HBOT Conversations:
Elena Schertz & Tom Fox (Part 2) – Concussion
Elena Schertz, NP and Tom Fox of Extivita-RTP in Raleigh, NC join us in a 5-part series to discuss the extraordinary healing they’ve witnessed through the God-given natural therapy of HBOT. This is Part 2, with a focus on how Hyperbaric Oxygen Therapy is helping people of all ages heal from concussions.
Elena Schetz, NP is the nurse practitioner, and Tom Fox is the Safety Director at Extivita-RTP. Extivita-RTP offers a positive environment for healing, and they encourage anyone seeking a better quality of life to come visit them and experience for themselves the wonder of Hyperbaric Oxygen Therapy.
Watch the Podcast
In a Special 5-part series with Extivita’s Nurse Practitioner, Elena Schertz, and Safety Director, Tom Fox, we dive into the extraordinary powers of HBOT, and the healing they have witnessed for a variety of conditions. Part 1 was released on 3/17/2023 with a focus on PTSD for veterans.
In Part 2 of 5, we discuss concussions, and the importance of treating concussions with Hyperbarics within days of the injury.
Host di Girolamo starts the conversation talking about the adolescent group in Wake County, North Carolina and stating that it’s his understanding there are approximately 3,000 adolescent concussions from sport injuries in this county alone (the country HBOT News studio and the clinic, Extivita-RTP is located at). This opens a door to discuss concussions and how critical it is to treat a head injury in the acute (very early) stage.
It’s a classic prognosis we’ve all heard regarding healing from concussions, ‘Rest your brain. Time will heal’.
Tom Fox explains, “Time also makes things worse”.
He uses a defensive back, Shazier, as an example. Shazier was injured and had a neurological injury with a contusion to the spinal cord. His prognosis was not good, and he was expected to become a quadriplegic. What’s critical in a case like this is the implementation of hyperbarics in a timely fashion, before any swelling can cause a scar to form.; as this can be the difference between whether the patient will be able to walk again, or if he/she is going to spend the rest of their days in a wheelchair. Shazier played for the Pittsburgh Steelers, and was under the care of Dr. Joseph Maroon (who was portrayed as a character in the movie, Concussion). Thanks to Dr. Maroon’s passion to treat with HBOT, Shazier received HBOT quickly, and is walking today! It’s a fascinating story of healing!
Since hypoxia and inflammation are the root cause of injury and illness, Fox expresses that it’s beyond time the medical community works together and starts asking the question, ‘Hey, which one of your patients would benefit from use of oxygen to relieve hypoxia and inflammation?’. Fox also mentions that concussions and strokes are similar in the way that they need to be treated with Hyperbaric Oxygen Therapy immediately before brain damage can be done.
It’s only evolving if you let it evolve, but if you actually have a timely implementation of therapeutic hyperbarics, then it may not be evolving. It may be stopped in its tracks. We as a community need to be better at communicating with the mainstream medicine and saying, ‘Hey, listen, we have a therapy that can make the difference in your patient’. You know, it’s not an alternative. It’s actually the drugs that are the alternative. So let’s try to reestablish and take care of the hypoxia that’s causing the injury.
Elena stresses that she’s seen many concussions in the clinic, and that if they can treat with HBOT preferably within 24 hours (although that’s not realistic many times), but at least within the acute phase, which is 72 hours, then it’s only two or three hyperbaric dives that the patient needs in order to return back to their baseline. In addition, she reiterates that even if the patient is in a subacute or chronic stage of concussion there’s still hope.
I also want to emphasize that even if it’s ten weeks out or a year out or ten years out, we’ve also seen benefits in those folks. But if we get them right away, it can bring them right back to baseline immediately. Like within three dives, like I said, 3 to 5, and I’ve seen that.
The number of treatments a patient would typically need is discussed, with Tom and Elena stressing that a 40 dives is excessive for concussions in the acute stage — even multiple concussions. Other factors come into play with a 40 dive protocol, including comorbidities. Tom Fox makes an excellent point in regards to the 40 dive treatment protocol that so many medical providers think is needed for a patient to complete HBOT dives and heal.
The thing with hyperbarics is it’s gotten a bad rap for extended protocols like 40 treatments. 60 treatments. Who can do that? Who can afford to do that? You know, why doesn’t insurance companies reimburse for this? Because usually it’s an extended course of therapy that requires an extraordinary amount of money. And that’s one of the chief things that holds us back.
Treat early and you will often eliminate the need for 40 or 60 treatments. If the concussed patient can get hyperbaric treatment immediately, then they will likely only need a handful of treatments. If you do this, HBOT treatments can be very affordable since the patient can return to their base line very quickly; eliminating the need to sit in a dark room and rest the brain, or deal with the migraines and dreaded post-concussive syndrome that typically follows a bad concussion. Like everything in the medical field, the treatment in Hyperbaric Oxygen Therapy is no different.
Early intervention is key.
Guests
Elena Schertz, NP - Clinic Manager at Extivita RTP
Elena attained her Bachelors of Science in Nursing from Michigan State University and received her Masters of Science in Nursing from Simmons University in Boston, MA. She has been practicing integrative medicine since 2010 and is currently working on her certification in functional medicine from the Institute of Functional Medicine.
Elena worked as a nurse in the pediatric oncology, cardiac, and surgical units at UNC hospitals for 15 years before deciding to work in integrative medicine. After years of working as a nurse, she decided to pursue her graduate degree, completing her masters with honors. She is board certified as a Family Nurse Practitioner (FNP) through the American Nurses Credentialing Center.
