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Hyperbaric Oxygen Therapy





As some of you will be aware from my IG stories I started Hyperbaric Oxygen Therapy (HBOT) at my local Multiple Sclerosis Therapy Centre last week. I looked into this treatment because I am having terrible problems with persisting fatigue, post exertional malaise, urge incontinence of my bladder and the most debilitating symptom, stopping me from working, cognitive dysfunction or “brain fog”. I don’t know for SURE the reasons for the brain fog but I know that I have Positional Orthostatic Tachycardia Syndrome (POTS) which causes reduced cerebral blood flow when sitting or standing upright [1] I also know that people with LC also have reduced cerebral perfusion on functional brain MRI’s [2]. Couple this with a possible initial traumatic brain injury in the first few weeks of my illness - I was hypoxic and confused [3,4]

And add in the fact I have had ongoing hypoxia (low oxygen saturations) from the acute illness (at rest) right through to the present day (at night and on exertion). All this feels to me that my brain has no chance of recovering so it made sense to me to try to do anything to increase the oxygen going to my brain tissues.

Like many with Long Covid I am having to find my own treatment paths as I am having very little to no support from health professionals.

Fingers crossed HBOT may be the answer….

A little history first

Hyperbaric oxygen therapy, or HBOT, was first used in the U.S.A in the early 20th century. Orville Cunningham used pure oxygen to successfully treat someone dying from the flu. He developed a the first hyperbaric chamber but dismantled it after his use of the therapy for other conditions failed.

The therapy was tried again in the 1940’s when the U.S. Navy used hyperbaric oxygen to treat deep-sea divers who had decompression sickness. By the 1960’s, the therapy was also used to combat carbon monoxide poisoning.

Today, it is still used to treat decompression sickness and carbon monoxide poisoning. It has also been approved for more than a dozen conditions ranging from burns, bone disease, chronic infections and necrotising fasciitis.

More recently it is being used by patients with

  • Multiple Sclerosis to help with fatigue, brain fog and bladder issues

  • For people with cancer, recovery from radiation treatment side effects

  • Fibromyalgia/ ME and CFS

  • Cerebral Palsy and Autism


HBOT in acute Covid-19 infection

Recently published case reports and small single-institution studies have proposed that HBOT can be used to improve hypoxemia and prevent transition to mechanical ventilation in COVID-19 patients.

A randomised controlled trial currently underway in Israel is investigating the efficacy of HBOT in moderate-severe COVID-19 patients and a similar study is being carried out by the Ochsner Health System in New Orleans, Louisiana.

At the NYU School of Medicine in New York, HBOT was used to treat 20 patients with respiratory distress due to COVID-19 infection. The results of this study indicated that HBOT can be utilised to safely treat patients with COVID-19 infection, although the results were limited by a small enrollment size and limited inclusion criteria. Even so It suggests that alternate treatment strategies such as HBOT may have the potential to increase oxygenation of tissue by means other than standard respiratory and ventilator support.


HBOT in Long Covid

The Hyperbaric Healing Treatment Center in Orlando is one of many centres in the USA using HBOT for the lingering effects of LC. Erika Jordan, director and founder says:

“The most frustrating part for these (LC) patients is no one knows exactly why this is happening and why it can happen to patients who had anywhere from severe to mild cases of the illness."

She believes that these lingering symptoms are due to the oxygen saturations dropping so low for multiple days while fighting the illness.

"The body is in such a hypoxic state from not getting enough oxygen that it is doing its best to fight the virus and the symptoms that, in most, do not present until after the illness. From there, it is causing a domino effect of symptoms that can vary from person to person."

Hyperbaric oxygen therapy is currently being used and studied as an effective form of treatment for lingering COVID-19 symptoms due to its ability to reverse hypoxia, reduce neuro-inflammation, and improve tissue oxygenation amongst other benefits. [6]


Centres are successfully treating patients with a wide variety of LC symptoms including:

  • Brain fog

  • Extreme fatigue

  • Dizziness

  • Headaches

  • Weakness

  • Wounds from blood clots while on ventilator

  • Cardiac conditions

  • Tremors

  • Persistent cough

  • Loss of taste.


It is thought that the BENEFICIAL EFFECTS OF HBOT IN THE TREATMENT OF COVID LONG HAULERS SYNDROME include:

  • Effects of Hypoxia and Inflammation in the Gut and Brain

  • Decreases Fatigue

  • Reduces the effects of depression brought about by hypoxia

  • Enhances Stem Cell Mobilization and Proliferation

  • Facilitates Neuroplasticity

  • Improves Sleep Quality

  • Preserves cellular metabolism

  • Reverses the effects of ischemic reperfusion injury

  • Enhances memory and mental performance

  • Diminishes headaches

  • Minimizes pain and discomfort

  • Significantly improves physical, cognitive and mental health functioning


What is hyperbaric oxygen treatment/therapy (HBOT)?

