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Re: [MedicaidforHDOT] hbot toxicity

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,

I will try to do a little more work on this next week. But, remember, O2

toxicity cannot be calc'd by number of treatments at the clinic. It comes

about as patients obtain more sessions with more O2, and their own

predispositions.

Thus, you can give 8000 treatments by giving 40 treatments to 200 patients

and it really would not mean much.

If the 8000 came about by giving 200 treatments to 40 patients, then that

is a relevant track record.

I am personally certain it exists though. had an issue with it

once before and I have been cautious ever since.

Best Regards,

Ed Nemeth

At 09:05 PM 9/5/2003, you wrote:

>This is to any and all hyperbaric facilities who treat brain injury at

>1.75 ata or below. Can you document a single case of oxygen toxicity at

>these pressures. Dr. Harch makes claims of oxygen toxicity. We have

>done almost 9000 treatments since April 2003 without a single

>case. There may have been a possibility of an issue to oxygen

>sensitivity but I don't think so. In the beginning when we were treating

>7 days a week, stress and exhaustion created some problems but after we

>went to 6 days with a more relaxful atmosphere, it was no longer a problem.

>

>I would like to hear your comments. If you would prefer to comment to me

>privately, you may do so at rhartsoe@...

>

>Of course, references will be appreciated.

>

>As you know, Dr. Harch cannot find the time to comment on any of these

>list, even the the hbot professionals list. Oxygen toxicity can be a

>serious issue and should not be used to scare people unless it can be

>documented. If it can be documented at these low pressures we need to do

>so and let the consumer know with proper advice on what to do. Protocols

>need to be changed to once a day or whatever it takes. As I said, I

>have never seen this problem. I know what to look for according to the

>training and the text books, etc. So if there is something new, it needs

>to be added to these references.

>

>thanks

> Hartsoe

>

>

>

>

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Yes O2 toxicity is very possible. After about 50 treatments the first

time Kaltyn began to get very agitated as I have said on here several times. I

didn't realize at the time and continued to 72 treatments at this time she

was so agitated that we were not getting sleep. Now we didn't understand she was

so much better and we were so happy we over looked the obvious. She was

getting sick from to much. It wasn't till we got her home about 10 to 15 day's

into

it she began to calm down and our lives was outstanding. This has been the

case with many. I know another parent that takes her child for HBOT now she goes

for a block of 40 but if at any time the child becomes severely agitated she

stops takes the child home waits several months and starts back up.I have a

chamber here at home and I don't treat her everyday. I have found that 5 to 20

treatments every 2 months is better for her. We usally get about 20 to 25 every

2 months hope this help's.

Darin

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Ed, many of our clients have now had over 150 sessions without any problems

and some have had over 300 (not all here, of course). We always require a

break between series of treatments. We need to make certain we know what

toxicity is. There is a major difference between toxicity and sensitivity.

thanks

Hartsoe

www.miraclemountain.org

Re: [MedicaidforHDOT] hbot toxicity

> ,

>

> I will try to do a little more work on this next week. But, remember, O2

> toxicity cannot be calc'd by number of treatments at the clinic. It comes

> about as patients obtain more sessions with more O2, and their own

> predispositions.

>

> Thus, you can give 8000 treatments by giving 40 treatments to 200 patients

> and it really would not mean much.

>

> If the 8000 came about by giving 200 treatments to 40 patients, then that

> is a relevant track record.

>

> I am personally certain it exists though. had an issue with it

> once before and I have been cautious ever since.

>

> Best Regards,

>

> Ed Nemeth

>

> At 09:05 PM 9/5/2003, you wrote:

> >This is to any and all hyperbaric facilities who treat brain injury at

> >1.75 ata or below. Can you document a single case of oxygen toxicity at

> >these pressures. Dr. Harch makes claims of oxygen toxicity. We have

> >done almost 9000 treatments since April 2003 without a single

> >case. There may have been a possibility of an issue to oxygen

> >sensitivity but I don't think so. In the beginning when we were

treating

> >7 days a week, stress and exhaustion created some problems but after we

> >went to 6 days with a more relaxful atmosphere, it was no longer a

problem.

> >

> >I would like to hear your comments. If you would prefer to comment to

me

> >privately, you may do so at rhartsoe@...

> >

> >Of course, references will be appreciated.

> >

> >As you know, Dr. Harch cannot find the time to comment on any of these

> >list, even the the hbot professionals list. Oxygen toxicity can be a

> >serious issue and should not be used to scare people unless it can be

> >documented. If it can be documented at these low pressures we need to do

> >so and let the consumer know with proper advice on what to do.

Protocols

> >need to be changed to once a day or whatever it takes. As I said, I

> >have never seen this problem. I know what to look for according to the

> >training and the text books, etc. So if there is something new, it

needs

> >to be added to these references.

> >

> >thanks

> > Hartsoe

> >

> >

> >

> >

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Darin,

Agitation is not just a sign or indication of Oxygen Toxicity. If it were

half of the kids would not be treated with hbot. It is a sign of stress and

exhaustion and being aggravated at having to continue to go through the same

routine. They learn very fast how to get response. We need to keep our

definitions clear. It takes a much clearer combination of symptoms to

diagnose Oxygen toxicity. That is what technicians and medical

professionals in hyperbarics are trained for.

In one 20 year study report by EC & Myers RAM (Undersea Biomedical

Res. 19 (Suppl.):109) central nervous system oxygen toxicity (0.7%)

occurred ONLY in critically ill patients who were unconscious and ventilator

dependent.

I cannot find any discussion of the existance of toxicity at treatments

under 2 ata and, in fact, most texts refer to the possibility of it

happening at treatments over 2 ata.

I think parents have enough to worry about without fears being instilled

into them which do not exist. If there are sensitivity issues which I have

not seen to my knowledge, parents will probably recognize them. And Oxygen

toxicity is not a permanent or lasting effect.

