Hyperbaric oxygen therapy (HBOT), once a common treatment of decompression sickness, a hazard of scuba diving, has moved on in the medical field to advance healing in other areas. The medical treatment can save a diabetic foot from being amputated, heal crush injuries and other wounds more quickly than traditional methods, and help injured athletes get back in the game faster. In select problems, hyperbaric oxygen therapy can do wonders, according to Dr. James Iferenta.
HBOT, an advanced medical treatment enables patients to breathe pressurized 100 percent oxygen, triggering natural wound-healing abilities to help the body recover more effectively. The treatment is an ideal solution for patients who suffer from chronic diseases, like diabetes, or nerve-related and auto-immune diseases, including lupus. Those who have experienced a stroke, burns or certain surgical procedures can also benefit from the treatment, said Dr. Iferenta, as he spoke on the topic at the most recent Doctors Hospital Distinguished Lecture Series.
"In a number of years, very soon, HBOT is going to be a standard for care, and will change the dynamics of persons who have had acute or life-changing illnesses or injuries," said the doctor, who, for the past month, has been offering the treatment at the Bahamas Medical Center (BMC) on Blake Road.
And, in The Bahamas, where some 35,000 Bahamian children have been diagnosed on the autism spectrum, parents have been given hope, as Dr. Iferenta says the use of HBOT on children with autism has been associated with improvements in overall functioning, receptive language, social interaction, eye contact and sensory/cognitive awareness. The use of HBOT to treat autism, he said, was based on the hypothesis that increasing atmospheric pressure enhances oxygen delivery to the brain to reduce swelling and promote brain recovery.
"What's been found with autism is that, when persons are treated with 100 percent oxygen, for a period of time, that they get changes that are not reversible. The way the brain cells talk to each other becomes faster, more frequent, easier ... [even though] the research is still out on autism, it's a tool that's being used more and more." The doctor said hyperbaric oxygen therapy to treat autism had not been approved by the United States Federal Drug Administration.
Concerning the high incidence of the BRCA 1 cancer gene mutation found in Bahamian women - whose options may be limited to radiation therapy, which has its own set of complications, including damage to bone, blood cells, muscles and the skin - Dr. Iferenta said HBOT, along with one or two medications, could effectively treat the breakdown of bone and soft tissue caused by radiation.
"In select problems, hyperbarics can do wonders," said the doctor. "It causes new blood vessels to form, new tissues to come in, causes the release of platelet-derived growth factor which is the source of healing in all kinds of wounds in humans. We're absolutely thrilled to have [HBOT] as a tool for our community and our patients that are going to benefit."

Hyperbaric oxygen treatment at Bahamas Medical Center
The Bahamas Medical Center monoplace (single person use) hyperbaric chamber is huge - at 40 inches in diameter - and transparent. According to Dr. James Iferenta, the chamber is so large that there have been no complaints of claustrophobia from any of the patients who have used it, to date; the transparent, acrylic tube allows patients to be able to see the doctor and the technician, while inside. With an attached television, they are also able to watch DVDs while receiving hyperbaric treatment.
When in the chamber, a patient breathes 100 percent oxygen, which Dr. Iferenta says changes the dynamics of healing. In comparison, normal air has 21 percent oxygen.
"Oxygen is the basis of life. Human beings can survive without food for up to 60 days and without water for days, but only minutes without oxygen. Oxygen can mean the difference between life, and mental alertness, and it can also mean the difference in a spinal cord injury and paralysis. Hyperbaric oxygen is a way to help to control, reduce or to get rid of most of these kinds of injuries. Healing cannot be achieved without sufficient oxygen levels, because oxygen is a lifeline for healing. Where there is no oxygen, organs get damaged, cells die, neurons don't do what they're supposed to do ... people have strokes, they have heart attacks," said the medical practitioner.
Referring to Dr. Richard Neubauer, a pioneer in hyperbaric oxygen therapy, Dr. Iferenta said hyperbaric oxygen promotes natural healing with virtually no risk because patients are being treated with an element that already exists in the environment and that the body is already using. He said using it in increased amounts to benefit the tissues, organs and cells has little or no side affects.
"HBOT helps the tissue to start healing 30 to 40 percent faster," he said. "It makes the cells that do the healing divide faster, so oxygen is a huge tool and giving it at high pressure makes it even better. When you increase the pressure, the oxygen molecules that go to the tissue help to heal things and shrink them, to get rid of infection, and that's where the power of the high intensity oxygen occurs. This decreases the need for antibiotics, because these oxygen concentrations, kills a lot of the bad bugs that we have to use antibiotics for. It stops them from dividing and in most cases will kill them because it activates a lot of enzymes, and that's important because a lot of our patients with these problems have diabetes, high blood pressure, high cholesterol, poor circulation, peripheral vascular disease...they're on multiple medications, and many of them cannot take one more thing or they have poor kidney function, which is the biggest problem we have in our environment. It stops us from treating infections because we can't use the full dosing. With this level of oxygen concentration we're able to begin to kill bacteria that will cause morbidity and even sometimes even kill the patient by sepsis.

The role of insurance
While Dr. Iferenta said HBOT could not fix everything, he said conditions covered by insurance that HBOT will treat include necrotizing soft tissue infections, involving flesh damaged by bacteria consumption; chronic refractory osteomyelitis; and skin grafts and flaps.
"Diabetes has become the biggest plague on the modern Bahamian community. Everybody knows somebody who has diabetes and is suffering with ulcers, suffering with sugar control, suffering with amputation, is at risk of amputation, has been amputated or is at risk of being amputated. We have salvaged a lot of limbs with HBOT and prevented people from becoming amputees, all through the use of this treatment modality."
In a study comparing the results of patients who had been treated with conventional methods and those who added HBOT to their treatments, Dr. Iferenta said 45 percent of the people who developed a foot or limb infection and were treated with traditional treatments would end up with an amputation below or above the knee; the risk was reduced to 8.3 percent in the group that had added HBOT to their therapies.
"There is nothing that works the way that oxygen works, the oxygen made the difference," said Dr. Iferenta.
HBOT is also used in the treatment of acute peripheral arterial insufficiency, acute traumatic peripheral ischemia, crush injuries and suturing of severed limbs, ostecardionecrosis, soft tissue and bone radionecrosis, clostridial myonecrosis (gas gangrene), carbon monoxide poisoning, air or gas embolism, decompression sickness and exceptional blood loss anemia.
Conditions not covered by insurance which HBOT can be used to treat include traumatic brain injury and cerebral strokes, acute myocardial infarction, autism, acute soft tissue injuries, sprains, strains and contusions, headaches, migraines, cluster headaches, dental abscess and jaw bone infection, infection, inflammation and delayed onset muscle soreness.
While Dr. Neubauer has said that the positive powers of hyperbaric oxygen are "really a modification of God's gift to man," Dr. Iferenta says patients should be aware that hyperbaric treatment cannot save dead tissue and cannot reverse dead tissue.

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