Re: Healing Under Pressure (HBOT treatments)

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http://miraclemountain.homestead.com/MiracleMountain.html Here is a website for Miracle Mountain. They provide HBOT at greatly reduced prices and housing for about $10./night. Love, Anita Healing Under Pressure (HBOT treatments) This article is primarily about HBOT on horses.However, HBOT has helped women recover from implantrelated diseases. Both Patty and I have used HBOT.--When I was doing HBOT, they were making progress witha child who was a victim of a near-drowning incident.If you have the resouces to get these treatments, Iwould suggest checking HBOT out.Rogene---------------Healing Under Pressure by: February 2004 Article # 4922 http://www.thehorse.com/viewarticle.aspx?ID=4922Oxygen is one of the most crucial components of theenergy production process that fuels body tissues. Itsustains life and enables injured tissues to heal Inrecent years, a very effective procedure for helpingheal many ailments has developed from the idea thatfor optimum healing, more oxygen than is normallycontained in and surrounding our bodies can bebeneficial. As usual, when human medicine makes abreakthrough, it isn't long until someone figures outhow to help horses with that same type of therapy.Enter hyperbaric oxygen therapy (HBOT) for horses.How It Works Hyperbaric oxygen therapy involves subjecting thepatient to high levels of oxygen under pressure in aspecial chamber. At normal atmospheric pressure, thereis a limit to the amount of oxygen carried by redblood cells and only a tiny amount of oxygen isdissolved in the plasma. HBOT is discussed in terms ofatmospheres absolute (ATA). Atmospheric pressure atsea level is equal to 1 ATA Higher pressure than thison the body would be similar to what a person wouldexperience under water; each 33 feet (10 meters) ofsea water provides an equivalent increase of 1 ATA ofpressure. Thus when you are 33 feet under water, youare experiencing 2 ATA (one from normal atmosphericpressure and one from the addition of 33 feet of seawater). This gives an idea of the pressure you wouldfeel in an oxygen chamber. Treatments in a chamber aregiven at 1.5 to three times the pressure of oneatmosphere.Increasing the amount of air breathed cannotsignificantly improve oxygen delivery to the body byway of hemoglobin, even if you breathe pure oxygen.But with increased pressure, the oxygen level in bloodplasma increases, with higher delivery to all bodytissues. Under these conditions, oxygen is physicallydissolved in the plasma, even in the veins (whichordinarily carry only blood that is depleted ofoxygen). The dissolved oxygen is more readily utilizedby the body than the oxygen carried by red bloodcells.In humans, pressure chambers are used to speed healingof soft tissue injuries, aid recovery of strokevictims, and in treating many problems--includingcarbon monoxide poisoning, coma, burns, circulatoryproblems, Lyme disease, lung abscesses, difficultwounds, bone infections, hard-to-treat infections(especially those caused by anaerobic bacteria),traumatic brain injuries, spider bites resulting innecrotic (dead) tissue, and diabetes (preventingnon-healing infections and amputations). Many studiesshow HBOT's efficacy in treating wounds and ischemictissue (that is deprived of blood), reducing edema,and stimulating the immune system.The patient is put in a chamber and the air pressureis slowly increased. When it reaches the prescribedpressure, pure oxygen is put in to replace the air.Normal partial pressure of oxygen in the arterialsystem is about 100 mm of mercury (mmHg). The oxygenlevel in the air inhaled at a pressure of threeatmospheres (in a pressure chamber) would be near2,280 mmHg. The actual amount in the arterial bloodwould be somewhat less than that, but this is a muchhigher amount than is normally dissolved in the blood,says Fairfield Bain, DVM, Dipl. ACVIM, ACVP, ACVECC,of Hagyard-son-McGee Veterinary Associates inLexington, Ky. The oxygen is forced into the blood andbody fluids, making its way to any damaged areas ofthe body that can't be reached by normal bloodcirculation or areas where vessels have been hinderedby injury or infection.HBOT for Horses A few years ago, the first pressure chamber for horseswas created by Equinox Technologies Limited inVancouver, British Columbia, and the first availableunit was purchased by Doug Herthel, DVM, for his AlamoPintado Equine Medical Center in Los Olivos, Calif. Itwas a mobile unit built like a large trailer that heldtwo horses at a time.Equinox had taken their first experimental chamber totwo racetracks n Canada, where it was tested on racinginjuries in Thoroughbreds and Standardbreds. Herthelhad been trying to develop a similar chamber for aboutsix years. "We actually started building one in 1994,but the mechanics of it became too difficult. We