Oxygen sensitivity or tolerance can be affected by certain issues, such as

drugs or certain high hormone levels (Adrenocortical) and can even be a sign

of CO2 inhalation which is one of my concerns with in home use of chambers.

Insulin as well as a deficiency in Vit. E can also increase sensitivity

levels.

I just recieved a report of another facility stating clearly they have never

seen a case of toxicity in treating below 2 ata. And they do a large number

of children with brain injury.

That is the reason I am asking for comments and reports from HBOT

facilities. It needs to be from a trained eye and not be mistaken as

toxicity when it is probably some of the other related issues including

stress, agitation, etc.

Hartsoe

www.miraclemountain.org

Re: [MedicaidforHDOT] hbot toxicity

> Yes O2 toxicity is very possible. After about 50 treatments the

first

> time Kaltyn began to get very agitated as I have said on here several

times. I

> didn't realize at the time and continued to 72 treatments at this time she

> was so agitated that we were not getting sleep. Now we didn't understand

she was

> so much better and we were so happy we over looked the obvious. She was

> getting sick from to much. It wasn't till we got her home about 10 to 15

day's into

> it she began to calm down and our lives was outstanding. This has been the

> case with many. I know another parent that takes her child for HBOT now

she goes

> for a block of 40 but if at any time the child becomes severely agitated

she

> stops takes the child home waits several months and starts back up.I have

a

> chamber here at home and I don't treat her everyday. I have found that 5

to 20

> treatments every 2 months is better for her. We usally get about 20 to 25

every

> 2 months hope this help's.

>

> Darin

>

>

>

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,

I think you hit one of the key issues - good breaks.

Also (speculating) maybe your " mountain air " gives them better recuperation

because it is a higher altitude?! One more reason for families to visit

your center.

Personally, I still disagree on the symantics of sensitivity and

toxicity...... not withstanding all of Dr. Foijels efforts to educate me

(see my last post on that subject several months ago.)

Either way (tox. / sens.) something physiologically negative is going on

for that patient in response to HBOT without enough rest.

On the extreme side O2 toxicity is well illustrated at the metabolic and

subcellular level in Jain's textbook in cases where normal patients are

given O2 at very high pressures for extended sessions.

Best Regards,

Ed Nemeth

At 05:08 AM 9/6/2003, you wrote:

>Ed, many of our clients have now had over 150 sessions without any problems

>and some have had over 300 (not all here, of course). We always require a

>break between series of treatments. We need to make certain we know what

>toxicity is. There is a major difference between toxicity and sensitivity.

>

>thanks

> Hartsoe

>www.miraclemountain.org

>

> Re: [MedicaidforHDOT] hbot toxicity

>

>

> > ,

> >

> > I will try to do a little more work on this next week. But, remember, O2

> > toxicity cannot be calc'd by number of treatments at the clinic. It comes

> > about as patients obtain more sessions with more O2, and their own

> > predispositions.

> >

> > Thus, you can give 8000 treatments by giving 40 treatments to 200 patients

> > and it really would not mean much.

> >

> > If the 8000 came about by giving 200 treatments to 40 patients, then that

> > is a relevant track record.

> >

> > I am personally certain it exists though. had an issue with it

> > once before and I have been cautious ever since.

> >

> > Best Regards,

> >

> > Ed Nemeth

> >

> > At 09:05 PM 9/5/2003, you wrote:

> > >This is to any and all hyperbaric facilities who treat brain injury at

> > >1.75 ata or below. Can you document a single case of oxygen toxicity at

> > >these pressures. Dr. Harch makes claims of oxygen toxicity. We have

> > >done almost 9000 treatments since April 2003 without a single

> > >case. There may have been a possibility of an issue to oxygen

> > >sensitivity but I don't think so. In the beginning when we were

>treating

> > >7 days a week, stress and exhaustion created some problems but after we

> > >went to 6 days with a more relaxful atmosphere, it was no longer a

>problem.

> > >

> > >I would like to hear your comments. If you would prefer to comment to

>me

> > >privately, you may do so at rhartsoe@...

> > >

> > >Of course, references will be appreciated.

> > >

> > >As you know, Dr. Harch cannot find the time to comment on any of these

> > >list, even the the hbot professionals list. Oxygen toxicity can be a

> > >serious issue and should not be used to scare people unless it can be

> > >documented. If it can be documented at these low pressures we need to do

> > >so and let the consumer know with proper advice on what to do.

>Protocols

> > >need to be changed to once a day or whatever it takes. As I said, I

> > >have never seen this problem. I know what to look for according to the

> > >training and the text books, etc. So if there is something new, it

>needs

> > >to be added to these references.

> > >

> > >thanks

> > > Hartsoe

> > >

> > >

> > >

> > >

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Actually it is my understanding that agitation is the first sign of

toxicity. My daughter has gotten to that point with too many treatments,

in her first block. Her other symptoms were pale skin, moody, tired and

she told me an upset stomach. How many kids can communicate these

symptoms? We really backed off and are now doing more then a few months

between. It is something for parents to be really be concerned with. My

daughter lost weight too, and this was upsetting. As far as symptoms go,

it really is the parents who know the child well who will be able to spot

these negative changes. As an example, so many people say my daughter

looks tired. Well they have no idea she always looks tired because of low

tone. I am the one who can judge true exhaustion or tell the difference

between being overwhelmed sensory wise, or lack of sleep, etc. So until

there is something definitive, I would trust parents input much more then

an operator who has no history with the child and spends a few minutes a

day observing. So what exactly are the symptoms of oxygen toxicity, other

then what I have described above? I am curious to know...thanks

>Darin,

>Agitation is not just a sign or indication of Oxygen Toxicity. If it were

>half of the kids would not be treated with hbot. It is a sign of stress and

>exhaustion and being aggravated at having to continue to go through the same

>routine.

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Oh, now this statement below seems like a real stretch...I live near the

mountains, next to the ocean, does that have any benefits? Is this from a

text or study somewhere?

>Also (speculating) maybe your " mountain air " gives them better recuperation

>because it is a higher altitude?!

