Healing Under Pressure ~ Hyperbaric Oxygen Therapy

[Guest guest]

I participated in an HBOT study for implanted women .

.. . A number of women claim it has helped them

immensely . . . Something to look into if you can get

access to an HBOT chamber.

It's been used sucessfuly with near-drowning victims.

.. . The guy who survived in the Sego mine received

this treatment and responded very well.

Rogene

---------------------------------------------

> Healing Under Pressure

> by:

> February 2004 Article # 4922

>

> <http://www.thehorse.com/viewarticle.aspx?ID=4922>

> http://www.thehorse.com/viewarticle.aspx?ID=4922

>

>

> Oxygen is one of the most crucial components of the

> energy production

> process that fuels body tissues. It sustains life

> and enables injured

> tissues to heal. In recent years, a very effective

> procedure for

> helping heal many ailments has developed from the

> idea that for

> optimum healing, more oxygen than is normally

> contained in and

> surrounding our bodies can be beneficial. As usual,

> when human

> medicine makes a breakthrough, it isn't long until

> someone figures out

> how to help horses with that same type of therapy.

> Enter hyperbaric

> oxygen therapy (HBOT) for horses.

>

> How It Works

>

> Hyperbaric oxygen therapy involves subjecting the

> patient to high

> levels of oxygen under pressure in a special

> chamber. At normal

> atmospheric pressure, there is a limit to the amount

> of oxygen carried

> by red blood cells and only a tiny amount of oxygen

> is dissolved in

> the plasma. HBOT is discussed in terms of

> atmospheres absolute (ATA).

> Atmospheric pressure at sea level is equal to 1 ATA.

> Higher pressure

> than this on the body would be similar to what a

> person would

> experience under water; each 33 feet (10 meters) of

> sea water provides

> an equivalent increase of 1 ATA of pressure. Thus

> when you are 33 feet

> under water, you are experiencing 2 ATA (one from

> normal atmospheric

> pressure and one from the addition of 33 feet of sea

> water). This

> gives an idea of the pressure you would feel in an

> oxygen chamber.

> Treatments in a chamber are given at 1.5 to three

> times the pressure

> of one atmosphere.

>

> Increasing the amount of air breathed cannot

> significantly improve

> oxygen delivery to the body by way of hemoglobin,

> even if you breathe

> pure oxygen. But with increased pressure, the oxygen

> level in blood

> plasma increases, with higher delivery to all body

> tissues. Under

> these conditions, oxygen is physically dissolved in

> the plasma, even

> in the veins (which ordinarily carry only blood that

> is depleted of

> oxygen). The dissolved oxygen is more readily

> utilized by the body

> than the oxygen carried by red blood cells.

>

> In humans, pressure chambers are used to speed

> healing of soft tissue

> injuries, aid recovery of stroke victims, and in

> treating many

> problems--including carbon monoxide poisoning, coma,

> burns,

> circulatory problems, Lyme disease, lung abscesses,

> difficult wounds,

> bone infections, hard-to-treat infections

> (especially those caused by

> anaerobic bacteria), traumatic brain injuries,

> spider bites resulting

> in necrotic (dead) tissue, and diabetes (preventing

> non-healing

> infections and amputations). Many studies show

> HBOT's efficacy in

> treating wounds and ischemic tissue (that is

> deprived of blood),

> reducing edema, and stimulating the immune system.

>

> The patient is put in a chamber and the air pressure

> is slowly

> increased. When it reaches the prescribed pressure,

> pure oxygen is put

> in to replace the air. Normal partial pressure of

> oxygen in the

> arterial system is about 100 mm of mercury (mmHg).

> The oxygen level in

> the air inhaled at a pressure of three atmospheres

> (in a pressure

> chamber) would be near 2,280 mmHg. The actual amount

> in the arterial

> blood would be somewhat less than that, but this is

> a much higher

> amount than is normally dissolved in the blood, says

> Fairfield Bain,

> DVM, Dipl. ACVIM, ACVP, ACVECC, of

> Hagyard-son-McGee Veterinary

> Associates in Lexington, Ky. The oxygen is forced

> into the blood and

> body fluids, making its way to any damaged areas of

> the body that

> can't be reached by normal blood circulation or

> areas where vessels

> have been hindered by injury or infection.