Elena’s passion for integrative medicine comes from her knowledge that the mind, body and psych/social/spiritual systems are not separate. The focus of Elena’s practice is to approach each of her patient’s healing process from the perspective of the whole, supported and grounded in safety and evidence-based medicine. She also maintains close consultative relationships with experts in the field to promote and enhance wellness for her patients. Elena joined the wonderful Extivita team in March 2019 and is thrilled to be a part of advancing health and wellness through hyperbaric medicine.
Thomas M. Fox, MAS,MS, CHT - Safety Director at Extivita RTP
Tom is the Research Physiologist for the Hyperbaric Institute for Research and Training, a division of Island Hyperbaric Centre in Pincourt QC. He has worked in the field of Clinical Hyperbaric Oxygen for the last 30 years. During this time, he has been intimately involved with the implementation and the development of the US Army’s Clinical Hyperbaric Service at Dwight David Eisenhower Army Medical Center. He has provided contract hyperbaric services since 1997. Prior to accepting his current position in Quebec, Canada, Mr. Fox served as the Chief of the Atmospherics Branch of the U.S. Army School of Aviation Medicine, Fort Rucker Alabama. In this capacity, he was responsible for hyperbaric/ hypobaric operations and training of US and NATO aviators, flight surgeons and flight medics. Mr. Fox is a senior army aviator and flew twelve years as a Medical Evacuation Pilot for the US Army.
Tom joined the Extivita team in 2022 as the Safety Director, helping Extivita to maintain a healthy and safe environment for exceptional patient care.
Extivita-RTP – Hyperbaric Oxygen Therapy Clinic
2012-D TW Alexander Drive
Durham, NC 27709
919-354-3775
919-354-3776
contact@extivita.org
https://www.extivita.org/
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Recent HBOT News
Cerebral hypoperfusion in autism spectrum disorder
Cerebral hypoperfusion, or insufficient blood flow in the brain, occurs in many areas of the brain in patients diagnosed with autism spectrum disorder (ASD). Hypoperfusion was demonstrated in the brains of individuals with ASD when compared to normal healthy control brains either using positron emission tomography (PET) or single‑photon emission computed tomography (SPECT). The affected areas include, but are not limited to the: prefrontal, frontal, temporal, occipital, and parietal cortices; thalami; basal ganglia; cingulate cortex; caudate nucleus; the limbic system including the hippocampal area; putamen; substantia nigra; cerebellum; and associative cortices. Moreover, correlations between symptom scores and hypoperfusion in the brains of individuals diagnosed with an ASD were found indicating that the greater the autism symptom pathology, the more significant the cerebral hypoperfusion or vascular pathology in the brain. Evidence suggests that brain inflammation and vascular inflammation may explain a part of the hypoperfusion. There is also evidence of a lack of normal compensatory increase in blood flow when the subjects are challenged with a task. Some studies propose treatments that can address the hypoperfusion found among individuals diagnosed with an ASD, bringing symptom relief to some extent. This review will explore the evidence that indicates cerebral hypoperfusion in ASD, as well as the possible etiological aspects, complications, and treatments.
Clinical Trial – Spinal Anesthesia in Caesarean Section
Spinal anesthesia is a safe technique, widely used and tested in the gynecological field, so
as to be considered the first choice technique in cesarean section, which allows to quickly
obtain a valid sensor and motor block. Bupivacaine is one of the most widely used drug for
obtaining spinal anesthesia in pregnant women undergoing caesarean section. Bupivacaine is a
local anesthetic available as a racemic mixture of its two enantiomers, the R (+)-
dextrobupivacaine and the S (-) – levobupivacaine, whose clinical use is widely validated.
Racemic bupivacaine is available as a simple or hyperbaric solution, the latter being the
most commonly used for spinal anesthesia. Levobupivacaine, which is the pure levorotatory
enantiomer of racemic bupivacaine, is a slightly hypobaric solution compared to liquor and
has shown less heart and nerve toxicity, probably due to its ability to bind proteins more
rapidly, and a greater selectivity towards the sensory component compared to Bupivacaine,
presents action and effects better predictable. Its baricity would also offer the advantage
of providing a less sensitive block to the position.
Hypotension is one of the most common complications of spinal anesthesia and is particularly
relevant in caesarean section because, in addition to the adverse effects on the parturient,
it can have repercussions on the fetus through a reduction of placental perfusion.
Some studies have showed a similar incidence of hypotension in patients treated with
bupivacaine compared to those treated with levobupivacaine, while others assert an
equivalence between the two drugs. In most studies, however, a significantly lower incidence
of hypotension and a greater hemodynamic stability were reported in pregnant patients
undergoing spinal anesthesia by caesarean section with levobupivacaine.
Being both hyperbaric bupivacaine and levobupivacaine routinely used at the "G. Rodolico"
Universitary Hospital of Catania for the spinal anesthesia of pregnant women undergoing
caesarean section and being their use decided exclusively at discretion of the treating
anesthesiologist, in the light of the discrepant data in the literature about the incidence
of hypotension with the two drugs, the main objective of this observational study is to
evaluate the hemodynamic effects mediated by levobupivacaine on pregnant women subjected to
elective cesarean section and to compare them with those mediated by hyperbaric bupivacaine
in an historical court of pregnant women subjected to caesarean section in the period between
April 2017 and April 2018. The hemodynamic parameters will be monitored in real time with a
non-invasive hemodynamic monitoring system (EV1000® platform + Clearsight® system – Edwards
LifeSciences), routinely used in the "G. Rodolico" Universitary Hospital of Catania, allowing
to obtain greater accuracy and veracity of the results compared to previous studies conducted
on such anesthetics.
Role of Hyperbaric Oxygen Therapy in Trauma Care
Article from Bio Spectrum Media discusses how technological advancements have made the use of HBOT more efficient in Trauma Care: Head Trauma is one of the major causes of death and disabilities across the world. This can be caused due a contusion (bruise),...