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WHAT
IS HYPERBARIC OXYGEN THERAPY?
Hyperbaric
Oxygen Therapy as Defined by the Undersea and Hyperbaric
Medical Society as the treatment of a patient who breathes
100% oxygen intermittently, while inside a hyperbaric
pressure chamber and the pressure of said chamber is increased
to greater than one atmosphere absolute (atm abs). Current
information indicates that pressurization should be at
least 1.4 atm abs. This may occur in a single person chamber
(monoplace) or multiplace chamber (hold 2 or more people
at a time). Breathing 100% oxygen at 1 atm abs or exposing
isolated parts of the body to 100% oxygen does not constitute
Hyperbaric Oxygen Therapy.
O.K.,
let’s get out of the dictionary. Basically, the
treatment involves a patient breathing oxygen through
one of a number of means, while they are completely enclosed
inside of a recompression (hyperbaric) chamber. Like being
in a land based submarine, that never leaves port. Just
exactly the opposite of taking-off in an airplane. The
sensations are similar, and the sights are familiar, but
the vessel is pressurized, not vacuumed to an altitude
of the equivalent of 10,000 feet.
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WHAT
IS THE HYPERBARIC PRESSURE CHAMBER?
There
are a variety of pressure vessels that qualify as Hyperbaric
Pressure Chambers. Classifications for the chambers are
also varied depending upon the context in which they are
addressed. There are two basic classifications of chambers,
one is the mono-place and the other is the multi-place.
The key component of the term’s, multi and mono,
are obvious. The term “Multi” refers to more
than one compartment, and the term “Mono”
refers to one compartment. Clinical practices differ as
to how they serve the patient needs of their community.
In most hospitals, larger chambers are pressurized with
air and after the appropriate pressure is achieved, the
patient breaths pure oxygen through a mask or hood. However,
in the stand-alone and smaller practices, the monoplace
type of chamber that accommodates one patient at a time,
is pressurized and operated entirely by oxygen.
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WHAT
DO HYPERBARIC PRESSURE CHAMBERS LOOL LIKE?
The
following pictures represent some of the chambers commonly
available.
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WHAT
DISEASES OR DISORDERS ARE TREATED BY HBOT?
New
studies being completed with regularity, there are specific
indications for HBOT. However, the resource we use as
our guideline for providing our service is the Undersea
and Hyperbaric Medical Society, as is listed below. You
may also visit their web site and see, first hand, what
the current indications are, by clicking on the icon to
the right.
Our
procedures allow us to treat patients for the following
indications:
1
Air or Gas Embolism
2 Carbon Monoxide Poisoning and Carbon Monoxide Poisoning
Complicated by Cyanide Poisoning
3 Clostridal Myositis and Myonecrosis (Gas Gangrene)
4 Crush Injury, Compartment Syndrome, and other Acute
Traumatic Ischemias
5 Decompression Sickness
6 Enhancement of Healing in Selected Problem Wounds
7 Exceptional Blood Loss (Anemia)
8 Intracranial Abscess
9 Necrotizing Soft Tissue Infections
10 Osteomyelitis (Refractory)
11 Delayed Radiation Injury (Soft Tissue and Bony Necrosis)
12 Skin Grafts & Flaps (Compromised)
13 Thermal Burns
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ARE
THERE RECOMMENDED TREATMENT PLANS?
Yes,
as a matter of fact. Each disease/disorder has specific
recommendations. However, a skilled practitioner may choose
to vary those orders for the needs of the patient. These
changes include Pre-surgical treatment, pre-radiation
therapy just to name two reasons.
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DOES
MY INSURANCE COVER THE TREATMENT?
In
1972 Congress enacted legislation to effectively do just
that. This legislation was designed to set a standard
that Insurance companies use as their guidelines. This
does not require the insurance company to pay, it only
sets a standard for them to use as a guideline.
Many
insurance carriers cover the entire cost of Hyperbaric
Oxygen Therapy, or have a small co-pay. Please consult
with your insurance carrier to determine your level of
coverage for these services.
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HOW
CAN A PATIENT QUALIFY FOR TREATMENT?
Ask
your physician if they think your condition warrants treatment,
or call, fax or click your request to us, and we can get
you an answer from a practitioner who is familiar with
your condition. Make sure that you tell us as much information
as possible, that way our response can be more thorough
and swift. Just click here and begin a new world of discovering
how you can Experience the Healing Power of Oxygen.
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WHAT
SHOULD PATIENTS DO BEFORE A TREATMENT?
Be
prepared to not do the usual. Once you have been referred
to be treated with Hyperbaric Oxygen Therapy, you will
be examined and given detailed instructions about what
the procedures are for a patient. You will be asked not
to wear certain materials in the chamber, such as: hair
oils, hair spray, perfumes, make-up, nylons (panty hose),
ointments, liniments, petroleum or Vaseline products,
wigs or hair pieces, aftershave, synthetics (i.e. rayon,
nylon, etc.), or salves. Additionally watches and some
jewelry should not be worn in the chamber because they
may break while under pressure or upon surfacing from
the pressure.
