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Therapies

oxygen therapy
What Is It?
How Does It Work?
What You Can Expect
Health Benefits
How To Choose a Practitioner
Cautions


What Is It?

Ever since the 1930s, when Navy researchers discovered that oxygen decompression could cure "rapture of the deep" in deep-sea divers, oxygen therapy has held a growing allure for doctors around the world. Generally referred to as hyperbaric ("high pressure") oxygen therapy, the treatment delivers pure oxygen to people with an array of maladies as they sit or lie comfortably in a pressurized chamber.

Oxygen was used as a therapy as early as 1783 by the French physician Caillens, and today oxygen tanks are a commonplace sight in homes and hospitals. Nasal prongs or masks deliver the gas to patients with lung diseases such as emphysema and it is used to promote recovery after major surgery. (The supplemental oxygen helps body tissues function better when the breathing capacity of the lungs is limited.) While hyperbaric oxygen therapy uses the same life-giving gas, it is delivered at pressures two to three times above normal.

Hyperbaric oxygen therapy is now routinely administered by mainstream doctors to treat scuba diving accidents, smoke inhalation, serious infections, and traumatic injuries. Many other uses have been proposed, from rehabilitating seniors who have suffered a stroke and football players sidelined by injury to treating children crippled by cerebral palsy (see also Health Benefits, below). In the summer of 2002, Navy rescuers deployed an oxygen chamber to stabilize one of the nine Pennsylvania miners trapped in a flooded mine 240 feet underground for nearly 80 hours.

Many of the benefits of oxygen therapy remain unproven, however, and it is considered an "alternative" treatment for some conditions. Even so, experts suspect that for many of these ailments it will become an accepted part of mainstream medicine in the years ahead.

Be aware: The term "oxygen therapy" covers a wide range of treatments besides hyperbaric therapy, many of which seek to capitalize on oxygen's healing powers. Examples include ozone therapy, hyper-oxygenation, iodized water, hydrogen peroxide and vitamin "O." All too often, these therapies are falsely touted as cures for aging, asthma, arthritis, cancer, chronic fatigue, and more.

Many of these remedies are untested, and some may even make ailments worse. Ozone air purifiers, for example, may actually cause indoor air pollution and aggravate asthma. Vitamin "O," according to the Federal Trade Commission, the government agency that regulates false advertising claims, is nothing but salt water. Some oxygen facials and skin creams may do more harm to skin than good (lotions containing anti-oxidants, like vitamin E, may be a better bet). And while splashing 3% hydrogen peroxide on cuts and scrapes does kill germs, there is no evidence that drinking the high concentration "food grade" formula or having it injected into your veins does any good at all. Remember: If it sounds too good to be true, it probably is.

How Does It Work?

If you've ever plunged into the deep end of a pool, you know the sensation of creeping pressure and aching ears as you descend ever deeper. Hyperbaric oxygen therapy recreates this feeling, but in a far more soothing way, as air is pumped into a sealed chamber to drive pressure up. At the same time, participants breathe 100% oxygen through a specialized tube or mask. All this occurs at a pressure you'd expect at a depth of about 50 feet under the sea. The end result is that when a patient is breathing 2.8 or more atmospheres of oxygen in the hyperbaric chamber, the gas is forced into the blood and tissues receive up to 20 times more oxygen than usual.

Forcing oxygen in forces other gases--such as nitrogen and carbon monoxide--out of the body. This mechanism helps explain the benefits of oxygen therapy for "the bends" (decompression sickness in divers that's caused by the build-up of nitrogen bubbles in the blood), as well as for smoke inhalation (due to carbon monoxide poisoning) and related ailments.

Raising oxygen levels has other healing properties as well. It fights infections by killing bacteria (many of which cannot survive in an oxygen-rich environment) and suppressing their deadly toxins. It creates "free radicals," unstable oxygen molecules that are lethal to germs. And it stimulates roving immune cells called phagocytes, which scavenge for infectious microbes.

An elevation in oxygen also helps heal injuries by fostering the growth of tiny blood vessels that funnel in important nutrients and by keeping existing blood vessels open. Oxygen is also conducive to the production of collagen, the main wound-repairing connective tissue in the body. By speeding up healing processes, oxygen may also boost immunity and the regeneration of nerve cells.

What You Can Expect

Hyperbaric oxygen therapy sessions are commonly referred to as "dives," an apt description since much of the equipment has been adapted from use in deep-sea dives and has a nautical look and feel. How you experience your "dive" will depend in part on whether you visit a facility built for one person, or for many.

An individual, or "monoplace," hyperbaric chamber looks something like a long, low, one-man submarine, with shiny metal knobs and control panels and valves that open and close the sealed chamber. During treatment, you lie face up in the padded interior, a porthole window above you. These single chambers are portable and more readily available than multi-person facilities, but some people find them claustrophobic. For this reason, you may prefer a larger, so-called "multi-place," chamber, which is roomier and easier to get used to. Inside, this type of chamber is about the size of a large minivan, with cushioned seats set along the walls. Most hold about six patients, plus an attendant.

Whichever type of facility you visit, the procedure is painless. You will be asked to change into surgical scrubs or other loose and comfortable garb that is 100% cotton and static free. A doctor or aide will take your blood pressure, pulse, and other vital signs, and you may be fitted with a soft vinyl diving mask that slips over the head. One person who has taken many "dives" offers this important reminder: Visit the rest room before your session! Once the doors are closed, they remain shut for at least an hour.

You may feel a slight pressure at first as the chamber begins to fill with oxygen. Over the next 10 to 15 minutes, as the chamber fills, the sensation is similar to being on an airplane as it begins its descent. One or both ears may feel plugged, "pop," or ache slightly. Simply swallowing, chewing gum, or holding the nose gently and blowing outward usually brings prompt relief.

