Chapter 14 of the HBOT Manual
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Boy sucked in by Jacuzzi saved by hyperbaric chamber

Jerusalem Post; 7/15/2002; JUDY SIEGEL

Headline: Boy sucked in by Jacuzzi saved by hyperbaric chamber
Edition; Daily
Section: News
Page: 04

Monday, July 15, 2002 -- An 11-year-old boy who was sucked into a Jacuzzi pump and lay in a coma for four weeks has regained consciousness and begun to walk, react, and smile.

Assaf Harofeh Hospital doctors said yesterday the boy's condition improved dramatically after he was treated in the medical center's hyperbaric (high-pressure oxygen) chamber. His relatives called it a "miracle."

The boy, from the Sharon area, was in the Jacuzzi outside his home when he suddenly was drawn into the mechanism, which was not covered by a metal screen.

He was found after he had been underwater for some 20 minutes, and a Magen David Adom mobile intensive care unit team performed resuscitation. He was then taken to a nearby hospital, where he was respirated for several days, and then to a pediatric rehabilitation facility, where doctors told his parents to "prepare for the worst."

The parents looked frantically for a way to improve his condition, using the Internet and calling doctors until they found the Tzrifin hospital's hyperbaric chamber - the only one in the center of the country (there is also one in Haifa and one in Eilat). For several weeks, the boy was taken by ambulance from the hospital to Assaf Harofeh for treatment.

"Even after the first treatment, the boy made eye contact for a few seconds," said Dr. Nahum Gal, the head of the hyperbaric unit. We were very encouraged. After a few treatments, he began to smile. After nine, he began to walk by himself and react to commands."

Gal said the boy has undergone 40 treatments, but still suffers from speech and coordination problems and it is not known how much these can be reversed.

Assaf Harofeh's hyperbaric unit has been functioning for four years; it has been found effective for treating carbon monoxide poisoning from gas heaters, the "bends" in divers, diabetic foot sores and necrosis, crushing accidents, blindness from clogged retinal arteries, bone infections, and other problems.


Copyright 2002 Jerusalem Post. All Rights Reserved


CENTEREACH Parents find hope in the help of others

Newsday; 10/21/2004; COLLIN NASH


Michael and Donna Caputo feel blessed that their daughter, Nicole, reacts now when someone enters a room, trailing them with her wide brown eyes and greeting them with a smile.

Left without the ability to speak or walk since a near-drowning four years ago, the Centereach girl, 8, is even able to stand unaided for up to five minutes, Michael Caputo said. "Her personality is coming back day by day," Michael Caputo said.

And with it, the family's hopes for Nicole's full turnaround, Caputo added.

Without the generosity shown to the family by well- wishers across Long Island, Nicole would have been denied the chance to snatch the wisp of hope promised by experimental oxygen treatments, her parents said. At $200 per session, the hyperbaric therapy is not reimbursable by Medicaid, Michael Caputo
said, because it's considered experimental.

He said, however, the family considers it Nicole's only chance.

So that Nicole can continue to take advantage of the only chance for recovery she has so far, the Caputos are hosting a fund-raising benefit to help pay for treatments. The event tomorrow at the Creative Ministries Performing Arts Center in Oakdale kicks off with a 7 p.m. wine and cheese reception  followed by an 8 p.m. production of Richard Rogers and Oscar Hammerstein's musical, "Cinderella." Tickets are $32.

Hyperbaric therapy, coupled with physical and occupational therapies, is the latest in a long line of treatments Nicole has undergone. Earlier treatments, including acupuncture and special massages, showed little success, Michael Caputo said.

Every weekday for the past year at two-month-on and one-month-off intervals, Nicole crawls into a glass chamber at a Great Neck clinic. Her mother crawls in beside her to keep her company.

Pure oxygen is pumped into the chamber at a pressure equal to that felt 16 1/2 feet under fresh water. The oxygen penetrates deep into the body, penetrating the neurons of the brain and building muscle tone and helping revitalize dormant cells, said Scott Warantz, practice manager at the clinic, Comprehensive Health Care Services.

He said hyperbaric treatment, which has been used for near-drowning victims in the United States for about 30 years, can cause varying degrees of improvements, depending on a variety of factors including length of treatment.

