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In the Atlanta metropolitan area there is a widely-available medical treatment that is highly-effective (as high as 90%) for several serious health problems.  Yet two of the largest groups of patients who could benefit from access to this powerful therapy often don’t ever hear about it.  Or, if they do find out about it they have been dealing with their problem for many months to years already.  In many cases these patients walk right by the door of these practices or right across the street from them to see their doctor, and don’t know we exist.  “What is this effective treatment you’re talking about?  And who needs it??” you ask.  I’m speaking of Hyperbaric Oxygen Therapy, or HBO.

What IS HBO?

HBO is the use of pure oxygen breathed by the patient while they’re inside a pressurized chamber.  The increased atmospheric pressure causes extremely high amounts of oxygen to be absorbed into the bloodstream and supersaturates the liquid portion of the blood (plasma).  When blood oxygen levels get this high it begins to cause drug-like responses in the body.  New capillaries (tiny blood vessels so small they’re seen only by microscope) are formed in tissues with poor blood supply from diabetes, vascular disease or radiation damage, infection-fighting cells are super-charged, Inflammation is suppressed, and others.  Here’s a great overview of hyperbaric oxygen therapy.

WHO needs hyperbaric oxygen therapy?

In both the research lab and in clinical practice, HBO has been shown to be very effective in the treatment of diabetic ulcers, ulcers caused by peripheral arterial disease (PAD), bone infections, and Late Effects of Radiation, among others.

If it works so well why doesn’t anyone know about it?

The biggest reason few people, including most physicians, know little about hyperbaric medicine is simple.  There are roughly 160 medical schools in the US.  Of those 160 medical colleges, only 30 have a hyperbaric medicine program (16 offer fellowships).  Additionally, the patients who typically need hyperbaric oxygen therapy are usually a relatively small group within what are usually statistically small groups who develop these chronic, serious problems.  So, little academic focus is given to the “portion of a portion” of folks who develop these complicated outcomes.  That means that nearly 85% of the physicians who come out of medical school are likely to know very little about this specialty.

For example, in men who receive treatment for prostate cancer, ~9% of them will report moderate to severe decreases in their quality of life due to effects on bowel function after their radiation treatment.  For them this includes rectal bleeding and painful bowel movements, they can experience frequency and urgency issues (have to go often and RIGHT NOW!), and they can experience chronic diarrhea.  Of these 9%, most of these problems resolve spontaneously or with some medical treatments such as special suppositories or laser procedures aimed at symptom relief.  But for some, their symptoms are not relieved by these measures.  That means they can suffer for months or even years with numerous trips back to the doctor’s office time and again without improvement or hope for a solution to the problem.  Their quality of life is negatively impacted since they have to stay close to a bathroom.  Their work and home life suffer, travel becomes almost impossible, and they are continually in pain.

Another harsh reality is sometimes finance plays a role.  Occasionally a patient will be receiving care from a provider for a chronic problem such as a diabetic wound or radiation injury that is not getting better.  They are seen week after week for months on end.  But they do not get better and they do not get referred to another specialist nearby that may have expertise, equipment, or therapy that would potentially help the problem.  Why?  “I don’t want to lose my patient,” is the answer.  Patients need to familiarize themselves with the problem they are facing by reading material available in print and online (from well-established, reputable sources), and through second opinion with other physicians.  This is particularly true if their problem is not getting better with ongoing care that is lasting weeks and months (or more).  Health problems such as diabetic ulcers and radiation injury often require more than one type of specialist contributing to the patient’s care to achieve the best outcome in the shortest period of time.

Where do I go for HBO treatment?

In the Atlanta area (including suburbs), nearly every major hospital has a hyperbaric medicine program as part of their wound center.  Our hyperbaric oxygen therapy practice has four locations in the Atlanta area alone.  Depending on the patient’s insurance plan, most do not require a referral to be evaluated by the HBO physician to determine if their problem could benefit from hyperbaric oxygen therapy.  Look for hyperbaric programs that are UHMS Accredited.  That means they are reviewed every 3 years by the Undersea and Hyperbaric Medicine Society to make sure they are maintaining records appropriately, keeping equipment in proper working order, implementing process improvement plans for their delivery of care, and more.