>

> HBOT for Horses

>

> A few years ago, the first pressure chamber for

> horses was created by

> Equinox Technologies Limited in Vancouver, British

> Columbia, and the

> first available unit was purchased by Doug Herthel,

> DVM, for his Alamo

> Pintado Equine Medical Center in Los Olivos, Calif.

> It was a mobile

> unit built like a large trailer that held two horses

> at a time.

>

> Equinox had taken their first experimental chamber

> to two racetracks

> in Canada, where it was tested on racing injuries in

> Thoroughbreds and

> Standardbreds. Herthel had been trying to develop a

> similar chamber

> for about six years. " We actually started building

> one in 1994, but

> the mechanics of it became too difficult. We were

> working with a Navy

> contractor, making one from concrete, but testing

> showed it wouldn't

> hold up to pressure. After Equinox came up with

> theirs, we were

> ecstatic, " says Herthel.

>

> He now treats horses from all over the country with

> a newer version of

> the chamber. It is in use every day, treating two to

> four horses

> daily.

>

> Since then, more units have been put into clinics,

> distributed by a

> company called Equine Oxygen Therapy. There are HBOT

> chambers at

> WinStar Farm and Hagyard-son-McGee Equine

> Hospital in Lexington,

> Ky.; KESMARC (an equine rehabilitation center) in

> Versailles, Ky.;

> Fossil Creek Veterinary Clinic in Loveland, Colo.

> (under the direction

> of Kara Keesling, DVM); and the University of

> Tennessee in Knoxville.

>

> Bill Casner, chairman and co-owner of WinStar Farm;

> Hub , owner

> of KESMARC; and Bain are partners in Equine Oxygen

> Therapy. Bain

> serves as vice president and medical adviser for the

> group.

>

> This partnership has designed several models for

> horses. " The function

> of our chambers has not changed, but we keep

> improving them for ease

> of use, operator safety, and comfort and safety of

> the horse, " says

> . " The most recent model--which was just

> installed at

> Hagyard-son-McGee--is the biggest one in

> existence at present. It

> is more than nine feet in diameter, opens at the

> back and front, and

> is stationary. The one we are designing now is a

> round stall, 10 feet

> in diameter and 9 1/2 feet tall. It's recessed into

> a concrete pad, so

> the horse doesn't have to walk up a ramp. He goes

> through a 42-inch

> door, you turn him loose, and he can walk around

> without being

> restrained in any way. A horse with laminitis can

> even lie down to be

> more comfortable. "

>

> The first model was less than eight feet in

> diameter, and there wasn't

> much head room for a horse. It was designed to be

> taken around the

> country. Horses accustomed to a trailer were

> comfortable in it, and

> foals were small enough to turn around in it, but

> young, inexperienced

> horses often became frantic. The larger chambers

> available now seem to

> work better.

>

> A horse being treated is put into the chamber for

> 30-90 minutes once a

> day, for however many treatments are needed for that

> particular

> condition.

>

> " It's usually a 90-minute treatment, once the

> chamber is up to

> pressure, " says Herthel. " Some conditions require

> only one or two

> treatments; others need 10 to 20 treatments. In

> severe cases of

> laminitis, we may treat a horse twice a day. "

>

> Not only does the treatment increase oxygen levels,

> but the pressure

> helps reduce swelling anywhere in the body. Herthel

> uses it for severe

> limb edema, lymphangitis, etc. " Any instance where

> there is

> swelling--in the brain, the foot, or intestines--the

> oxygen therapy is

> helpful, " he says. " The pressure per square inch in

> the chamber is

> incredible. It's like being 60 feet under water. "

>

> Herthel says that care must be taken using HBOT.

> Short daily

> treatments are better than prolonged sessions, since

> exposure to

> high-pressure oxygen for long periods could lead to

> oxygen toxicity.

