HBOT Conversations:
Elena Schertz & Tom Fox (Part 3) – Heart Disease
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. The following segments preluding are as follows:
Part 1 – HBOT for PTSD (veteran focus)
Part 2 – Concussions & HBOT
In Part 3 of 5, we discuss heart disease and how HBOT can help. Tom explains that one of the first cardiac patients he treated with HBOT was a necrosing cardiac surgical patient who had a necrosing sternum. The patient’s sternum was black before treatment, and after it was a fuchsia from the returned blood flow! The cardiac surgeon’s face was priceless as he witness this patient have such an incredible response to HBOT.
Tom states, “I think a lot of the physicians that are out there today, their reason why they haven’t considered hyperbarics is because they haven’t been exposed to it. If they were exposed and they could see what it was capable of doing, it would make the difference.”
Elena informs our host that she hasn’t had anyone come to Extivita to receive HBOT specifically for heart disease, but she has witnessed patients who were getting treated for other conditions benefit from HBOT for heart health. This is known through ejection fraction measurement, as Elena describes…
“I could say from about three people who have have reported improved ejection fraction from doing hyperbarics alone.”
di Girolamo reflects on a story where he heard from two HBOT patients in their late 60s, who had less than 50% heart function. They started to use hyperbarics for other reasons, and discovered that after 28 HBOT treatments they now had 70% heart function. When the Cardiologist asked with amazement, “What did you do?!”, they said we didn’t do anything — just HBOT diving.
The topic of myocarditis arises, and how HBOT can help. Myocarditis is inflammation around the heart, and in this case, hyperbaric oxygen therapy could have an intimate role in bringing about improvement to the condition. Tom continues to explain how people want to see studies, but most of the studies out there on HBOT are simply not good.
There’s never been a lot of studies about hyperbarics, and the structure of the studies comes into question. Because when we look at the hyperbaric studies that are out there, you look and see that they’re always comparing hyperbarics to slightly pressurized room air. You’ll see that traditionally how they write it up and it could be cerebral palsy, it could be post-traumatic stress disorder, the same write up, just replace the words. Both groups improved from baseline. However, there was no differentiation between the groups.
Tom goes into a discussion about a PhD student at the University of Wisconsin who went the extra mile and looked at the therapeutic effects of hyperbaric air – hyperbaric air at 1.3, slightly pressurized room air. And what he was able to do is document mobilization of stem cells. By doing so, that encouraged the medical community to rethink hyperbaric studies using hyperbaric air as the “control”.
Tom continues to dive into HBOT and heart health in general….
“Just by basis of how hyperbarics works, you can see why that did work, how that was very helpful for these folks who had myocardial infarctions. So with with the re-oxygenation of the heart, with the stem cell mobilization, with growth of new blood vessels, you could see how the heart does start to basically regenerate and get better and heal.”
When your heart is damaged from a heart attack, it’s like a wound in one of your organs or muscle. Hyperbarics is known to be incredibly beneficial for wound care, 1500 hospitals across our nation have HBOT chambers that are used often simply for wound care. So, if hypoxia and the inflammation resulting from a cardiac event is causing damage to the heart, hyperbaric oxygen therapy will work to naturally resolve and remove those two things. di Girolamo stresses that you don’t have to be an expert in HBOT to understand this, and if he had a bad heart he’d most certainly be getting hyperbaric treatments, and encourages you to do the same.
They mention that if you were to have a heart attack, inside a hyperbaric chamber is exactly where you’d want to be so you’re supersaturated with oxygen. This leads into the reasons why it’s important to pre-condition your body with oxygen prior to heart surgery, or really even any surgery. Tom references a study, “Research report: the effects of hyperbaric oxygen preconditioning on myocardial biomarkers of cardioprotection in patients having coronary artery bypass graft surgery” and explains that prepping your body for surgery can be critical in achieving a better outcome.
Tom explains, “The number one complication out of cardiac bypass surgery is post-cardiac surgical stroke. If you can actually precondition, you can avoid this.”
Cost savings and money for health and wellness remains a hot topic. Tom educates us that one of the chief things that has always been identified with how health care is practiced in the United States and Canada is it’s a for-profit industry. But, if we looked at reinstituting a payment process that actually rewarded people for being healthy, managing patients, and avoiding conditions, then we could transition the current medical industrial to be incentivized to make people healthier. If there was a way to ever do that, using hyperbaric oxygen therapy as one of the key treatments would surely be a huge leap in the right direction.
