|Hyperbaric Oxygen Therapy (HBO) is an approved medical therapy that is commonly used to treat conditions such as decompression sickness, diabetic or non-healing wounds, and carbon monoxide poisoning. It is also used experimentally for traumatic brain injury, stroke, cerebral palsy, burns, Autism, Multiple Sclerosis and Lyme disease. SCUBA divers frequently use hyperbaric chambers for decompression sickness commonly know as the bends, associated with deep-sea exploration.
Hyperbaric chambers and hyperbaric oxygen therapy have been in use for centuries, dating back to as early as 1662. However, hyperbaric oxygen therapy has been used clinically since the mid 1800's. HBO was tested and developed by the U.S. Military after World War I. HBO is the delivery of a drug “oxygen” under pressure, and is currently considered one of the safest medical therapies in health care.
The use of HBO as a treatment for Lyme disease is relatively new, yet seems to be showing promise. I would like to provide a brief introduction to the various types of HBO treatments available, followed by my personal experience with HBO. Since increasing numbers of patients appear to be seeking out alternatives to antibiotics, my intention is to provide Lyme patients with another viable option in their treatment plan.
Although HBO is labeled as “experimental” by much of the medical community for the treatment of Lyme disease, it is becoming increasingly popular. William Fife, Ph. D., a Hyperbaric Medicine specialist at Texas A&M University, helped establish the Lyme disease protocols for HBO. The basic principle is that by exposing the entire body to 100% pure oxygen, under pressure, the Lyme disease bacteria (borrelia burgdorferi) will be destroyed. HBO offers a strong alternative to traditional antibiotic therapy, as well as a powerful adjunctive therapy.
Normally, the earth’s atmosphere exerts approximately 15 pounds per square inch of pressure (psi) at sea level. In hyperbaric medicine, the pressure at the earth’s surface is defined as 1 atmosphere absolute (1ATA). Human beings breathe about 80% nitrogen, and 20% oxygen. During HBO, the atmospheric pressure doubles to 2 atmospheres absolute (2ATA), while breathing 100% pure oxygen. The increase in oxygen, combined with the increase in atmospheric pressure allows significant physiological changes to take place in the body.
As the oxygen penetrates deep into the blood plasma and tissues, it stimulates the formation of new blood vessels, increases circulation to existing blood vessels, and helps those with decreased circulation heal. Most importantly for Lyme disease treatment is the potential for HBO to increase the effectiveness of antibiotics.
As documented by Dr Glen Burkland in a “ Retrospective Review of Lyme Patients who received Hyperbaric Oxygen,” Borrelia burgdorferi cannot survive in an oxygen-rich environment, because it is a facultative anaerobe. HBO therapy increases the amount of oxygen in the body, which in turn causes spirochetes to die. When combined with HBO, the effectiveness of antibiotics to kill the Lyme organism is increased as the medication is pushed deep into the body, attacking the spirochetes.
When a patient is pressurized in a hyperbaric chamber, the forces acting on the body are quite similar to diving under the ocean. Patients who are undergoing HBO experience “diving” much the same way as SCUBA divers do. The beginning of an HBO treatment starts with pressurization, or going down. Once the chamber is pressurized to the desired depth, the patient remains “at pressure” for 60-90 minutes. It is common to take a five minute “air break” to avoid oxygen toxicity and breathing compressed air through a special mask inside the chamber. The final phase of an HBO treatment is depressurization, or coming up.
There are three basic types of HBO chambers, all which I have experience with. The first is a single person, or monoplace chamber. A monoplace chamber looks like a large capsule, with a control panel on the outside for the hyperbaric technician. Monoplace chambers are capable of “diving” to pressures of 3.0 ATA. A single patient lies on a moving stretcher as the entire body is exposed to 100% pure oxygen. Monoplace chambers appear to be the best chambers for chronic Lyme disease patients because 100% pure oxygen is pushed in through the skin, where spirochetes like to hide out.
