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Chamber of Hope

Divers have long used them for the bends. Now hyperbaric units--7-foot tubes infused with pure oxygen--are working wonders on burns, gangrene, even the flesh-eating bacteria.

May 22, 1996|DENISE MARIE SIINO | SPECIAL TO THE TIMES

Bob Lavacot of La Habra woke up one morning while on vacation with a boil-like ulcer on his chest. He thought little of it until the ulcer started spreading and he began to run a fever.

He cut the vacation short and made an appointment with Dr. Bonnie Bock at Hoag Hospital in Newport Beach.

"The tissue and underlying pectoral muscle were already badly infected," Lavacot recalls. The chest wound, he learned, was a delayed side effect of radiation treatment he underwent 25 years ago for a cancerous tumor.

The course of treatment Bock prescribed: surgery to cut away the infected area and reconstruct the muscle, skin graft and--to Lavacot's surprise--hyperbaric oxygen therapy to promote healing of new tissue.

"I had done a lot of scuba diving in the past, and I said, 'Hyperbaric--isn't that for divers with the bends?' I couldn't believe I was going to be treated in a hyperbaric chamber," Lavacot says.

His surprise is echoed by many patients these days who learn that part of their treatment will be in a pressurized oxygen chamber, the equivalent of being about 65 feet below sea level. The infusion of pure oxygen into damaged tissue has been found to promote healing in a number of difficult conditions such as Lavacot's. In his case, the wound is nearly healed now, and his prognosis is excellent, Bock says.

Hyperbaric oxygen treatment is typically prescribed today for patients with severe burns, flesh-eating bacteria, gangrene, cyanide poisoning, crush injuries and a number of other specific conditions.

In Los Angeles and Orange counties, there are 10 hospital-based hyperbaric programs.

While the chambers are credited with life-saving recoveries, they are not without risk. And though some results achieved with them have been miraculous, they are not the cure-all that some suggest, say those in the medical community experienced with hyperbaric procedures.

The hyperbaric chambers most common in the United States are one-person, see-through acrylic cylinders--about 2 feet in diameter and 7 feet long. The patient lies in the chamber for treatments that last from 1 1/2 to two hours. Some patients receive only a few treatments, others as many as 60.

Patients in the chamber are breathing pure oxygen, about five times the concentration of normal breathing air, which is 21% oxygen. The pressure inside the chamber can be three times higher than normal, which, combined with the higher oxygen level, delivers 15 times as much physically dissolved oxygen to tissues as breathing normal air would. To prevent static sparks in the pressurized, oxygen-rich atmosphere, only all-cotton clothing and bedding are allowed in the chamber.

The leading manufacturer of the chambers, Sechrist Industries Inc., is based in Anaheim. It has built more than 600 of the units, which are in use around the world--predominately in the United States and Japan. The units cost $95,000 to $120,000.

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The history of hyperbaric medicine is tied to the evolution of diving.

Back in 320 BC, Alexander the Great used a glass barrel "diving bell" to extend the limit of diving beyond the time a person could hold his breath. Around the same time, Aristotle noted in a journal a case of ruptured eardrums caused by a deep-sea dive.

But it wasn't until 1670 that there was a record made of the decompression phenomenon known as "the bends," which is caused by nitrogen bubbles expanding in the bloodstream due to rapid ascent. It was in 1841 that "recompression" to relieve its symptoms was devised. In that process, the patient is placed in a chamber where the pressure mimics that of the deep-sea experience and is then slowly brought back to sea level pressure, allowing the nitrogen bubbles time to dissolve.

In the early 1800s, compressed air--or hyperbaric--treatment became popular for a variety of ailments, though there was no documentation of benefits from it. By the early 1900s, pure oxygen replaced regular air in hyperbaric chambers and some specific benefits began to be documented, primarily in pulmonary cases.

During World War II, the Navy began using Jacques Cousteau's aqua lung, and there was a subsequent increase in decompression chambers. Their increased use led to an important discovery: While compressed oxygen cured the bends, the wounds suffered during a dive also healed at an unprecedented pace.

During the Vietnam War in the 1960s, Dr. George Hart of the Long Beach Naval Hospital decided to put hyperbaric oxygen to another test. He achieved remarkable results treating soldiers who had suffered burns.

Hart was using some European hyperbaric chambers but envisioned improvements and asked friend Ron Sechrist, who was working in the aerospace industry, to build a new version of the pressurized chamber. Sechrist took up Hart's invitation and in 1975 built his first chamber, which is still in use--although it's been updated--at Long Beach Memorial Hospital.

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