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Reflections on My First Hyperbaric Oxygen Intake Appointment for mTBI Treatment
A thought-provoking first step toward receiving HBOT for mTBI
This morning I had my first “intake appointment” at a hyperbaric oxygen clinic within a university hospital. Technically, it’s a Wound Care Clinic because that’s the most common use case for HBOT at present.
Why was I here? A confluence of things.
First and foremost, my ND prescribed this treatment for brain injury recovery. Some of her patients have seen benefits from hyperbaric oxygen treatments, and I’ve come to trust her guidance.
Second, I was watching a press conference with interim head coach of the Denver Broncos, Jerry Rosburg, when he suddenly waxed rhapsodic about hyperbaric oxygen treatment. He said his son, a hockey player, had a healing experience with it.
Third, I was listening to a podcast conversation between doctors Peter Attia and Andrew Huberman, and the former said that if he had a concussive injury, say, in a car accident, he would turn to HBOT despite the fact that the evidence for its efficacy is fairly nascent.
And last but certainly not least, I did a search on PubMed for “hyperbaric oxygen therapy TBI” and found several promising studies that convinced me of its potential. One looked specifically at patients who had an mTBI in the past, and those patients saw significant improvements.
Here’s the summary.
The trial population included 56 mTBI patients 1–5 years after injury with prolonged post-concussion syndrome (PCS). Patients in the treated group were evaluated at baseline and following 40 HBOT sessions; patients in the crossover group were evaluated three times: at baseline, following a 2-month control period of no treatment, and following subsequent 2-months of 40 HBOT sessions. The HBOT protocol included 40 treatment sessions (5 days/week), 60 minutes each, with 100% oxygen at 1.5 ATA. “Mindstreams” was used for cognitive evaluations, quality of life (QOL) was evaluated by the EQ-5D, and changes in brain activity were assessed by SPECT imaging. Significant improvements were demonstrated in cognitive function and QOL in both groups following HBOT but no significant improvement was observed following the control period. SPECT imaging revealed elevated brain activity in good agreement with the cognitive improvements.
In the hospital room, I sat in a chair and answered questions from the intake technician as she entered my answers into a database. I’ve gone through this same list of questions so many times, it’s almost rote.
In essence, the questions are: Do you have THIS disease? Do you have THAT disease? Do you do THIS behaviour which we know is correlated to THAT disease?
I stare at the room and the objects within it, and think about the words one might use to conjure this space into being if one were a magician who could conjure spaces from the ether. I’m guessing the spell would include Latin versions of Mitigation, Disease, Stasis, System, Volume, Procedure, Container.
As I answer “no” to questions about the diseases and conditions that I don’t have, I am reminded of how much worse my state could be and how fortunate I am. In the voice of the technician, I hear a trace of incredulity when I answer that I don’t currently take any medications. She asks me twice to be sure.
My answers entered into the system, I am left to wait alone for an indeterminate period of time. I initially feel echoes of being left to wait alone when I was a child, but I mitigate this feeling by playing a podcast.
I worry that The Provider will form a bad first impression of me if I’m wearing my headphones, so I turn them off and play the podcast from the speaker on my phone instead. Simultaneously, I do a few rounds of Wim Hof breathing.
Eventually, two women enter the room, a nurse and a technician. I like them immediately. And they seem to like me.
They already looked at the PubMed study I sent them prior to the appointment. They simultaneously respect that I am knowledgable and don’t feel threatened by that. They tell me that the hospital had planned to do its own study about hyperbaric oxygen therapy for TBI patients, but the inclusion criteria were so restrictive, they couldn’t do it.
From the beginning, it’s clear they’re on my side, despite (or because of) the fact that HBOT isn’t officially sanctioned for TBI therapy—yet.
They ask me when my first concussion was.
I hear myself say “As a child.”
They want me to know I’ll have to come in for a couple of hours a day, 5 days a week, for a month or more. Am I okay with this? I think of how trivial a month is in the context of how long I’ve been dealing with this. I say yes.
Concerned about what would happen should a spark of static electricity ignite the oxygen and set me ablaze, I ask about fire suppression and safety protocols.
They assure me that a fire has never happened at their facility, and if it did, their entire operation should be shut down. An attendant is in the room the whole time. They’re not even allowed to go to the bathroom. Even if a fire erupted, it would last seconds and you’d be out of the tank inside of a minute.
They take me to the room where two oxygen chambers lie side by side. If you’re imagining a classic sci-fi cloning tank, lying prone, you have it exactly.
The tank is almost entirely translucent, a bit larger than a London telephone booth, and you slide into it like a piece of mail popped into a pneumatic tube container. To reassure me that it isn’t too loud, they turn on the oxygen for a moment. It’s basically white noise, comforting in its way.
I am completely reassured and as I walk out of the room I begin to feel excited about doing this. All that remains is the all-important question: Will the private company that administrates the insurance policy that I require in order to access healthcare in the United States approve coverage for this treatment?
I’ll have to hold my breath for a few weeks to find out.
On my way out, moving down the corridor, I walk through the main lobby where people are waiting for their name to be called. A lady is in a wheelchair. She’s barely able to form words. I am once again reminded of how fortunate I am.
I notice the way I’m walking. Not striding through, as I might have when I was younger, as if to tell everyone around me that I’m better than this place and them. I’m not in a hurry to get away from the suffering around me. For a moment, I imagine healing everyone there with a touch. I push the button for the lift and the doors slide open.
Brainwave is a newsletter about brain health, a personal blog about my own journey, and an informational resource for people whose symptoms haven’t resolved after a concussion or mTBI. I aim to present this information in a clear and concise way, spelling out what’s backed by science and what remains unknown. Nothing here is meant as a substitute for professional medical advice, diagnosis, or treatment. I am not a physician or a healthcare practitioner of any kind; I’ve had a lot of sports-related head trauma and had to learn this stuff the hard way. If you found this information helpful or know someone who might benefit from it, please share and subscribe to Brainwave.