Hyperbaric Oxygen Therapy to Treat Traumatic Brain Injuries
An HBOT session, or “dive,” begins with the client changing into a 100 percent cotton scrubs, ensuring the client is as “natural” as possible (no oils, no make-up, etc, anything with static which would negatively impact the treatment in the oxygen chamber environment). The client’s vital signs are checked, ensuring their blood pressure is at a proper level, as well as no other health issues, including a fever. The client then enters the FDA-approved hyperbaric chamber; once inside, the door is closed as atmospheric pressure increases. It is loud in the chamber at first (as the chamber is building pressure), and the client’s ears begin to pop; the chamber is pressurized within five to 15 minutes, and the noise stops. Hampton Roads Hyperbaric Therapy utilizes a multi-hyperbaric chamber, where a “hood” (a plastic balloon) is placed on the client’s head, which delivers the oxygen to the client; in a single hyperbaric chamber, the entire chamber is pressurized.
During the dive, people can relax, sleep, read, or watch a movie; on the outside, a television and speaker system is in place; clients can watch movies or documentaries, meditate, even sleep, as the dives give clients the “time to relax and rest the brain for a while.” Clients deeply breathe in the oxygen, where the dive can exhaust clients the first few times. The entire session, from the time the client walks in to the time the client walks out, is a duration of approximately 90 minutes; the time a client is in the hyperbaric chamber at pressure, is approximately 60 minutes. Hampton Roads Hyperbaric Therapy generally schedules the dives once a day, five days a week, for eight weeks; the goal is to have a “daily saturation for progress,” where the treatments become a part of the client’s daily routine.
To Stoltman-Miller, seeing the change in her clients’ lives is night and day, recalling Frank Hughes, an Army and Navy Veteran, who finished his treatment in early May of 2015. Hughes had slipped on ice and hit his head in 2012, resulting in a brain injury. Hughes couldn’t do things with his family, began having anger issues and headaches, slurred speech, and couldn’t remember to change gears in his car. After receiving treatment through Hampton Roads Hyperbaric Therapy, his headaches disappeared, had better response with less outbursts; by the second week, he was also sleeping better; after treatment he improved over 100 percent in almost every cognitive test (motor speed, reaction time, memory). Stoltman-Miller also notes, many Veterans can develop gastroenterological issues, such as Ulcerative Colitis or Crohn’s Disease, as the brain is connected to the stomach (and other systems); simply, if brain functions are diminished, so are the functions of our other bodily systems. After treatment, Hughes’s flare-ups have dissipated, and no longer needs medication for Ulcerative Colitis.
“I cannot even remember the old him now.” Hughes has trained to become an HBOT technician.
HBOT was a life changer for Retired-US Army Sergeant, Toby Yarbrough, where his life turned 180 degrees after treatment, crediting HBOT as a “way to help the body heal itself.” Retired-Sergeant Yarbrough was working on a piece of engineering equipment, which was a front-end loader. Retired-Sergeant Yarbrough was fixing a flat tire on the front, when the equipment shifted, flipped, and pinned him down; Retired-Sergeant Yarbrough sustained a TBI, severe damage to his back, and a seizure disorder.
Retired-Sergeant Yarbrough first learned of HBOT as an effective treatment for TBI in May of 2014, when he met representatives of Heal the Warriors at an event sponsored by Wounded Wear, an organization which provides service programs to Combat Wounded Warriors awarded the Purple Heart. Heal the Warriors had a booth at the event, where Retired-Sergeant Yarbrough soon connected with Heal the Warriors, beginning treatment in July of 2014, finishing treatment in September.
As Retired-Sergeant Yarbrough accounts, “Life before treatment, I couldn’t remember a thing. I had to put sticky notes all over the place [as reminders].” Retired-Sergeant Yarbrough also had major headaches, as well as losing much of his short-term memory, as he sustained injury to the part of the brain responsible for short-term memory. After he finished treatment, Retired-Sergeant Yarbrough’s headaches have generally dissipated (having them sporadically, rather than daily); approximately ten percent of his short-term memories have returned, “which is great, because I don’t have to have sticky notes all over my house!”
