Friday, June 27, 2003
Madeline Richards developed a serious ulcer on her left foot that wouldn't heal -- a result of vascular disease. "It took up the entire side of my heel,'' recalls the 54-year-old Sidney candy store owner. Her doctor mentioned amputation as a worst-case scenario should the foot not improve after surgery.
Beyond panic, Richards undertook 16 hyperbaric oxygen treatments in a new Victoria alternative health centre and is ecstatic with the result. The skin is healed and intact and she believes amputation threats are gone.
Richards is one of many people who swear by this quietly debated antidote -- debated because it gets the blessing of the medical establishment for some serious conditions but not for others and can cost clients thousands of dollars in repeat visits. The posted rate at the Hyperbaric Oxygenation Corporation's Centre on Alpha Street, which opened last fall, is $100 per treatment in an oxygen chamber. And it takes plenty of so-called dives to capitalize on the healing effects of pure oxygen absorbed at a deep cellular level.
Victoria's is one of only 15 private hyperbaric facilities in Canada and one of two on the Island: the other is at the Department of National Defence and is used by divers suffering the bends.
Pricate hyperbaric oxygenation falls into the same category of alternative options as health food stores or colonic irrigation, says Dr. Richard Stanwick, chief medical health officer for the Island. "As long as people aren't being harmed, they're entitled to pursue alternatives.''
The new centre is not licensed by the Vancouver Island Health Authority, which says it does not come under its jurisdiction, nor by the College of Physicians and Surgeons of B.C., nor by the Ministry of Health.
It does have a business licence and a spacious spa ambiance -- low lights, high ceilings, soft music, artfully placed plants and $300,000 worth of oxygen chambers.
These metallic blue-and-white bathroom-sized chambers allow clients wearing oxygen masks or hoods to breathe 100 per cent oxygen as operator Kenneth Barrett takes them to different atmospheric pressures. Air is 21 per cent oxygen at normal atmospheric pressure. Breathing pure oxygen at two or three atmospheres is touted to promote cellular repair, growth of new blood vessels, increased ability of while blood cells to destroy bacteria, and perhaps most controversially, enhance marginally functioning brain neurons. Being inside is distinctly uneventful -- people watch TV, read or rest. It's as painless as breathing but can provoke the same ear-popping feeling as flying as the change in pressure is equalized in the ears.
The centre brochure boasts it can help patients of stroke, cerebral palsy, coma, multiple sclerosis, hearing loss, Lyme disease and Parkinson's -- far beyond the 13 uses for hyperbaric therapy approved by the College of Physicians and Surgeons of B.C. And going this route is not supported by medical research, says registrar Dr. Morris VanAndel. Desperate people are exposed to it at significant cost, he adds, with benefits based on anecdotal testimonials.
The college does approves HBOT for the following: air or gas embolism, carbon monoxide poisoning and smoke inhalation, gas gangrene, crush injury, decompression sickness, healing enhancement for "selected problem wounds,'' anemia, dying tissue infections, bone marrow infection, radiation tissue damage, compromised skin grafts, thermal burns and brain abscess.
Even though individuals will say they feel better after all kinds of alternative practices, it is scientifically reviewed "double blind" studies, in which patients don't know which therapy they're receiving, that determine whether something is beneficial, says VanAndel, who is not an expert in HBOT. But no complaints to the college have been made about it in B.C., even though the centre fails to meet the college guidelines in many ways -- from not having a registered respiratory technologist running the chamber to treating people under age 14.
Humphrey Killam, a director of the HOC Centre (also called the Centre for Progressive Medicine), where hyperbaric oxygen is one of many treatments on offer, views the medical profession's list as too restrictive.
"There's experiments going on all over the world with this, with successes,'' he says. Cells need oxygen to live, whether they're brain cells or muscle cells, "so why would you say it doesn't work for your nervous system when it works for your muscles or your bones or whatever?"
Most doctors don't know very much about it, he says, adding that there is a Victoria physician who has brought patients for treatment. He says the company has provided 70,000 treatments over the years, largely in Coquitlam, without incident other than infrequent seizures in people who already have seizures. The centre relies on an experienced diver to run equipment and Barrett is familiar with maintaining it. "If they break wind in there I know it,'' he says, while watching readouts.