In Nicole's case, her cognitive factors have improved, as has her muscle tone and her ability to swallow, he said. "We expect more of these changes over the course of her treatment, which also includes physical and occupational therapy."

Nicole, who was 4 at the time, was found unconscious in her backyard above-ground pool by relatives soon after she was reported missing.

She loves to watch her younger siblings, 5-year-old twins Anthony and Jessica, play soccer, her father said. "Before, she'd just sit there, rigid, stiff. Now, you can see by the way she perks up and smiles, she is really
enjoying watching them play. It's a slow process, but compared to a year ago when we had very little hope, we are a lot more optimistic now for her future."

Copyright 2004, Newsday Inc.


The Little Fighter As a boy works to recover from a near-drowning, his parents struggle to pay bills.(LOCAL NEWS)

The Fresno Bee (Fresno, CA); 4/4/2004; McEwen, Bill

Byline: Bill McEwen THE FRESNO BEE

One moment Susan and James Jeff were putting together a new swing set in the back yard. It was a birthday present for their 2-year-old son. He was all smiles as he kicked his legs and hung from a support bar.

The phone rang inside the house. The toddler, as he loved to do, tagged along with his dad. Mom continued working on the swing set at their northwest Fresno tract home.

Out of sight for a split second, Marcus "Ryan" Jeff didn't follow his dad all the way into the house. He fell into the family swimming pool, and their lives changed forever.

This is a story of tragedy, perseverance and friends helping friends. It's also about a family's quest for help in getting the medical treatment they believe will aid their son's recovery from severe brain injuries incurred during his near-drowning last June.

At the crux of the Jeffs' challenge: Hyperbaric oxygen therapy, which they credit with helping Ryan, isn't approved by the Food and Drug Administration for treating near-drowning victims. That means treatments, which have cost about $22,800 thus far, aren't covered by medical insurance.

Relying on the generosity of friends and relatives and overtime pay James Jeff earns as a machinist, the Jeffs have been sending Ryan to the Chico Hyperbaric Center in Northern California since last fall.

"I feel like I'm being guided by a higher power," Susan Jeff says. "Every time I run into a closed door -- be it money or someone's negative views -- someone else comes along and opens the door.

"People keep coming into our lives because of Ryan, and they are helping him so much."

Last week, Susan Jeff says, Ryan's neurologist said he would try to arrange hyperbaric oxygen sessions at University Medical Center in Fresno -- sparing the family the expense of going to Chico.

But the treatments still won't be covered by their insurance.

Hyperbaric oxygen therapy isn't new. It has long been used to treat divers and fliers suffering from decompression sickness, commonly known as "the bends."

Patients recline in chambers where they receive oxygen at increased atmospheric pressure. This nourishes cells that previously have been deprived of oxygen and may stimulate growth of blood vessels in damaged tissues.

The FDA has approved the therapy for 14 conditions. Among them are decompression sickness, smoke inhalation, diabetic foot ulcers, anemia, radiation tissue damage stemming from cancer treatment, burns and skin grafts.

But oxygen chambers haven't received the FDA stamp for about two dozen other diseases and injuries that hyperbaric oxygen centers commonly treat. Some of these include strokes, autism, cerebral palsy, multiple sclerosis, spinal cord injuries and traumatic brain injuries.

The reason, says Dr. Kent Yamaguchi, is a lack of scientific study to justify the therapy for conditions not approved by the FDA. Yamaguchi oversees the hyperbaric oxygen unit at University Medical Center, which served 6,040 patients in 2003.

"The problem is, the uses have expanded, but the evidence is sometimes lacking," Yamaguchi says. "It's difficult to do those kind of scientific trials."

Also contributing to the controversy is that some promoters of the therapy oversold its effectiveness in the 1960s, saying it could treat such things as senility and cancer. Clinical trials at that time didn't back those claims, creating skepticism.

"The therapy has its place just like any other medical treatment," says Mitch Hoggard, founder and president of the Chico Hyperbaric Center. "It is not a cure-all. It does not make one younger, and it does not remove wrinkles. But its place in treatment is certainly greater than the 14 approved uses."

Among them, Hoggard says, is treating brain injuries. He cites Ryan's progress as evidence of the therapy's effectiveness.

