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Doctors Use Curing Power Of Oxygen

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By JO-ANN JOHNSTON, The Tampa Tribune

Published: September 16, 2007

Updated: 09/15/2007 04:44 pm

Katrina Reedy's knee problems make it difficult for her to walk, let alone get in and out of a car easily. And yet, for two months, she has been driving five days a week from Lakeland to Pasco Regional Medical Center's new wound care clinic, 30 miles away in Zephyrhills.

There, Reedy literally enters a different atmosphere. She gets onto a stretcher and is wheeled into a long, enclosed capsule. She lies quietly in a plastic cocoon for two hours, inhaling pure oxygen.

To be sure, there are days she doesn't feel like making the trip to the Center for Wound Healing and Hyperbaric Medicine, but then the 49-year-old former nurse weighs the advantages.

If the oxygen treatments work - and Reedy says they are - a recurrent bone infection and the related flesh wounds that have afflicted her left knee since March will disappear. Once they heal, Reedy can get the knee-replacement operation that should allow her to walk normally again. No more being cooped up in the house for days on end. No more using a walker to get from one room to another.

So, five days a week, she makes the drive and gets in the chamber.

More patients in Pasco County are receiving the same course of therapy, called hyperbaric oxygen treatment. Patients are put into a pressurized environment and given 100 percent oxygen to breathe. By comparison, the air we normally breathe is about 20 percent oxygen.

The treatment is similar to the one invented for deep-sea divers suffering from the 'bends' after surfacing too rapidly. High levels of oxygen are used to restore blood flow and nurture injured tissues. In addition to helping scar tissue heal, the added oxygen stimulates the growth of new blood vessels.

In recent decades, doctors have applied the same principles to the care of people with sores, ulcers and abrasions that won't heal with traditional treatments. Medicare and other commercially available insurance plans now cover the hyperbaric treatment, minus deductibles.

Many patients are referred to wound care and hyperbaric specialists by their primary-care doctors, often after they see wounds or ulcers that have persisted for weeks or months. But some patients, such as Reedy, seek out the treatment on their own.

Patients Are Carefully Screened

In fact, only about 15 percent of wound center patients need hyperbaric treatment, doctors say. Most patients improve with proper diet, wound dressings or by using special pumps that vacuum away excess moisture. For patients who don't improve, though, hyperbaric treatments are vital.

With any open wound, infections and, at worst, gangrene are concerns.

Hyperbaric treatments are often 'a last-ditch stand' to prevent the loss of a leg or a foot to amputation, said Donald Vierling, medical director of the Regional Wound Care & Hyperbaric Medicine center, an outpatient clinic run by Regional Medical Center Bayonet Point in Hudson. In November 1998, the Hudson facility became the first in Pasco to offer hyperbaric treatments.

Many of those at risk for amputation are diabetics, who suffer from poor circulation and can easily develop ulcers on their feet from simple blisters, Vierling said. Blisters and cuts sometimes become more serious problems in people with nerve damage because they never feel the pain that normally would signal a problem.

Radiation treatments, poor circulation, car crashes and bone infections are other typical causes of chronic wounds.

Largely because of an increasing population of diabetics in America, doctors are predicting there will be more people needing outpatient wound care and perhaps hyperbaric treatment. The national Centers for Disease Control and Prevention, for instance, reported that in 2005, 8.3 percent of Florida's adult population was diabetic, compared with 5.1 percent in 1995.

Nationwide, 5 to 7 million people suffer from chronic wounds. At the Hudson center, that translated to more than 7,000 patient visits to the wound care center in 2006, up from 5,731 the year before.

Most hyperbaric treatments are successful, meaning the wounds heal with no signs of infection, Vierling said. In part, that's because doctors carefully screen patients for the treatment. Some might need surgery to remove blockages before being good candidates for the oxygen therapy, for instance. Patients also get plenty of counseling about changing their diets, quitting smoking and adopting regular exercise routines.

The Hudson facility houses its two hyperbaric chambers in a single treatment room, making the treatment room look a little like a hospital room with two beds, enclosed in space capsules.

The chambers operate from 7 a.m. to 7 p.m. weekdays and are almost always booked, Vierling said. The center has tallied between 1,700 and 1,900 patient visits for each of the last three years.

The treatments take two hours. The number of sessions needed varies patient to patient.

Patience Is A Virtue

Some patients are well enough to stop after 20 treatments. Others need 40 to 60 - eight to 12 weeks of clinic visits, Vierling said.

For years, Bayonet Point was the only Pasco hospital offering hyperbaric treatment. Aside from the normal fears about embracing new technology, hospital officials may be wary of investing in the hyperbaric chambers, which can cost as much as $250,000 apiece.

In March, Pasco Regional Medical Center in Dade City opened an outpatient wound care clinic in Zephyrhills, with the idea of also serving patients from Dade City, Wesley Chapel and New Tampa. The clinic leased two hyperbaric chambers in May.

'We realized quickly it wasn't enough,' said Linda Lowman, a registered nurse who directs the wound care program.

In their first two months, the two chambers logged more than 1,000 treatments. After the hospital leased a third chamber in July, the center logged 250 treatments, or 'dives,' in August, compared to about 200 in July. Hospital officials may lease a fourth later this year.

So far, all of the hyperbaric patients coming to Pasco Regional have shown improvement, said Emilio Dominguez, hyperbaric medical director.

Reedy is a prime example, but she warns other patients and their families to be patient. It took three weeks of treatment before the deep, tunnel-like wounds in her knee started to heal.

'It was gradual, but when it happened, I could feel it,' she said.

Reedy is scheduled to meet with her orthopedic surgeon this month. If all goes well, she's optimistic he will be able to re-open her knee, remove a temporary rod and implant a replacement joint that will allow her to bend her left leg and walk normally.

Already, she is venturing out of the house more than she has in months.

'My husband and I went out to dinner on Labor Day. It was the first time we had gone out to dinner in two years,' she said.

Reporter Jo-Ann Johnston can be reached at (352) 521-3062 or jfjohnston@tampatrib.com.

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