But Dr. David Harrison, hyperbaric specialist at Vancouver General Hospital, says a physician should supervise hyperbaric oxygen used to treat medical conditions. He's in charge of B.C.'s only in-hospital hyperbaric unit, where 1,500 treatments are given annually.
"Hyperbaric oxygen is a drug and like any drug, there are benefits and there are side effects,'' says Harrison. By far the most common of the latter are claustrophobia and ear popping, although a collapsed lung could occur. Richard Stanwick also adds that newborns should not be given oxygen treatment because blindness could result.
The list of ailments approved for treatment by the college is to be reviewed in the next year, and changes may occur, Harrison adds. "It's possible that's we'll find out five years down the road that cerebral palsy does benefit from hyperbaric oxygen. And at this point there's not sufficient evidence in my mind to be convincing.''
Since October, about 50 clients have been treated locally and the clinic is reaching break-even status.
The average number of treatments ranges from 30 to 40 over weeks or months or however long it takes people to afford them.
Recent checks with the Better Business Bureaus of Victoria and the Lower Mainland revealed no complaints about Hyperbaric Oxygenation Corporation centres. Nor did two provincial ministries have any complaints on file. No licensing provisions exist within the Ministry of Health for any kind of private clinics, said spokesman Tara Wilson, adding that it would be up to the regulatory colleges of various practitioners to get involved if there were complaints.
No concerns have come to Stanwick's attention about the centre. HBOT does not appear to harm healthy adults with short-term exposures and people with MS or cerebral palsy indicate they feel better after it, he adds.
"At this stage, there is no obligation for them to be licensed by us -- this is not something like restaurants or tattoo parlours.'' For practices such as colonic irrigation and hyperbaric oxygen, it's up to the consumer to educate themselves as to the risks and weigh the benefits, Stanwick says, or else his office would have to inspect every health food store in town as well concerning therapeutic claims.
TREATMENTS HAVE HELPED DAUGHTER, MOM BELIEVES
Candie Dunsmore, 33, a hair stylist from Campbell River, has eagerly resumed hyperbaric oxygen treatments for her daughter, McKayla, eight, who was born with severe cerebral palsy.
She began the treatments four years ago and Dunsmore found that just 11 of them led to so much improvement she's ended up taking more than 100. Now her tailbone is chronically bruised from holding her daughter on her lap during the treatments.
In Dunsmore's opinion, they've helped with everything from ease of swallowing to standing up with assistance, to McKayla's being able to put hands together to decreased crossing of her eyes. She says even the child's Vancouver neurologist has noticed her spasticity is reduced and advises she keep it up. But she hasn't been able to afford it for the last year or two, having spent close to $12,000 in Coquitlam at HOC's affiliated centre and another $8,000 in travel costs
Is it worth it?
"Oh, yes, I wish I had $100,000 so I could put one of these in our house so I could do it daily. I wouldn't spend that kind of money if I didn't see that much of a change.'' McKayla had conventional physical therapies for four years without making the difference that HBOT did, she says.
McKayla would probably be "a lot worse now if I had never done those treatments. It's a better quality of life. Life is a long time if you can't do anything.'' And she talked to many other parents of CP kids before trying it out.
McKayla's Campbell River consulting physician Dr. Mark Lund said he had not noticed much difference in the girl's condition when he last examined her in December 2000, although her mother did. But she was not any worse and as they grow, children with CP become less functional and their muscles tighter.
"If there's something subtle that could result in improved muscle tone and quality of life, it might be difficult to prove with medical studies but it might be reasonable to pursue, and I think that's what Candie's doing.'' And if the family's willing to take the risk of potential complications, such as a punctured lung, for theoretic benefit to the family, he's willing to support it.
There is no proof that cerebral palsy is improved by hyperbaric oxygen treatments, only the testimonials of parents, says VanAndel.
He gets concerned when people in such situations are offered "a ray of hope" and scrimp to pay for it.
"There's a difference between hope and exploitation.''
Are such clinics crossing that line? "I don't think people are wise or prudent to spend their money on unproven treatments, but I fully understand the desperation involved in seeking that -- that's human nature.''
Ran with fact box "Treatments have helped daughter, mom believes" which
has been appended to the story.
© Copyright 2003 Times Colonist (Victoria)