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I am confused too. I thought that air nearer sea level (we are in FL) contained

more oxygen than air in higher elevations, such as the Rocky Mtns. Wouldn't it

be better to recuperate at an elevation at sea level, with higher

oxygen levels?

Sheri, Rex's mom.

Delray Beach, FL

and Juneau, AK

Re: [MedicaidforHDOT] hbot toxicity

Oh, now this statement below seems like a real stretch...I live near the

mountains, next to the ocean, does that have any benefits? Is this from a

text or study somewhere?

>Also (speculating) maybe your " mountain air " gives them better recuperation

>because it is a higher altitude?!

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Sheri,

Again, this is only speculation, but if the issue of O2 sensitvity /

toxicity is the effects of too much O2...... then the solution could be to

more rapidly deplete the system of the excess O2 and let it

readjust. Being at a higher altitude could possibly accomplish that better

than sea level.

Note this is only logical metabolic speculation. I know of no studies or

research on these specifics.

Ed Nemeth

At 11:37 AM 9/6/2003, you wrote:

>I am confused too. I thought that air nearer sea level (we are in FL)

>contained more oxygen than air in higher elevations, such as the Rocky

>Mtns. Wouldn't it be better to recuperate at an elevation at sea level,

>with higher

>oxygen levels?

>

>Sheri, Rex's mom.

>Delray Beach, FL

>and Juneau, AK

>

> Re: [MedicaidforHDOT] hbot toxicity

>

>

> Oh, now this statement below seems like a real stretch...I live near

> the mountains, next to the ocean, does that have any benefits? Is this from a

> text or study somewhere?

>

> >Also (speculating) maybe your " mountain air " gives them better

> recuperation

> >because it is a higher altitude?!

>

>

>

>

>

>

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Greetings,

The ocean waves and the winds create ozone, the natural oxygenation

of the earth. And in the mountains esp. where is have a

saturation of it because instead of being dry, as it is out west in

the Sierras and Rockies, they are full of condensation. The western

mountains are dryer because of their higher altitude and distance

from the ocean. If you go to the Ozarks in AR and MO you see and

experience the same thing. That's just a novice explanation of the

effect. I'm sure there is someone out there that will use scientific

explanations for it. Dr. , are you out there?

With Much Respect,

Marlena Orndorff

> Oh, now this statement below seems like a real stretch...I live

near the

> mountains, next to the ocean, does that have any benefits? Is this

from a

> text or study somewhere?

>

> >Also (speculating) maybe your " mountain air " gives them better

recuperation

> >because it is a higher altitude?!

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We are fast approaching 750 treatments. We try not to go out of town for

more than a couple of days at a time as we find if we miss too many it is

like starting over. To make this clearer; it takes Eddie about 32

treatments to show improvement, therefore, every time we take a break we see

nothing for 32 or more days. We try never to break for more than 3 days at

a time at the most. He has never showed any signs of toxicity. Yes, he

gets agitated, mad, cranky, doesn't always sleep well, gets colds, and gets

sick, He's a kid. All I know is that the more we do the better he gets.

And better is my goal. If we stopped now I am sure he would stay the way he

is. It's not good enough and he gets older everyday. Time is my emeny.

We also did 350 in a row (meaning no breaks) with my 3 year old nephew and

he showed no signs of toxicity. In fact, he is completely well.

Stay below 1.75.

Love to all,

Rose

[MedicaidforHDOT] hbot toxicity

> This is to any and all hyperbaric facilities who treat brain injury at

1.75 ata or below. Can you document a single case of oxygen toxicity at

these pressures. Dr. Harch makes claims of oxygen toxicity. We have done

almost 9000 treatments since April 2003 without a single case. There may

have been a possibility of an issue to oxygen sensitivity but I don't think

so. In the beginning when we were treating 7 days a week, stress and

exhaustion created some problems but after we went to 6 days with a more

relaxful atmosphere, it was no longer a problem.

>

> I would like to hear your comments. If you would prefer to comment to me

privately, you may do so at rhartsoe@...

>

> Of course, references will be appreciated.

>

> As you know, Dr. Harch cannot find the time to comment on any of these

list, even the the hbot professionals list. Oxygen toxicity can be a

serious issue and should not be used to scare people unless it can be

documented. If it can be documented at these low pressures we need to do so

and let the consumer know with proper advice on what to do. Protocols need

to be changed to once a day or whatever it takes. As I said, I have

never seen this problem. I know what to look for according to the training

and the text books, etc. So if there is something new, it needs to be

added to these references.

>

> thanks

> Hartsoe

>

>

>

>

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While I know that is asking for info regarding treatment at 2

ata or less, this discussion brings to mind a question I've had for

some time but never had answered. It is my understanding that in

acute situations such as carbon monoxide poisoning or a diving

accident, individuals can be treated at signficantly higher pressures

than 2 ata and for fairly extended periods of time. Do these

individuals exhibit toxicity issues? It would seem to me that if

there is any concern that toxicity can develop at less than 2 ata,

then it would be a really serious concern in acute situations. OTOH,

perhaps it is more important that the poisoning or whatever condition

be treated, even if there are risks of toxicity. Perhaps the

possibility of toxicity is the lesser of the evils? If someone can

shed light on this for me, I'd appreciate it.

Lynn

> > > >This is to any and all hyperbaric facilities who treat brain

injury at

> > > >1.75 ata or below. Can you document a single case of oxygen

toxicity at

> > > >these pressures. Dr. Harch makes claims of oxygen toxicity.

We have

> > > >done almost 9000 treatments since April 2003 without a single

> > > >case. There may have been a possibility of an issue to oxygen

> > > >sensitivity but I don't think so. In the beginning when we

were

> >treating

> > > >7 days a week, stress and exhaustion created some problems but

after we

> > > >went to 6 days with a more relaxful atmosphere, it was no

longer a

> >problem.

> > > >

> > > >I would like to hear your comments. If you would prefer to

comment to

> >me

> > > >privately, you may do so at rhartsoe@s...

