative self-help subjects.

>

> THERE IS NO MEDICAL ADVICE HERE!

>

> This list is the 1st Amendment in action. The things you will find here

are for information and research purposes only. We are people sharing

information we believe in. If you act on ideas found here, you do so at your

own risk. Self-help requires intelligence, common sense, and the ability to

take responsibility for your own actions. By joining the list you agree to

hold yourself FULLY responsible FOR yourself. Do not use any ideas found

here without consulting a medical professional, unless you are a researcher

or health care provider.

>

> You can unsubscribe via e-mail by sending A NEW e-mail to the following

address - NOT TO THE OXYPLUS LIST! -

> DO NOT USE REPLY BUTTON & DO NOT PUT THIS IN THE SUBJECT LINE or BODY of

the message! :

>

> oxyplus-unsubscribeegroups

>

> oxyplus-normalonelist - switch your subscription to normal mode.

>

>

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  • 1 year later...
Guest guest

I did a small scale research project in 1998 for presentation to the local

hospital grand rounds on stroke incidence with CMT. I took the number of

stroke cases over a two year period from the two malpractice carriers as the

numerator, and the number of practicing DCs x average visits per week x 104 x

50%. the assumptions were:

1. every stroke case following manipulation will result in litigation

2. about half of DC office visits involve cervical manipulation

3. Washington DC's visit average is about the same as the national average.

(I think it was about 100 office visits at the time. )

This number came out to a frequency of 1/3.5 million office visits. This was

a considerably lower frequency than was published to the time, and I thought

it would cause a furor with the MDs at grand rounds. Oddly, they weren't up

in arms about it...

This type of analysis was used by Haldeman in the 2001 Spine article, with

even lower frequency; about 1:5.8 million office visits.

Most of the malpractice cases I have seen really revolve around the lack of

proper response to a stroke in evolution, rather than strictly causation.

Dr. Roy Steinberg

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Guest guest

Your right on Roy. The cases I have reviewed always file on negligence

which is always based on the DC not gaining proper informed consent from the

patient. I personally recommend a written informed constent form that both

the doctor and the patient signs after the patient has read the consent

form. I follow this up with a note in my chart note that I discussed this

informed consent and asked if the patient if they had any questions and that

they did not etc. It's not enough to simply have the patient's sign a form

and then place it in their file you MUST have a conversation with the

patient and document this conversation in your chart.

Alternatively you DO NOT have to tell them that " oh and by the way did I

mention that this could KILL YOU! Its very very rare of course but just the

same you could DIE! You only have to mention material risks, in my form it

covers the term stroke. The statement or analogy I use is this " Mr./Ms.

you have a 300 to 400 times greater chance of having a serious side

effect from taking Advil than any thing I'm going to do. "

If any of you colleagues would like a copy of my informed constent form and

the paragraph I use in my chart note system respond to this E-mail with your

mailing information and I'll get this out to you ASAP.

Vern Saboe, DC

ACA Delegate (Oregon)

CAO Executive Board

Albany

Re: stroke

> I did a small scale research project in 1998 for presentation to the local

> hospital grand rounds on stroke incidence with CMT. I took the number of

> stroke cases over a two year period from the two malpractice carriers as

the

> numerator, and the number of practicing DCs x average visits per week x

104 x

> 50%. the assumptions were:

>

> 1. every stroke case following manipulation will result in litigation

> 2. about half of DC office visits involve cervical manipulation

> 3. Washington DC's visit average is about the same as the national

average.

> (I think it was about 100 office visits at the time. )

>

> This number came out to a frequency of 1/3.5 million office visits. This

was

> a considerably lower frequency than was published to the time, and I

thought

> it would cause a furor with the MDs at grand rounds. Oddly, they weren't

up

> in arms about it...

>

> This type of analysis was used by Haldeman in the 2001 Spine article, with

> even lower frequency; about 1:5.8 million office visits.

>

> Most of the malpractice cases I have seen really revolve around the lack

of

> proper response to a stroke in evolution, rather than strictly causation.

>

> Dr. Roy Steinberg

>

>

> OregonDCs rules:

> 1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve

members will be tolerated.

> 2. Always sign your e-mails with your first and last name.

> 3. The listserve is not secure; your e-mail could end up anywhere.

However, it is against the rules of the listserve to copy, print, forward,

or otherwise distribute correspondence written by another member without his

or her consent, unless all personal identifiers have been removed.

>

>

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  • 7 months later...

Mark,

Do an assessment.

Look for the excessive slow activity, especially if you find it in a focal

area

Train down the slow activity where you find it.

Pete

Stroke

Dear Group:

Monday morning I will be assessing my first stroke victim. If anyone has

any tips for working with this type of client, I would really appreciate

them.

Mark

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