Hyperbaric Oxygen Therapy
Frequently Asked Questions
You've got questions, we've got answers
WHAT IS HYPERBARIC OXYGEN THERAPY (HBT)?
HBT is a method of delivering extra oxygen into the body, mainly through the process of increasing the pressure that the body is normally under. In terms of HBT, pressure is normally quantified in ATA and currently we are all standardized to be less than 1.0 ATA of atmospheric pressure. When someone undergoes hyperbaric therapy, the pressure becomes greater than 1.0 ATA and in hospitals and wound care centers can typically reach 2.0 or even 3.0 ATA. Each atmospheric pressure represents 33 feet of seawater, so at 2.0 ATA, it would be equivalent for you to be at a depth of 33 feet below sea level. Once at this depth, 100% oxygen will be administered for the full duration of the treatment, which normally lasts for 60 to 90 minutes per session, and this procedure can be repeated twice per day with a 4-hour break in between. For chronic or hard-to-heal wounds, this dosage is typically repeated daily from anywhere between 10 and 80 hours. The FDA approves hyperbaric treatments for the following 13 conditions:
Decompression Sickness, Gas embolism, CO and Cyanide poisoning, Gas Gangrene, Selected aerobic and anaerobic soft tissue infections, Osteomyelitis, Intracranial abscess, Management of Fungal disease, Radiation injury to tissue, Exceptional blood loss/anemia, Crush injury/compartment syndrome, Ischemia reperfusion injuries, Skin grafts and flaps, Healing in selected problem wounds, Treatment of thermal burns.
Many doctors and clinical researchers in the field of hyperbaric medicine believe that HBT may help many more conditions and improve quality of life. Please be aware that if you are using this to treat a medical condition other than the 13 above conditions, then the FDA considers this an ‘off-label’ treatment and wishes you to make sure that you have sought out all FDA-approved treatments first and fully understand the benefit to risk ratio before making your decision.
WHAT IS MILD HYPERBARIC OXYGEN THERAPY (m-HBT)?
m-HBT represents a lower pressurized chamber, generally under 1.5 ATA, and typically at 1.3 ATA. These lower atmospheric pressures (representing roughly only 10 feet below sea level) allow for greater safety, while still allowing for the delivery of much higher levels of oxygen into the tissues. The FDA has cleared m-HBT as an approved treatment for those suffering from altitude sickness, where oxygen levels can become dangerously low at higher elevations -- a condition that is life threatening. The extra oxygen delivered through m-HBT is so significant that it can be enough to help reverse this life threatening condition.
WHAT ARE THE BENEFITS OF MILD HYPERBARIC OXYGEN THERAPY (m-HBT)?
One of the key determinants of HBT is pressure and the greater the pressure, the greater the amount of dissolved oxygen into the body. Note, it does not take much pressure to deliver extra amounts of physiologically- available oxygen. During m-HBT, the added pressure allows extra oxygen to be absorbed and transferred from the lungs into the blood, causing a greater saturation of blood oxygen levels. As this rich oxygenated blood makes its way to damaged tissue, extra oxygen is now readily available and can be potentially utilized for enhancing tissue repair and regeneration while also still being able to provide its potent anti-inflammatory and anti-bacterial effects. The FDA once again cautions the use of HBT, including m-HBT if it’s not used for one of the approved medical conditions, in this case ‘altitude sickness’. Although these lower pressures have both been reported to have significant benefits, which are now being supported and validated though clinical research trials, we would still encourage you to follow the FDA guidelines in looking into ‘medically-approved’ options if you are looking at using m-HBT to help with a medical condition.
DO I HAVE TO BREATHE 100% OXYGEN OR AMBIENT AIR?
Traditionally, hyperbaric oxygen is defined as breathing 100% oxygen under pressure. However, ambient air still contains 21% oxygen, and when you breathe it under pressure, more oxygen will get transferred into the body. More importantly, the extra oxygen enters the blood plasma (liquid) and gets oxygen into much deeper areas (i.e., where inflammation impedes blood flow) and in places where red blood cells cannot normally reach. This is a great technique to achieve greater levels of oxygen without the associated risks of being in high oxygen environments.
WHAT IS THE RECOMMENDED SCHEDULE?
The reported benefits using HBT or m-HBT have typically been from those who have had one to two sessions per day (with a 4-hour interval between the start of each session for those who have 2 sessions per day). People who live nearby may choose to do one session daily. The leading proponents of HBT recommend a minimum of 20 sessions and preferably up to 40 in the initial schedule. Following 40 sessions, you may re-evaluate for discernible benefits before proceeding. If you have local areas of concern, you may combine this procedure with Near Infrared Light therapy, providing a focused approach, which we have found has provided noticeable benefits when applied once or twice per week.