> > > >

> > > >Of course, references will be appreciated.

> > > >

> > > >As you know, Dr. Harch cannot find the time to comment on any

of these

> > > >list, even the the hbot professionals list. Oxygen toxicity

can be a

> > > >serious issue and should not be used to scare people unless it

can be

> > > >documented. If it can be documented at these low pressures we

need to do

> > > >so and let the consumer know with proper advice on what to do.

> >Protocols

> > > >need to be changed to once a day or whatever it takes. As

I said, I

> > > >have never seen this problem. I know what to look for

according to the

> > > >training and the text books, etc. So if there is something

new, it

> >needs

> > > >to be added to these references.

> > > >

> > > >thanks

> > > > Hartsoe

> > > >

> > > >

> > > >

> > > >

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While toxicity can take place in anyone and at any pressure, the general

rule of thumb is that patients that have had to adapt to low oxygen

tensions over time, such as individuals with COPD or Sickle Cell Disease,

are much more likely to have toxicity issues than the average man on the

street.

KP Stoller, MD, FAAP

Assistant Clinical Prof, UNM HSC Dept Pediatrics

Simply Hyperbarics

www.simplyhyperbarics.com

> While I know that is asking for info regarding treatment at 2

> ata or less, this discussion brings to mind a question I've had for

> some time but never had answered. It is my understanding that in acute

> situations such as carbon monoxide poisoning or a diving

> accident, individuals can be treated at signficantly higher pressures

> than 2 ata and for fairly extended periods of time. Do these

> individuals exhibit toxicity issues? It would seem to me that if there

> is any concern that toxicity can develop at less than 2 ata, then it

> would be a really serious concern in acute situations. OTOH, perhaps

> it is more important that the poisoning or whatever condition be

> treated, even if there are risks of toxicity. Perhaps the

> possibility of toxicity is the lesser of the evils? If someone can

> shed light on this for me, I'd appreciate it.

>

> Lynn

>

>

>> > > >This is to any and all hyperbaric facilities who treat brain

> injury at

>> > > >1.75 ata or below. Can you document a single case of oxygen

> toxicity at

>> > > >these pressures. Dr. Harch makes claims of oxygen toxicity.

> We have

>> > > >done almost 9000 treatments since April 2003 without a single

>> case. There may have been a possibility of an issue to oxygen

>> sensitivity but I don't think so. In the beginning when we

> were

>> >treating

>> > > >7 days a week, stress and exhaustion created some problems but

> after we

>> > > >went to 6 days with a more relaxful atmosphere, it was no

> longer a

>> >problem.

>> > > >

>> > > >I would like to hear your comments. If you would prefer to

> comment to

>> >me

>> > > >privately, you may do so at rhartsoe@s...

>> > > >

>> > > >Of course, references will be appreciated.

>> > > >

>> > > >As you know, Dr. Harch cannot find the time to comment on any

> of these

>> > > >list, even the the hbot professionals list. Oxygen toxicity

> can be a

>> > > >serious issue and should not be used to scare people unless it

> can be

>> > > >documented. If it can be documented at these low pressures we

> need to do

>> > > >so and let the consumer know with proper advice on what to do.

>> >Protocols

>> > > >need to be changed to once a day or whatever it takes. As

> I said, I

>> > > >have never seen this problem. I know what to look for

> according to the

>> > > >training and the text books, etc. So if there is something

> new, it

>> >needs

>> > > >to be added to these references.

>> > > >

>> > > >thanks

>> > > > Hartsoe

>> > > >

>> > > >

>> > > >

>> > > >

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In a message dated 9/8/03 10:43:02 AM Pacific Daylight Time,

esslr@... writes:

> We are fast approaching 750 treatments.

Does this mean that you have your own portable chamber at home? Do you use

just ambient air room or have you added a concentrator?

Dina

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Dear friends, Dr Harch is talking about the fact that Hyperbaric Oxygen is

an immune suppressant as well as an immune enhancement, Doing HBOT twice

daily for certain people can at a certain number ( upper end) cause the

patient to have a little free Radical activity, and therefore some people

develop a cold, that is why you need to watch children., If towards the end

of the 40 they become lethargic or have a running nose, you need to take a

couple of days off, then resume.

Here is what I usually do, I give patients Sunday and weds off, and if they

have a time frame that they must return home or a limited amount of time. We

will do two on Saturday, then a full 24 hours off on Sunday, One on Monday,

Two on Tuesday and a full 24 hours off on Weds, One on Thursday, one on

Friday, then two on Saturday and so on..... I arrange it to fit the needs of

the people because no two patients are alike as you well know, However in

the last ten years I have never had even a hint of a problem. there again we

have them take a vitamin E after the last treatment of the day.

I watch carefully, not to mistake this for a personality change.

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Rose,

Thanks for the info. You are treading in territory where very few have

gone so far. Your info. is useful and important.

Thanks & Warm Regards,

Ed Nemeth

At 10:47 AM 9/8/2003, you wrote:

>We are fast approaching 750 treatments. We try not to go out of town for

>more than a couple of days at a time as we find if we miss too many it is

>like starting over. To make this clearer; it takes Eddie about 32

>treatments to show improvement, therefore, every time we take a break we see

>nothing for 32 or more days. We try never to break for more than 3 days at

>a time at the most. He has never showed any signs of toxicity. Yes, he

>gets agitated, mad, cranky, doesn't always sleep well, gets colds, and gets

>sick, He's a kid. All I know is that the more we do the better he gets.

>And better is my goal. If we stopped now I am sure he would stay the way he

>is. It's not good enough and he gets older everyday. Time is my emeny.

>We also did 350 in a row (meaning no breaks) with my 3 year old nephew and

>he showed no signs of toxicity. In fact, he is completely well.

>Stay below 1.75.

