Hyperbaric Oxygen Therapy: Take a Deep Breath and Squeeze
Posted: Tuesday, October 04, 2011
by Jack H. Schick
One day, when I was working at the oil refinery in Casper, Wyoming, Nurse Nancy demonstrated why she wasn’t working in a hospital and had to resort to being a company “health officer” where she was limited to giving superficial physicals or calling the ambulance if some one got hurt. She was okay at that, though, I guess. Nobody ever died. I have to say, she was pretty. I sort of liked her; at least until she gained that 75 pounds, went on a solicitous, pushy, “come join me!” diet and health food kick, lost the 75 pounds, then gained back 100; all within two years. She was a big woman at the end, that’s for sure, especially if you saw her from behind. She still had a pretty face, though.
Not unexpectedly, I guess, one guy passed out; keeled right over into the goop and had to be dragged out of the tank. I was working Light Oils Blending that day so it was my area. I was on site when the commotion began. I radioed to the base station at the Boiler House and they set the emergency response ball rolling. They got the guy out onto the slope of the dike that ringed the tank. He was a mess, but had come around and was sitting up when Nurse Nancy pulled up in her white “medic’s” van.
She’d already called the ambulance, of course. She waddled over to me carrying a mask and an oxygen tank. I gave her a hand with it. There was no way she wasn’t going to ruin her white nurse’s suit getting down into that tank basin. I held her by the arm so she didn’t slip and roll down the dike like a snowball. When she came at the victim with the oxygen mask he tried to wave her off. He was pretty much recovered. He had just hyperventilated in the heat while wearing a pressurized SCBA.
She insisted, though. It was the most action she’d seen since she’d gained back the weight. She opened the tank’s valve wide and slapped the mask on his face. I was skeptical. I figured she should just let him alone until the professionals arrived. In a few minutes he passed out again. She continued to hold the mask over his face forcing more and more oxygen into his blood stream. In another minute his feet, legs and hands started twitching spastically. When she took the mask off to check what was wrong with his legs, he calmed down and started to come to again.
Even I could see that it was she who was knocking him out. He didn’t need more oxygen, he needed less. Every time he started to come around, she put the mask back on his face and held it there until he passed out again and his feet started to twitch. I knew a guy at college who used to do that to himself all the time with nitrous oxide, but this was an industrial work place. I tried to get her to quit it, to no avail. The ambulance finally arrived and rescued the poor guy. He could hardly walk by then. Nurse Nancy needed help getting up the hill and back to her van. As I’d foreseen, her uniform was ruined.
*
I was reminded of the incident at the refinery by an article I read in the newspaper. Federal agents raided his new, ready to open for business facility in Middletown, PA, and absconded with Dr. William J. O’Brien’s hyperbaris oxygen therapy equipment and all of his patient files. Nothing had happened at the Hyper Ox center. There were no complaints. It was simply a preemptive, investigatory strike, made because there was a potential for abuse. They figured, if they dug deep enough, they’d probably be able to find at least one “i” un-dotted or “t” un-crossed.
Recently, hyperbaric oxygen therapy has gained mainstream medical community acceptance, especially for the healing of chronic wounds. Most hospitals in the southeastern Pennsylvania area use it as part of their wound care programs. The Food and Drug Administration has oversight and has approved the treatment and the equipment used. Most insurance companies cover the treatments for approved ailments. Medicare and Medicaid will reimburse for treatments received at a hospital owned hyperbaric facility.
Hyperbaric oxygen therapy involves the patient breathing pure oxygen while inside of a sealed chamber. The pressure inside the chamber is increased to about three times normal atmospheric pressure (which is around 14 psi). In those conditions the lungs can collect up to three times more oxygen than is normally possible by breathing pure oxygen at regular pressure. The increased oxygen in the blood stimulates a release of growth factors and stem cells that promote faster healing. It’s the same process used to treat the water-divers’ ailment, “the bends,” or decompression sickness.
The FDA has approved the hyperbaric therapy for various ailments including: the bends, of course; carbon monoxide poisoning; crush injuries; air or gas embolisms; gangrene; intracranial abscesses; acute thermal burn injuries; and half a dozen others. The FDA requires that the chambers meet safety standards set by the American Society of Mechanical Engineers and the National Fire Prevention Association. The FDA considers oxygen a drug, consequently it can be prescribed only by a doctor or licensed health care provider.
Tom Workman, director of quality assurance and regulatory affairs for the Undersea & Hyperbaric Medical Society, an independent group that is the leading source of information and accreditation on the therapy and equipment, said of the process: “It’s less regulated than what I think most of us would like.” The Society estimates that more than 1,000 hyperbaric oxygen programs in the U.S. are located in hospitals. The Society has accredited only about 100 of them. Pennsylvania has 58 facilities with only four accredited.
Accreditation of hyperbaric oxygen programs is voluntary. Training and certification programs do exist, but are not mandatory, either. To qualify for Medicare payments it is only required that the doctor completes a 40 hour introductory training class. Other employees of the facility may perform the treatments, however. The sale or use of hyperbaric oxygen services by anyone other than a doctor is a violation of federal law. In Pennsylvania it could result in charges of practicing medicine without a license.
Doctors are free to use the therapy for conditions other than the 13 FDA approved ones, if they believe it is medically appropriate. In increasing numbers, people are willing to fork over the $100 to $200 charged for a 60 to 90 minute session. Not covered ailments for which treatments are sought include: autism spectrum disorder, cancer, head injuries, Lyme disease, stroke, sports injuries and cerebral palsy. There is a lack of scientific studies to prove it will help for any of the conditions. It is illegal to ‘market’ the therapy for any condition that is not approved by the FDA.
For the unapproved aliments, no medical protocol exists for how the therapy should be administered. There is no defined frequency, length of treatment, amount of pressure or oxygen use time established. There are several side effects of the treatments that include: temporary nearsightedness caused by increased blood oxygen levels, middle and inner ear injuries due to increased air pressure, organ damage caused by air pressure changes and seizures as a result of too much oxygen in the central nervous system (like Nurse Nancy’s patient).
Doctor O’Brien holds a medical license in Pennsylvania. His Hyper Ox 101 machine was approved by the FDA. For three years it had been used safely in more than 4,000 ‘dives’ at its previous location. He acquired the requisite certificate of occupancy permit and fire marshal inspection for his new facility. Twenty to thirty patients had already scheduled appointments. O’Brien admitted that he had used his ‘chamber’ for private-pay treatments of ‘unapproved’ aliments, but had not marteted it for that purpose. Along with the equipment, five years of notes he had compiled the treatment of children with autism and individuals with head injuries were confiscated. O’Brien had hoped to prepare a report on the effects of treatments on those conditions.
Authorities claim the raid and confiscation of equipment was associated with the bankruptcy of WJO Inc. a company O’Brien owns. WJO is a network of family medical practices in Bucks, Philadelphia and Northampton Counties. Among WJO holdings are TMR Inc, a pain-management practice, and Hyper Ox. The FBI’s interest in O’Brien’s hyperbaric oxygen therapy business seems to extend beyond the bankruptcy, though.
I don’t know what to think about the whole thing. If its FDA approved, Medicare or insurance pays for it and nobody seems to get hurt trying it out for new stuff—have at it. But, if your feet and hands start twitching, back off a little.
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