Medicine and Health

Hyperbaric oxygen therapy

HBOT To Treat Chronic Conditions

By Dr. W. Gifford Jones

Tuesday, July 12, 2005

What treatment would you choose, a leg amputation or increased amount of oxygen? Foolish question. But according to a recent report diabetes patients who develop diabetic leg ulcers are too often facing needless amputation because of a failure to use hyperbaric oxygen therapy (HBOT).

Today an epidemic of obesity in North America has triggered an epidemic of diabetes. And a major complication of diabetes is gangrene of the legs. I'll never forget seeing Ella Fitzgerald, the famous singer, being led on stage after losing her sight to this disease. Later, diabetes cost her both legs.

For diabetes patients foot problems are the number one cause of hospital admissions. It's estimated that 25 percent of diabetes patients develop foot problems and one in 15 requires amputation during their lifetime.

Drs. Ted Sosiak and Wayne Evans make a shocking claim in the Ontario Medical Review. They say that HBOT could save up to 75 percent of the more than 2,160 amputations that occur every year in Ontario due to diabetic foot ulcers that will not heal. And that HBOT treatment could save 100 million dollars and the costs of chronic disability caused by amputation.

But how could HBOT end this tragedy? The air we normally breath contains from 19 to 21 percent oxygen. This is enough to keep us alive. But it's not sufficient to cure diabetic ulcers desperately in need of oxygen.

Hyperbaric oxygen therapy provides pure oxygen to speed up and enhance the body's natural ability to heal. It's more than a mere whiff of oxygen. By using HBOT the concentration of oxygen normally dissolved in the bloodstream is raised by as much as 2,000 percent.

It's not just blood that benefits from HBOT. Body fluids such as lymph and cerebrospinal fluids are infused with the healing benefits of increased oxygen. Pure oxygen also reaches bone and tissues that are inaccessible to red blood cells, and helps to increase white cell production and the formation of new peripheral blood vessels. This results in increased infection control and faster healing.

The benefit of HBOT is not limited to saving legs. A report in The New England Journal of Medicine claims that HBOT should be the standard treatment for those suffering from acute carbon monoxide poisoning, the leading cause of injury and death due to poisoning worldwide.

It's also estimated that between four and 14 percent of cancer patients who are treated by radiation will develop radiation injury and delayed healing. This can occur in patients treated for prostate cancer who develop radiation proctitis and cystitis. Or when the jaw bone fails to heal after radiation. HBOT could speed up healing in these cases.

This therapy can also be of value for patients with severe burns, brain abscess, flesh-eating disease and skin grafts that are not healing well.

HBOT has been available for 100 years. During that time it has saved the lives of many divers stricken by decompression sickness (the bends) when they've surfaced too quickly. But HBOT has been largely collecting cobwebs in treatment of other conditions.

It's hard to blame doctors for not being aware of this therapy when it's not taught in medical school or postgraduate medical specialties. Canadian hyperbaric physicians are generally trained either in the U.S. or the Canadian military forces.

The main problem is funding. HBOT is usually paid by a hospital's global or fixed budget. So if there's no specified amount for HBOT there's a great incentive for hospital administrators to limit treatment of HBOT. The waiting time for elective procedures is over one year at the Toronto General Hospital and eight months at Ottawa General and Hamilton General Hospitals.

Another problem is that in Canada most decompression chambers have room for one or two patients. This is time consuming as most patients require 40 treatments of HBOT. To get around this, Melbourne, Australia, has a unit that holds 20 people.

My crystal ball sees more needless amputations unless more funds are allocated to HBOT. It's not only more humanitarian to save these legs, but also less costly than caring for those who become chronically disabled from amputations. Will good sense ever prevail?

W. Gifford-Jones M.D Most recent columns

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: docgiff.com.
Dr. Walker can be reached at info@docgiff.com
Dr. Ken Walker (Gifford-Jones) is accepting a limited number of women in his gynecological practice. For appointments call: 416-368-7637.