>Love to all,

>Rose

>

> [MedicaidforHDOT] hbot toxicity

>

>

> > This is to any and all hyperbaric facilities who treat brain injury at

>1.75 ata or below. Can you document a single case of oxygen toxicity at

>these pressures. Dr. Harch makes claims of oxygen toxicity. We have done

>almost 9000 treatments since April 2003 without a single case. There may

>have been a possibility of an issue to oxygen sensitivity but I don't think

>so. In the beginning when we were treating 7 days a week, stress and

>exhaustion created some problems but after we went to 6 days with a more

>relaxful atmosphere, it was no longer a problem.

> >

> > I would like to hear your comments. If you would prefer to comment to me

>privately, you may do so at rhartsoe@...

> >

> > Of course, references will be appreciated.

> >

> > As you know, Dr. Harch cannot find the time to comment on any of these

>list, even the the hbot professionals list. Oxygen toxicity can be a

>serious issue and should not be used to scare people unless it can be

>documented. If it can be documented at these low pressures we need to do so

>and let the consumer know with proper advice on what to do. Protocols need

>to be changed to once a day or whatever it takes. As I said, I have

>never seen this problem. I know what to look for according to the training

>and the text books, etc. So if there is something new, it needs to be

>added to these references.

> >

> > thanks

> > Hartsoe

> >

> >

> >

> >

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Dear :

It was most helpful for you to write what you are doing with the protocols

for your patients.

It is so important to get and to keep and open and candid dialogue on the

protocols for HBOT. Both on the national level and at the international level.

I have tried without success to find out what the military research has been

regarding the milder portable chambers. I was told last week that the Navy

has put in an order for 53 of the hyperlites madein the U.K.

It would be ever so helpful if we could get the international hyperbaric

community to exchange info on what their research is finding. Perhaps the two

associations will turn up some of the findings from the international as well as

the national community in all types of chambers. Meanwhile thanks for

all the valuable info you posted on the subject of toxicity or lack of it with

respect to your own experience. Manson

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Yes and no, we have a 54 " dual lock, multi place chamber made of steel. As

far as O2 is concerned, my son's doctor is wonderful. He is amazed and

impressed with his improvement and therefore supports us fully. (gives us a

script). We use liquid medical grade O2 because it cost less. We compress

with air and breath O2 via hood or mask. Both my husband and myself went to

Hyperbarics International in Key Largo, Fl to be trained.

Love to all,

Rose

Re: [MedicaidforHDOT] hbot toxicity

> In a message dated 9/8/03 10:43:02 AM Pacific Daylight Time,

> esslr@... writes:

>

> > We are fast approaching 750 treatments.

>

> Does this mean that you have your own portable chamber at home? Do you use

> just ambient air room or have you added a concentrator?

>

> Dina

>

>

>

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Yes, thank you Rose - and Ed for pointing it out. The only way great discoveries

are made is by making those careful steps into unknown territories! Keep

treading carefully and with your obvious love and dedication for your family.

Hopefully those great discoveries and healings will be yours.

Best wishes and much love, Ken

Ken Gullan

Institute for Research Integration (IRI)

San Diego, CA 92106-2424

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

developmental difficulties.

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

[MedicaidforHDOT] hbot toxicity

>

>

> > This is to any and all hyperbaric facilities who treat brain injury at

>1.75 ata or below. Can you document a single case of oxygen toxicity at

>these pressures. Dr. Harch makes claims of oxygen toxicity. We have done

>almost 9000 treatments since April 2003 without a single case. There may

>have been a possibility of an issue to oxygen sensitivity but I don't think

>so. In the beginning when we were treating 7 days a week, stress and

>exhaustion created some problems but after we went to 6 days with a more

>relaxful atmosphere, it was no longer a problem.

> >

> > I would like to hear your comments. If you would prefer to comment to me

>privately, you may do so at rhartsoe@...

> >

> > Of course, references will be appreciated.

> >

> > As you know, Dr. Harch cannot find the time to comment on any of these

>list, even the the hbot professionals list. Oxygen toxicity can be a

>serious issue and should not be used to scare people unless it can be

>documented. If it can be documented at these low pressures we need to do so

>and let the consumer know with proper advice on what to do. Protocols need

>to be changed to once a day or whatever it takes. As I said, I have

>never seen this problem. I know what to look for according to the training

>and the text books, etc. So if there is something new, it needs to be

>added to these references.

> >

> > thanks

> > Hartsoe

> >

> >

> >

> >

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Ken,

Thanks for the encouragement. I have to admit, right now I need it. I am

pretty worn out.

Warm REgards,

Ed Nemeth

At 12:36 PM 9/9/2003, you wrote:

>Yes, thank you Rose - and Ed for pointing it out. The only way great

>discoveries are made is by making those careful steps into unknown

>territories! Keep treading carefully and with your obvious love and

>dedication for your family. Hopefully those great discoveries and healings

>will be yours.

>Best wishes and much love, Ken

>

>Ken Gullan

>Institute for Research Integration (IRI)

>San Diego, CA 92106-2424

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

>developmental difficulties.

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

> [MedicaidforHDOT] hbot toxicity

> >

> >

> > > This is to any and all hyperbaric facilities who treat brain injury at

> >1.75 ata or below. Can you document a single case of oxygen toxicity at

> >these pressures. Dr. Harch makes claims of oxygen toxicity. We have

> done

> >almost 9000 treatments since April 2003 without a single case. There may

> >have been a possibility of an issue to oxygen sensitivity but I don't

> think

> >so. In the beginning when we were treating 7 days a week, stress and

> >exhaustion created some problems but after we went to 6 days with a more

> >relaxful atmosphere, it was no longer a problem.

> > >

> > > I would like to hear your comments. If you would prefer to

> comment to me

> >privately, you may do so at rhartsoe@...

> > >

> > > Of course, references will be appreciated.

> > >

> > > As you know, Dr. Harch cannot find the time to comment on any of these

> >list, even the the hbot professionals list. Oxygen toxicity can be a

> >serious issue and should not be used to scare people unless it can be

> >documented. If it can be documented at these low pressures we need to

> do so

> >and let the consumer know with proper advice on what to

> do. Protocols need

> >to be changed to once a day or whatever it takes. As I said, I have

> >never seen this problem. I know what to look for according to the

> training

> >and the text books, etc. So if there is something new, it needs to be

> >added to these references.