To Stoltman-Miller, the more challenging cases are the clients who also have PTSD, where treatment is a conjunction of HBOT and treatment to adjust the psychological effects of PTSD. Holding back emotion, Stoltman-Miller recalls Tom (who wishes to remain anonymous), the first Veteran Stoltman-Miller treated at Hampton Roads Hyperbaric Therapy, with a referral from Stop Soldier Suicide, founded by Brian Kinsella, who served as a United States Army officer with a few dedicated Veterans, amidst “the worst suicide crisis our military has ever seen,” in efforts to provide alternative solutions for Soldiers, Veterans, and their family members, as well as changing the stigma of receiving treatment.
Tom had a mild TBI, post-concussion syndrome, and moderate PSTD, who refused to take medication, but was open to HBOT. Stoltman-Miller’s colleagues attempted to dissuade Stoltman-Miller from treating Tom, concerned of the unpredictability of his behavior due to PSTD; however, Stoltman-Miller was determined to help; she couldn’t possibly turn someone away once he had reached out to her. Tom was particularly challenging, as he was not only depressed, barricading himself in his home, but also living with a 25-year injury. After the first few treatments, Tom expressed sentiments of “There’s no hope,” “I don’t know why I am doing this,” and “Just forget about me.” Stoltman-Miller refused to give up, where her persistence and compassion has been rewarding: Tom now talks more, attends outdoor events, and had agreed to see a therapist to help him with his PTSD. “Talking to him as a friend has made a difference,” as Stoltman-Miller would check on him each week after each treatment; it has been over a year since Tom has finished treatment, and he still visits Hampton Roads Hyperbaric Therapy to say hello. HBOT has been a life-changer for Tom, as he has expressed to Stoltman-Miller, “You’re the first person, this is the first place, that didn’t turn me away.” Tom wants to be a support system for others who have suicidal ideations.
HBOT: A Mainstream Treatment
Despite the numerous success stories of HBOT as an effective treatment to help individuals suffering from blast injuries, post-concussion syndrome, and Veterans returning from war zones (TBIs), most people aren’t aware of it. Stoltman-Miller notes, many countries around the world “acknowledge this valuable yet [relatively] inexpensive therapy,” as many global HBOT clinics have yielded similar therapeutic success with HBOT. Most egregious: insurance and the Department of Veteran Affairs (VA) will not cover the treatment, considering it as “off label.” Unfortunately, there is not enough evidence among the medical community to warrant HBOT as an effective treatment, therefore justifying coverage; also, the treatments are expensive. Stoltman-Miller offers a comparison: the hospital can charge up to $2,000 each treatment, while private clinics, such as Hampton Roads Hyperbaric Therapy, charge a range of $100-300 each treatment. In addition, mainstream treatment relies on medication, yet to Stoltman-Miller, medication only masks the symptoms. In the long-run, HBOT treatments is far less expensive compared to the years of medication, which only offers a short-term solution, in addition to what is gained: clients now go to school, are able to get jobs, truly having “a second chance at life,” something much more valuable than money.
In January of 2015, Hampton Roads Hyperbaric Therapy took the initiative by proposing a bill to bring awareness about HBOT as an efficient treatment for Veterans with TBI, Virginia SB 873, Virginia’s Veteran Recovery Program; SB 873 was not written to provide funding for HBOT for Veterans, only establishing a fund. Stoltman-Miller accounts, she had hoped Virginia would follow Oklahoma’s lead to state-fund HBOT to Veterans within the state; Oklahoma is the first state to enact this type of law. The Oklahoma Veterans Traumatic Brain Injury Treatment Recovery Act of 2014 would provide HBOT to Veterans with TBI in the state, for free, which could potentially help approximately 40,000 Veterans, according to Hyperbaric Medical Solutions. A similar bill was introduced in Indiana and Florida, with grassroots movements in Texas, Kentucky, Arkansas, and Iowa.
