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Highway to Health
April/May 2000(This letter goes only to patients and to interested people. If you it bothers you, please accept my apologies and reply with "remove" in the subject--you won't be bothered again. If you find it useful, feel free to copy it or to forward as you wish.)
Anti-Aging Therapies: Hyperbaric Oxygen
Remember the picture of Michael Jackson? The one where he was sleeping in a hyperbaric chamber (it looked like a glass tube)? The headlines read that he used it to keep from aging. Recent television reports again brought up the possibility of oxygen as an anti-aging treatment. A few people asked me about hyperbaric chambers, so I thought you might be interested in what it can and can't do for you.
Can the hyperbaric chamber really be used as an anti-aging therapy? I’ll tell you, but to understand the answer, it would help you to review a couple of interesting facts about pressure and air.
The original developers of the hyperbaric chamber invented the device to treat caisson’s disease (what we now call “the bends” or “decompression sickness.”) To understand the bends, picture the bubbles that appear in a soft drink when you release the pressure by removing the cap. That’s what happens to your blood when you surface from the bottom of the ocean too quickly or after staying too long. Bubbles in your arteries, block blood flow and cause pain (so you “bend” and moan and have a stroke or a heart attack).
Scientists invented the hyperbaric chamber to put the bubbles back into the Coke. The hyperbaric chamber puts your blood (the soft drink in this analogy) under pressure and forces the bubbles to disappear.
At Springhill Hospital, in Mobile, Alabama, where I practice hyperbaric medicine, we also use the pressure of a hyperbaric chamber to force oxygen into tissues that need higher levels for healing. You can force so much oxygen into a person’s blood stream that he or she could actually live without any (that’s 0) red blood cells—until you took them out of the chamber.
So you can do only two things (that we know) to a person with a hyperbaric chamber: 1. You can give extremely high levels of oxygen. 2. You can pressurize tissue.
Insurance companies don’t usually pay for therapy not proven to work. They do pay for hyperbaric oxygen therapy…but only to treat a few things (see list).
1.the bends and air emboli.
With high oxygen:
2. necrotizing fasciitis
4. soft tissue necrosis
5. failed skin graft
6. Fournier’s gangrene,
7. crush injury,
8. osteomyelitis not improving on antibiotics,
9. severe hemorrhage in someone not able or willing to undergo transfusion quickly enough,
10. Carbon monoxide poisoning.
Until last year, they paid to treat diabetic foot ulcers, but now we have to graft the wound and wait for the graft to fail (last year they would pay for us to treat before and after the first graft to help survival for the first time around). They quit paying to treat brown recluse spider bites until after the bite becomes infected. Medicare plans to cut by 2/3’s how much they pay the hospitals for any hyperbaric treatment. Ooops, sorry for the editorial.
Back to the Michael Jackson part: and why was he sleeping in that glass tube anyway? Unlike an x-ray machine or most drugs, anyone (with $250,000) can buy a hyperbaric chamber. For now, the FDA considers the hyperbaric chamber a device instead of a drug, so chambers can be sold to anyone and used for any reason.
Many pro-football teams own them because the athletes report that they recover more quickly from injury when they use the chamber (a day or two makes a difference to an owner who’s paying someone a few million per year to run). This quicker recover has not been proven but sometimes the athletes are worth hearing.
Don’t forget that it wasn’t until the late 1980’s that the medical literature in this country confessed that anabolic steroids truly make you stronger (remember in the 1970’s when the doctors were saying that the bodybuilders were just gaining water and the anabolics really didn’t increase strength). Remember when the doctors debated about whether there really is a runner’s high while the runners knew there was one 10 years before we learned about making endorphins by pumping your Nikes.
The only point is that the pro’s think that it speeds recovery of a joint to use a hyperbaric chamber. The only thing that’s been proven is that the chamber speeds the disappearance of the swelling but there may be some good uses of the chamber that are still unproven.
When people question me about whether pressurized oxygen is really powerful enough to use as a drug, I sometimes ask them to hold their breath for a few minutes while they think about whether oxygen could have an effect on the body.
Now before we get further into the hyperbaric chamber as an anti-aging device, let’s clarify one point best made by a George Sheehan. I went to hear this prophet (when I was in high school in the 70’s, his was the only book by an MD in the Birmingham public library about running) speak once. He said that even if running didn’t make him live longer, he would keep doing it because it helped him live better. Running works as an anti-aging strategy because those who don’t take it to extremes have more time and energy for their day and live fuller, healthier lives (and now we know they live longer lives as well).
How could the hyperbaric chamber be an anti-aging strategy? Some have guessed that maybe by increasing the level of oxygen in the tissues to high levels that the person might live longer by nourishing the normal tissue. Unless it causes the person to live better that day, then it already fails the first test of a good anti-aging therapy. I don’t consider lying in a glass tube for 90 minutes a fun game; so, if I’m going to do it as an anti-aging therapy, there better be some good evidence that it will help me live longer. I’d even do it without evidence if it made sense. Here is where I have some trouble coming up with good reasons. The high oxygen levels increase the number of free radicals (the same ones that cause aging). So, the chamber doesn’t pass the test as a pure anti-aging therapy. In some ways, it could actually accelerate the aging process.
But, for a disease for which it makes sense that oxygen might help, it makes sense that the chamber could work very powerfully to de-age the body. There is some evidence that it might be helpful in heart attacks, strokes, and acute brain injuries. There is good evidence that it helps with bladder control in people with multiple sclerosis but no good evidence that it cures the disease. In recovery of a joint, it probably does help, but you may have to be an elite athlete to notice the difference.
The FDA recently ended the “device” classification of the hyperbaric chamber. Now, chambers will be controlled like a drug. This will make it difficult to use a chamber if you do not have one of the diseases that the insurance companies pay to treat. But, be careful of discounting something just because your insurance doesn’t pay for it. I haven’t found an insurance company yet that will buy my running shoes, yet research proved that my New Balance shoes (if I move them 3 miles down the road 3 days a week) would do more to protect my heart than will any of the blood pressure medicines that the insurance companies do buy (a 30% decrease in heart attack with running shoes in an article published August 1999 in the New England Journal).
So, the hyperbaric chamber works powerfully to salvage limbs from amputation and save lives from “flesh eating” infections, and from the bends. It holds promise in diseases that involve lack of oxygen (like heart attacks and strokes). But look somewhere else for a pure anti-aging therapy.
Michael Jackson donated his chamber to a children’s hospital. The picture was just a publicity stunt.
Here's to your health!!
For more information regarding hyperbaric medicine click here to view in-depth PowerPoint presesntation