FAQ
WHAT IS HYPERBARIC OXYGEN THERAPY (HBOT)?
HBOT 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 HBOT, 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, wellness centers 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, 95%-100% oxygen is typically 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 and other conditions, this dosage is typically repeated daily from anywhere between 10 and 80 hours of sessions. All of our staff are certified hyperbaric technicians who follow well-documented procedures of the International Hyperbarics Association and the International Board of Undersea Medicine. We use hard chambers made of steel and acrylic pressurized with air, with telescoping gurneys and a clear view of outside the chamber.
WHAT IS HBOT USED FOR?
The FDA approves hyperbaric treatments ONLY for the following 14 conditions and for altitude sickness: 14 MEDICAL 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, and Idiopathic sudden sensorineural hearing loss. Typical treatment pressures range between 2.0 to 2.5 ATA for most of these 14 conditions. ALTITUDE SICKNESS – Treatment pressure is 1.3 ATA (also known as mild hyperbaric therapy or m-HBOT). 1.3 ATA is commonly termed m-HBOT (mild hyperbaric therapy) and an FDA cleared 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-HBOT is so significant that it can be enough to help reverse this life-threatening condition! OFF-LABEL INDICATIONS PRESCRIBED BY A DOCTOR. Many doctors and clinical researchers in the field of hyperbaric medicine believe that HBOT 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 15 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. Typical treatment pressures vary between 1.3 – 2.4 ATA. HBOT is becoming more popularized for the physiological and energetic support being achieved from the surplus levels of oxygen created when breathing in a hyperbaric environment. Typical pressures used for general health and wellness range between 1.3 - 2.4 ATA (Again, 1.3 ATA is often described as mild hyperbaric therapy or m-HBOT). Note, not everyone is ‘fit’ for being in a pressurized environment so If you are using HBOT for its physiological benefits to support overall health and wellness, proper hyperbaric ‘fitness’ screening by a healthcare provider is required before undergoing any HBOT sessions. ***The FDA once again cautions the use of HBOT or m-HBOT if it’s not used for one of the 14 approved medical conditions or for altitude sickness respectively. 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 HBOT to help with a medical condition.
ARE LOWER PRESSURES STRONG ENOUGH?
Lower pressure protocols at 1.3 to 1.5 ATA can effectively deliver these higher levels of oxygen, while allowing for greater safety. Note, it does not take much pressure to deliver extra amounts of physiologically available oxygen. 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. If greater oxygen dosages are required to localized tissue, then the procedure can be increased or combined with Photobiomodulation therapy (PBM) at wavelengths between 450 and 950 nm. Flexible light pads, panels or chambers delivering the LLLT (Low Level Light Therapy) can be used directly over the area being treated. This combination of PBM hyperbaric therapy is often termed t-HBOT or targeted hyperbaric therapy, as this procedure basically ‘points’ to an area of the body to help deliver the effects of HBOT to that focused area -- a targeted approach. Both therapies have been individually shown to exert positive effects, but the combined approach has recently been reported to have much greater effects. While still in its research phase, t-HBOT may prove to be a powerful tool for localizing the effects of HBOT. We offer pressures up to 2.9 ATA, but most sessions will be at 2.5 ATA or below, often 2.2 or below, except in special circumstances.
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 swelling and 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 higher oxygen environments. We offer oxygen levels at 21%-95%+.
WHAT IS THE RECOMMENDED HBOT SCHEDULE?
The reported benefits using hyperbaric oxygen therapy 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 HBOT recommend a minimum of 20 sessions and preferably up to 40 in the initial schedule. Following 20 sessions, you may re-evaluate for discernible benefits before proceeding. If you have local areas of concern, you may combine this procedure with PBM or Near Infra-red Light therapy, providing a focused approach, which we have found has provided noticeable benefits when applied even for just once or twice per week.
HOW LONG DOES EACH HBOT SESSION LAST?
Hyperbaric sessions are typically 60 minutes but can vary from 30 -120 minutes. Sessions that last more than 30 minutes can require 5-minute air-breaks. This is for safety precautions, oxidative variation, and are generally recommended when pressures exceed 2.0 ATA. The total session time must consider the time to both pressurize and depressurize. Lower pressure protocols will take less time to pressurize/depressurize (as little as 5 minutes each way), while higher pressure protocols will take longer (up to 25 minutes each way).
HOW DOES HBOT FEEL?
As the chamber is being pressurized, air presses on your eardrums and pushes them inwards. This pressure feels like the pressure that you feel in your ears when you are flying in an airplane. Most 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, like 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 HBOT, we would encourage you to signal or radio your technician immediately if you have discomfort in your ears or sinuses. Don’t wait until it really hurts. Your technician will stop pressurizing and decrease the pressure until you are comfortable and able to equalize the pressure. When you’re comfortable the technician will resume pressurizing. Our certified technicians 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. We also offer fermented drinks based on vinegar or kombucha tea which can open your air passages.
WHAT IS MY ROLE AND RESPONSIBILITY TO ENSURE SAFETY FOR HBOT?
