HYPERBARIC OXYGEN
TREATMENT CENTERS
1395 North Main St.
Randolph, MA 02368
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(800) 973-3009
(781) 961-7887
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M.D. News

Reprint from M.D. News | Reprint from The Patriot Ledger

Hyperbaric Oxygen Treatment Centers

An Accelerated Healing Treatment Center Dedicated to Patient Comfort and Well-Being

By Karen Ellery-Jones

The theory of breathing pressurized oxygen to facilitate healing had its origins in 17th Century England, when in 1664, a British physician began using compressed air to treat digestion an respiration in a specially designed chamber. Over three centuries later in Randolph, MA, Dr. Grace Doherty, Medical Doctor of Hyperbaric Oxygen Treatment Centers, is using the healing principles of compressed oxygen to treat patients suffering from radionecrosis (radiation tissue damage) to chronic wounds.

Through and extensive physician outreach program, Dr. Doherty has been educating her fellow colleagues on this safe and highly effective adjunctive therapy. "Some physicians may have misconceptions about hyperbaric oxygen therapy," says Dr. Doherty. "They may think it is a big hassle to refer patients, or are worried about reimbursement." Dr. Doherty carefully screens each patient before a treatment protocol is developed. "We also handle the insurance claims and will write the prescription for hyperbaric therapy."

Dr. Dr. Doherty's early exposure to the benefits of hyperbaric oxygen treatment began when she was a pulmonary fellow at the Tufts-affiliated St. Elizabeth's Hospital in the mid-1970s. Her chief, Dr. Kenneth MacDonnell, who spoke regularly of hyperbaric treatment, was also the editor of the textbook that contained a chapter written by Doherty on oxygen therapy. Dr. Doherty, who graduated from the Medical College of Pennsylvania and is board-certified in both internal and pulmonary medicine, went on to work at the Massachusetts Respiratory Hospital, now Northeast Specialty Hospital. She remained there working in pulmonary medicine for 20 years. "I was interested in doing something a little bit different," Doherty admits, and when the opportunity arose to become involved in hyperbaric oxygen treatment, she was ready to make the change.

It has worked out very well," she says. Richard Doherty, President and CEO of Hyperbaric Oxygen Treatment Centers--who has done much research on hyperbaric therapy--convinced Dr. Doherty that providing this service would be beneficial to many patients, including those suffering from conditions that were not responding to conventional treatment.

Though hyperbaric oxygen therapy is the primary treatment modality for decompression sickness, air/gas embolism and carbon monoxide poisoning, it is considered to be an adjunctive treatment for 14 other indications including radiation tissue damage, gas gangrene osteomyelitis, crush injuries, skin grafts and flaps, thermal burns and intracranial abscesses. Medicare coverage for treating diabetic ulcers began in January 2003 and will, according to Dr. Doherty, become a significant treatment option for those afflicted with these non-healing wounds.

Dr. Doherty explains that hyperbaric treatment works by "jump-starting" the healing process. "The center of all wounds has no oxygen. The reason it heals is because the oxygen environment around the wound is higher than the center. It gives direction to heal from high to low oxygen. In the microcroangiopathies like an irradiated bed or a diabetic foot ulcer, the entire area surrounding the wound doesn't have a high oxygen level so there's no gradient, or difference. Hyperbaric treatment raises that gradient. It reestablishes that difference.

And that is what stimulates the healing." Hyperbaric oxygen therapy works by raising the oxygen saturation levels at the tissue level 10-15 times higher than normal, increasing the oxygen tension in hypoxic areas, reducing edema through vasoconstriction, and by forming neovascularizations.

Having operated the Hyperbaric Oxygen Treatment Center since February of 2001, Dr. Doherty has seen firsthand the many advantages of hyperbaric treatment, particularly in the areas of radiation tissue damage and chronic wounds. While she acknowledges the controversy surrounding hyperbaric oxygen treatment for some indications, Dr. Doherty explains that there is no doubt that radiation tissue damage responds to hyperbaric therapy.

"The protocols for radiation tissue damage have been around for 25 years and there is little controversy. It is very effective, 95-100 percent effective. It won't resurrect dead tissue, so if the patient has pieces of bone that have actually  died, then they have to resect them, Then you can heal the area around it." Radiation tissue damage can occur after a simple tooth extraction or injury, Dr. Doherty says, resulting in a non-healing wound.

"The blood vessels are not adequate. They may be adequate for day-to-day survival of the tissue but not for healing. The oxygen causes new blood vessels to be laid down. It restores the health of the tissue so it is capable of healing."

Getting the word out to patients suffering from radiation tissue damage is important to Dr. Doherty, who believes this segment of the population is underserved. "They may not  know that their wounds can be treated," she notes.