Guests

Elena Schertz, NP - Clinic Manager at Extivita RTP
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 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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Clinical Trial – Can Erythropoietin Protect the Cerebral Blood Flow and Oxygenation During Simulated Dive?
During facial cooling and especially during breath hold, can mammals – and also humans –
elicit a so called dive reflex, causing bradycardia, peripheral vasoconstriction and
centralization of blood flow to brain, lungs and heart but the reflex is suppressed by
physical activity. The dive reflex can be elicited by breath hold alone and will be more
pronounced during simultaneously facial cooling, but not by stimulation of other skin
receptors.
The dive reflex has an oxygen conserving effect, because of intense vasoconstriction in both
viscera and muscles, and simultaneously with reduction in cardiac output (CO). Therefore
plasma lactate will rise, to compensate for the lesser regional blood flow. If one
hyperventilates with 100 % oxygen, then the reflex can still be elicited, but it is more
pronounced during asphyxia. Experienced sports divers, who has been diving for more than 7-10
years have reduced post apnea acidosis and oxidational stress, but probably also less
sensitivity for progressive hypoxia and hypercapnia, because these individuals have a more
pronounced dive reflex.
Transcranial Doppler ultrasonography (TCD) gives a reproducibly value for brain perfusion by
continuously non-invasive real-time sampling. A single piezo-electrical transducer sends and
collects ultrasound through the temporal region of the scull, where it is the thinnest.
Hereby can the blood flow of arteria cerebri anterior, media (MCA) and posterior and
basilaris be estimated.
With TCD it can be shown that the cerebral blood flow rises in MCA in healthy subjects during
facial cooling, with normal ventilation, when resting in a supine position without affecting
the systemic blood pressure. Single Photon Emission Computerized Tomography (SPECT)-scanning
during normo-baric and hyperbaric pressure of professional divers breathing 100 % oxygen has
shown to reduce the cerebral blood flow in several regions of the brain.
But it is yet unknown how brain blood flow and metabolism are affected by an "face immersion
dive" and simultaneously prolonged physical activity, and hence a rise in lactate under
hyperbaric pressure (3 meters), breathing atmospheric air, similar to the circumstances for
trained scuba divers work.
Presumably it will cause a fall in brain blood flow and in time cognitive deficits.
Erythropoietin (rhEPO) is a well known drug, used as doping in sports for about 15 years. So
far the only known enhancement in athletic achievement by rhEPO is caused by peripheral
improvements and especially blood capability to transport oxygen to the working muscles; this
has been documented by a rise in haematocrit. rhEPO has also a neuroprotective effect on
neurons in patients with neuron damage caused by cerebral hypoxic ischeamia.
rhEPO work also on a series of cerebral mechanisms, including enhanced motor and spatial
learning and more. Enhanced motor learning may improve the professional divers choices during
work and may be also physical performance and mechanical efficiency. Intravenous injection of
rhEPO will increase rhEPO in cerebrospinal fluids, since rhEPO is capable of crossing blood
brain. All together this may indicate that rhEPO, not only works on physical performance, but
also has effects on the brain. rhEPO has also an effect on the condition of cancer and
dialysis patients, not only explained by merely increased hematocrit.
This project will add new knowledge in the understanding of the mechanisms of clinical use of
rhEPO.
The purpose of this study is to investigate, how brain blood flow and metabolism are affected
by face immersion dive and simultaneously breath hold during normo-baric and hyperbaric
pressure (3 m depth) when breathing atmospheric air in trained sports divers. IL-6, HSP-72,
lactate, ammonium and body-temperature will be measured. Brain and muscle oxygenation will be
measured by near-infrared spectroscopi (NIRS). Furthermore we will investigate whether a
small dose of rhEPO affects mentioned parameters during simulated dive in pressure chamber
with facial cooling.
Hypothesis Brain blood flow in trained divers will be diminished during prolonged physical
activity during simultaneously face immersion dive and breath hold under hyperbaric pressure.
There will be a release of IL-6 and HSP-72. Pretreatment with a small amount of rhEPO before
prolonged physical activity during simulated dive has a protective effect on brain blood flow
and oxygenation.