Because
the therapy involves 100 percent oxygen, any thing flammable
poses a fire risk. NO SMOKING MATERIAL, LIGHTERS OR MATCHES
are permitted in the chamber and should not be used for
more than a hour after treatment. Books, magazines, and
writing pads may be allowed in a multi-person chamber;
newspapers and loose papers should not be taken in. Anything
not specifically allowed in the chamber must not be taken
in under any circumstances.
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WHAT
DOES THE TREATMENT FEEL LIKE?
If
you have ever dove to the bottom of a pool, or flown in
a plane, you can relate to the sensation of your ears
popping. You will be instructed on methods of equalizing
the pressure in your ears. Please follow the instructions
carefully and avoid a feeling of fullness in your ears,
this will protect your from any discomfort during your
experience. By holding your nose and attempting to blow
through it, or simply swallowing, chewing gum, or sipping
on water will allow the pressure to equalize in the middle
ear, through the eustachian tube. It is only necessary
to do this during the first few minutes of the treatment.
The remainder of your treatment should be a time for you
to read, sleep, watch TV, or just relax. Patients of all
ages generally tolerate the treatments very well.
At
first, while the chamber is being pressurized, or what
is referred to as a diving to depth, you will experience
the sound of the air or oxygen (This is depending upon
the type of chamber you are being treated in.), which
may be quite noisy. It will get warm at first because
as you add pressure to any given object, it will increase
the temperature, but when the chamber reaches the pressure
or “Depth of Dive”, the temperature will automatically
adjusted to a comfortable setting.
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ARE
THERE ANY SIDE EFFECTS?
Yes,
there are several, but first a note about certain sensations
a patient may experience directly after emerging from
a chamber. There is a sensation of joints feeling thick,
full or like cracking as with a knuckle, muscle relaxation
and increased energy, are among the most commonly recognized
sensations.
The
most common side effect however is barotrauma to the ears
and sinuses caused by pressure changes. This is commonly
referred to as a “Squeeze” by the diving community,
and is generally brought about by the patient not being
able to clear their ears or sinuses during a dive or ascent
to the surface. To minimize this risk, patients learn
techniques to promote adequate clearing of the ears during
the entire dive.
And
yes, there are other side effects, however more rare they
are, they still exist. They may include oxygen toxicity,
claustrophobia, and accelerated maturation of cataracts.
Occasionally some patients experience visual changes after
several treatments that cause them to have changes in
their visual acuity. This is usually only temporary and
should disappear three to four months after the treatments
stop. Any other side effects not mentioned are extremely
rare, and should be reported to the treating attendants
immediately.
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WHAT
IF I AM A SMOKER?
The
whole idea behind this treatment is to promote healing
and recovery. This process of introducing oxygen, in solution,
into the tissues of the body, promotes the clustering
of capillaries and increased collagen to the tissues where
the body needs the effect the greatest. Tobacco smoke
is known to reduce that effect and literally retard the
benefit of the therapy the smoking patient receives. It
is highly recommended that the patient refrain from smoking
during their entire course of treatment, maybe even allowing
the patient to quit all together.
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CONTRAINDICATIONS:
ARE THERE ANY CONDITIONS THAT WOULD PREVENT A PATIENT
FROM BEING TREATED?
Yes,
there are a number of conditions that would prevent a
patient from being treated, but not permanently in many
cases. It is a matter of a pneumothorax, that once healed
and the referring physician approves, will prevent the
patient from being treated temporarily. Any form of congenital
spherocytosis, any alcohol related treatment with
Disulfiram
(Antabuse), and cancer patient being treated with Doxorubicin
(Adriamycin) or Cis-Platinum
until released by their oncologist for HBOT, and any burn
patient being treated with the anti-biotic Mafenide
Acetate (Sulfamylon) are contraindications. Each patient
is evaluated to determine the relative risks and benefits
of Hyperbaric Oxygen Therapy.
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DOES
MY PRIMARY CARE PHYSICIAN OR A SPECIALIST REFER ME FOR
THIS TREATMENT?
That
depends upon the reason you are being referred for Hyperbaric
Oxygen Therapy. Your Primary Care Physician may refer
you directly to us for treatments or he or she may first
refer you to a specialist who may then recommend treatment
with Hyperbaric Oxygen Therapy.
In
any case do not feel intimidated from asking your Primary
Care Physician to prescribe the therapy for you. If you
need treatment for one of the above source
diseases or disorders, you may wish to seek advice
from a second physician to be sure you are getting the
best treatments available. If your practitioner hesitates
or is not completely familiar with Hyperbaric Oxygen Therapy,
check out our library of articles and show them to the
practitioner, or even refer your practitioner to us.
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HOW
MUCH DOES IT COST?
One
of our greatest concerns is the cost of treatments. The
practice of Medicine is wrought with expenses, and this
is one of the greatest concerns on the minds of everyone.
But, one of the benefits of Hyperbaric Therapy is that
many insurance carriers cover the entire cost, or have
a small co-pay. Please consult with your insurance carrier
to determine your level of coverage for these services.
Pricing varies depending on the level of treatment so
please contact us for more
information.
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ADDITIONAL
QUESTIONS?
If you have any additional questions, please contact
us! We'd be happy to answer any questions you may
have!
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