wereworking with a Navy contractor, making one fromconcrete, but testing showed it wouldn't hold up topressure. After Equinox came up with theirs, we wereecstatic," says Herthel.He now treats horses from all over the country with anewer 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 andHagyard-son-McGee Equine Hospital in Lexington,Ky.; KESMARC (an equine rehabilitation center) inVersailles, Ky.; Fossil Creek Veterinary Clinic inLoveland, 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 partnersin Equine Oxygen Therapy. Bain serves as vicepresident and medical adviser for the group.This partnership has designed several models forhorses. "The function of our chambers has not changed,but we keep improving them for ease of use, operatorsafety, and comfort and safety of the horse," says. "The most recent model--which was justinstalled at Hagyard-son-McGee--is the biggestone in existence at present. It is more than nine feetin diameter, opens at the back and front, and isstationary. The one we are designing now is a roundstall, 10 feet in diameter and 9 1/2 feet tall. It'srecessed into a concrete pad, so the horse doesn'thave to walk up a ramp. He goes through a 42-inchdoor, you turn him loose, and he can walk aroundwithout being restrained in any way. A horse withlaminitis 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 wasdesigned to be taken around the country. Horsesaccustomed to a trailer were comfortable in it, andfoals were small enough to turn around in it, butyoung, inexperienced horses often became frantic. Thelarger chambers available now seem to work better.A horse being treated is put into the chamber for30-90 minutes once a day, for however many treatmentsare needed for that particular condition."It's usually a 90-minute treatment, once the chamberis up to pressure," says Herthel. "Some conditionsrequire only one or two treatments; others need 10 to20 treatments In severe cases of laminitis, we maytreat a horse twice a day."Not only does the treatment increase oxygen levels,but the pressure helps reduce swelling anywhere in thebody. Herthel uses it for severe limb edema,lymphangitis, etc. "Any instance where there isswelling--in the brain, the foot, or intestines--theoxygen therapy is helpful," he says. "The pressure persquare inch in the chamber is incredible. It's likebeing 60 feet under water."Herthel says that care must be taken using HBOT. Shortdaily treatments are better than prolonged sessions,since exposure to high-pressure oxygen for longperiods could lead to oxygen toxicity."You also take precautions to have the humidity in thechamber just right, and ground the horse," saysHerthel. "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 toground the horse, depending on the chamber, either arubber strap can be attached to the horse's body orthe horse can stand on a rubber mat.Commonly Treated Conditions HBOT is one of the most powerful tools available as anadjunctive form of therapy, and in some cases it workswell as the primary therapy in horses, says Casner.Colic and laminitis are the number one and twokillers, respectively, of horses, and oxygen therapy(in conjunction with other therapies) can be veryuseful in treating both.Colic--HBOT helps restore blood flow to tissues aftercolic surgery. Herthel says it also reducesobstructive swelling in the intestinal tissue andimproves oxygenation of the resection (after abdominalsurgery to correct colon torsion, small intestinestrangulation, etc.). Herthel has found that manycolic cases respond much better to surgery whentreated with HBOT before and after surgery. says HBOT is used in human medicine to relieveor prevent gaseous buildup after abdominal surgeries."This also works well in horses, and we are hopingthere will be a study on gas colics," he says.Laminitis and navicular syndrome--HBOT can arrestlaminitis in the early stages, Casner says. "If youcan treat the horse before the structures in the footcollapse (before there's crushing of the bloodvessels), it is very effective," explains Casner. "Inolder stallions, the two things that most commonlykill them are colic and laminitis."Effects of oxygen therapy on problems like navicularsyndrome and laminitis are now being studied.Researchers at the University of Tennessee arestarting controlled studies on laminitis to get thedata needed to document the effects of HBOT."They will be working with different stages oflaminitis, with a control group to make comparisons,to see how well this really works," says ."At Hagyard-son-McGee Equine Hospital, they'vetreated acute onset cases of laminitis that resolvedvery quickly and successfully," says . "There'sa better success rate if you can start treatment rightaway, rather than waiting a week--after the damage isdone. We are hoping that after the controlled studiesare published, the veterinary community will embracethis, and people will