"When he came here, he was not responsive, not tracking with his eyes at all and he could not right himself," Hoggard says.

Hoggard agrees with Yamaguchi that FDA and insurance-industry acceptance for nonapproved conditions will only come with clinical documentation of successful treatment.

"If we can obtain a couple of studies, it will open up dramatically," Hoggard says. "Scientists in other countries have proven that hyperbaric oxygen therapy does things that we are not discussing in this country. It probably can play a major part in helping brain-injured individuals."

Ryan's progress has been slow yet steady, Susan Jeff says.

He sits up in his car seat. He recognizes voices -- especially his dad's -- and recently graduated from baby food to small bits of pizza, spaghetti, green beans, strawberries and bananas.

He wants to be picked up, and he cries if family members leave the room. He flips over to grab his favorite toy, an orange-colored Nemo.

"It will take five to 10 minutes, but he will do it," Susan says.

Last week, Ryan said his first word since his accident when a nurse lifted strands of his hair to attach an electrode for an electroencephalogram, or EEG.


One word might not sound like much. But it was a landmark for Ryan, who coughed up water when Susan Jeff began CPR after finding him in the pool.

Ryan was rushed to Kaiser Permanente Medical Center, where he was treated for about seven hours and then was transferred to Children's Hospital Central California in Madera County.

Susan Jeff says she doesn't recall half of the details from that chaotic, emotional time. But she remembers these words: "They told us, 'Your little boy is in very, very bad shape. It doesn't look like he's going to make it through the night. It's going to take a miracle.' "

Three days later, Ryan hadn't opened his eyes. But the Jeffs didn't surrender hope. Not even as they blamed themselves for briefly losing track of Ryan.

Strengthening their resolve was an outpouring of support. Relatives and co-workers donated vacation time, food and money so the Jeffs could stay with Ryan in the hospital and later accompany him during stays in Chico.

James Jeff, 32, is a machinist at Floway Pumps; Susan, 34, works in the instructional technology department at Central Unified School District. Their family also includes two older children, James 13, and Matthew, 11.

Larry Powell, Central Unified superintendent, counseled the family and helped organize support.

"When we asked for help, there was no shortage," says Powell, a minister who led prayers for Ryan at the hospital. "People really stepped up."

Powell says he is inspired by the Jeffs' tenacity and love for Ryan.

"They were faced with the monumental decision -- do you pull the plug?" Powell says. "They didn't, and it's amazing how things are working out.

"The easier choice would have been to stop going. The harder choice is knowing all the energy and commitment it would take to go forward."

On July 5, 2003, Ryan was taken off a ventilator at Children's Hospital and breathed on his own. He left intensive care three weeks later and, after a few more days, went home.

But the reality of Ryan's condition muted the celebration. He was not the happy, active child he'd been before.

Ryan couldn't sit up, much less walk. He couldn't talk. Though his eyes were fine, brain injuries left him partially blind. He had to be fed through a tube. Physical therapy to loosen his muscles hurt so much he screamed.

James Jeff is part Choinumni, so his relatives sent American Indian healing necklaces and they burned sage over Ryan.

"We tried everything," Susan says.

Then Susan's sister-in-law Lisa Aleman went to the Internet looking for therapies that might help Ryan. She discovered oxygen chambers, and Susan eventually contacted the clinic in Chico, which accepted Ryan immediately and has provided treatment at discount rates.

Susan is hopeful but realistic about Ryan's future.

"It's easy to get depressed, but then I see him do some new little thing and I get excited again. I think he will always have problems, but I also have dreams of him running around and playing."

Ryan's spirit feeds those dreams. Every week he endures a taxing schedule of doctors' exams and therapy.

Fresno police officer Brad Bailey knows something about Ryan's will. Bailey answered the call when Ryan was found in the pool and took over CPR from Susan Jeff.

"To be perfectly honest with you, I was really surprised we were able to get him back," says Bailey, who received a life-saving award from his department.

"I think it shows how much of a fighter he is. There must have been something special inside him to hang on like that."

The columnist can be reached at or 441-6632.



A trust fund has been set up for Marcus "Ryan" Jeff at Citibank, 2270 W. Shaw Ave., Fresno. The contact at the bank is Carlos Galaviz.



