HYPERBARIC MEDICINE

Dr. Michael Ott

THE PRESSURIZED OXYGEN therapy popularized as a treatment for scuba divers suffering from decompression sickness has become an accepted and sometimes under utilized therapy option for people suffering from chronic wounds.

Hyperbaric Oxygen Therapy, or HBOT, works by having patients breath 100 percent oxygen, instead of the 21 percent we breath normally — and a special chamber allows you to breath the oxygen under increased pressure, resulting in the oxygen-enriched bloodstream that speeds healing.

Medicare now has approved more than a dozen conditions as eligible for reimbursement, including the recent addition of diabetics who suffer from wounds in their lower extremities that have not healed within 30 days and show a level of severity that warrants the therapy.

HBOT helps chronic wound patients because of its impact at the microscopic level inside blood vessels. To grow healthy tissue, you must first grow new microscopic blood vessels and a course of hyperbaric oxygen therapy can lead to a seven-fold increase in the affected area. The impact can be dramatic and life changing as it helps wounds to finally heal.

That same process can benefit anyone who’s undergone radiation treatment, a beneficial therapy that can also have the unwanted side affect of attacking those tiny blood vessels that are so vital for the ability to heal following surgery or an injury to the irradiated area. In some cases, radiation patients can even benefit from using HBOT as a preventive measure before surgery, what’s known as prophylactic use. As with any treatment option, it just takes a conversation between doctor and patient to decide the best course of action.

The therapy itself is painless, although some patients do report feeling some “fullness” or popping as their ears adjust to the chamber’s changing pressure, similar to the feeling during take off and landing in an aircraft.

A TRAINED physician is always present to monitor the HOBOT therapy. Multi-person chambers, like this one, even allow the physician to be by the patient’s side during treatment if needed.

Hyperbaric therapy is also closely tied to scuba diving. If a diver rises to the water’s surface too quickly or stays down too long, dangerous air bubbles can form in the body causing the decompression sickness commonly known as “the bends.” Those air bubbles can be fatal or cause chronic health problems.  HBOT helps shrink the dangerous bubbles by a combination of pressure and oxygen breathing to eliminate the nitrogen bubbles.

Hyperbaric Oxygen Therapy also can benefit burn victims and aid in the healing of skin grafts. Plus in the 1960s, HBOT researchers discovered the potentially life-saving benefits in treating victims of carbon monoxide poisoning.

A trained physician is always present to monitor the therapy.  Multi-person chambers even allow the physician to be by the patient’s side during treatment if needed. Outpatient Hyperbaric Oxygen Therapy is the norm. For outpatients with chronic wounds, soft tissue or bone infections, or radiation tissue damage a course of therapy may include 20 to 40 sessions inside the hyperbaric chamber, with one session per day, five days a week.

It’s a time commitment well worth the investment in terms of the impact on quality of life and a potential therapy that any chronic wound patient should discuss with their physician.

Dr. Ott is a board-certified Pulmonolgist/Intensivist at Melbourne Internal Medicine Associates in Brevard County, Florida. He’s also board-certified in Undersea and Hyperbaric Medicine and is the Medical Director for the Hyperbaric Oxygen Program at Health First, which operates an eight-person hyperbaric chamber located at the Health First Wound Management and Hyperbaric Center in Palm Bay. A certified SCUBA instructor, he’s a member of the National Oceanic and Atmospheric Administration (NOAA) Diving Medical Review Board and has participated in numerous NOAA research diving expeditions. Dr. Ott earned his medical degree from Wake Forest University and performed his Residency and Fellowship training with Mayo Clinic.

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