start HBOT earlier in the courseof the disease."Infections--HBOT increases blood flow to the infectionsite, which increases the amount of antibioticdelivery. The extra oxygen also increases theeffectiveness of the antibiotic, magnifying the way itworks against bacteria. Herthel says that high-doseoxygen "tends to potentiate the effect of someantibiotics, such as sulfamethoxazole (SMZ). You arealso getting 15 times the amount of oxygen to a tissuethat was lacking oxygen due to infection or poorcirculation." Oxygen also stimulates faster cellturnover, and thus faster healing.Casner says, "Oxygen acts to kill bacteria. Mostbacteria causing serious infection areanaerobic--working best in an environment withoutoxygen. At pressure, with oxygen at a higher level, itis also detrimental to aerobic bacteria."Extra oxygen also helps white blood cells functionbetter to kill the organisms.Bain adds, "Certain antibiotics such as gentocin andamikacin don't work well in low-oxygen environments.Oxygen therapy enhances their function and gives awhole combination of benefits. HBOT is an adjunctivetherapy; we are still using antibiotics andanti-inflammatory drugs and other treatments. It's acomponent process in which everything is workingtogether."Abscesses--Internal abscesses (such as in the lungs orthe abdomen) are sometimes not diagnosed early. says, "By the time they are diagnosed, thereis a thick-walled capsule of connective tissue aroundthem that keeps antibiotics from reaching the site.This results in prolonged antibiotic treatment (oftenwith no resolution of the abscess) at high cost to theowner, and potentially fatal consequences for thehorse. HBOT helps the antibiotic get to the site andenhances its ability to fight the infection."Bone injuries--Casner says studies have been done inwhich fractures were created in rabbits, with HBOTused to treat one group and a control group withouttreatment. The rabbits were euthanized to determinethe amount of healing. In the rabbits treated withHBOT, the bones healed not only faster, but stronger.Septicemia and joint ill in foals--AtHagyard-son-McGee, Bain and Slovis, DVM,Dipl. ACVIM, evaluated HBOT for treating foals withseptic joints. In 2002, all the foals which came intothe clinic with septic joints went through a standardprotocol using systemic antibiotics, lavage to flushthe joints with antibiotics, etc. After 30 to 90 days'treatment, they took the foals which were hopeless(which would ordinarily be euthanized) and moved theminto a test group. They continued to use theirstandard treatments, but combined them with HBOT. Theyhad a 60% recovery rate in foals which were going tobe put down!Infection eats the bone away, but with oxygentreatment the joints healed and the integrity of thebone was regenerated. Bain says, "The changes we seeon X rays in these foals indicates dead bone. Eventhough we have the foals on antibiotics, there is poorblood supply to dead bone; the antibiotics don't getthere and are not very active if they do. Even if thefoal survives, the body has to clean up all that deadtissue. HBOT stimulates and enhances the clean-upprocess and healing process to speed resorption ofdead bone. It can also help salvage some tissues thatwould otherwise go on to die."Soft tissue injuries--Many injuries result ininflammation and swelling. Studies have shown thatsoft tissue injuries treated with HBOT recover in halfthe time. New blood vessels form more quickly,improving blood supply to injured areas, and there isswift reduction in edema (swelling). Since oxygen isnormally carried by red blood cells, any tissues witha compromised blood supply suffer from poor healing.But with HBOT, oxygen is forced into all body fluidsand delivered to areas with restricted circulation.Injured tendons and ligaments respond well totreatment; HBOT can be useful in dealing with bowedtendons, surgical repair of tendon or ligamentinjuries, etc. Surgical traumas (incisions) also healfaster with HBOT, as do large surface wounds andpressure sores It decreases tissue swelling and helpssalvage damaged tissues in traumatic injury. Inchronic wounds, it assists growth of new skin andstimulates collagen production.Bain says, "In a severe wound with lots of tissuedamage, there is usually a certain amount of sloughingaway. Using HBOT early in treatment may salvage someof the tissues that have lost their blood supply; wecan sometimes save bits around the margin and reducethe amount of tissue lost."Reproductive problems--Herthel wrote an article threeyears ago describing how he'd treated some olderstallions for laminitis and noticed an increase infertility. After reading that, Casner decided to treatWinStar's stallion Kris S. in the chamber, and therewas a ery dramatic change The stallion's covers inthe breeding shed had declined, but after HBOTtreatments his libido increased (along with his spermcount), and