Susan Jeff, left, watches Kathryn Manalo, a counselor with Blind Babies Foundation, work with Marcus "Ryan" Jeff, 2, in the Jeffs' home recently in Fresno. Ryan almost drowned in his family's swimming pool last year, damaging his brain and leaving him partially blind.


Marcus "Ryan" Jeff, 2, is calmed by his mother, Susan, after recent therapy at their home in Fresno. Ryan's parents say oxygen therapy has helped him, but medical insurance does not cover it.

COPYRIGHT 2004 The Fresno Bee. All rights reserved. Reproduced with the permission of the Dialog Corporation by Gale Group.


Waking up sleeping cells.(Brief Article)

Alberta Report; 2/28/2000; MCLEAN, CANDIS

Hyperbaric oxygen treatment offers new hope for brain injuries

On February 20, 1995, three-year-old Cash Carleton fell into a creek in southern Alberta and disappeared. A frantic call was placed to the general store, the entire community of Del Bonita, two miles from the American border, was notified and rushed out to join the search. Approximately half an hour later the little boy was found trapped underwater, his overalls snagged on a tree root. Unconscious and unresponsive, he was rushed to hospital, the paramedics uncertain they had even found a heartbeat. When he regained consciousness a week later, the once bright and active little boy was severely brain damaged, totally dependent upon others to feed, move and change him.

By the time he turned eight last fall, Cash was four feet tall, weighed 40 pounds, and spent most of his day lying on his back, looking up and to the left, "in his own little world." If someone walked by, he could track them with his eyes, but he was unresponsive to voices, and worst of all for his mother, the little boy who once had a giggle "that bubbled up from his toes to his head," could no longer even smile.

On November 7 he began therapy in a hyperbaric oxygen chamber, the same type of device used by divers to decompress after they have developed "the bends." The patient breathes 100% oxygen at a pressure of up to twice that at sea level, or the same pressure a person would feel swimming under 16 1/2 feet of water. Four weeks later, Cash began gaining weight. For the first time, he turned his head from side to side, and voices startled him.

"We've had four Christmases since the accident and this is the first one that was fun," reports Ms. Juhasz jubilantly. "Cash now realizes there's a world out there. After we showed him a Christmas tree in the mall, then pushed his wheelchair away, he turned his head back to look at it and we had to all turn around and go back. The little worm is now waking up at four in the morning thinking it's time to eat. He got a pet bunny for Christmas and when we say, 'Pat the bunny,' with effort and time he can move his hand down onto its back and move his fingers. Before we didn't know if he was in there, if he could hear or understand. Now we know. He was just locked up in there and now he's coming out. But most of all," she concludes, "he smiles."

Although hyperbaric oxygen therapy (HBOT) is new to Canada, in other parts of the world it has been used for years to treat various medical problems. In Japan there are over 200 chambers to ensure that a patient is never more than an hour away from treatment, and in Italy, doctors are sanctioned for the failure to use HBOT for certain conditions. Interest was generated in Canada in 1998 after Claudine Nadeau of Montreal took her three-year-old twin boys suffering from Cerebral Palsy (CP) to England for HBOT. One son who previously couldn't sit up was soon feeding himself; the other who had walked with braces was running around without them. The twins' rehabilitation specialist, Dr. Pierre Marois, immediately launched a pilot study on HBOT. The results, including improved gross and fine motor function as well as reduced spasticity in three of four muscle groups, will be detailed this month in the Journal of the Undersea and Hyperbaric Medical Society.

HBOT works by flooding bodily tissues with life-giving oxygen. Normally oxygen is carried only in the blood's hemoglobin, but under pressure is carried in all body fluids, including plasma, cerebrospinal and intracellular fluids. This allows oxygen to reach into areas of compromised blood supply, effectively "waking up" those cells which are "asleep but not dead" around the damaged area.

Although neurological trauma such as CP and near-drowning cannot be "cured" unless HBOT is administered within minutes, word has spread like wildfire about its effectiveness in helping patients develop to their own potential, and over the past year hyperbaric chambers have sprung up across Canada at the rate of one a month. Although most have been opened by delighted parents, as Cash's mother hopes to do, some operators are motivated purely by finances. Dr. Marois warns, "Some business people in Ontario and B.C. are putting millions in their pockets with no medical specialists to deal with the rare health issues that may arise."