Hyperbaric oxygen treatment (HBOT) involves giving the body extra oxygen. 'Hyper' means increased and 'baric' relates to pressure. Oxygen is one of the gases in the air and we need it to live. Normally, oxygen makes up just over one fifth (21%) of the air.

In HBOT, you breathe in pure (100%) oxygen under increased pressure. You sit in a hyperbaric oxygen chamber that controls the pressure. You breathe in oxygen using a mask over your nose and mouth.


How HBOT works

Oxygen is carried around the body by the blood. HBO gives the blood extra oxygen. The extra oxygen can help wounds to heal if:

  • infection is affecting healing

  • tissue damage is making it difficult for the blood to reach the area.

HBOT:

  • increases oxygen levels in areas where they are low because of illness or injury

  • encourages new blood vessels to grow so that they can carry more oxygen and nutrients to the tissues

  • increases the ability of white blood cells to kill bacteria and prevent infection

  • reduces any swelling, pressure and pain that may happen around the wound.


My experience

So for those of us with Long Covid, in the UK, we are currently able to access HBOT at Multiple Sclerosis National Therapy Centres [7].



Amazingly these lovely people listened when details of Long Covid started emerging and realised that HBOT could help with a lot of our symptoms.

I contacted my local centre directly. You will be asked to fill in a few forms and get a signed letter from your GP saying they are happy for you to have the treatment. That in itself maybe an issue for some but you can try taking this blog to your GP - it has worked for some!


There are private HBOT centres around the country but they are a lot more expensive.

The British Hyperbaric Association lists some of the UK centres that use HBOT [8].

I attended my induction session a couple of weeks ago. They talk you through the science and the process and initially "take you down" to about 8 ft under sea level for about 10-15 minutes to see how you get on.

Be warned it is a little bit claustrophobic as you are wearing a heavy mask and inside an enclosed space. In mine I can only sit so POTS induced coat hanger can be a little bit of a problem after a while.

It’s really the same sensation as taking off or landing in an aeroplane or climbing a mountain (!) so you need to be able to clear your ears, swallow lots or drink water otherwise it can be a bit uncomfortable.

I personally haven’t been able to do a full session yet as I had a severe cold and didn’t think I would be able to equilibrate. You may need to delay treatment with:

  • a severe cold or flu

  • a chest infection

  • a runny nose

  • sickness (nausea).

as the HBO treatment can make some side effects worse. If you smoke, you will be asked to stop smoking before and during treatment. This is because smoking can reduce the level of oxygen in your body.

I am currently going in to do one hour sessions breathing in almost 100 % oxygen through an oxygen concentrator.

Initially even the travel to this and back and sitting upright for an hour was exhausting but its improving. Already I am noticing I am not so fatigued and my brain definitely feels more switched on. Usually I can only manage to write my posts in the morning for about an hour. Today I have started Couch to 5K and am still having the energy and mental clarity to do this post in the afternoon. This is unheard of.....

Next week I start treatment in the actual chamber. At the treatment centre these sit 4-6 people and treatment lasts for an hour and a half. I am hoping my bladder will behave as you can’t just nip out for a comfort break!

Apparently side effects can be lightheadedness, fatigue, and headaches.

Currently MS treatment centres are offering 10 sessions over a block of 2 weeks or so. The aim is to start at 16 ft and gradually increase to 24 ft. MS patients are allowed to 33 ft but due to the uncertainty of the pathology of LC it has been recommended that we still at 24 ft.

I will of course update you when treatment gets underway. But even after 4 sessions of high concentrated oxygen I am feeling positive.

Precautions

Hyperbaric oxygen therapy is not for everyone. It should not be used by people who have had a recent ear surgery or ear trauma, a cold or fever, or certain types of lung disease.

There are known complications such as trauma to the middle ear, eye damage and sinus problems. Considering the possible risks and benefits, the decision to use hyperbaric oxygen therapy must be carefully made after a detailed discussion with your healthcare provider.


References

1. Reduced cerebral blood flow in POTS https://pubmed.ncbi.nlm.nih.gov/24711524/ 2. Reduced cerebral blood flow in LC https://www.newswise.com/coronavirus/covid-19-blood-flow-changes-may-be-reason-for-brain-fog-depression

3. New Long Covid Treatments Borrow From Brain Rehab Tactics https://www.wsj.com/articles/new-long-covid-treatments-borrow-from-brain-rehab-tactics-11617652800

4. When viruses like Covid-19 have long term effects on the brain https://www.cognitivefxusa.com/blog/viral-encephalitis-long-term-effects-on-the-brain

5. Hyperbaric Healing Treatment Centre Orlando https://hyperbaricsorlando.com/hbot-for-lingering-covid-19-symptoms/

6. Safety and Efficacy of Hyperbaric Oxygen Therapy for Long COVID Syndrome (HOT-LoCO)

https://clinicaltrials.gov/ct2/show/NCT04842448

7. Multiple Sclerosis Treatment Centres https://www.msntc.org.uk

8. British Hyperbaric Assosciation https://www.ukhyperbaric.com

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