Recently, I was talking to a woman in her late 70s, who had suffered a serious concussion while ice skating last winter. She said she found immediate relief by going for regularly treatments with hyperbaric oxygen therapy (HBOT). For about 4 months she went 2-3 times a week. Currently she goes approximately once a month as she finds it helpful for memory.
Just before talking to her, I had read two research articles on HBOT for traumatic Brain Injury (TBI) and fibromyalgia caused by TBI. As a result, I thought a post on HBOT might be useful as this medical treatment is used for various chronic conditions, and in recent years, there has been a proliferation of HBOT offered by clinics, chiropractors, naturopaths and alternative care providers.
Talk to your provider before undergoing any type of new or alternative treatment.
WHAT IS HBOT: If you are not familiar with HBOT, it’s a form of treatment in which the patient stays in special chambers where the pressure is higher than the atmospheric pressure at sea level, and breathe 100% oxygen. The increased air pressure in the chamber helps the lungs collect more oxygen. Getting more oxygen to the tissues that need it can help the body heal and fight certain infections. This video is 5 years old but it’s a helpful overview of HBOT
WHO BENEFITS FROM HBOT: As of July 2021, the FDA has cleared hyperbaric chambers for the following disorders:
• Air and gas bubbles in blood vessels
• Anemia (severe anemia when blood transfusions cannot be used)
• Burns (severe and large burns treated at a specialized burn center)
• Carbon monoxide poisoning
• Crush injury
• Decompression sickness (diving risk)
• Gas gangrene
• Hearing loss (complete hearing loss that occurs suddenly and without any known cause)
• Infection of the skin and bone (severe)
• Radiation injury
• Skin graft flap at risk of tissue death
• Vision loss (when sudden and painless in one eye due to blockage of blood flow)
• Wounds (non-healing, diabetic foot ulcers)
HBOT is being heavily studied in Israel, and is being used for a number of conditions beyond what the FDA has approved to date. For diseases like Lyme, and TBI doctors use it as an off-label course of treatment.
While it may not yet have FDA approval, there are a number of studies underway that appear to show effectiveness of HBOT in the treatment of various conditions including: traumatic brain injury ; Lyme-particularly neurological Lyme, Long Covid; Fibromyalgia caused by head injury; veterans with PTSD; Alzheimer’s Disease
ARE THERE RISKS? HBOT is generally safe, and serious complications are rare. Because of the increased pressure and increased concentration of the oxygen during HBOT, potential risks include: Ear and sinus pain; Middle ear injuries, including tympanic membrane rupture; Temporary vision changes; Lung collapse (rare).
CLAUSTROPHOBIA: Because chambers are enclosed, people who suffer from claustrophobia, fear of confined spaces, may be concerned how they’ll react. Many chambers are designed with this concern and most allow you to see outside. Hyperbaric physicians can prescribe medication that will relax you and make your treatment less stressful.
HOW LONG IS THE TREATMENT?: Each person differs based on the condition they are being treated for. The average treatment lasts about one-two hours and the number of sessions is condition dependent. Treatments are generally scheduled Monday-Friday.
DOES INSURANCE COVER IT? Medicare has approved coverage for HBOT therapy for conditions which have FDA approval. Most private insurance companies follow Medicare’s guidelines, including Medicaid. Conditions not approved by the FDA, see list above, or “off-label” are generally not covered by insurance. Check with your insurance before undergoing treatment as the out of pocket costs could be quite high.
If your treatment would not be covered, check to see if there are sliding scale fees or other services that could help with costs. Lyme Disease.org offers Lyme Treatment Grants. Check out if there are clinical trials you could participate in at clinicaltrials.gov.
Veterans should check the VA’s Center for Compassionate Innovation as the VA does provide HBOT for some off label conditions, including PTSD.
ARE THERE DIFFERENT TYPES OF HBOT?: The woman I spoke with had her treatments at a private office in Brattleboro, VT receiving “mild hyperbaric oxygen therapy” (mHBOT) in what is referred to as a “soft chamber.” The difference between mHBOT and HBOT is that mHBOT uses lower concentration and pressure than HBOT to deliver oxygen. There has been limited research done on the effectiveness of mHBOT compared to HBOT though the mild form has become very popular with athletes and various celebrities have soft chambers in their home.
NEXT STEPS: If you’d like to learn more about HBOT for your specific chronic condition:
• Talk to your health provider.
• Check with the organization that specializes in your condition, e.g. The American Diabetic Association.
• If you do decide to try it, look for a qualified HBOT technician or center, up-to-date equipment, with knowledge of using HBOT to treat someone with your condition.
RESOURCES
• Undersea & Hyberbaric Medical Society They provide a list of chambers that meet their accreditation.
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