Leslie and Gordon Ward of Red Deer were horrified with their experience in December 1998. While their son Samuel, 7, who has CP, was being treated in a B.C. hyperbaric chamber along with nine other patients and their parents, suddenly the "sprinkler" system was activated. Because fire in an oxygen-rich area can spread extremely rapidly, Mr. Ward explains, "the water pours in like Noah's flood. And the first person to panic and abandon a chamber full of crippled children is the technician operating it. Then the parents panic. The man sitting next to my son, to his credit, picks up his son under one arm, my son under the other and runs out as fast as he can. He's just flying, and he slams my son's forehead into the iron door, opening an inch-long gash requiring stitches. Meanwhile a mother carrying a set of twins trips and falls, spraining her back and legs. And you know what?" Mr. Ward continues. "All those parents were so impressed with what the chamber was doing for their kids, and so desperate due to lack of facilities, that the very next day they were all right back in there."

All except Mr. and Mrs. Ward, who were hustling home, planning as they drove to open their own HBOT centre, Canadian Hyperbarics. Now they want to see more chambers opened and more commonly used. Mr. Ward points to a study published 20 years ago in the Undersea and Hyperbaric Journal involving 830 infants who were born not breathing, then resuscitated and treated within five minutes with HBOT. "It reduced the severity of the results by four times, and fatalities by eight times," Mr. Ward explains. "How many more babies have to die before these things are approved by the medical community and covered by healthcare insurance?"

The Undersea and Hyperbaric Medical Society is the body which approves new conditions for HBOT. Currently 13 conditions, such as carbon monoxide poisoning, crush injuries, burns and skin grafts, are approved, but not brain injuries such as CP, autism and strokes. President Dr. Caroline Fife of Houston, Texas, says what is required is randomized, double-blind studies. "We've had lots of case reports and we're not saying it doesn't work, we're just saying they don't equate to solid evidence. It's possible that one study could be enough if it were so well-designed that no one could argue with its findings."

Such a study for CP may now be in the works at McGill University under the direction of Dr. Marois, expanding upon his pilot study and due out this spring. "If it is positive, it will open minds for studies into epilepsy, strokes and learning disabilities," he predicts. If covered by health insurance, he expects it would not only change lives but save taxpayers $10,000 a patient for procedures no longer required, such as braces outgrown every six months and surgery to sever nerves from spastic muscles before they warp growing bones. With 20,000 CP children under 18 across Canada and an additional 40,000 adults, that figure would be significant. But even if his study were accepted, he warns, provincial health ministers across the country "will probably need some pressure from families to get things going faster."

Improperly used they can be fatal

A Pelham, Ont., man who died of suffocation in a hyperbaric chamber January 31 while treating himself for severe headaches may have fallen asleep and stopped breathing, according to Vancouver naturopathic physician, Jim Chan. Mr. Chan trained with the American Board of Oxidative Medicine after his wife was paralyzed with a severed spine in a car accident, and found that HBOT and other therapies regenerated her spine. Today she walks up stairs unassisted.

"We have cancer patients in remission and do all sorts of crazy things here," Mr. Chan says. "Just don't send any bureaucrats." However, he strongly advises against "casual home use" of HBOT. Among other risks, patients can fall asleep and stop breathing because the autonomic nervous system requires carbon dioxide to stimulate it.

One man for whom a home hyperbaric chamber worked miracles was a 26-year-old Montana-based commercial pilot rendered totally dependent by a drunk driver. When he responded well to an initial round of 40 "dives" at a cost of $100 each, his parents bought a chamber of their own. Four hundred dives later he has regained his private pilot's licence and hopes to requalify as a commercial pilot--the reason he asked to remain anonymous.

Darren Dancey is a 32-year-old Alberta forester who fell 60 feet when his rockclimbing equipment broke, resulting in the surgical removal of the back part of his brain. After two rounds of HBOT, he is relearning to walk and talk and "wants to get back to work," according to his father Don of Grande Prairie. "Just imagine the impact on healthcare," declares Mr. Dancey, "if we got more people out of $1,000/day hospitals and back to work."

COPYRIGHT 2000 United Western Communications