The second type of hyperbaric chamber is called a multiplace (multiple person) chamber. Multiplace chambers are common in hospitals and clinics because they can accommodate up to 12 people, depending on chamber size. Treatment in a multiplace chamber requires that you wear a plastic hood over your head and breathe oxygen through vents in the hood. Multiplace chambers are a good choice for parents and children, or for those patients who need a nurse to accompany them in the chamber.
The third type of chamber is called the mild hyperbaric chamber. Mild chambers are basically inflatable heavy plastic cocoons. Mild chambers require no supervision from medical professionals, and can be done at any time in your own home. Mild chambers cost about $15,000 for a used chamber, and are only capable of “diving” to the equivalent of about 10 feet below the ocean surface while breathing compressed room air. Although mild chambers may help boost the immune system, they do not have the ability to dive to the pressure necessary to treat Lyme disease.
Your Lyme literate medical doctor will help you determine which chamber is best for your personal needs, and a prescription is required to begin HBO treatment. There is a whole list of precautions and preparation, which I will be explaining in part 2 of “Deep Diving for a Cure.”
I began HBO as an adjunctive therapy to my antibiotic protocol. My treatment began with a series of 60 treatments in a monoplace hyperbaric oxygen chamber. My prescribed HBO protocol consisted of a series of two treatments daily, at 2.4 atmospheres, (ATA) the pressure and depth shown in studies by Dr. William Fife, to kill borrelia burgdorferi. A pressure of 2.4 atm is the equivalent to an ocean depth of 49 FSW (feet of sea water). My first dive took some getting used to, but I did well thanks to what my nurse called my "divers ears." The chamber was comfortable with a mattress, pillow and blanket if I needed it. I could watch TV, movies, and listen to music thanks to special speakers. I had a hyperbaric technician, a registered nurse, and a doctor all with me to monitor my treatments, so I was not afraid.
It took about 10 minutes to dive to pressure depth (compression), during that time I had to equalize my ears. The chamber atmosphere pressurization was gradual, allowing me time to adjust slowly to ear pressure changes. As the air pressure increased, I popped my ears by holding my nose and attempting to blow air out my nose. I found equalizing my ears very simple using the procedure the technicians taught me.
I did learn that HBO could increase blood pressure, which was wonderful for me since I suffer from neurally mediated hypotension (NMH). HBO can also lower blood sugar, so I always ate a protein rich snack before my treatments. To prevent oxygen toxicity, I was instructed to take 400 IU of Vitamin E daily, and a high quality multivitamin.
Beginning with my first HBO treatment, the impact on my body was dramatic. I began having herxheimer reactions immediately. The worst of my neurological symptoms came out during HBO. I had panic attacks, hallucinations, nerve pains, muscle spasms, encephalitis, fevers, facial flushing, joint swelling, edema, and total exhaustion. I grew so debilitated from the herxing that my Mom had to stay with me all the time, feed me and help administer my IV's. The flushing in my face was so bad it felt like I had a severe sunburn 24/7, and I was so dizzy because all my blood was in my skin. To manage the Lyme anxiety brought out from all the herxing, my LLMD prescribed Zoloft and Xanax to help me control my symptoms.
After the initial six weeks of HBO, I went home to lie in bed while the herx cleared. I could not handle lights being on, cars driving by the house, any noises or sounds. Even people talking had me shrieking in pain from my brain inflammation. All I did besides sleep was stare at my lava lamp for hours in the darkness. Monoplace chambers made me herx so hard; I had visible shakes, muscle twitching, rashes and nerve pain during my dives.
I continued with the treatments in the monoplace chamber for over a year. I started with 60 dives, and then did 10-15 treatments every 4-6 weeks as maintenance. I infused my IV an hour before each treatment to maximize the effect. I also did hot bath treatments before and after each dive. According to my LLMD, Hyperthermia treatments with hot baths would make the antibiotics 16 times more effective. I figured with the hot bath, and infusing my IV right before my HBO treatment, I was getting the most aggressive Lyme disease treatment available.