>

> " You also take precautions to have the humidity in

> the chamber just

> right, and ground the horse, " says Herthel. " If

> there's any static

> electricity in there, you could have a major fire. "

> For good airway

> health, air breathed in should not be too dry. In

> order to ground the

> horse, depending on the chamber, either a rubber

> strap can be attached

> to the horse's body or the horse can stand on a

> rubber mat.

>

> Commonly Treated Conditions

>

> HBOT is one of the most powerful tools available as

> an adjunctive form

> of therapy, and in some cases it works well as the

> primary therapy in

> horses, says Casner. Colic and laminitis are the

> number one and two

> killers, respectively, of horses, and oxygen therapy

> (in conjunction

> with other therapies) can be very useful in treating

> both.

>

> Colic--HBOT helps restore blood flow to tissues

> after colic surgery.

> Herthel says it also reduces obstructive swelling in

> the intestinal

> tissue and improves oxygenation of the resection

> (after abdominal

> surgery to correct colon torsion, small intestine

> strangulation,

> etc.). Herthel has found that many colic cases

> respond much better to

> surgery when treated with HBOT before and after

> surgery.

>

> says HBOT is used in human medicine to

> relieve or prevent

> gaseous buildup after abdominal surgeries. " This

> also works well in

> horses, and we are hoping there will be a study on

> gas colics, " he

> says.

>

> Laminitis and navicular syndrome--HBOT can arrest

> laminitis in the

> early stages, Casner says. " If you can treat the

> horse before the

> structures in the foot collapse (before there's

> crushing of the blood

> vessels), it is very effective, " explains Casner.

> " In older stallions,

> the two things that most commonly kill them are

> colic and laminitis. "

>

> Effects of oxygen therapy on problems like navicular

> syndrome and

> laminitis are now being studied. Researchers at the

> University of

> Tennessee are starting controlled studies on

> laminitis to get the data

> needed to document the effects of HBOT.

>

> " They will be working with different stages of

> laminitis, with a

> control group to make comparisons, to see how well

> this really works, "

> says .

>

> " At Hagyard-son-McGee Equine Hospital, they've

> treated acute

> onset cases of laminitis that resolved very quickly

> and successfully, "

> says . " There's a better success rate if you

> can start

> treatment right away, rather than waiting a

> week--after the damage is

> done. We are hoping that after the controlled

> studies are published,

> the veterinary community will embrace this, and

> people will start HBOT

> earlier in the course of the disease. "

>

> Infections--HBOT increases blood flow to the

> infection site, which

> increases the amount of antibiotic delivery. The

> extra oxygen also

> increases the effectiveness of the antibiotic,

> magnifying the way it

> works against bacteria. Herthel says that high-dose

> oxygen " tends to

> potentiate the effect of some antibiotics, such as

> sulfamethoxazole

> (SMZ). You are also getting 15 times the amount of

> oxygen to a tissue

> that was lacking oxygen due to infection or poor

> circulation. " Oxygen

> also stimulates faster cell turnover, and thus

> faster healing.

>

> Casner says, " Oxygen acts to kill bacteria. Most

> bacteria causing

> serious infection are anaerobic--working best in an

> environment

> without oxygen. At pressure, with oxygen at a higher

> level, it is also

> detrimental to aerobic bacteria. "

>

> Extra oxygen also helps white blood cells function

> better to kill the

> organisms.

>

> Bain adds, " Certain antibiotics such as gentocin and

> amikacin don't

> work well in low-oxygen environments. Oxygen therapy

> enhances their

> function and gives a whole combination of benefits.

> HBOT is an

> adjunctive therapy; we are still using antibiotics

> and

> anti-inflammatory drugs and other treatments. It's a

> component process

> in which everything is working together. "

>

> Abscesses--Internal abscesses (such as in the lungs

> or the abdomen)

> are sometimes not diagnosed early. says, " By

> the time they are

> diagnosed, there is a thick-walled capsule of

> connective tissue around

> them that keeps antibiotics from reaching the site.

> This results in

> prolonged antibiotic treatment (often with no

> resolution of the

> abscess) at high cost to the owner, and potentially

> fatal consequences

> for the horse. HBOT helps the antibiotic get to the

> site and enhances

> its ability to fight the infection. "

>

> Bone injuries--Casner says studies have been done in

> which fractures

> were created in rabbits, with HBOT used to treat one

> group and a

> control group without treatment. The rabbits were

> euthanized to

> determine the amount of healing. In the rabbits

> treated with HBOT, the

> bones healed not only faster, but stronger.