HOW LONG DOES EACH SESSION LAST?
Typically, sessions last 60 minutes. Pressurizing the chamber takes 5 -10 minutes (up to 25 min.). At the therapeutic depth you will receive a timed 60 minutes session, after which we depressurize (for 5 - 10 minutes). Allow up to 1.5-hours for each session.
HOW DOES IT FEEL?
As the chamber is being pressurized, air presses on your eardrums and pushes them inwards. This pressure feels similar to the pressure that you feel in your ears when you are flying in an airplane. The majority of people (90%) automatically and easily adjust to these pressure changes, while reporting no adverse effects. If you are in the 10% minority, then the only problem that you may experience with this is either discomfort or pain in your ears or sinuses, similar to that which you would feel if you were congested while landing from an airplane. The only difference is that you ‘cannot tell the pilot on an airplane to stop’. In the case of HBT, we would encourage you to signal or radio the attendant immediately if you have discomfort in your ears or sinuses. Don’t wait until it really hurts. The attendant will stop pressurizing and decrease the pressure until you are comfortable and able to equalize the pressure. When you’re comfortable the attendant will resume pressurizing. Our attendants are well experienced at dealing with these cases and are willing to work with you as required. Here are some techniques in helping to equalize your ears:
• Try to swallow; yawn or drink sips of water. Turn your head to one side and swallow, then turn to the other side and swallow. Repeat if necessary.
• The Valsalva Maneuver – Pinch your nose closed, close your mouth and lift the front-tip of your tongue towards the roof of your mouth. Attempt to blow through your pinched nose (short and sharp) but not too forcefully. This directs air from your throat into your ears and sinus air passages.
• A third method combines these techniques: try swallowing and wiggling your jaw while blowing gently against your pinched nose. Now that’s coordination!
• If you have a history of problems with the ear when flying or traveling in the mountains you may wish to use nasal decongestants before the first few treatments. With young children tilt their head back and you can put one drop of pediatric (baby) nose drops in each nostril one and a half to two hours before HBOT. Wait 5-10 min. and then put a second drop in each nostril. You can use Afrin or a similar nasal spray 20-30 minutes after the nose drops. Do not repeat the nasal spray.
WHAT IS MY ROLE AND RESPONSIBLILTY TO ENSURE SAFETY?
Your role is quite simple: to show up on time, communicate with our staff and attendants each time, and let them know if there are any changes in your health. For example, you may have reported on your first visit that you were not pregnant, but when you come in for multiple visits it is your responsibility to let us know if there are any changes in your health, and in this example it would be ‘if you are potentially pregnant’. This is for your safety and once again it is your responsibility to let us know each time you go in ‘if there are any changes’ in your health.
WHAT ARE THE RISKS, CONTRAINDICATIONS, AND AREAS OF CONCERN?
Performed in a clinical setting, m-HBT has repeatedly been shown to be extremely safe. The only noted side effects have been limited to higher-pressure chambers used to treat acute life-threatening conditions in hospitals, and even those side effects are very rare.
It should be noted that the only absolute contraindication for undergoing HBT is a collapsed lung (pneumothorax).
Areas of concern would be:
• Severe lung or heart disease: This is because we would not want fluid to build up into the lungs.
• Uncontrolled Diabetes: This is because we do not want the blood sugars to drop too low if HBT was combined with overdose of diabetic drug therapy.
• History of Seizure or Uncontrolled fever: This is because we would be concerned with exacerbating seizure activity, particularly if blood sugars are low.
• Changes in Vision: This is rare and a temporary change in vision that has been associated with higher pressure chambers and not m-HBT. Changes in vision include getting either a little worse (Myopia) or better (Presbyopia). Note: these cases are rare and associated with higher oxygen dosages. If you notice any changes, please let the attendant know and don’t worry as the vision tends to go back to its original state within 3 months from discontinuing the sessions. For that reason, it is not advised to change prescriptions during this time period.
• Cataracts: Though HBT cannot cause cataracts, this procedure may cause formed cataracts to mature more quickly.
• Pregnancy: As a precaution, HBT is not used during pregnancy unless indicated for acute life-threatening conditions.
• Current upper respiratory infections, chronic sinusitis or sinus problems: These conditions cause a higher probability of problems during pressurization and are generally recommended to be treated before going into HBT.