> > >

> > > thanks

> > > Hartsoe

> > >

> > >

> > >

> > >

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Dear Ed,

two months ago you ended a posting with these words:

> Personally, I feel sensitivity is a better term, because we are only

> discussing this in a safe therapeutic range. But, everyone in HBOT

> discusses it as toxicity, so I use their language.

>

> Maybe this is one bad habit I can break!

>

We tried to refine this discussion, but to little avail, it seems...

Let's tackle it again:

There is overdose and there is sensitivity, -two different entities-, that may

coexist.

'Overdose' is an excessive dose or too many doses ( a function of mass and

biochemical work),

while 'sensitivity' denotes the exquisite reactivity of an injured biological

system

to an otherwise innocuous dose of a substance (a bio-pathological reaction of

the body).

Does overdose happen in the correct hyperbaric protocol for a chronic

neurological conditions?

No, by definition.

May sensitivity appear there? Yes, as injuries or their scars or effects may

subsist for years,

and eventual unrelated diseases or untoward metabolic incidents may complicate

the scenario.

Does sensitivity occur in the acute neurological patient? It usually does.

Sensitivity is a sign of impairment of the defence mechanisms against

hyperoxia,

or some exaggerated vasoconstrictive reaction, as Dr. explained.

The blood-brain barrier, a function of the glia, is also involved.

Care should be exerted to differenciate those sensitivity symptoms from

tiredness, excitment,

or from developments of the basic condition.

We are dealing with complex, auto-regulative, semi-open systems.

As the distribution and metabolization of oxygen is dependent on several factors

(temperature, pressure, local vasodilatation, blood rheology, target organ,

oxygen use at cellular levels,

autonomic nervous regulation etc.),

and its level of availability ultimately regulates them,

it may not be easy to accurately adscribe symptoms without taking those factors

into account.

'Toxicity' applies to the effects of substances poisonous at a usual dose.

Oxygen is not such a substance. Oxygen toxicity is both an unfortunate and

illegitimate term.

Gerschman (from Argentina) was the first scientist to propose that

free radical intermediates

(superoxide anions, hydrogen peroxide, hydroperoxy and hydroxyl radicals, and

singlet oxygen)

were responsible for the so-called oxygen toxicity, during excessive exposure,

-in terms of pressure/ O2 concentration and time-,

specially if the anti-ROS protective mechanisms are impaired (SOD, catalase,

etc.).

It should be taken into account that hypoxia will also generate deleterious free

radicals,

where a generous but graduated supply of oxygen will be the cure.

Although clinical hyperbaric oxygen dosage is always a relatively high dose,

comparing to natural conditions,

a healthy, auto-regulating body can take it without problems,

within empyrically established limits.

Tired, hungry, ill, stressed, intoxicated, inflammed, edematose or otherwise

affected patients

cannot be deemed healthy, though.

Shorter courses, lower frequency, and breaks may be necessary,

as oxygen may elicit side-effects in sensitive, pre-affected individuals.

Brain injured persons display these effects much earlier, at lower levels,

meeker pressures, diminished concentrations, and if oftenness were excessive.

With all due respect, recourse to the authority of a single distiguished

practitioner,

or a decontextualized quotation from a book will not take us any further.

Only the acknowledgment of the factors at work could prompt us to foresee any

side effect,

and to correct an erroneous dosage, before it provokes any damage.

Another problem may be the difficulty of identifying overdose symptoms

in a stable condition that becomes dynamic as a result of treatment,

or that dwindles as a result of coexistent conditions, lack of rest, stress,

etc..

It may not be easy to differenciate a symptom from a result,

or a result from a natural development, either.

Mountain air is scant in oxygen and other gases.

Gauge pressure/oxygen concentration must be corrected for the lower barometric

pressure.

Several days at altitude elicit an increase in red blood cells count,

and other acclimatization mechanisms, that may last for several weeks.

Hyper and hypobarics may be concurrent to the same end, for disparate reasons,

but it depends on the occasion.

How high are you located, ? Moderate altitudes can modify some

therapeutic effects.

" Rehabilitation of hypoxemic patients with COPD at low altitude at the Dead Sea,

the

lowest place on earth " MR Kramer, C Springer, N Berkman, M Glazer, M Bublil, E

Bar-Yishay and S Godfrey

Pulmonary Institute, Hadassah University Hospital, Ein Kerem, Hebrew University,

Jerusalem, Israel.

The discussion may be meaningless, if all known variables are not quantified

and seriously taken into account.

German research has established 1.5 ATA/100% as the optimal neurological dose,

and a Russian school advocates much less (1.2ATA/30%/30 min/qd/4 sessions),

if the patient has been brain injured in any way. They use several paraclinical

parameters to assess treatment outcomes.

Best regards, as always.

Ignacio

Ignacio FOJGEL, m.d.

Buenos Aires, Argentina

Ed Nemeth wrote:

> ,

>

> I think you hit one of the key issues - good breaks.

>

> Also (speculating) maybe your " mountain air " gives them better recuperation

> because it is a higher altitude?! One more reason for families to visit

> your center.

>

> Personally, I still disagree on the symantics of sensitivity and

> toxicity...... not withstanding all of Dr. Foijels efforts to educate me

> (see my last post on that subject several months ago.)

>

> Either way (tox. / sens.) something physiologically negative is going on

> for that patient in response to HBOT without enough rest.

>

> On the extreme side O2 toxicity is well illustrated at the metabolic and

> subcellular level in Jain's textbook in cases where normal patients are

> given O2 at very high pressures for extended sessions.

>

> Best Regards,

>

> Ed Nemeth

>

> At 05:08 AM 9/6/2003, you wrote:

> >Ed, many of our clients have now had over 150 sessions without any problems

> >and some have had over 300 (not all here, of course). We always require a

> >break between series of treatments. We need to make certain we know what

> >toxicity is. There is a major difference between toxicity and sensitivity.