Right in the middle of my treatment, I decided to try a different type of oxygen chamber, the multiplace (multi-person) chamber. It was less expensive than the monoplace, and closer to home. My experience in the multiplace chamber was not positive. I found the lack of individual attention frustrating, as well as very uncomfortable. I had to sit up and wear a mask over my head. The mask kept leaking air out of the neck gasket and deflating on my face trying to suffocate me.
My treatments were interrupted countless times, and the other patients diving with me were being treated for different medical conditions than I was, and they did not want to go as deep as 2.4 ATA. I was very frustrated at the lack of quality treatment. Unlike the monoplace chamber, where I could fall asleep for 90 minutes, I could not rest in the multiplace chamber. I was forced to sit upright, which made me weak and dizzy. I did not experience any herxing from the multiplace chamber, which to me meant that is was not powerful enough. After 2 weeks in the multiplace chamber, I knew it was not working for me, and went back to the monoplace chamber.
I found out later from my LLMD that in the multiplace chamber, I did not absorb the pressurized oxygen through my skin, which is where spirochetes like to hide. The hood had a design flaw, and it lost its potential effectiveness through air leaks. I was also told that seated in the multiplace chamber I was only experiencing approximately 1.7-2.0 ATA, despite what the pressure gauge read. Even when the hood was changed to a mask, and I was taken to 2.4 ATA, the treatment still felt “wimpy”, and I was frustrated at the amount of time and money I wasted.
On a break from my monoplace hyperbaric treatments, just for kicks, I tried out a portable, mild hyperbaric chamber that a friend of mine bought. The idea made sense, a portable chamber in your own house. After a week of daily mild HBO treatments, the laugh was on me, and my experiment over. I got no benefit, or the slightest hint of a herx from that little capsule. As far as Lyme disease treatment goes, I would not recommend a mild chamber because of its inability to dive to 2.4-3.0 ATA.
As soon as I went back into the monoplace chamber, the herxing began. I experienced muscle twitching, neuropathy, and even rashes coming back again on my skin from my original tick bites, amazing things! My herxing was so strong back in the monoplace chamber that I needed medical intervention to calm it down, and a break from the antibiotics. All the bacteria die-off and herxing caused a build up of toxins in my body. I did everything possible to detox, including FIR sauna, hot Epsom salt baths, acupuncture, colon cleansing, Questran, and a large variety of supplements.
After a month’s rest, I continued my dives, all the while taking multiple antibiotics, both IV, and oral. My energy and stamina increased steadily after my HBO treatments ended. Each day I felt better and better. My brain fog disappeared, my skin rashes were gone for good, and my muscles and joints were no longer painful and swollen. Antibiotics took me to a certain stable level of functioning, and HBO raised me up to an even higher level of functioning.
Based on my experience with HBO, I strongly recommend it as an adjunctive treatment for Lyme disease patients. In my opinion, HBO is the most powerful when combined with aggressive doses of multiple antibiotics. After completing over 200 HBO treatments, all combined with aggressive antibiotics, my health improved dramatically. After my first 90 dives, I began to function at a much higher level, and finally became independent. After 200 dives, I was back to climbing mountains, traveling, and enjoying life once again. Five years after completing my 200 dives, my health has remained strong, and I have never relapsed to my pre-HBO state.
There is anecdotal evidence that indicates that the Lyme disease organism can be killed by oxygen free radicals. HBO increases the production of free radicals, and it appears that the deeper the depth of treatment, the greater the number of free radicals are produced. Combined with antibiotics, there is little doubt at what a powerful combination treatment HBO offers.
According to the Lombard/Birkland study, the simultaneous use of antibiotics with HBO is strongly recommended. HBO therapy can enhance the function of the body's immune system. HBO may help Lyme patients because of the seemingly endless fight to eradicate invading organisms our immune systems must endure. Although HBO can be expensive and time consuming, I believe Lyme disease treatment is like climbing a mountain, with new treatment possibilities popping up around every corner. It was well worth the time and money to get my health back, and thanks to a brilliant LLMD, and HBO, I have made tremendous progress.