>

> Septicemia and joint ill in foals--At

> Hagyard-son-McGee, Bain and

> Slovis, DVM, Dipl. ACVIM, evaluated HBOT for

> treating foals

> with septic joints. In 2002, all the foals which

> came into the clinic

> with septic joints went through a standard protocol

> using systemic

> antibiotics, lavage to flush the joints with

> antibiotics, etc. After

> 30 to 90 days' treatment, they took the foals which

> were hopeless

> (which would ordinarily be euthanized) and moved

> them into a test

> group. They continued to use their standard

> treatments, but combined

> them with HBOT. They had a 60% recovery rate in

> foals which were going

> to be put down!

>

> Infection eats the bone away, but with oxygen

> treatment the joints

> healed and the integrity of the bone was

> regenerated. Bain says, " The

> changes we see on X rays in these foals indicates

> dead bone. Even

> though we have the foals on antibiotics, there is

> poor blood supply to

> dead bone; the antibiotics don't get there and are

> not very active if

> they do. Even if the foal survives, the body has to

> clean up all that

> dead tissue. HBOT stimulates and enhances the

> clean-up process and

> healing process to speed resorption of dead bone. It

> can also help

> salvage some tissues that would otherwise go on to

> die. "

>

> Soft tissue injuries--Many injuries result in

> inflammation and

> swelling. Studies have shown that soft tissue

> injuries treated with

> HBOT recover in half the time. New blood vessels

> form more quickly,

> improving blood supply to injured areas, and there

> is swift reduction

> in edema (swelling). Since oxygen is normally

> carried by red blood

> cells, any tissues with a compromised blood supply

> suffer from poor

> healing. But with HBOT, oxygen is forced into all

> body fluids and

> delivered to areas with restricted circulation.

>

> Injured tendons and ligaments respond well to

> treatment; HBOT can be

> useful in dealing with bowed tendons, surgical

> repair of tendon or

> ligament injuries, etc. Surgical traumas (incisions)

> also heal faster

> with HBOT, as do large surface wounds and pressure

> sores. It decreases

> tissue swelling and helps salvage damaged tissues in

> traumatic injury.

> In chronic wounds, it assists growth of new skin and

> stimulates

> collagen production.

>

> Bain says, " In a severe wound with lots of tissue

> damage, there is

> usually a certain amount of sloughing away. Using

> HBOT early in

> treatment may salvage some of the tissues that have

> lost their blood

> supply; we can sometimes save bits around the margin

> and reduce the

> amount of tissue lost. "

>

> Reproductive problems--Herthel wrote an article

> three years ago

> describing how he'd treated some older stallions for

> laminitis and

> noticed an increase in fertility. After reading

> that, Casner decided

> to treat WinStar's stallion Kris S. in the chamber,

> and there was a

> very dramatic change. The stallion's covers in the

> breeding shed had

> declined, but after HBOT treatments his libido

> increased (along with

> his sperm count), and the morphology (cell

> structure) of his semen was

> much improved.

>

> Casner says HBOT has also worked well for mares they

> hadn't been able

> to get in foal. " We treated four out of five mares

> one year that had

> been bred on multiple covers, " he says. " We finally

> put them in the

> chamber, and they got in foal the next time they

> cycled. We don't

> entirely understand why it worked, but suspect there

> may have been a

> bacteria involved that we were able to eliminate

> with the oxygen

> treatment. We probably also enhanced the integrity

> of the uterine

> lining. "

>

> has also treated mares which were unable to

> conceive. " One

> mare went to the breeding shed 16 times in two years

> without becoming

> pregnant. After three treatments in the chamber, she

> was bred, and had

> a live, healthy foal this spring, " he says.

>

> Bleeders--Casner uses HBOT on horses which have bled

> (suffered from

> exercise-induced pulmonary hemorrhage, or EIPH).

