COMMUNITY HOSPITALS

DIVING FOR A CURE

By Hattie J. Horn

Nikki Farkas lay on the small, narrow bed as it slid into the 7-foot-long, glass case. The door closed over her head and she heard a click. She adjusted her oxygen mask for optimal inhalation, moved a bottle of water closer and settled in to watch CNN on the small, fl at panel TV mounted above her head. For the next two hours, she caught up on the day’s current news events.

A 71-year-old mother of seven, grandmother of 10 and great-grandmother of one, Farkas wasn’t visiting a spaceage exhibit at the Johnson Space Center in Houston. She was minutes away from her Baytown home, at San Jacinto Methodist Hospital, where she underwent hyperbaric oxygen therapy through the hospital’s Wound and Hyperbaric Treatment Program.

The program, which offers a comprehensive, multidisciplinary approach to heal complex wounds, is the only one of its kind in the Houston area and one of only 10 in Texas.

Hyperbaric oxygen therapy or HBOT has been in existence as far back as 1662, but it wasn’t used medically until the U.S. military developed and tested it after World War I. It has been used safely since the 1930s to treat deepsea divers and later astronauts suffering from decom pression sickness, commonly known as “the bends.”

HBOT is now used to treat patients who suffer from chronic wounds such as gangrene, vascular disease and radiation injuries, like Farkas who underwent several weeks of radiation therapy for cervical cancer earlier this year.

Other candidates for this therapy include patients whose wounds are unusual in appearance and are 30 days old or older; or those who have wounds that don’t show signifi cant progress or response to conventional therapies. Program medical director Dr. Boutros Kahla says one of the most persistent and common wounds he sees is the lower extremity ulcer, particularly in the feet of diabetic patients. “An underlying problem for diabetics is that the disease affects blood supply to the extremities,” he said. “They have what is called small artery disease, which affects the eyes-vision and toes. Decreased blood fl ow to the feet creates dry skin, fl aking and cracking, which leads to infection and ulceration.”

Sometimes diabetic patients also have neuropathy, a complication of diabetes that damages the nerves, eliminates normal sensation and causes patients to develop wounds.

Once a wound is diagnosed, a strict regimen is incorporated into the patient’s daily life that includes inspecting feet regularly; bathing and caring for toenails, corns and calluses; even choosing shoes and socks; and taking steps to improve circulation.

Hyperbaric Oxygen Therapy uses high pressure oxygen to heal. Each session lasts approximately two hours. HBOT is a medical treatment that increases the amount of oxygen in the patient’s blood, allowing oxygen to pass more easily through the plasma into the wounds to heal them. Clinically approved uses for HBOT include: • Diabetic Foot Ulcers • Compromised Skin Grafts/Flaps/Replants • Necrotizing Soft Tissue Infections • Thermal Burns •

Radiation Tissue Damage

• Air or Gas Embolism

• Problem Wounds

• Refractory Osteomyelitis

• Crush Injury/Other Acute Traumatic Ischemias

• Clostridial Myonecrosis (Gas Gangrene)

• Exceptional Blood Loss Anemia

For more information, call the San Jacinto Methodist Hospital Wound Care & Hyperbaric Medicine Program at 281-425-2160. How HBOT works

Patients who have a persistent ulcer that does not respond to routine treatment can be referred to the program by their primary care physician. Wound care physicians assess the patient and determine the most effective

Dr. Boutros Kahla Patients inside the HBOT chamber are surrounded with pure oxygen, which helps the wound heal faster.

treatment plan, which is then communicated to the patient’s primary care physician.

A patient who meets the program’s criteria and depending on the stage, or condition of the ulcer, can be prescribed oxygen therapy to be administered fi ve days a week, for six weeks. Patients receive a thorough explanation of what to expect before starting treatment, with particular attention paid to individuals who might be claustrophobic and need to be medicated prior to each session.

Once inside the chamber, which weighs more than one ton, the patient is surrounded with 100 percent (pure) oxygen at a controlled pressure — typically 2.5 times the normal atmospheric pressure — for two hours. The elevated oxygen level in the blood increases the fl ow of oxygen to the wound, helping it to heal faster.

Farkas knew her oxygen therapy session had started when she experienced a physical sensation of “going down.” She said she felt slight pressure on her eardrums, similar to what one might feel when a plane lands.

Not having heard of hyperbaric oxygen therapy and the diving process prior to her treatment, Farkas laughed at her misconception of what it involved. “When they said I was going to be diving, I thought it meant lying on a water board. I’m a good swimmer,” she chuckled. After seeing the oxygen chamber, she realized it was just a closed-in hospital bed. “I was fi ne with it. I’m not claustrophobic. I just put my knees up, lie back and watch a couple of TV programs.”

A growing trend

Celebrities such as Madonna, Mick Jagger and Michael Jackson turned to oxygen therapy in recent years, claiming that it made them feel younger, more energized and refreshed.

But the effects of hyperbaric oxygen therapy vary. Typically, there is no medical benefi t to increasing the level of oxygen for normal, healthy individuals. For others, such as diabetic patients, the increased oxygen accelerates the healing process, with some patients experiencing positive results after only two sessions.

Farkas was an avid exerciser who worked out 45 minutes a day and rode her bike for hours, but she had lost hope of enjoying her favorite activities because of the tremendous pain associated with her cancer treatment. Ten sessions into her 30-session program, she sat pain-free on her bicycle seat, breathing in the outdoor air as she pedaled down the road.

“After my very last treatment, I went home and put some bottled water in a champagne glass. I made a toast to everyone who goes through oxygen treatment after me,” Farkas said. “I hope they feel as good as I do.” !