Ed Nemeth HBOT NFL: Healing Powers

www.CHERISHfoundation.orgIndep. Football Veterans Conf. March 25, 2011

NFL Brain Injuries, Treatments & Medical

Rights

Ed NemethRebecca’s Dad

Hyperbaric Oxygen Therapies

www.CHERISHfoundation.orgIndep. Football Veterans Conf. March 25, 2011

Who am I?

The loving and faithfulfather of Rebecca,

a severely disabled child!

Hyperbaric Oxygen Therapies

www.CHERISHfoundation.orgIndep. Football Veterans Conf.

March 25, 2011Hyperbaric Oxygen

Therapies

Who am I?

Rebecca’s Dad!

Trained as a scientist - objective Researched nerve regeneration /

plasticity Department of Neurobiology, University of Vermont Medical School

Businessman / Entrepreneur - pragmatic



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Our Journey Birth, Death &

Resuscitation



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Our JourneyComa



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Our Journey~~ The Journey! ~~



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Our Journey~~ The Journey! ~~



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Our JourneyHypberbaric Oxygen!

Dismissed HBOT in 1998

Struggled to get help for Rebecca Mouth-to-mouth rescusitation 9 times 1-hour long static gran mal seizures monthly Bronchitis & pneumonia 6 times a year Weak, myriad challenging problems

Then…. Surgical Neurology, vol 10 Oct. 78 Ischemic Penumbra reversed @ 7 years post

injury HBOT “had to” work!



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What we did!

Went to Dr Neubauer’s HBOT Clinic in Florida For Hyperbaric Oxygen Therapies - HBOT

40 Sessions in 2 months July-August, 2000

Great immediate responses Horrible SPECT scans 2nd SPECT’s showed great response!



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Fantastic Changes!

Went seizure and drug FREE for 6 years! Could maintain own body temp. at

night! Pneumonias and bronchitis STOPPED! Feeding time dropped from:

1 hour 10 minutes to 20 minutes! Gained coordination (had NONE!)! Gained endurance and strength (had

NONE!)!



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SPECT Scans Single Photon Emission Computed Tomography

Uses Ceretec radio-isotope Crosses blood brain barrier (BBB) Binds to active neurons

Objective View function, not structure Compares CNS metabolism

before & after HBOT



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before & after HBOT



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Clear Benefits - SPECT Scans Pre HBOT Post 36 HBOT



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Clear Benefits - SPECT Scans Post 36 HBOT Post 4

Month Rest



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Clear Benefits - SPECT Scans Post 4 Month Rest Post 32 HBOT

(add’l)



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Clear Benefits - SPECT Scans Pre HBOT Post 72 HBOT



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at 2.4 ATA HBOT delivers O2 = HbO2 desaturation HBOT creates high O2 gradient & O2 activity

HBO Effect on Blood O2 Content



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Depth Application

0 fsw; 1 ATA16.5 fsw; 1.5 ATA

33 fsw; 2 ATA49.5 fsw; 2.5 ATA59.4 fsw; 2.8 ATA

66 fsw; 3 ATA165 fsw; 6 ATA

Sea levelChronic Brain InjuryBurnsDiabetic Wounds/OsteoCO PoisoningAcute Cyanide

PoisoningAcute Decompression

Illness

www.CHERISHfoundation.orgIndep. Football Veterans

Conf. March 25, 2011Hyperbaric Oxygen

Therapies

HBOT Mechanisms

Multiple mechanisms Angiogenisis Neural re-activation *

Normalization of oxygen deficit Re-establish neuronal metabolism Neuronal Regeneration

Increase natural stem cells 800%* Ischemic penumbra is now accepted as the

primary cause of deficits

www.CHERISHfoundation.org

How it works - 5,769+* ways* Oxygen-sensitive outcomes and gene expression in acute ischemic stroke. Rink C, Roy S, Khan M, Ananth P, Kuppusamy P, Sen CK, Khanna S. J Cereb Blood Flow Metab. 2010 Feb 10.

Up-regulates growth factors

Reduces edema Increases neuronal ATP Enhances Mitochondrial:

Replication Energy Production (ATP)

Promotes neural pathway growth

Stimlates aging neurons Down-regulates

inflammation Reduces reperfusion

injury

Indep. Football Veterans Conf. March 25, 2011



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HBOT Benefits - SPECT Scans

Pre HBOT Post 72 HBOT



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HBOT Is Very Safe

From a 10 year study of 1,505 patients receiving 52,758 2-hour HBOT sessions at 2.4 ATA once or twice daily.

inability to equalize middle ear pressure 0.37% paranasal sinus blocks 0.09% confinement anxiety 0.05% oxygen convulsions 0.009% pulmonary oxygen toxicity 0.00% permanent ocular refractive changes 0.00%



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USA Today 1998:

16,500 died from gastrointestinal bleeding taking NSAIDs (1997)

…...yet is fully accepted.

Comparative Drug Safety


Different HBOT Chambers

Multi-place Chamber

www.CHERISHfoundation.orgHyperbaric Oxygen

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Mono-place Chamber




Home Chamber



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before & after HBOT



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War Veteran TBIBefore & After HBOT


NFL Player: TBI impact assessment

NFL football player with concussion

Loss of about 2% of the fiber tracts in the region of the corpus callosum.