If you are interested in more information on HBO, or in doing HBO treatment yourself please refer to the links provided below. Many thanks to Julia Sudylo, Registered Nurse and Certified Hyperbaric Technician, of Julia’s Hyperbaric, for all of her insight and assistance in the writing of this article.
|In Part 1 of "Deep Diving for a Cure" I discussed the basics of the use of Hyperbaric Oxygen therapy (HBOT) for Lyme disease treatment. To summarize, the basic principle is that by exposing the entire body to 100% pure oxygen, under pressure, the Lyme disease bacteria (borrelia burgdorferi) will be destroyed.
HBOT offers a strong alternative to traditional antibiotic therapy, as well as a powerful adjunctive therapy. HBOT has shown promise as a powerful treatment option for those afflicted with Lyme disease, especially when combined with antibiotics. In my experience, monoplace (single person) chambers gave me the best results during my Lyme treatment.
I recently had the opportunity to discuss the use of hyperbaric oxygen treatment in Lyme disease with Julia Sudylo, R.N. Julia is a Certified Hyperbaric Technician (CHT), who owns, and operates a HBOT clinic in Basking Ridge, New Jersey. The following is a question and answer with Julia which will describe the basics of monoplace HBOT.
How can hyperbaric oxygen help Lyme disease patients?
Hyperbaric oxygen increases circulation to the body and that includes the brain. Oxygen crosses the blood brain barrier. This is why simultaneous use of antibiotics with HBOT is highly recommended. The increases of pressure and oxygen allow the antibiotics to penetrate deep into the body tissues where spirochetes like to hide. The 100% pure oxygen, administered at 2.4 ATA has been shown in studies (see references below) to directly kill borrelia burgdorferi.
How does HBO kill the Lyme bacteria?
Borrelia burgdorferi (Bb) is a bacterium that does not survive under increased oxygen. Just as a fish would not survive out of water, these bacteria cannot survive in an increased oxygen environment. Lyme bacteria are microaerophilic, which means that they are debilitated in high oxygen environments.The spirochete that causes Lyme prefers an environment with decreased circulation because of the lack of tissue oxygenation in those areas of the body.
According to a study by Dr. Charles Pavia, spirochetes were shown to die in the presence of hyperbaric oxygen both in vitro and in vivo. As the oxygen penetrates deep into the blood plasma and tissues, it stimulates the formation of new blood vessels, increases circulation to existing blood vessels, and helps those with decreased circulation heal. Most importantly for Lyme disease treatment is the potential for HBO to increase the effectiveness of antibiotics.
As documented by Dr. Glen Burkland in a “Retrospective Review of Lyme Patients who received Hyperbaric Oxygen," Borrelia burgdorferi cannot survive in an oxygen-rich environment, because it is a facultative anaerobe. HBOT increases the amount of oxygen in the body, which in turn causes spirochetes to die. When combined with HBOT, the effectiveness of antibiotics to kill the Lyme organism is increased as the medication is pushed deep into the body, attacking the spirochetes.
What is a typical treatment protocol?
Treatment protocols vary depending on the condition of the patient. They range from 1.5 ATA for brain injury to 2.4 ATA for Lyme disease. This does not account for Decompression Sickness (DCS) where you would require a repetitive dive sequence. Therapeutic sessions are typically 40 sessions long. However, in the Lombard/Burkland study, it was observed that more permanent results where achieved with up to 60 to 80 sessions.
Individual results vary. Typically, Lyme patients begin a protocol of 30-60 initial treatments, followed by 10 treatments every 4-6 weeks for as long as it takes for symptoms to abate. Each patient’s LLMD will prescribe an individual protocol specifying the length of treatment. Each patient responds differently. Some patients dive once daily, while others prefer the more aggressive approach of 2 dives per day.
You must have a doctors prescription for HBOT. William Fife, Ph. D., a Hyperbaric Medicine specialist at Texas A&M University, helped establish the Lyme disease protocols for HBO.
Is HBOT covered by insurance?