During the session, most people do not feel any "altered states" or heady sensations. In fact, some describe it as "boring." In the multi-place chamber, videos may be shown, or you may read a book or magazine. The chamber may be depressurized to give you a break to get regular air. And then you may be asked to re-enter.

Each session typically lasts about 90 minutes, and on average 20 to 30 treatments are required, although 40 or more sessions are not uncommon. Sessions are given daily on consecutive days or several times a week. The length and number of treatments depends on your condition and its severity. However, much additional research needs to be done to assess when doctors should start treatments and how long they should continue for best results.

Not surprisingly, all of this can be expensive. The cost for a single 90-minute "dive" may range from $300 to $400. A prolonged course to treat a festering wound may total as much as $16,000--still cheaper than surgery, but a considerable expense, especially since only certain "approved" treatments, such as decompression sickness, may be covered by insurance.

Health Benefits

Oxygen therapy has been called "a therapy in search of diseases," for medics knew it worked for diving accidents and other ailments long before they knew how or why. Unfortunately, this has opened up oxygen therapy to claims that it can cure everything from AIDS to cancer. Today, the Undersea and Hyperbaric Medical Society has approved the use of oxygen therapy for only 13 conditions.

The most widely known use is for decompression sickness. Not only is the therapy is a lifesaver for the more than 500 scuba divers who get "the bends" every year, it is also used to treat mountain climbers who get decompression sickness when descending from above 18,000 feet. Another approved use is in the treatment of certain serious infections and wounds, especially those caused by diabetes and poor circulation in the limbs. In one report, some patients with extremely serious wounds were able to forego amputation after as little as four sessions of oxygen therapy. If surgery is required, oxygen may be used to aid healing, and it may also enhance the effectiveness of antibiotics. In addition, doctors turn to oxygen therapy when patients undergoing heart surgery, dialysis, or certain other medical procedures develop potentially lethal bubbles of gas in the blood.

Oxygen therapy is also used to treat serious and stubborn infections, such as gangrene, brain abscesses, and sinus, bone, or skin infections, including necrotizing fasciitis, which is caused by a deadly flesh-eating bacteria. And it can reduce swelling and speed healing of injuries due to car accidents, gunshot wounds, radiation treatments, burns, or falls. Christian Scientists who lose a massive amount of blood and refuse transfusions on religious grounds may be given oxygen therapy to boost red blood cells.

Lack of well-designed trials makes it difficult to judge how effective oxygen therapy is for many additional ailments, although small studies and anecdotal reports are promising. It has been used as a complementary therapy for stroke, multiple sclerosis, migraines, spinal cord injuries, sports accidents, ulcers, and inflammatory bowel disease (ulcerative colitis and Crohn's disease). It is also being explored for treating autism, near drowning, chronic Lyme disease, ringing in the ears, epilepsy, cerebral palsy, AIDS, and autoimmune diseases (such as rheumatoid arthritis).

A report in the October 2002 New England Journal of Medicine confirmed that hyperbaric oxygen therapy helps prevent the long-term memory, mood, and attention problems that result from carbon monoxide poisoning, a leading cause of injury and death worldwide. An accompanying editorial stated: "One might hope that the current study will inspire greater interest in the scientific investigation of hyperbaric oxygen therapy. During the past 10 years, only 23 investigators at 14 academic institutions have received NIH funding for studies of the therapeutic aspects of hyperbaric oxygen."

Fortunately, much pioneering work is being done in the field by alternative and complementary practitioners. Today's research will help to uncover the true benefits of hyperbaric oxygen therapy for an array of conditions in the years ahead.

How To Choose a Practitioner

Once solely the domain of university hospitals, Coast Guard rescue centers, deep-sea drilling operations, and diver training schools, hyperbaric oxygen facilities are becoming more common worldwide. There are now more than 250 multi-person facilities and almost 350 single-occupant chambers in the United States.

Look for a facility that is staffed by an expert health professional, such as a medical doctor (M.D.) or an osteopathic physician (D.O.). Oxygen therapy is generally safe, but complications requiring prompt medical attention occasionally arise. Make sure your doctor is well informed about your medical condition and history.

In addition, work with a medical team that offers a range of treatment options. Hyperbaric oxygen therapy for wounds, for example, should be combined with appropriate medical and surgical care. And rehabilitation from a neurological illness, such as stroke, is often most effective when combined with physical, occupational, or behavioral therapy. Biofeedback and other mind-body therapies may also be enhanced by hyperbaric oxygen therapy.

As with any other type of treatment, seek referrals from friends and doctors whom you trust, and research a practitioner's credentials and background before signing on. Doctors may be licensed for hyperbaric medicine, but this is a relatively new specialty and only a handful are currently certified, mainly to treat diving accidents. In addition, make sure your facility meets all health-care and fire codes.

Cautions

 Because oxygen is so flammable, don't take anything into a hyperbaric oxygen chamber that could create sparks or ignite. This includes any electrical devices (such as radios or CD players), watches, or clothes made of rayon or nylon. Books and magazines are okay, but newspapers are not.

 Oxygen therapy is generally safe, although as with any therapy, side effects can occur. The most common are vision problems, which develop in up to one in five of those treated. Usually the problem is a mild case of shortsightedness that goes away once treatment is stopped, although it occasionally persists for several weeks or months. More permanent problems, like cataracts, do not occur.

 Sudden pain from a ruptured eardrum or sinus occasionally occurs, and a toothache or chest pain may develop. With repeated treatments, some patients develop cough, tightness, or a burning sensation in the chest, but these go away once the therapy is completed.

 Other complications can include headaches, fatigue, seizures, or vomiting, but these are very rare, cause no lasting damage, and can be readily treated.



Date Published: 04/19/2005
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