• Claustrophobia: Some clients may suffer from Claustrophobia. This is managed by maintaining communication, and use of relaxation technique. If you have a problem with this condition please let us know
HBT is a method of delivering extra oxygen into the body, mainly through the process of increasing the pressure that the body is normally under. In terms of HBT, pressure is normally quantified in ATA and currently we are all standardized to be less than 1.0 ATA of atmospheric pressure. When someone undergoes hyperbaric therapy, the pressure becomes greater than 1.0 ATA and in hospitals and wound care centers can typically reach 2.0 or even 3.0 ATA. Each atmospheric pressure represents 33 feet of seawater, so at 2.0 ATA, it would be equivalent for you to be at a depth of 33 feet below sea level. Once at this depth, 100% oxygen will be administered for the full duration of the treatment, which normally lasts for 60 to 90 minutes per session, and this procedure can be repeated twice per day with a 4-hour break in between. For chronic or hard-to-heal wounds, this dosage is typically repeated daily from anywhere between 10 and 80 hours. The FDA approves hyperbaric treatments for the following 13 conditions:
Decompression Sickness, Gas embolism, CO and Cyanide poisoning, Gas Gangrene, Selected aerobic and anaerobic soft tissue infections, Osteomyelitis, Intracranial abscess, Management of Fungal disease, Radiation injury to tissue, Exceptional blood loss/anemia, Crush injury/compartment syndrome, Ischemia reperfusion injuries, Skin grafts and flaps, Healing in selected problem wounds, Treatment of thermal burns.
Many doctors and clinical researchers in the field of hyperbaric medicine believe that HBT may help many more conditions and improve quality of life. Please be aware that if you are using this to treat a medical condition other than the 13 above conditions, then the FDA considers this an ‘off-label’ treatment and wishes you to make sure that you have sought out all FDA-approved treatments first and fully understand the benefit to risk ratio before making your decision.
WHAT IS MILD HYPERBARIC OXYGEN THERAPY (m-HBT)?
m-HBT represents a lower pressurized chamber, generally under 1.5 ATA, and typically at 1.3 ATA. These lower atmospheric pressures (representing roughly only 10 feet below sea level) allow for greater safety, while still allowing for the delivery of much higher levels of oxygen into the tissues. The FDA has cleared m-HBT as an approved treatment for those suffering from altitude sickness, where oxygen levels can become dangerously low at higher elevations -- a condition that is life threatening. The extra oxygen delivered through m-HBT is so significant that it can be enough to help reverse this life threatening condition.
WHAT ARE THE BENEFITS OF MILD HYPERBARIC OXYGEN THERAPY (m-HBT)?
One of the key determinants of HBT is pressure and the greater the pressure, the greater the amount of dissolved oxygen into the body. Note, it does not take much pressure to deliver extra amounts of physiologically- available oxygen. During m-HBT, the added pressure allows extra oxygen to be absorbed and transferred from the lungs into the blood, causing a greater saturation of blood oxygen levels. As this rich oxygenated blood makes its way to damaged tissue, extra oxygen is now readily available and can be potentially utilized for enhancing tissue repair and regeneration while also still being able to provide its potent anti-inflammatory and anti-bacterial effects. The FDA once again cautions the use of HBT, including m-HBT if it’s not used for one of the approved medical conditions, in this case ‘altitude sickness’. Although these lower pressures have both been reported to have significant benefits, which are now being supported and validated though clinical research trials, we would still encourage you to follow the FDA guidelines in looking into ‘medically-approved’ options if you are looking at using m-HBT to help with a medical condition.
DO I HAVE TO BREATHE 100% OXYGEN OR AMBIENT AIR?
Traditionally, hyperbaric oxygen is defined as breathing 100% oxygen under pressure. However, ambient air still contains 21% oxygen, and when you breathe it under pressure, more oxygen will get transferred into the body. More importantly, the extra oxygen enters the blood plasma (liquid) and gets oxygen into much deeper areas (i.e., where inflammation impedes blood flow) and in places where red blood cells cannot normally reach. This is a great technique to achieve greater levels of oxygen without the associated risks of being in high oxygen environments.
WHAT IS THE RECOMMENDED SCHEDULE?
The reported benefits using HBT or m-HBT have typically been from those who have had one to two sessions per day (with a 4-hour interval between the start of each session for those who have 2 sessions per day). People who live nearby may choose to do one session daily. The leading proponents of HBT recommend a minimum of 20 sessions and preferably up to 40 in the initial schedule. Following 40 sessions, you may re-evaluate for discernible benefits before proceeding. If you have local areas of concern, you may combine this procedure with Near Infrared Light therapy, providing a focused approach, which we have found has provided noticeable benefits when applied once or twice per week.