Currently, the insurance industry has only been friendly to a limited amount of indications. Reimbursement is limited to the 13 approved conditions by the Undersea Hyperbaric Medical Society (UHMS). Lyme is not one of the diseases that is approved, and although it has shown to be a significant benefit to Lyme patients, it is still labeled as investigational.
What are some preparations for HBO therapy?
A completed physical is indicated, including a chest x-ray. Before any session, it is advisable to consume a healthy meal, free of any carbonated drinks. For those with a history of upper respiratory infections, it is advisable to take a decongestant the evening before going to bed and in some cases before your session. Make a list of all the medications that you are taking, and make sure that you give them to the technician before your sessions.
There are several absolute rules which patients must follow during HBOT. Smoking is not compatible with HBOT. Once HBOT has been prescribed, patients should stop the use of tobacco in any form until therapy is complete. This "no smoking" rule applies to cigarettes, pipe tobacco, and cigars, as well as chewing tobacco and snuff. If a person just cannot stop the use of tobacco, HBOT will not be effective.
Cosmetics such as hair spray, nail polish, perfume, or shaving lotion containing petroleum, alcohol or oil base are not allowed while in the hyperbaric chamber. However, those products may be reapplied after each treatment. It is important to discuss all skin care products with the HBOT technician so they may assure safety.
All patients are provided with 100% cotton scrubs to wear during treatment. No articles containing nylon or polyester can be worn in the chamber. Watches and other jewelry, dentures, contact lenses and other prosthetic devices will also need to be removed before treatment. No titanium glasses, heating patches or dressings that have not been approved by the technician are permitted during treatment. No battery operated items are ever allowed in the chamber.
All medical records, prescription drugs, over the counter drugs, vitamins, and herbs are carefully reviewed for any contraindications. Additional tests may be ordered such as a chest x-ray, pulmonary function testing, examination of ear drums, prescriptions for sinus issues, etc. All patients should be examined by their physician, and all patients will attend an orientation session with a Certified Hyperbaric Technician (CHT) or RN in the chamber.
What are the risks of a HBO dive?
Hyperbaric therapy is generally safe and well tolerated. Most side effects are mild and reversible, although severe consequences can occur in rare cases. There are risks associated with HBOT, similar to some diving disorders. Pressure changes can cause a "squeeze" or barotrauma in the tissues surrounding trapped air inside the body, such as the lungs, behind the eardrum, inside para-nasal sinuses, or even trapped underneath dental fillings. This is why a complete physical is essential to minimize theses risks.
Middle ear barotrauma is the most common side effect of HBOT. It is prevented in most patients by teaching the auto- inflation maneuver or by use of tympanotomy tubes for those who cannot auto- inflate. However, this rarely is a problem. Sinus squeeze is seen less frequently than middle ear barotrauma. The nurse on duty will examine patients and contact your doctor if necessary.
Prescriptions for antihistamines, decongestants, and/or nasal spray should be given by your doctor. Temporarily, the treatment could be postponed. However, with slow compression and decompression, usually there are no problems.
Vision changes (myopia or nearsightedness) caused by swelling of the lens, this is more a temporary side-effect than a complication and usually resolves in two to four weeks following completion of HBOT.
Myopia is a reversible complication of repeated exposure to HBOT. Even when progressive, myopia does occur during a series of HBOT therapies, after treatment the visual acuity changes reverse completely. Acceleration of growth in existing cataracts is a complication of chronic long-term exposure at pressures over 2 ATA. Published reports as well as extensive clinical experience indicate that new cataracts do not develop with in the series of 30 to 50 therapies that are commonly used in the USA.
Pulmonary and neurological manifestations of oxygen poisoning are often cited as major concerns with HBOT. Oxygen tolerance limits that avoid these manifestations are well defined for continuous exposures in normal people. Pulmonary symptoms are not produced by daily exposures to oxygen at 2.0 or 2.4 ATA for 2.0 or 1.5 hours respectively. The incidence of oxygen convulsions when using similar exposures is about 1 per 10,000 patient therapies. Even when oxygen convulsions do occur, there are no residual effects if mechanical trauma can be avoided.