> " Many of them have

> chronic infections in the back of their lungs, " he

> says. " We bring

> them to the farm, put them in the chamber, and give

> them five or six

> treatments in combination with antibiotics. We've

> had very good

> results in clearing up the infection and healing the

> lung tissue. "

>

> Dummy foals and other neurological problems-- " We use

> it on dummy foals

> because it reduces edema, " says Casner. " The oxygen

> in a pressure

> chamber has the ability to penetrate the

> cerebrospinal fluid. " Head

> and spinal trauma often create neurological damage,

> thought to result

> from swelling of these tissues within a confined

> space, loss of blood

> and oxygen supply, and the sequential effects of

> these factors on

> nervous tissue. HBOT reduces the swelling and

> increases the blood

> supply.

>

> " We've also used HBOT experimentally on EPM, " says

> Casner. " There are

> many things it holds promise for; it will be another

> strong tool in

> the veterinarian's arsenal. "

>

> Spreading the Word

>

> " HBOT is an amazing tool, and the veterinary

> community is starting to

> embrace it, but there are some who are so

> traditional in their forms

> of treatment that they continue to be very narrow in

> their

> vision--though there are volumes of clinical

> research in the human

> field to support this therapy, " says Casner.

>

> " Dr. Bain says hyperbarics is the most significant

> veterinary tool

> since the ultrasound machine, " Casner adds. " He

> recently worked with a

> racehorse with a lung abscess that was treated with

> conventional

> methods for 30 days and continuing to worsen. The

> trainer then

> requested that hyperbarics be combined with

> traditional treatment. Dr.

> Bain was then able to heal the horse in a very short

> time. "

>

> But veterinarians who have chambers are cautious

> about using this

> routinely even though they want to. " I use the term

> 'cautious' only in

> the spirit of selecting appropriate patients for

> HBOT treatments and

> not just treating any willy-nilly problem, " says

> Bain. " The

> theoretical applications are considered for each

> patient's clinical

> problem before considering HBOT as a treatment

> modality. "

>

> " Oxygen therapy is nothing short of miraculous in

> treating many

> problems--especially infections--but the question a

> lot of people have

> is that if it's so good, why aren't more

> veterinarians doing it? Many

> vets have never heard of it; this treatment was not

> taught in vet

> school, and until recently there were no equine

> chambers, " explains

> Casner. " Most veterinarians have no experience with

> it. But this will

> eventually change. "

>

> Herthel says HBOT is such a powerful tool, " that the

> way we use it,

> oxygen is a drug. " He feels that eventually more

> veterinarians and

> equine clinics will use this, and that there should

> be a chamber in

> every major horse center.

>

> " It can save a horse in many situations where there

> is no hope

> otherwise, " says Herthel. " We have horses doing fine

> today that had

> acute laminitis and would not have made it without

> the oxygen therapy.

> We've treated many horses with bone infections that

> would have died.

> Some of the colics with intestinal obstruction, and

> some horrific

> infected wounds, can turn around quickly with oxygen

> treatment. "

>

> This useful tool can make the difference between

> life or death for

> many horses, he says. However, HBOT can get

> expensive with one

> treatment session running $400-$500. The type of

> injury or illness

> being treated will determine how many sessions are

> needed.

>

> Bain says that since HBOT is such a new therapeutic

> modality to the

> horse, there isn't much research out there yet.

> " We've had a few small

> clinical case studies that Dr. Herthel has done or

> that we've done

> here at our hospital, " says Bain. " But there have

> been no basic

> research projects yet at academic institutions

> involving the horse

> specifically. Many medical schools have hyperbaric

> facilities,

> however. Duke University is a leader in this field,

> along with the

> University of Kansas Medical Center and

> Washington University.

> They have what they call a 'magic list' of things

> that Medicare will

> pay for (including wounds, diabetic wounds, chronic

> bone infections,

> burn injuries, etc.), and this is basically how HBOT

> is applied to

> human medicine.

>

> " Usually medicine looks at what animal research has

> done and applies

> it to humans, " says Bain. " We are looking at what

> they are doing with

> people and applying it to horses--and hoping this

> will find its place

> in veterinary medicine. "

>

>

>

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