What Hyperbaric Oxygen Therapy Actually Does - and Who It's Really For

Host (Steve) Welcome to this episode of Spotlight Sioux Falls. We're in a pretty cool place here. I'm here with Dr. Todd, and we are at the Lincoln County Airport. We've got a couple of pretty cool devices that we're going to talk about. Dr. Todd is an ENT surgeon, an entrepreneur, and a pilot. What don't you do? Dr. Dan Todd Well, not a real pilot. I say I'm a good flyer, but I'm actually a sport pilot. I didn't get into flying until I was 52. And as far as the hyperbaric stuff, that just started this year. Host So as an entrepreneur, you own Midwest Hyperbarics. We're here in this hangar for a reason. There's a common through line between flying, pressure components in aviation, and hyperbaric medicine. Tell us more about that. Dr. Dan Todd Well, hyperbaric means high pressure, and it's the pressure that matters - not the oxygen concentration. It's fascinating. We're sitting here at about 1,500 feet above sea level, and our pressure is about 14 to 15 psi because we have 100,000 feet of air on top of us. If you take this gyroplane up 30,000 feet, the pressure becomes so low that you can't absorb even the 20% oxygen like we have here. But if you go into hyperbaric chambers, they go down the equivalent of 30 to 60 feet underwater, and the pressure drives oxygen into your system. Pressure is actually more important than oxygen concentration for healing. Host So that popping feeling when you go up in a plane? Dr. Dan Todd That's your eustachian tubes equalizing pressure. Your eardrum has an air pocket in the middle ear behind it. As you descend, pressure increases, so you need to open your eustachian tubes to equalize. It's way more extreme underwater - 30 feet equals 2 atmospheres, 60 feet equals 3 atmospheres. Host Okay, so the pressure is more important than the oxygen? Dr. Dan Todd Yes. At sea level, oxygen is 21%. At 30,000 feet, it's still 20% oxygen, but the pressure is so low it's equivalent to 6% oxygen. Remember Payne Stewart? His plane depressurized at 40,000 feet, and the crew passed out because there was no pressure to push oxygen into their lungs. Even if you're breathing 100% oxygen, without pressure, you pass out. There was actually a doctor named Boersma in 1959 who exsanguinated pigs - replaced their blood with clear plasma. At 3 atmospheres with 100% oxygen, the pigs lived fine with zero hemoglobin. That's how powerful pressure is. Host That's incredible. So hyperbaric oxygen therapy is not new? Dr. Dan Todd Not at all. It dates back to when they were building the Brooklyn Bridge. Workers would go down in caissons to deep underwater levels. They'd pump air down to keep them working. But when they came up too fast, the nitrogen in their tissues would come out of solution as bubbles, causing "the bends" - incredibly painful. They discovered that putting them back down resolved the symptoms. The Navy figured out that if you replace nitrogen with oxygen, your body can metabolize the oxygen, so they could gradually decompress without the bends. They also figured out the therapeutic benefits. There was a guy named Cunningham who built a huge hyperbaric dome in Cleveland around 1925. It was like a hyperbaric hotel. People got better - even tuberculosis patients. But the AMA came after him because his data collection wasn't rigorous enough, and they labeled him a fraud. They scrapped the dome during World War II. But Dr. Boersma was doing open heart surgery in hyperbaric operating rooms. He didn't need blood pumps - he could just pressurize oxygen directly into the patient. Host Wow. Dr. Dan Todd When you have any injury or wound, there's always edema and ischemia - swelling and lack of blood flow. You can't get blood to that area to heal. But with pressurized oxygen, you don't need blood. It dissolves directly into the serum and tissues. Host So the swelling prevents healing? Dr. Dan Todd Right. With an injury, you get swelling and you can't re-oxygenate that area. That's why hyperbaric oxygen is great for expediting healing. You see these 100% oxygen bars in Vegas, and people think they're going to feel better. But at sea level, we already saturate our hemoglobin to almost 100%. You're already maxed out. You need the pressure. That's the key. Host So oxygen bars don't work? Dr. Dan Todd Not really. At sea level with the same pressure we're at now - 14 psi - breathing 100% oxygen doesn't do much more. You're already saturating your hemoglobin. If you wanted more endurance or faster recovery, you need pressure. Or you could get more hemoglobin, like Lance Armstrong did. He'd have his own blood stored and would infuse himself with extra red cells, making himself polycythemic. That's why he won the Tour de France seven times. But that's not legal anymore. With pressure, you don't even need the extra red cells. Host Should I store my red blood cells in the fridge? Dr. Dan Todd You could, but you'd probably need to win the Tour de France to justify it. Host Yeah. I'd probably need to lift more weights. Dr. Dan Todd With pressure, you don't even need all that. In diabetics, blood vessels get damaged. Same thing with radiation. When we treat head and neck cancer patients with radiation, it kills the cancer but also damages the microvasculature. The skin becomes hard, and bone might show up in the mouth and won't heal. With hyperbaric oxygen, we can remove the bone, and then the area can heal because we're driving oxygen directly into the tissues. Host Okay. Dr. Dan Todd That's the same approach with diabetic foot ulcers and wounds that won't heal - to hopefully avoid amputation. Once you start amputating, bad things happen. Host So you've been using this for cancer patients for 30 years? Dr. Dan Todd Yes. I've watched more and more interest. Michael Jackson slept in a chamber. LeBron James is in a chamber. You see all the athletes doing it. But what really got me into it was my wife, Nicole. She got talked into helping a lady with ulcerative colitis who was doing hyperbarics. The doctors said she'd need a colectomy