Though fellow physicians refer most patients, some of the radiation tissue damage patients are self-referred, having learned about hyperbaric oxygen therapy from other patients who have responded well to their treatment. Still others, like patient Richard Bertucci, who is being treated for radiation tissue damage, are referred to Doherty because she uses a multiplace hyperbaric chamber. Bertucci, who was scheduled to receive treatment in a monoplace chamber, said he "took on e look at it" and realized that it was too confining. A multiplace hyperbaric chamber allows multiple patients to be treated simultaneously and is ideal for those patients who experience claustrophobia. In the 10' x 6' chamber, patients can read, choose to watch one of 150 diverse movie titles that Dr. Doherty has on hand, or converse with each other. Each patient has his own nonconfining transparent hood that is worn over the head. Oxygen is delivered through a hose and exhausted out into the chamber.

 Ensuring that patients are comfortable being inside the chamber is a vital component of patient compliance, so reluctant patients are gradually introduced to the chamber. "We have a process called deconditioning. We have them come and when they are able we have them close the door. If they are up for it, we apply some pressure, letting then know at any time, if they have had enough, they can get out. One of the ways we deal with the issue of claustrophobia is by giving them control. If they have some control, they are much better. For the first treatment, sometimes we give them abbreviated treatments and occasionally we have to give them tranquilizers."

Dr. Doherty says that because patients are batched according to the length of treatment needed, there are undoubtedly "veterans" in the group who are always eager to help those who have "misgivings about going in." An intercom allows for two-way conversations, while a video monitor reveals visual clues on the patients' physical and emotional status.

The staff at Hyperbaric Oxygen Treatment Centers is instrumental in not only helping patients acclimate to the chamber, but also by monitoring those patients receiving treatment. "We are clinically very strong," stresses Dr. Doherty, who praises Registered Nurse Eileen Cleary and Occupational Therapist Linda Butts. "Some freestanding clinics don not have licensed personnel running them," she says, noting that they are all licensed chamber operators. Although their multiplace chamber is pressurized with air, an important safety feature that monochambers lack, the chamber operators must constantly monitor the oxygen levels that are exhausted into the chamber. "If there is a leak from the hood or tube, the oxygen in the tank will go up. We want to be pressurizing air, not a hyperoxygenated environment. It is much safer to keep the percentage of oxygen down below 23%." In addition to monitoring oxygen levels, they also watch for inner ear symptoms, making sure patients have equalized the pressure within their eustachian tubes to relieve the same type of discomfort that occurs when a plane takes off or lands. This discomfort does not occur in all patients and is only present during the compression and decompression phases. Patients are also observed for transient oxygen toxicity that results in seizures, a rare side effect of hyperbaric treatment. To reduce that risk, Dr. Doherty adheres to strict time length protocols and ensures that patients receive a 10-minute break after each 30-minutes of oxygen. Because hyperbaric oxygen therapy also decreases glucose levels up to 20% in all patients, Dr. Doherty reminds each patient  of the importance of eating prior to treatment. A supply of snack bars guarantees that no patient will enter the chamber without having a snack.

Though a majority of her patients have radiation tissue damage, Dr. Doherty does treat other conditions that are considered "off-label." "Many patients research their own  chronic illnesses an will find treatment that may not be accepted by traditional medicine, but that doesn't mean it is not effective," she says, stating acupuncture was initially viewed with suspicion and is now an acceptable treatment option for certain conditions.

"We will treat people who have "off-label" diagnoses. We see our role is to not block people from getting therapy, especially if they have an untreatable disease. Our role is to provide safe access to therapy. If there is substantial evidence and experience in the world in treating certain diagnoses and if we can safely treat the person, we will not refuse them." However, Dr. Doherty stresses, "If someone comes to us with a diagnosis that has never been treated (using hyperbaric oxygen therapy) and not tried, we draw the line there, and we do that for wellness."

Dr. Doherty is currently treating several "off-label" diagnoses, including a patient who was referred by a New Hampshire physician for a sudden onset of tinnitus. Tinnitus is widely treated in Germany by hyperbaric oxygen therapy. Indeed, over 80 percent of all hyperbaric therapy in Germany is used for sensory-neurological conditions in the ear, wit ha substantial level of effectiveness.

Children are safely treated with hyperbaric oxygen therapy, though a parent or family member must accompany the child into the chamber. A selection of children's videos helps occupy the during treatment.

Because of Dr. Doherty's commitment and dedication to the field of hyperbaric oxygen therapy, hundreds of patients seeking adjunctive therapy in a compassionate environment need to travel any further than Randolph.

Hyperbaric Oxygen Treatment Centers is located in Randolph. For more information, please call 1 (800)973-3009 or visit www.hyperbaricoxygenchamber.com

Dr. Doherty monitors the oxygen level in the chamber, ensuring that it stays below 23 percent. A video camera and an intercom provide an essential communication link between Dr. Doherty and her patients.