HOW LONG DOES EACH SESSION LAST?
Typically, sessions last 60 minutes. Pressurizing the chamber takes 5 -10 minutes (up to 25 min.). At the therapeutic depth you will receive a timed 60 minutes session, after which we depressurize (for 5 - 10 minutes). Allow up to 1.5-hours for each session.
HOW DOES IT FEEL?
As the chamber is being pressurized, air presses on your eardrums and pushes them inwards. This pressure feels similar to the pressure that you feel in your ears when you are flying in an airplane. The majority of people (90%) automatically and easily adjust to these pressure changes, while reporting no adverse effects. If you are in the 10% minority, then the only problem that you may experience with this is either discomfort or pain in your ears or sinuses, similar to that which you would feel if you were congested while landing from an airplane. The only difference is that you ‘cannot tell the pilot on an airplane to stop’. In the case of HBT, we would encourage you to signal or radio the attendant immediately if you have discomfort in your ears or sinuses. Don’t wait until it really hurts. The attendant will stop pressurizing and decrease the pressure until you are comfortable and able to equalize the pressure. When you’re comfortable the attendant will resume pressurizing. Our attendants are well experienced at dealing with these cases and are willing to work with you as required. Here are some techniques in helping to equalize your ears:
• Try to swallow; yawn or drink sips of water. Turn your head to one side and swallow, then turn to the other side and swallow. Repeat if necessary.
• The Valsalva Maneuver – Pinch your nose closed, close your mouth and lift the front-tip of your tongue towards the roof of your mouth. Attempt to blow through your pinched nose (short and sharp) but not too forcefully. This directs air from your throat into your ears and sinus air passages.
• A third method combines these techniques: try swallowing and wiggling your jaw while blowing gently against your pinched nose. Now that’s coordination!
• If you have a history of problems with the ear when flying or traveling in the mountains you may wish to use nasal decongestants before the first few treatments. With young children tilt their head back and you can put one drop of pediatric (baby) nose drops in each nostril one and a half to two hours before HBOT. Wait 5-10 min. and then put a second drop in each nostril. You can use Afrin or a similar nasal spray 20-30 minutes after the nose drops. Do not repeat the nasal spray.
WHAT IS MY ROLE AND RESPONSIBLILTY TO ENSURE SAFETY?
Your role is quite simple: to show up on time, communicate with our staff and attendants each time, and let them know if there are any changes in your health. For example, you may have reported on your first visit that you were not pregnant, but when you come in for multiple visits it is your responsibility to let us know if there are any changes in your health, and in this example it would be ‘if you are potentially pregnant’. This is for your safety and once again it is your responsibility to let us know each time you go in ‘if there are any changes’ in your health.
WHAT ARE THE RISKS, CONTRAINDICATIONS, AND AREAS OF CONCERN?
Performed in a clinical setting, m-HBT has repeatedly been shown to be extremely safe. The only noted side effects have been limited to higher-pressure chambers used to treat acute life-threatening conditions in hospitals, and even those side effects are very rare.
It should be noted that the only absolute contraindication for undergoing HBT is a collapsed lung (pneumothorax).
Areas of concern would be:
• Severe lung or heart disease: This is because we would not want fluid to build up into the lungs.
• Uncontrolled Diabetes: This is because we do not want the blood sugars to drop too low if HBT was combined with overdose of diabetic drug therapy.
• History of Seizure or Uncontrolled fever: This is because we would be concerned with exacerbating seizure activity, particularly if blood sugars are low.
• Changes in Vision: This is rare and a temporary change in vision that has been associated with higher pressure chambers and not m-HBT. Changes in vision include getting either a little worse (Myopia) or better (Presbyopia). Note: these cases are rare and associated with higher oxygen dosages. If you notice any changes, please let the attendant know and don’t worry as the vision tends to go back to its original state within 3 months from discontinuing the sessions. For that reason, it is not advised to change prescriptions during this time period.
• Cataracts: Though HBT cannot cause cataracts, this procedure may cause formed cataracts to mature more quickly.
• Pregnancy: As a precaution, HBT is not used during pregnancy unless indicated for acute life-threatening conditions.
• Current upper respiratory infections, chronic sinusitis or sinus problems: These conditions cause a higher probability of problems during pressurization and are generally recommended to be treated before going into HBT.
• Claustrophobia: Some clients may suffer from Claustrophobia. This is managed by maintaining communication, and use of relaxation technique. If you have a problem with this condition please let us know