and was going to die. But she got better from soft chambers at the mall. So Nicole got her own chamber, but she couldn't quite get into it herself. The lady said she could use it too. Nicole would go every night - two hours for the lady, two hours for herself. Five hours total. But Nicole had neuropathies, carpal tunnel, ulnar neuropathies, and fibromyalgia. Just terrible. She was miserable. And then it got better. She said, "I'm getting one of these." We looked into it and decided hard chambers are better. So we got a hard chamber at home. Host Are you really in the hyperbaric chamber? Dr. Dan Todd Yes. She filled it with her sisters, her friends, her family - all day long. Then we got another chamber at home because I liked getting in it too. It made me feel better, made my bad knees feel better. Pretty soon, both chambers were full all the time. I'd come home from work, and there'd be someone in the living room, someone in the chamber, someone waiting, and they're all baking sourdough bread. Then my daughter Jada got her nurse practitioner degree, and we thought, "Why don't we open a clinic?" People want to be in our house, so let's do this professionally. Host That makes sense. Dr. Dan Todd We tried to do it in my ENT clinic at Midwest ENT, but it was complicated with seven physicians. Having your wife and a nurse practitioner trying to bring hyperbaric chambers into a medical practice - you have to have meetings, get approval. It's complex. Host Does it make sense now? Dr. Dan Todd Yeah. You and Steve work together well, but sometimes when you have all these partners, your partner says, "I can't fire your wife." Host Right. That makes it more complicated. Dr. Dan Todd So what's the difference between soft chambers you see at the mall and what we have at the clinic? Host Tell me the clinical difference between those devices. Dr. Dan Todd It comes down to pressure. Soft chambers are much less expensive. They're like a thick tube or bag. You get in and it tightens up. They get to about 1.5 atmospheres - maybe 7 to 10 psi. What's made hard home chambers really good is the advent of oxygen generators. You can generate oxygen extremely efficiently using electricity - get the nitrogen off - and pump it into the chambers instantly. You don't need tanks. At our center, we use liquid oxygen and pressurized room air. But it's all about the pressure. Hard chambers go to 3 atmospheres. They're very thick, industrial medical chambers. The one in our clinic weighs 20,000 pounds. Host You mentioned atmospheres. At sea level, we're at about 15 psi. Is that right? Dr. Dan Todd We're 1,500 feet above sea level in Sioux Falls, but essentially at sea level. The pressure from the air is about 14 to 15 psi. We call that one atmosphere. It's the atmosphere of air sitting on us. When you go underwater, they extrapolated from sea level. At 30 feet, that's 2 atmospheres - another 15 psi. At 60 feet, that's 3 atmospheres - 30 psi. We use gauge pressure - so zero is our starting point. At 30 feet underwater, we're at 15 psi gauge. At 60 feet, we're at 30 psi. Host Got it. I'm with you. Dr. Dan Todd Nobody treats anybody therapeutically above 3 atmospheres. Most people treat at 2.5 to 2.6 atmospheres, or even 2 atmospheres. I think more pressure is good - I'm a "more is better" kind of guy. But there's diminishing returns. Host Why is that? Dr. Dan Todd It just hasn't proved effective. I haven't really studied why. Host Okay. Dr. Dan Todd The soft chambers can't handle the pressure. You just can't get that far. Host So the oxygen bars in Vegas are basically zero pressure? Dr. Dan Todd Right. If you have a pulmonary condition like COPD, extra oxygen helps. But if you're normal and your oxygen saturation is 99%, like most people's are, you can't saturate anymore. Your hemoglobin is already saturated. Host Right. Dr. Dan Todd So soft chambers help a little bit. Hard chambers at 2 to 3 atmospheres are much more clinically effective. Host What about sudden hearing loss? Can HBOT help? Dr. Dan Todd Absolutely. We have a patient, Grace Hockstetter. She had sudden hearing loss. She did hyperbaric treatments, and when she went back for her hearing test, she'd gone from 3% to 95% hearing recovery. It was like a miracle. Host Wow. How does that work? Dr. Dan Todd The inner ear is very sensitive to ischemia - lack of blood flow. Sudden hearing loss is usually from vascular insufficiency or a viral injury. With HBOT, we drive oxygen directly into those tissues, and the hearing comes back. Early intervention is critical though. Treatment within the first two weeks gives the best results. Host So it's time-sensitive? Dr. Dan Todd Yes. The sooner you do it, the better the outcome. Host What about addiction recovery and mental health? Can HBOT help with that? Dr. Dan Todd Yes. One of our patients who struggled with addiction said that after HBOT treatments, there was "progression to joy." He said, "Staying sober wasn't a chore. There was joy again in my life." The mechanism likely involves improved cerebral oxygen delivery and reduced neuroinflammation. Host That's powerful. Dr. Dan Todd We also treat anxiety, depression, PTSD, and other conditions. Athletes use it for recovery. General wellness optimization is huge. Host What about chronic pain? Can HBOT help with herniated discs? Dr. Dan Todd Yes. One of our patients with herniated discs at C2 through C7 said hyperbaric was the one thing that brought his pain level to zero. He said, "Try this before you go to things you can't undo later." HBOT reduces inflammation and improves blood flow to damaged tissue. It's a conservative approach before surgery. Host What does a session feel like? Dr. Dan Todd Patients consistently describe it as extremely relaxing. You lie down, get blankets, and can watch TV. The main sensation is ear pressure as you descend - like landing on a plane. Many patients fall asleep. Sessions last about 90 to 120 minutes depending on the protocol. Host That sounds amazing. Dr. Dan Todd It is. People come back because they feel so good. Plus, the science is solid.