<blockquote id="quote"><font size="1" face="Verdana, Arial, Helvetica" id="quote">quote:<hr height="1" noshade id="quote"><i>Originally posted by Pam</i>
Hyperbaric Therapy is one of those areas of medicine that has well-documented success in some applications, but is promoted for other uses with no documented or scientifically reproducible benefits.
I work as a Respiratory Therapist at a large teaching hospital in Canada. I am also the daughter of a lovely lady who passed away in 1995, misdiagnosed with PD for 21 years until she lay dying in the hospital and was seen by a new neurologist, who pointed out she had PSP. So I'm very interested in PSP, but also have professional insight into hyperbaric.
Our hospital has a very busy hyperbaric chamber, one of the few publicly available in Canada (i.e. patients don't need insurance to use it). We treat only patients who have conditions recognized as treatable in hyperbaric oxygen. The very few available private chambers in Canada are promoted to patients who are seeking unproven therapy out of "desperation", including cerebral palsy, and possibly other neuro diseases as well, or who do not want to wait on the hospital's waiting list. They pay "out of pocket", and I'm sure it is very expensive.
Hyperbaric Oxygen Therapy is proven (meaning there are well designed studies with positive results on many patients) to work in the following ways:
1. hyperoxygenates - the amount of O2 in the blood plasma increases 10 to 15 times, which obviously makes O2 more available to cells
2. neovascularizes - it stimulates the growth of new tiny blood vessels, especially in damaged tissue (e.g. from cancer radiation)
3. antimicrobial - it directly and indirectly fights bacteria and the toxins produced by the bacteria
4. vasoconstriction - high levels of oxygen cause blood vessels to constrict (an interesting paradox) which reduces swelling, useful when the swelling is cutting off blood supply to an area of injury
5. decreasing overactivity by leucocytes (immune cells) - this over-activity can cause damage just when the healing is starting
6. direct pressure - the high oxygen pressure reduces the capacity of the blood for other gases, like nitrogen (in treating "the bends") and carbon monoxide (smoke inhalation)
These mechanisms are very useful to the Respiratory Therapists and Physicians who treat patients in hyperbaric oxygen.
The "indications", or reasons for the use of hyperbaric are the treatment of:
Carbon monoxide poisoning - from smoke inhalation caused by a fire or suicide attempt
Necrotic (dying) tissue: gangrene caused by diabetes, gas gangrene (caused by Clostridium bacteria), third degree burns, radiation necrosis (death of tissue caused by cancer radiation therapy, especially in cancers of the jaw and facial bones which are difficult to treat); also in cases of extensive infections that are hard to treat with antibiotics
Arterial Gas Emboli - bubbles of gas in the bloodstream from rapid decompression after a scuba dive or from other causes
Crush injuries - helps in increasing blood flow to areas with damaged blood vessels
Severe anemia, or when blood transfusion is impossible or refused
As you can see from this long and probably boring explanation, Hyperbaric Oxygen Therapy is really great when the problem is blood flow related. There is no evidence of any mobility improvement in patients with neuro disorders, and as you know the movement problems in PSP are brain-related, not muscle-tissue related. Hyperbaric will usually help heal painful pressure sores that impede full movement, so this might be a benefit to the PSP patient.
I write this (long long) reply in hopes that those who read it can avoid spending huge sums of money on treatment that is promoted as helpful when it really isn't for their disease. It's very easy for a few "successes" to be produced by almost any "therapy", when really the improvement would have happened anyway. Hyperbaric Therapy seems very strange and magical to the non-medical person, but there is good research and strong evidence that our practise is based on. Your patient's improvement was more likely from the OT and and your PT sessions.
The oxygen he is receiving from a tank is not at all similar to the effect of hyperbaric oxygen therapy. Patients with PD and PSP often have a reduction of movement in their chest wall and diaphragm muscles, which leads to shallow breathing, low oxygen and high carbon dioxide in their blood. They can benefit from extra oxygen as their bodies are working so hard to breathe, move, etc. And aspiration can damage the lung tissue, so parts of the lungs can't pass oxygen into the blood. By the way, oxygen doesn't last in the blood stream, it's gone in minutes. Perhaps he would do better with less oxygen (1-2 l/min) for the whole day? or just while sleeping and during exertion? Just a thought. 2 hours a day of oxygen from a tank is a bit odd.
As far as supplements go, my mum had many many vitamin and mineral supplements, who knows if they worked or not, but she lived for 21 years (from age 50 to 71) with PSP and was only in a really bad way for the last 3 or 4 years. She had great bones (and took lots and lots of calcium) and even with all the falls, never broke a bone until her hip, a month before her release from her body. I think she's having a much better time now, and I'm sure she's making up for all the talking that she couldn't do!
Keep up the good work! I'm sure what you do is of great help to this poor fellow.
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