The US DOD has spent over $125,000,000 investigating the use of hyperbaric therapy to address the silent signature wounds of the wars in Afghanistan and Iraq. In these studies significant benefits were documented at two different pressures while breathing oxygen at two different concentrations. People did get better and we can’t allow these results to be forgotten.
In an invited commentary of the largest hyperbaric study by the US military (Miller et. al.) appearing in JAMA Internal Medicine November 17, 2014 these significant improvements are documented (Hoge CW and Jonas WB. The Ritual of Hyperbaric Oxygen and Lessons for the Treatment of Persistent Post Concussion Symptoms in Military Personnel, Published online JAMA Internal Medicine November 17, 2014, E1-E2). Drs. Hoge and Jonas (critics of hyperbaric oxygen therapy) acknowledged “significant improvements in post concussive symptoms and secondary outcomes, including PTSD (which most participant had) depression, sleep quality, satisfaction with life, and physical, cognitive and mental health functioning.” To date Hyperbaric Oxygen is the only therapeutic approach that is able to produce consistent and reproducible improvements in individuals with neurological injuries. These findings have been independently verified by studies out of Israel. (Boussi-Gross R et al, Hyperbaric Oxygen Therapy Can Improve Post-Concussion Syndrome Years after Mild Traumatic Brain Injury- Randomized Prospective Trial,PLOS One November 2013 Vol 8/ Issue 11/ e79995 pages 1-18.
Hyperbaric oxygen is a powerful therapeutic option capable of producing dramatic results. It is much more impressive in this role than any other treatment thus far. The results are durable. It causes one to wonder , “Why isn’t it being pursued by military medicine?” Time after time I have been told by senior officers in the medical corps, “Its political.” The definition of political in military terms is delaying a decision until the answer is no longer relevant. We need to step up and do the right thing.
Why does Hyperbaric Oxygen Treatment work? In short HBOT is effective in treating the effects of extraordinary pressure changes on the Human Body. In the combat environment extraordinary pressure changes occur with exposure to explosions, detonations, firing of large caliber crew served weapons and yes even the sustained firing of the individual combat weapon such as seen in firefights. The evidence is there if you care to look for it.
“TBIs from Iraq are different,” “Concussions from motorcycle accidents injure the brain by stretching or tearing it,” he noted. But in Iraq, something else is going on. “When the sound wave moves through the brain, it seems to cause little gas bubbles to form,” he said. “When they pop, it leaves a cavity. So you are littering people’s brains with these little holes.”(Glasser, R, WAR’S NEW WOUNDS-A Shock Wave of Brain Injuries; Washington Post, April 8, 2007)
There is no doubt that there is a dual narrative being put forward when it comes to hyperbaric oxygen therapy. Those that had had the opportunity to be treated attest to its effectiveness.
Could it be that this may affect our ability to field a force? The one thing that is certain is the Veterans of this 18 year conflict deserve better. They deserve to have the opportunity to finally come home and rejoin their families.