Oxygen therapy treats diabetic ulcers, tissue damage

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Oxygen therapy treats diabetic ulcers, tissue damage

By Thom Gabrukiewicz
Monday, March 17, 2008

Sixty-four-year-old Judy Berg has been down for a dive -- 60 of them, actually -- but didn't dip so much as a toe in the water. She even got to nap and watch a little television.

The Lake Shastina resident was a patient at Shasta Regional Medical Center's Center for Wound Care and Hyperbaric Medicine last fall. Five times a week for 12 weeks, she was sealed in an acrylic tube -- think of one of those things banks use at drive-through tellers, but large enough to fit a whole person -- and inhaled 100 percent oxygen for two hours at a time.

The dives, she said, helped save her foot.

"I'm a diabetic, and I had an infected blister that just wouldn't heal," Berg said. "One doctor wanted to amputate. I am walking, in regular shoes, fully healed and doing beautifully.

"I think it's amazing," Berg said.

The "it" is hyperbaric oxygen therapy, or HBOT.

The air we all breathe contains about 21 percent oxygen. But with HBOT, the patient is saturated with pure oxygen -- and has the added benefit of being compressed to one atmosphere of pressure.

"Basically, it's the equivalent of scuba diving," said Becky Harper, a HBOT technician. "So we call it diving. When the patient is in the chamber, it's like being 33 feet under saltwater."

Without actually being underwater.

SRMC has used HBOT in its Center for Wound Care since July. The hospital has three of the units, made by Perry Baromedical of Riviera Beach, Fla.

Mercy Medical Center in Redding plans on opening its own wound-care unit in July, according to Mercy spokesman Michael Burke.

Hyperbaric therapy has been around in various forms since 1662 and has been used clinically since the 1800s. Most notably, hyperbaric chambers have been used by the U.S. military to treat decompression sickness, or the bends, in deep-sea divers.

And while hucksters across time have claimed increased oxygen could treat everything from male-pattern baldness, anti-aging and even creaky backs, there is proof that the treatment works for certain ailments.

SRMC's unit typically treats patients with diabetic ulcers, skin graphs and flaps that won't heal and tissue damage from radiation treatments.

"For adjunctive care, it's another tool in the tool in the toolbox," said Dr. Andrew Knapp, medical director for the center. "It's new to Redding and only certain wounds will work. But it's been an invaluable resource, a nice application to chronic wounds that will not heal."

The unit, Knapp said, has experienced healing rates in excess of 89 percent since the wound center opened more than three years ago.

"It seems like a good idea to me," said Dr. Jerry Nystrom, a retired optometrist who completed his fourth week of dives Friday for a diabetic ulcer on the bottom of his right foot. "It saturates the blood with oxygen, which speeds healing."

Nystrom, a diabetic for 40 years, received a double organ transplant -- kidney and pancreas -- on Christmas Day 2005.

"While not a diabetic now (the pancreas produces insulin and regulated blood sugar), I still have some of the problems associated with it," he said. "It started out as a blister after walking across the UC Berkeley campus last fall."

With 20 treatments completed, the wound is healing nicely, Nystrom said.

In HBOT, oxygen levels in blood plasma can increase 10 to 20 times than what is normal, Knapp said. And with increased oxygen levels reaching damaged tissue, it helps stimulate the healing process.

The therapy can even increase the migration of white blood cells to fight infection and can cause the proliferation of fibroblasts, which help manufacture new tissue, according to the Undersea and Hyperbaric Medical Society, which since 1967 has exchanged data and helped oversee the ethical practice of hyperbaric medicine.

There can be side affects, Harper said, but they are generally mild. There's barotrauma, which begins as the pressure you feel in your ears when you're in an aircraft. Some people also can get a little claustrophobic in the chamber.

"Oh, it's quite relaxing, actually," said Berg, who completed her HBOT therapy just before Christmas. "Very comfortable. They taught me to clear my ears on the way down -- it's just like driving down the mountain -- and I found swallowing and just yawning worked for me."

"I'm a big guy and claustrophobic to begin with," Nystrom said. "It wasn't bad. You watch videos. I was pleasantly surprised."

Reporter Thom Gabrukiewicz can be reached at 225-8230 or at tgabrukiewicz@redding.com.

http://www.redding.com/news/2008/mar/17/a-healing-dive/?printer=1/

Photo by Nathan Morgan / Record Searchlight

INSIDE PATIENT: Dr. Jerry Nystrom watches the movie, “Inside Man,” during a recent two-hour treatment inside a hyperbaric chamber at Shasta Regional Medical Center in Redding. The retired optometrist was getting the oxygen treatment to speed the healing of a diabetic ulcer on the bottom of his right foot.