Hyperbaric physiologist Thomas Fox, dressed casually in a dark blue baseball cap moved to his chair, swiveling it quickly around to face a panel of dials and buttons, as he reached for his audio headphones.
"What are you going to put in, Tom?" asked his assistant technician, Tiffany Nadeau, peering into a cabinet of children’s DVDs. "Ah, here, trucks," she said, reaching in to pull out a colorful plastic sing-a-long movie case. "Can we put in trucks?"
Nodding in agreement, Fox slid the DVD into the player, a nearby monitor coming to life with the children’s program. A few steps below, three monitors attached to the outside windows of a hyperbaric deck decompression chamber, come to life.
The light blue 18-foot metal chamber, occupied by three children and two adults, sealed shut, and Fox began to turn the knobs at the control panel, the artificial pressure slowly building.
"Putting in a child’s video has a calming effect," Fox said as the dial marking the atmospheric pressure in the unit slowly climbed. "We just want the kids to be as comfortable as possible."
FOX IS THE CERTIFIED hyperbaric technologist and chief operator of a mobile hyperbaric oxygen therapy unit presently located at the Capital Church on Leesburg Pike in the Herndon-area of Fairfax County. The unit, owned by American Hyperbarics, Inc., which is worth approximately $250,000, will be in the area for local residents seeking hyperbaric therapy until the middle of May.
This particular unit is used by Fox and the American Hyperbarics crew as an alternative treatment for brain and nerve injuries and disorders, such as cerebral palsy, stroke and traumatic brain injury. According to Fox, hyperbaric oxygen therapy treatment, alongside other, traditional rehabilitation programs, can work in many cases to improve brain function of those who have been diagnosed as having permanent brain damage.
While this alternative treatment has not been definitively and scientifically proven to improve the functioning of individuals who have been diagnosed with chronic brain injuries, Fox said that his personal experiences and that of other doctors throughout the world, have shown that progress can often be made.
"What we are finding is that many of these injuries are not permanent, over time, you can try and normalize [them] with hyperbaric treatment," Fox said.
HYPERBARIC THERAPY as an alternative method for treatment of brain injuries and disorders first came to Fox’s attention when he sent his 4-year-old twin sons, who were diagnosed with cerebral palsy at birth, to England for the treatment.
Fox, who had been trained in hyperbaric therapy with the United States Army, was interested in its possible merits for affecting long-term and apparently irreversible brain damage.
Within six weeks of the regular treatment, Fox said, one son, who was confined to a wheel chair, was walking and the other was speaking in full sentences and feeding himself.
"Now they are extremely highly functioning," said Fox. "It’s not as if you can never tell that they had cerebral palsy … but they are at equivalent grade levels" in school.
His experiences with his sons led Fox to devote more of his time to getting hyperbaric treatment to more children. He now works with American Hyperbarics in a volunteer capacity by administering treatments with the mobile unit, his primary source of income coming from the operation of hyperbaric equipment for other reasons.
THE TREATMENT focuses on the use of a hyperbaric "deck decompression chamber" typically used to treat divers or pilots who return too quickly from areas with inconsistent pressure from that of the surface. By artificially increasing pressure on patients and filling the lungs with pure oxygen, added levels of oxygen will reach areas of the brain that have been damaged, possibly causing an increase of blood flow and, in turn, nerve growth, to the affected areas, Fox said.
"What this does it returns energy to parts of the brain … to reawaken dying cells," Fox said.
If hyperbaric therapy is found to be effective, Fox said, its widespread use in treatment of certain brain conditions could alleviate several billions of dollars in pharmaceutical and medical treatment costs, as well as cut down on care costs and improve the overall quality of life of those who have undergone extensive brain injuries.
The treatment has been especially effective in acute cases — where brain damage has just occurred — through the natural elimination of the swelling of the brain that can ultimately lead to chronic damage and impairing of the brain’s functions, according to Fox.
If hyperbaric treatment is administered within 24 hours of a damaging brain injury or beginning of a brain condition, such as a stroke, it can decrease swelling and increase oxygen to affected areas, he said.
ACUTE TREATMENT of brain injuries using hyperbaric therapy, while still not proven scientifically, might be a more effective use of the technology than treatment of long-term brain injuries and disorders, according to Dr. Jonathan Titus, hyperbarics medicine specialist for 27 years at Inova Mount Vernon Hospital.
Hyperbaric treatment "decreases brain swelling, and that’s exactly what you’re worried about with acute brain damage," Titus said. "But there is also the risk of a rebound, where they come out and it may even be worse than when they went in."
While Titus described the use of hyperbaric treatment for children and adults with permanent brain damage "very safe," he could not recommend its use as an effective therapy for chronic disorders, as they do not meet the 13 approved indications for decompression treatment, set by the Undersea and Hyperbaric Medical Society.
The Undersea and Hyperbaric Medical Society, an international non-profit organization of doctors concerned with the use of hyperbaric oxygen physiology and therapy, has set the 13 indications, which include carbon monoxide poisoning, decompression sickness and anemia, for which the treatment should be administered. Long-term and acute brain damage do not fall in these approved indications.
WHETHER IT HAS been scientifically proven or not, Herndon resident Lana Smolak-Traub, whose 13-year-old son Wally suffered brain damage after a near-drowning in 1996, said that she believes it to be working for her son.
Since undergoing the treatment, Wally has appeared more cognitive of what is happening around him and can write simple sentences expressing desires to his family, she said.
And while Smolak-Traub said that she acknowledges the treatment to be controversial in its proven effectiveness, undergoing it is better than standing by and hoping the condition will improve.
"When a mother is holding her child in her arms, she will do anything to make sure that the child is better," she said. "When you have a child, you have a responsibility to give him the best quality of life possible."
It's that desire to undergo a variety of treatments that may have lent the most support to hyperbaric therapy for long-term brain damage, Titus said.
"We’re talking about particularly tragic cases and the willingness of some of these people to undergo these treatments are a part of that," Titus said. "There very well may be some benefits … but unless somebody does the study to determine if these have efficacy, we just can’t know."