Your role is quite simple: to show up on time, read and comply with our therapy safety guidelines, communicate with our staff and technicians each time, and let them know your health details and 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 the reason why the checklist for on-going hyperbaric sessions* must be answered each time you go into the hyperbaric chamber. 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. Most therapy costs are not covered by insurance. We provide receipts and documentation to you for any such filings. CHECKLIST FOR ON-GOING HYPERBARIC SESSIONS: Please inform the staff EVERY TIME you enter the hyperbaric chamber if: **There have been any changes in your health, in your medical condition, or in your medications/supplements. **You experience a cold, flu symptoms, sinus or nasal congestion, or chest congestion. **There is a possibility you may be pregnant. **You have skipped a meal prior to HBOT treatment as your glucose level needs to be stable. **You are a diabetic and did not take your insulin prior to treatment. Also, inform the staff IF THE PRESSURE IS TOO GREAT FOR YOUR EARS. Often, people have trouble adjusting to an increased atmospheric pressure. If your ears hurt, inform the staff immediately and he/she can stop or slow down the rate of pressurization until you are comfortable. DO NOT LET IT GET PAINFUL!!! The Airplane Analogy: In an airplane, if your ears are hurting, you cannot tell the pilot to stop climbing or descending. However, in a hyperbaric chamber, it is your responsibility to tell the HBOT technician to slow down or stop the pressurization process. This will help avoid an unpleasant experience during your hyperbaric session. Please arrive at least 30 minutes prior to your scheduled treatment time. In consideration to all clients, we would like to start all therapy sessions on time and late arrivals will result in delays. You may be denied the Hyperbaric Chamber if you arrive late. You need time to dress, use the restroom and prepare for your session. We appreciate your cooperation. Please call or come see us with questions or concerns.
WHAT ARE THE RISKS, CONTRAINDICATIONS, AND AREAS OF CONCERN IN HBOT AND PBM?
Hyperbaric Oxygen and PBM Light therapies are very simple, non-invasive, and safe procedures. Both have demonstrated excellent safety records and generally are extremely safe procedures. Serious adverse reactions are very rare, and generally not seen at lower dosages in air-pressurized HBOT. ABSOLUTE CONTRAINDICATIONS FOR HBOT **UNTREATED PNEUMOTHORAX** The only absolute contraindication for hyperbaric oxygen therapy is an ‘untreated pneumothorax (collapsed lung)’. Anyone needing to enter a hyperbaric chamber with an untreated pneumothorax needs to have a chest tube inserted and be evaluated by a medical practitioner before entering a hyperbaric chamber. MOST COMMON SIDE EFFECTS/ADVERSE REACTIONS TO HBOT **EAR/SINUS DISCOMFORT: This occurs in about 10% of the population during the hyperbaric pressurization period. Taking extra time and making routine stops will help to reduce discomfort and is recommended as a precautionary measure for all clients undergoing HBOT. **CLAUSTROPHOBIA: Since you are in a closed environment, claustrophobia may occur. This is completely different from being in an MRI machine, as you can freely move around and can get out by yourself. Once the body acclimatizes to the inside environment and feels comfortable and with full control, the procedure is typically well-tolerated. AREAS OF CONCERN, RISKS, AND RELATIVE CONTRAINDICATIONS FOR HBOT **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 HBOT 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 over extended time in HBOT. 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 your technician 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. **CATARACTS: Though HBOT cannot cause cataracts, this procedure may cause formed cataracts to mature more quickly. **PREGNANCY: As a precaution, HBOT 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 HBOT. **CLAUSTROPHOBIA: Some clients may suffer from Claustrophobia. This is managed by maintaining communication, use of relaxation techniques and mild sedation, if necessary. If you have a problem with this condition, please let us know. POTENTIAL SIDE EFFECTS FROM PBM LIGHT THERAPY Generally, any potential side effects from PBM Therapy are minimal and short lived. Failure to wear eye protection in the bright lights of the chamber may cause temporary vision loss until your eyes adjust to normal lighting. We recommend the use of our eye protection for most of the session time, or closing your eyes, although limited exposure with eyes wide open (for 5-7 minutes) may be beneficial to healthy eyes. The chamber does not generate high heat but a user may be exposed to more heat than normal. CONTRAINDICATIONS FOR PBM LIGHT THERAPY ***DISEASES INVOLVING THE RETINA OF THE EYE SUCH AS DIABETES *** USE OF PHOTOSENSITIZING MEDICATIONS LIKE LITHIUM, MEDICAL MELATONIN THERAPY, PHENOTHIAZINE ANTIPSYCHOTICS, AND CERTAIN ANTIBIOTICS. ***HISTORY OF SKIN CANCER AND SYSTEMIC LUPUS ERYTHEMATOSUS People will these conditions or using these medications should avoid PBM light treatment.
IS IT WARM INSIDE THE HBOT CHAMBER?
The air warms as we pressurize (before your session) and cools as we depressurize (after your session). Ventilation keeps the air moving when it is warm, and blankets are available if you become cold.
WHAT ABOUT THE EFFECT OF SMOKING AND OTHER ODORS/FRAGRANCES ON HBOT?
Smoke and other odors/fragrances are accentuated within the confines of the pressurized chamber. Try to minimize the detrimental effect of smoking on HBOT results by abstaining within 1-hour pre- and post-treatment. Please do not use strong scented perfumes, lotions, oils or deodorants prior to your HBOT session as noted in our Safety Guidelines.