> >

> >thanks

> > Hartsoe

> >www.miraclemountain.org

> >

> > Re: [MedicaidforHDOT] hbot toxicity

> >

> >

> > > ,

> > >

> > > I will try to do a little more work on this next week. But, remember, O2

> > > toxicity cannot be calc'd by number of treatments at the clinic. It comes

> > > about as patients obtain more sessions with more O2, and their own

> > > predispositions.

> > >

> > > Thus, you can give 8000 treatments by giving 40 treatments to 200 patients

> > > and it really would not mean much.

> > >

> > > If the 8000 came about by giving 200 treatments to 40 patients, then that

> > > is a relevant track record.

> > >

> > > I am personally certain it exists though. had an issue with it

> > > once before and I have been cautious ever since.

> > >

> > > Best Regards,

> > >

> > > Ed Nemeth

> > >

> > > At 09:05 PM 9/5/2003, you wrote:

> > > >This is to any and all hyperbaric facilities who treat brain injury at

> > > >1.75 ata or below. Can you document a single case of oxygen toxicity at

> > > >these pressures. Dr. Harch makes claims of oxygen toxicity. We have

> > > >done almost 9000 treatments since April 2003 without a single

> > > >case. There may have been a possibility of an issue to oxygen

> > > >sensitivity but I don't think so. In the beginning when we were

> >treating

> > > >7 days a week, stress and exhaustion created some problems but after we

> > > >went to 6 days with a more relaxful atmosphere, it was no longer a

> >problem.

> > > >

> > > >I would like to hear your comments. If you would prefer to comment to

> >me

> > > >privately, you may do so at rhartsoe@...

> > > >

> > > >Of course, references will be appreciated.

> > > >

> > > >As you know, Dr. Harch cannot find the time to comment on any of these

> > > >list, even the the hbot professionals list. Oxygen toxicity can be a

> > > >serious issue and should not be used to scare people unless it can be

> > > >documented. If it can be documented at these low pressures we need to do

> > > >so and let the consumer know with proper advice on what to do.

> >Protocols

> > > >need to be changed to once a day or whatever it takes. As I said, I

> > > >have never seen this problem. I know what to look for according to the

> > > >training and the text books, etc. So if there is something new, it

> >needs

> > > >to be added to these references.

> > > >

> > > >thanks

> > > > Hartsoe

> > > >

> > > >

> > > >

> > > >

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I'll bet that seeing turn 8 and knowing how very far she's

come due to her unextinguishable spirit and your hard work made your

exhaustion a bit less (or at least tolerable). Happy birthday to

!

Lynn

> > >We are fast approaching 750 treatments. We try not to go out

of town for

> > >more than a couple of days at a time as we find if we miss too

many it is

> > >like starting over. To make this clearer; it takes Eddie

about 32

> > >treatments to show improvement, therefore, every time we take

a break

> > we see

> > >nothing for 32 or more days. We try never to break for more

than 3

> > days at

> > >a time at the most. He has never showed any signs of

toxicity. Yes, he

> > >gets agitated, mad, cranky, doesn't always sleep well, gets

colds, and

> > gets

> > >sick, He's a kid. All I know is that the more we do the

better he gets.

> > >And better is my goal. If we stopped now I am sure he would

stay the

> > way he

> > >is. It's not good enough and he gets older everyday. Time

is my emeny.

> > >We also did 350 in a row (meaning no breaks) with my 3 year

old nephew and

> > >he showed no signs of toxicity. In fact, he is completely

well.

> > >Stay below 1.75.

> > >Love to all,

> > >Rose

> > >

> > > [MedicaidforHDOT] hbot toxicity

> > >

> > >

> > > > This is to any and all hyperbaric facilities who treat

brain injury at

> > >1.75 ata or below. Can you document a single case of oxygen

toxicity at

> > >these pressures. Dr. Harch makes claims of oxygen toxicity.

We have

> > done

> > >almost 9000 treatments since April 2003 without a single

case. There may

> > >have been a possibility of an issue to oxygen sensitivity but

I don't

> > think

> > >so. In the beginning when we were treating 7 days a week,

stress and

> > >exhaustion created some problems but after we went to 6 days

with a more

> > >relaxful atmosphere, it was no longer a problem.

> > > >

> > > > I would like to hear your comments. If you would prefer

to

> > comment to me

> > >privately, you may do so at rhartsoe@s...

> > > >

> > > > Of course, references will be appreciated.

> > > >

> > > > As you know, Dr. Harch cannot find the time to comment on

any of these

> > >list, even the the hbot professionals list. Oxygen toxicity

can be a

> > >serious issue and should not be used to scare people unless it

can be

> > >documented. If it can be documented at these low pressures we

need to

> > do so

> > >and let the consumer know with proper advice on what to

> > do. Protocols need

> > >to be changed to once a day or whatever it takes. As I

said, I have

> > >never seen this problem. I know what to look for according

to the

> > training

> > >and the text books, etc. So if there is something new, it

needs to be

> > >added to these references.

> > > >

> > > > thanks

> > > > Hartsoe

> > > >

> > > >

> > > >

> > > >

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Dear Lynn,

brain injuries impair the blood brain barrier, and the vascular and tissue

protective mechanisms against oxidative effects.

Carbon monoxide can damage CNS organs and structures, induce coma, etc..

In this scenario, excessive oxygen cannot but damage further.

Spasticity ensues more rapidly after high pressures and concentrations,

and degradations of the condition are more difficult to treat or become fixed.

Certain symptoms are expected in any brain injury,

and some of those can be confused with the ensuing oxygen sensitivity (some

people call it toxicity, blaming innocent oxygen...).

Monoxide is considered the main foe, and free radical damage by excess oxygen is

not given the proper attention,

so USN Table 5 is usual protocol.

You are right: individuals can be, -and are- thus treated,

but should they?