Despite the fact that the Virginia bill was not signed, getting the bill passed to the Senate was “a huge step,” where Stoltman-Miller acknowledges that funding for HBOT and other alternative treatments, as well as travel and lodging for the treatments, takes one step at a time. Stoltman-Miller and her team will make another attempt at proposing a similar bill this next year. There is no current Federal law to cover HBOT treatments for Veterans with TBI.
Heal the Warriors
Although the VA does not offer HBOT as treatment, private clinics and compassionate people have stepped in to provide treatment. Stoltman-Miller recognized that not nearly enough people were getting the help they needed, particularly living in a military area. Stoltman-Miller had been involved with HBOT for seven years, as her Heal the Warriors partner, Cara Mae Melton, had been doing research on HBOT, both wondering why HBOT is not covered; Heal the Warriors was created in 2014 to provide access to HBOT for more people: Veterans, First Responders, and their families, using a three-step integrative program: treating the brain, treating the physical and psychological symptoms, and treating the family.
As Heal the Warriors accounts, the first step is to treat the injured brain, utilizing HBOT, which will improve blood flow, create new blood vessels, regenerate the injured cells, and restore functionality in the damaged brain. The second step is to treat the physical and psychological symptoms, as Veterans with TBI often experience depression, anxiety, memory loss, the inability to focus, insomnia, and daily headaches. Stoltman-Miller continues, HBOT turns off the “fight or flight” response, allowing the person to think clearly. Brain injuries also affect other parts of the body, where the doctors will recommend the proper therapies, as well as replenishing the body with vitamins and minerals the body may be deficient in, and recommending healthy foods for the brain; the integrative program “treats all angles, helping every part of the body and well-being.” The individual client’s treatment is based on what the doctors feel is the best fit for them, whether including metabolic and nutriceutrical therapies, acupuncture, or having a personal trainer. The third step is treating the family; as the Veteran struggling with TBI, his/her family struggles with him/her.
To Cara Mae Melton, Hampton Roads Hyperbaric Therapy Co-Owner, and Heal the Warriors President and Co-Founder, the injury the Veteran or Soldier sustains in not encapsulated: not only is the Veteran or Soldier suffering, so is his family caregiver; in most cases, his spouse or significant other. Melton accounts the reason why the family caregivers are not usually recognized, not only in the big picture of PTSD and/or TBI, but also in the journey towards healing: they are hesitant to ask for help, believing they can handle everything, with the ideation, “He’s my husband, I’ll take care of him; it’s my responsibility.” However, Melton urges for the spouse/significant other to “take off the Superwoman cape. You have to be healthy and in a good place to provide the best care you can.” Also, understand that other people are experiencing your same situation; often spouses/significant others feel alone; when the spouses/significant others speak with others experiencing a similar situation, “the clouds open.” To Stoltman-Miller, HBOT is the best thing for TBI, but it is only helping one part of the problem. Heal the Warrior’s integrative program “sets [the clients] up for success in every way we can for long-term success.”
Stoltman-Miller is amazed in the change in her clients’ lives after treatment, documenting their lives before and after treatment, proud to have been a part of their journey towards able regaining their lives. Stoltman-Miller advises to anyone struggling with TBI, to keep trying, and never give up, as they are “not alone, there is help out there.” Retired-Sergeant Yarbrough agrees, as he advises to any Veteran or Active-duty service member who is struggling, “Go and get yourself checked out and see if you have a TBI, because there are treatments… like HBOT that could help with the injury.” All the clients Stoltman-Miller has helped have reached their low point, but have asked for help. Despite the feeling of “This is my life now,” that is not the case, as there is always hope for a better quality of life. Stoltman-Miller’s advice to the Veteran’s family: don’t give up. Often times, it is the caregivers, such as the spouse, who finds the treatments, “push loved ones to get treatment.” Everyone has the power to save a life.