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 – Tranexamic Acid and Thromboelastography During Cesarean Delivery
The aim of this study is to characterize the coagulation changes, using thromboelastography
(TEG), after prophylactic tranexamic administration during cesarean delivery. Specifically,
TEG values will be compared in patients who receive prophylactic tranexamic acid or placebo
before surgery, during elective cesarean delivery, and 2 hours postpartum.
Postpartum hemorrhage (PPH) is increasing in incidence in the United States, renewing
interest in multimodal approaches to blood conservation during cesarean delivery.
Pharmacologic therapy with the antifibrinolytic agent, tranexamic acid (TA), has been shown
to reduce estimated blood loss (EBL) during cesarean delivery, but its effect on global
coagulation as assessed by TEG, and how this correlates with lowering blood loss, has not
been elucidated.
This study will be conducted as a randomized, double-blind, controlled trial with two study
arms: control (60 patients); and treatment (60 patients).
Subjects will be pre-medicated with routine pre-cesarean delivery medications including oral
sodium citrate 30 mL and intravenous (IV) metoclopramide 10 mg. A peripheral IV and
noninvasive hemoglobin monitor will be placed, and baseline labs sent: type and screen, serum
hemoglobin, platelet count, fibrinogen, activated partial thromboplastin time (aPTT),
prothrombin time (PT), and baseline TEG values (r time, k time, alpha angle, and maximum
amplitude). Patients will have blood pressure, heart rate, and pulse oximetry measured
throughout surgery as per standard of care. Patients will all receive IV lactated Ringers’
(LR) solution prior to surgery and throughout surgery, with volume recorded and a goal of
less than 2 L unless more IV fluid is clinically indicated. All patients will have a spinal
anesthetic as per standard of care, with hyperbaric bupivacaine 12 mg, fentanyl 10 μg, and
hydromorphone 100 μg. If the anesthetic plan is altered (combined spinal-epidural, general
anesthesia conversion, general anesthesia planned), indications and medication doses used
will be noted for analysis.
Immediately following induction of anesthesia and prior to skin incision, infusion of study
solution will be initiated.
Study solutions will consist of:
1. Control group: 100 mL 0.9% normal saline (NS).
2. Treatment group: 100 mL 0.9% NS containing 1g tranexamic acid (TA). Study solution will
be infused via an infusion pump over 10 minutes. Blood loss will be measured by visual
estimate and weight of surgical sponges. Noninvasive hemoglobin will be measured
throughout the study. All routine care lab values will be noted. At minimum, one lab
panel will be sent one hour after study solution initiation (hemoglobin, fibrinogen,
platelet count, aPTT, PT, and TEG).