the morphology (cell structure) of hissemen was much improved.Casner says HBOT has also worked well for mares theyhadn't been able to get in foal. "We treated four outof five mares one year that had been bred on multiplecovers," he says. "We finally put them in the chamber,and they got in foal the next time they cycled. Wedon't entirely understand why it worked, but suspectthere may have been a bacteria involved that we wereable to eliminate with the oxygen treatment. Weprobably also enhanced the integrity of the uterinelining." has also treated mares which were unable toconceive. "One mare went to the breeding shed 16 timesin two years without becoming pregnant. After threetreatments in the chamber, she was bred, and had alive, 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 theback of their lungs," he says. "We bring them to thefarm, put them in the chamber, and give them five orsix treatments in combination with antibiotics. We'vehad very good esults in clearing up the infection andhealing the lung tissue."Dummy foals and other neurological problems--"We useit on dummy foals because it reduces edema," saysCasner. "The oxygen in a pressure chamber has theability to penetrate the cerebrospinal fluid." Headand spinal trauma often create neurological damage,thought to result from swelling of these tissueswithin a confined space, loss of blood and oxygensupply, and the sequential effects of these factors onnervous tissue. HBOT reduces the swelling andincreases the blood supply."We've also used HBOT experimentally on EPM," saysCasner. "There are many things it holds promise for;it will be another strong tool in the veterinarian'sarsenal."Spreading the Word "HBOT is an amazing tool, and the veterinary communityis starting to embrace it, but there are some who areso traditional in their forms of treatment that theycontinue to be very narrow in their vision--thoughthere are volumes of clinical research in the humanfield to support this therapy," says Casner."Dr. Bain says hyperbarics is the most significantveterinary tool since the ultrasound machine," Casneradds. "He recently worked with a racehorse with a lungabscess that was treated with conventional methods for30 days and continuing to worsen. The trainer thenrequested that hyperbarics be combined withtraditional treatment. Dr. Bain was then able to healthe horse in a very short time."But veterinarians who have chambers are cautious aboutusing this routinely even though they want to. "I usethe term 'cautious' only in the spirit of selectingappropriate patients for HBOT treatments and not justtreating any willy-nilly problem," says Bain. "Thetheoretical applications are considered for eachpatient's clinical problem before considering HBOT asa treatment modality.""Oxygen therapy is nothing short of miraculous intreating many problems--especially infections--but thequestion a lot of people have is that if it's so good,why aren't more veterinarians doing it? Many vets havenever heard of it; this treatment was not taught invet school, and until recently there were no equinechambers," explains Casner. "Most veterinarians haveno experience with it. But this will eventuallychange"Herthel says HBOT is such a powerful tool, "that theway we use it, oxygen is a drug." He feels thateventually more veterinarians and equine clinics willuse this, and that there should be a chamber in everymajor horse center."It can save a horse in many situations where there isno hope otherwise," says Herthel. "We have horsesdoing fine today that had acute laminitis and wouldnot have made it without the oxygen therapy. We'vetreated many horses with bone infections that wouldhave died. Some of the colics with intestinalobstruction, and some horrific infected wounds, canturn around quickly with oxygen treatment."This useful tool can make the difference between lifeor death for many horses, he says. However, HBOT canget expensive with one treatment session running$400-$500. The type of injury or illness being treatedwill determine how many sessions are needed.Bain says that since HBOT is such a new therapeuticmodality to the horse, there isn't much research outthere yet. "We've had a few small clinical casestudies that Dr. Herthel has done or that we've donehere at our hospital," says Bain. "But there have beenno basic research projects yet at academicinstitutions involving the horse specifically. Manymedical schools have hyperbaric facilities, however.Duke University is a leader in this field, along withthe 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 boneinfections, burn injuries, etc.), and this isbasically how HBOT is applied to human medicine."Usually medicine looks at what animal research hasdone and applies it to humans," says Bain. "We arelooking at what they are doing with people andapplying it to horses--and hoping this will find itsplace in veterinary medicine."