Commonly associated with scuba diving accidents and decompression sickness – the bends – hyperbaric oxygen therapy is now frequently used to treat other medical conditions, including wound healing and certain infections.
The theory behind the therapy, which allows a patient to breathe in 100 percent oxygen levels while inside a pressurized chamber, is that oxygen breathes new life into neurons.
“There are numerous studies being conducted all over the world in different areas of [hyperbaric oxygen] treatment, each looking for the ‘magic bullet’ for certain illnesses, but at present, nothing concrete,” said Dr. Denise Osterloh, a physician at the Cayman Clinic with extensive experience in hyperbaric medicine.
As one of the top diving destinations in the world, the Cayman Islands has seen its share of diving accidents. There are two recompression chambers on the islands, one in Grand Cayman and a smaller one in Cayman Brac.
The chamber on Grand Cayman is at the Cayman Islands Hospital and is run by John Elliott and his wife, Ann, who together have more than 35 years’ experience operating recompression chambers.
The chamber comfortably fits two people and requires at least three staff around the clock to monitor the equipment, including one who sits in the chamber with the patient.
“At each hour, we need three people. One person monitors the controls, the other sits inside, and then we have a senior member of staff outside so that if the patient doesn’t feel well, they can contact the doctor. They oversee everything,” Mrs. Elliott said.
Not just the ‘bends’
According to Mr. Elliott, the chamber sees fewer divers now than before; in 2000, the team saw a total of 60 divers, and more medical patients.
“Generally speaking, we do about three or four medical treatments a year, but this particular month has been very unusual. We’ve had five patients this month already,” he said in an interview in late January.
Senior operator Richard McLeod said he has noticed the change. “Most people consider hyperbaric chambers for diving accidents, but we are seeing a lot more medical patients now than divers,” he said.
The team is currently using the chamber to treat a patient suffering from gangrene as a result of extreme diabetes.
“It’s an alternative to chopping off toes and feet. Because the patient tends to get gangrene, this treatment gets the circulation going again. Diabetics have wounds that sometimes don’t heal, but with a lot of oxygen, the wounds heal much faster,” said Mr. McLeod.
While using hyperbaric oxygen therapy for treating cancer is considered experimental, cancer patients can still receive the therapy to alleviate the symptoms of their radiation treatments.
“We have done people with throat cancer, but we don’t treat the cancer, we’re wound healing. We’re treating the damage caused by their treatment,” said Mr. McLeod. “We had one lady who had cancer and she said, ‘This was the only treatment that made me feel better.’”
Dr. Osterloh said the experimental results look promising. “Cancer treatment with HBOT is a big area being studied at present. At the moment, studies are showing promise, but it is difficult as HBOT enhances the growth of healing tissue and angiogenesis, and angiogenesis is a major consideration with cancer growth, so very complex,” she said.
Claims have also been made that the therapy is an effective treatment for autism, a neuro-developmental disorder affecting as many as one in 166 children in the United States.
Researchers from the International Child Development Resource Center in Florida conducted a study in 2009, which observed 62 autistic children after they received 40 hour-long hyperbaric treatments. The report described the treatment as “promising.”
Following the treatments, the children showed signs of “significant improvements in overall functioning, receptive language, social interaction, eye contact,” the report said.
While hyperbaric oxygen therapy has been cleared by the U.S. Food and Drug Administration to treat certain medical conditions, including decompression sickness, carbon monoxide poisoning and burns caused by heat or fire, the device has not been approved to treat any other medical conditions.
“Hyperbaric oxygen therapy has not been clinically proven to cure or be effective in the treatment of cancer, autism, or diabetes. But do a quick search on the Internet, and you’ll see all kinds of claims for these and other diseases for which the device has not been cleared or approved by FDA,” according to the FDA’s website.
Mr. Elliott said he tries not to get involved in non-FDA approved cases. However, he did “try once” but the patient’s symptoms kept returning after treatment.
“We did try a treatment for multiple sclerosis. It certainly gave the patient better quality of life while we were treating them, but it means the patient would have to be done regularly for the rest of their life,” he said.
Although Mr. Elliott has not used the chamber to treat any patients with autism, he is aware of cases in the U.S. “Hyperbaric therapy for autism has been gaining popularity in the U.S., where parents can buy their own hyperbaric chamber – well, if they have a spare $14,000 to $17,000.”
Only FDA-approved medical conditions are covered by insurance, according to Dr. Osterloh.
To undergo hyperbaric oxygen therapy treatments for an uninsured medical condition, five hours in the chamber costs a total of $4,050. Medical patients typically need 10 or 20 treatments, Mr. Elliott said.
The Elliotts took over the chamber in 1996 from the British Sub-Aqua Club, but the device has been treating patients since as early as 1972.
Cayman Hyperbaric Services currently has the support of 35 volunteers who are trained to monitor the equipment; most of them have diving experience. The chamber is available 24/7 for emergencies.