Although rare, one of the risks of HBOT is oxygen toxicity which is treatable by removing the oxygen. It is common to take a five minute "air break" to avoid oxygen toxicity and breathing compressed air through a special mask inside the chamber.
Pulmonary barotrauma during decompression may rarely occur. Patients with airway obstruction have an increased risk for pulmonary barotrauma during decompression. Patients must be cautioned against breath holding during decompression. All patients should attend a private Orientation session accompanied by a CHT or a R.N.
What happens if you feel claustrophobic?
Reassurance, emotional support and entertainment go a long way in preventing confinement anxiety. In some cases, a mild sedative may be required. If you still have anxiety during the treatment, your technician can safely and gradually bring you up from pressure depth. Each chamber is equipped with a telephone system, so your technician can hear you and talk to you while you are undergoing treatment. There is always a technician by your side monitoring you.
Can you bring books, food, or CD’s in the chamber with you?
Many centers will allow you to bring items into a multiple chamber. However, the Undersea and Hyperbaric Medical Society (UHMS) that governs hyperbaric medicine restricts this. It is contraindicated to bring any item into a monoplace chamber where you will be surrounded by a pure oxygen environment.
Most hyperbaric facilities have some form of entertainment such as movies or CD’s that can be used. TVs are viewed through the glass chamber with special speakers inside the chamber.
Can you get the bends like SCUBA divers do?
Air embolism is a rare but possible occurrence. That is why it is essential to have a trained hyperbaric technician offering you this therapy. You wouldn’t go to someone untrained to take an x-ray would you?
Will you herx from HBOT?
Most Lyme patients do experience some form of a Jarisch-Herxheimer reaction during HBOT. It has been noted anecdotally that a few divers have had "reactions" seemingly out of nowhere and later went on to test positive for Lyme. I can not tell you what the mechanism of action is however. It appears to be a herx brought on by the pressure. Also, some people respond to the oxygen immediately. Others do not herx for several days afterward. It is not unusual in either case.
You should start to see herx reactions within the first ten sessions. Some herx immediately and it is not uncommon to herx while in the chamber. You should see gains by forty sessions and in order to maintain those you should do a maintenance session at least once every 4-6 weeks.A Herxheimer reaction occurs when the Lyme bacteria are killed off quickly, and the body suddenly has to deal with a tremendous amount of toxins. The higher the amount of toxins, the stronger the herxheimer reaction will be. The Herxheimer reaction can be used as a clue to help clinically diagnose the presence of Borrellia Burgdorferi.
Are there any contraindications?
Some commonly used medications may potentiate side effects from HBOT. They must be limited or substituted with another drug. These include: high doses of aspirin and prednisone (or similar cortisone type drugs), and morphine, or alcohol within 8 hours of treatment. Some of the drugs that are contraindicated with HBOT are Doxorubicin (Adrianmycin), Bleomycin, Cis-platinum, Disulfiram (Antabuse), and Insulin. HBOT can lower blood sugar, and so hypoglycemic patients require blood monitoring and proper diet. Emphysema with CO2 Retention (COPD) is contraindicated.
Pregnant women are not advised to undergo HBOT unless it is an emergency situation. Patients with high fevers should postpone HBOT until the cause is found, and the patient is stable. An absolute contraindication to hyperbaric oxygen therapy is untreated pneumothorax.
Hopefully this question and answer will help any of you who are interested in doing HBOT treatment. It made a tremendous difference in my health, and made my Lyme disease protocol more effective. Although HBOT can be expensive and time consuming, it helped me make tremendous strides in getting my health back. I never experienced any side effects during my 200 treatments. In my opinion, HBOT is a safe and suitable option for anyone suffering from chronic Lyme disease.
|Disclaimer *Any information presented on this website is intended for educational purposes only. Wildcondor's personal Lyme disease story may not be copied, posted elsewhere on the inernet, or printed without written permission from Wildcondor.com. Information and links provided should not be a substitute for seeking professional medical advice. Please explore at your own risk. Thank you.|