By: Sara Cooke
“She’s locked and grounded.”
Safety officer John Mercado has just slid a young lady named Jamie off of a gurney and into a long tube-shaped chamber. He clamps the chamber lid shut and respiratory therapist, Donnette, monitors Jamie’s well being on a computer screen, while the patient herself enjoys an episode of Everybody Loves Raymond on the TV suspended above her. Jamie is suffering from traumatic brain injury after her involvement in a car crash and is undergoing a method of treatment called hyperbaric oxygen therapy (HBOT) at a new clinic in Fayetteville.
John and his wife Denise are co-owners of Fayetteville Hyperbarics. They have a personal investment in alternative methods of healing. Originally from New York, the couple settled down in Fayetteville after John, a retired Army Captain, spent some time at Fort Bragg. Their older son currently serves in Army Special Forces, but their younger son, Danny, passed away in 2006 at the age of 24 after a lifelong battle with meningitis. It was at this time that the family began looking for answer. This meant they spent a lot of time conversing with parents of kids with diagnoses similar to Danny’s. What they found were the remarkable success stories of HBOT helping to heal those with chronic illnesses such as autism and cerebral palsy.
After a great deal of research, the Mercados opened their clinic’s doors in March 2013, and soon found that the Bragg area is the ideal location for helping not only those with disabilities, chronic illnesses and injuries, but also a unique group: the military. In fact, there are over 50 conditions treated internationally with HBOT, from ADD to Chrohn’s disease, but perhaps those with the most local significance are conditions such as post traumatic stress disorder (PTSD) and TBI that run rampant throughout the military. Local veterans once traveled to Raleigh or even Charlotte for HBOT treatments, Denise notes, before the Mercados’ office opened. Now, they can find relief closer to home. Nine of the 50 patients treated since March are service members.
“We’re military serving military,” said Denise, smiling as she describes the rest of their staff. Rounding out the clinic’s team are medical director, retired US Air National Guard Colonel, Dr. Robert Ferguson, Karen Estep, clinic director and wife of a retired soldier and Donnette Webber, respiratory therapist and the only staff member who is not military.
When a couple of Bragg area Green Beret vets were looking for relief, concerned members of the Green Beret Foundation called Denise personally and made the decision to help foot the bill for local Green Beret to undergo HBOT. Denise noted there has been talk in Congress for the past five years about potential federal funding toward HBOT treatments for military with PTSD and TBI. Such funding could be a game changer. Cost is where many patients may find an issue, considering a full course of treatment can run upwards of $100,000. Also, bear in mind that insurance companies typically only help with the cost of treating FDA-approved treated conditions, which make up only a handful of the ailments for which patients seek treatment. PTSD and TBI are not included in the FDA’s list. Many hospitals, including Cape Fear, do offer HBOT- but only for those select conditions. For now, many families throw fundraisers in order to cover the cost of treatments.
When a patient lies inside an enclosed tube called a “chamber” breathing 100% oxygen under pressure (in contrast to the only 21% oxygen air we breathe), the idea is that the oxygen is fully permeated into her brain, heart and all vital organs, allowing injured areas to heal. Treatment sessions are referred to as “dives” because the chamber’s air pressure simulates atmospheres below sea level- every 33 feet marking a lower atmosphere. Typically, patients will dive for one and a half hours at a time, long enough to slowly descend and ascend two atmospheres. However, the length of time varies depending on whether the injury is neurological or muscle related. Specialists recommend patients dive twice a day, three days a week for a total of 40 dives to achieve maximum results. Two chambers stand next to each other in a large, open room, with space and piping for two more chambers for which the clinic is seeking funding. They have the capacity to serve 12 patients a day, though the schedule is rarely that packed.
“Patient safety is our main concern,” said John, describing how he performed a pre-dive check of all of Jamie’s vital signs. “If we find anything wrong, we do not follow through with the dive.” While it can take up to five dives to become comfortable adapting to the pressure change, after so many dives the staff reports that patients visibly relax when entering the chamber. In order to prevent oxygen toxicity or injury to the eardrum, clinicians perform particularly extensive ear checks after those first five dives, and make sure sessions do not exceed two and a half hours. All treatments are fully monitored by the respiratory technician, particularly during descent and ascent, as she tracks both the computer screen and the patient herself to look for signs of discomfort.
“We’re often asked, ‘What does it feel like?’” reported John, “The answer is, it’s different for everyone. No one has reported pain, and the worst part is a little pressure in the ears- like you’re on an airplane. We encourage patients to swallow. Also, some people might feel a little claustrophobic, but that usually passes.” More than keeping patient safety in mind, the clinic also caters to their comfort. Lights are dimmed to make the room appear less stark, and the staff kindly converse with Jamie throughout, calling her “sweetheart.”
John is very clear about one thing; HBOT itself does not heal, but rather promotes healing. It allows all systems of the body to work together, providing it the oxygen it needs in order to grow, heal and recover on its own. There is no objective test to measure success, but it is made apparent through observation and asking the simple question, “How are you feeling?” Denise and her team treated an autistic boy who was nonverbal and unable to keep eye contact. By his 15th dive, the boy was reciting the ABCs and was able to look his mother in the eyes and say, “I love you.”
In cases of service members being treated for combat or training-related neurological issues, John also relies on the patients’ dependents to report their loved one’s progress and any behavioral changes. In those with PTSD, this often means their moods change as they become looser, more alert and less jumpy. More importantly, it means an improved state of mind.
“We call them ‘service members,’ not ‘veterans,’” said Denise, referring to the soldiers and airmen they care for, “Often training and even the lifestyle itself can cause damage that manifests in ways like PTSD.” A 39-year-old veteran with combat related TBI as well as shoulder, arm and back injuries states that after treatment he feels “more alert and better able to handle situations as they arise.” He also says he no longer struggles for words, and his reading comprehension, multi-tasking skills and sleep patterns have improved. Another veteran who suffered TBI, PTSD, blackouts, depression, anxiety, memory loss, back and knee injuries and migraine headaches reports after just 18 dives, “This is the best I’ve felt in a long time,” continuing, “[My] depression is a lot better, [my] memory is better, and [I] haven’t taken anything for pain since my third treatment. I sleep better. No migraine headaches.” Due to the success of the treatments, his primary care physician has cut back his medications from ten to three. The proof of the treatment’s effectiveness, if not measurable, is worth noting.
This soldier’s testimony brings up an added bonus: because the oxygen treatments increase metabolism, they quicken the absorption of prescription drugs. This means that many service members who returned to the States with a laundry list of pain medications and other narcotics are no longer dependent and often no longer require their drugs at all. We can’t ‘fix’ them, but we can bring them back to almost where they were,” John said. He recalls a note from a soldier and former patient’s wife: “Thank you for brining my husband home to us.”
Standing beside Jamie’s chamber sipping on a complimentary coffee, Jamie’s father laughs and teases the clinic’s staff, “They give you free coffee, but the ten dollar cup is where they get you.” He added seriously: “Jamie’s recovery is definitely improved by her dives here. I recommend it to anyone.”