Area of Tissue change Fibers passing through areas

Enlarged Fiber Tract showing fibers from concussive event

Courtesy Dr. Walter Schneider, U Pittsburgh



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NFL Veteran TBIBefore HBOT



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NFL Veteran TBIAfter HBOT


Case Presentation Alzheimer’s Disease

Scan #1

Scan #2



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Medicare Reimbursed IndicationsHBOT increases tissue O2

Compromised Skin (Acute traumatic peripheral ischemia)

Compromised Skin Grafts Burns Chronic Refractory Osteomyelitis Diabetic Wounds Clostridial Myonecrosis (Gas Gangrene) Progressive Necrotizing Infection (Meleney’s Ulcer)

Soft Tissue Radiation Necrosis Osteoradionecrosis Acute Peripheral Arterial Insufficiency (ulcers) Actinomycosis

Acute Cyanide Poisoning Carbon Monoxide Poisoning (acute) Intravascular Gas Embolism Decompression Illness



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Non-healing Wounds

1) 1 year mainstream medicine2) 26 HBOT’s later3) 50 HBOT’s later



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HBOT for

Burns

Textbook on Hyperbaric SurgeryBakker MD, Cramer MD

Summary:

Control HBOTBurn (%) 48% 61.8%Days Hosp. 108 51.8Surgeries 7.8 2.1Costs $391k $215kScarring (reduced 95%)



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SB2046 Mandates HBOT Reimbursement

California SB 2046 in its amendments to:

• H&S Code 1367.21; • W&I 14105.26; • Insurance Code 10123.195

Mandates reimbursement for FDA Approved, “off label” drugs, that meet specific criteria - HBOT qualifies under those criteria.



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California SB 2046 “prohibits a health care service plan contract, and specified disability insurance policies, from limiting or excluding coverage for a drug on the basis that the drug is prescribed for a use different than the use for which the drug has been approved for marketing by the federal Food and Drug Administration (off-label use) if specified conditions are met, including that the drug prescribed is for the treatment of a life-threatening… chronic and seriously debilitating conditions.”




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1367.21. (a)…. provided that all of the following conditions have been met:

(1) The drug is approved by the FDA.




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(2)(B) The drug :is prescribed by a physician for treatment of a debilitating

condition,is medically necessary is on the plan formulary.




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(3) The drug has been recognized for treatment of that condition by one of the following:

(D) Two articles from major peer reviewed medical journals supporting the proposed off-label use as safe and effective.




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Golden ZL, Neubauer RA, Golden CJ, et al.: Improvement in cerebral metabol-ism in chronic brain injury after hyperbaric oxygen therapy. Int J Neurosci 2002, 112:119-131.

Harch PG, Gottlieb SF, Van Meter KW, Staab P. HMPAO SPECT brain imaging and low pressure HBOT in the diagnosis and treatment of chronic traumatic, ischemic, hypoxic and anoxic encephalopathies. Undersea & Hyperbaric Medicine, 1994; 21(Suppl):30.

Harch PG, Fogarty EF, Staab PK, Van Meter K. Low pressure hyperbaric oxygen therapy and SPECT brain imaging in the treatment of blast-induced chronic traumatic brain injury (post-concussion syndrome) and post traumatic stress disorder: a case report. Cases J. 2009 Jun 9; 2:6538.

Lin JW, Tsai JT, Lee LM, Lin CM, Hung CC, Hung KS, Chen WY, Wei L, Ko CP, Su YK, Chiu WT. Effect of hyperbaric oxygen on patients with traumatic brain injury. Acta Neurochir Suppl. 2008; 101:145–9.




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Lin JW, Tsai JT, Lee LM, Lin CM, Hung CC, Hung KS, Chen WY, Wei L, Ko CP, Su YK, Chiu WT. Effect of hyperbaric oxygen on patients with traumatic brain injury. Acta Neurochir Suppl. 2008; 101:145–9.

Low pressure hyperbaric oxygen therapy and SPECT brain imaging in the treatment of blast-induced chronic traumatic brain injury (post-concussion syndrome) and post traumatic stress disorder: a case report Paul G Harch, Edward F Fogarty, Paul K Staab and Keith Van Meter

Neubauer RA, Gottlieb SF, Pevsner NH: Hyperbaric oxygen treatment of closed head injury. South Med J 1994, 87:933-936.




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Palzur E, Zaaroor M, Vlodavsky E, Milman F, Soustiel JF. Neuroprotective effect of hyperbaric oxygen therapy in brain injury is mediated by preservation of mitochondrial membrane properties. Brain Res. 2008; 1221:126–33. Epub 2008 May 11.

Rockswold SB, Rockswold GL, Defillo A. Hyperbaric oxygen in traumatic brain injury. Neurol Res. 2007; 29:162–72.

Shi XY, Tang ZQ, Xiong B, Bao JX, Sun D, Zhang YQ, Yao Y. Cerebral perfusion SPECT imaging for assessment of the effect of hyperbaric oxygen therapy on patients with post brain injury neural status. Chin J Traumatol. 2003; 6:346–9.




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Tinianow CL, Tinianow TK, Wilcox M. Effects of hyperbaric oxygen on focal brain contusions. Biomed Sci Instrum. 2000; 36:275–81.

UHM 2009, Vol. 36, No. 6 – Treatment of mild traumatic brain injury with hyperbaric oxygen

391 Case report: Treatment of mild traumatic brain injury with hyperbaric oxygen

Colonel James K. Wright, Eddie Zant, Kevin Groom, Robert E. Schlegel, Kirby Gilliland




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California SB 2046

“A willful violation of the provisions

governing health care service plans

is a crime. ”




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Rebecca Thanks you!

Sports

Ed Nemeth HBOT NFL: Healing Powers