I do not believe it conducive to an optimal treatment.

Best regards.

Ignacio Fojgel, M.D.

Buenos Aires, Argentina.

dubblmom wrote:

> While I know that is asking for info regarding treatment at 2

> ata or less, this discussion brings to mind a question I've had for

> some time but never had answered. It is my understanding that in

> acute situations such as carbon monoxide poisoning or a diving

> accident, individuals can be treated at signficantly higher pressures

> than 2 ata and for fairly extended periods of time. Do these

> individuals exhibit toxicity issues? It would seem to me that if

> there is any concern that toxicity can develop at less than 2 ata,

> then it would be a really serious concern in acute situations. OTOH,

> perhaps it is more important that the poisoning or whatever condition

> be treated, even if there are risks of toxicity. Perhaps the

> possibility of toxicity is the lesser of the evils? If someone can

> shed light on this for me, I'd appreciate it.

>

> Lynn

>

>

> > > > >This is to any and all hyperbaric facilities who treat brain

> injury at

> > > > >1.75 ata or below. Can you document a single case of oxygen

> toxicity at

> > > > >these pressures. Dr. Harch makes claims of oxygen toxicity.

> We have

> > > > >done almost 9000 treatments since April 2003 without a single

> > > > >case. There may have been a possibility of an issue to oxygen

> > > > >sensitivity but I don't think so. In the beginning when we

> were

> > >treating

> > > > >7 days a week, stress and exhaustion created some problems but

> after we

> > > > >went to 6 days with a more relaxful atmosphere, it was no

> longer a

> > >problem.

> > > > >

> > > > >I would like to hear your comments. If you would prefer to

> comment to

> > >me

> > > > >privately, you may do so at rhartsoe@s...

> > > > >

> > > > >Of course, references will be appreciated.

> > > > >

> > > > >As you know, Dr. Harch cannot find the time to comment on any

> of these

> > > > >list, even the the hbot professionals list. Oxygen toxicity

> can be a

> > > > >serious issue and should not be used to scare people unless it

> can be

> > > > >documented. If it can be documented at these low pressures we

> need to do

> > > > >so and let the consumer know with proper advice on what to do.

> > >Protocols

> > > > >need to be changed to once a day or whatever it takes. As

> I said, I

> > > > >have never seen this problem. I know what to look for

> according to the

> > > > >training and the text books, etc. So if there is something

> new, it

> > >needs

> > > > >to be added to these references.

> > > > >

> > > > >thanks

> > > > > Hartsoe

> > > > >

> > > > >

> > > > >

> > > > >

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Dear ,

Chronic Altitude Sickness is another model for your concept.

Those chronic patients show free radicals damage from hypoxia.

CAS adds reactive polycytemia and blood hyperviscocity, etc..

Nonetheless, acute carbon monoxide intoxication with CNS injury,

as any other acute brain injury, is excedingly more likely to have those issues.

Best regards,

Ignacio

Ignacio Fojgel, M.D.

Buenos Aires, Argentina

P Stoller MD wrote:

> While toxicity can take place in anyone and at any pressure, the general

> rule of thumb is that patients that have had to adapt to low oxygen

> tensions over time, such as individuals with COPD or Sickle Cell Disease,

> are much more likely to have toxicity issues than the average man on the

> street.

>

> KP Stoller, MD, FAAP

> Assistant Clinical Prof, UNM HSC Dept Pediatrics

> Simply Hyperbarics

> www.simplyhyperbarics.com

>

> > While I know that is asking for info regarding treatment at 2

> > ata or less, this discussion brings to mind a question I've had for

> > some time but never had answered. It is my understanding that in acute

> > situations such as carbon monoxide poisoning or a diving

> > accident, individuals can be treated at signficantly higher pressures

> > than 2 ata and for fairly extended periods of time. Do these

> > individuals exhibit toxicity issues? It would seem to me that if there

> > is any concern that toxicity can develop at less than 2 ata, then it

> > would be a really serious concern in acute situations. OTOH, perhaps

> > it is more important that the poisoning or whatever condition be

> > treated, even if there are risks of toxicity. Perhaps the

> > possibility of toxicity is the lesser of the evils? If someone can

> > shed light on this for me, I'd appreciate it.

> >

> > Lynn

> >

> >

> >> > > >This is to any and all hyperbaric facilities who treat brain

> > injury at

> >> > > >1.75 ata or below. Can you document a single case of oxygen

> > toxicity at

> >> > > >these pressures. Dr. Harch makes claims of oxygen toxicity.

> > We have

> >> > > >done almost 9000 treatments since April 2003 without a single

> >> case. There may have been a possibility of an issue to oxygen

> >> sensitivity but I don't think so. In the beginning when we

> > were

> >> >treating

> >> > > >7 days a week, stress and exhaustion created some problems but

> > after we

> >> > > >went to 6 days with a more relaxful atmosphere, it was no

> > longer a

> >> >problem.

> >> > > >

> >> > > >I would like to hear your comments. If you would prefer to

> > comment to

> >> >me

> >> > > >privately, you may do so at rhartsoe@s...

> >> > > >

> >> > > >Of course, references will be appreciated.

> >> > > >

> >> > > >As you know, Dr. Harch cannot find the time to comment on any

> > of these

> >> > > >list, even the the hbot professionals list. Oxygen toxicity

> > can be a

> >> > > >serious issue and should not be used to scare people unless it

> > can be

> >> > > >documented. If it can be documented at these low pressures we

> > need to do

> >> > > >so and let the consumer know with proper advice on what to do.

> >> >Protocols

> >> > > >need to be changed to once a day or whatever it takes. As

> > I said, I

> >> > > >have never seen this problem. I know what to look for

> > according to the

> >> > > >training and the text books, etc. So if there is something

> > new, it

> >> >needs

> >> > > >to be added to these references.

> >> > > >

> >> > > >thanks

> >> > > > Hartsoe

> >> > > >

> >> > > >

> >> > > >

> >> > > >

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