Hyperbaric oxygen therapy saved Park Rapids man from amputation
Hyperbaric oxygen therapy, or HBOT, is a relatively new form of treatment to this area, but it's actually been around since the 1960s. Though it was originally known as the primary form of treatment for deep sea divers suffering from "the bends," HBOT has been adapted to a variety of uses. For one Park Rapids, Minnesota, man, it meant the difference between an eventual, full healing and further amputation of a limb on which he already used a prosthetic.
PARK RAPIDS, Minn. — Hyperbaric oxygen therapy: For some, the name might be associated solely with scuba diving, as for many years, it was the primary treatment for divers needing to decompress and avoid "the bends" after a deep-water dive.
For others, it was long associated with the late Michael Jackson, as the music icon reportedly used a hyperbaric oxygen therapy (HBOT) chamber to rejuvenate himself and extend his life.
Today, however, HBOT has many practical applications, and is used in the treatment of myriad injuries, illnesses and conditions — including wound care. That's what brought Park Rapids, Minnesota, sixth-grade teacher Josh Cook to Dr. Olayinka Ajayi, a physician at Essentia Health-Fargo who specializes in hyperbaric medicine.
Cook, whose diabetes led to the amputation of the front half of his right foot, had developed "quite a blister" on the area of his foot that attaches to the prosthetic. That blister became a large, silver dollar-sized wound that had begun "burrowing back into the bone," he explained.
"Hyperbaric oxygen therapy was the last ditch effort before more amputation," says Cook, adding that he knew next to nothing about HBOT when it was recommended to him by his doctor. Now, he can explain it almost as well as a medical professional.
"I learned a lot, but also, the staff is so great at explaining the process and why we're doing things and getting you to the point where you feel comfortable that it's going to be successful," Cook said.
And successful it was: Ajayi describes Cook as "a living testimony to how successful this therapy is."
And though his treatments necessitated trips back and forth between Park Rapids and Fargo for 35 consecutive working days, Cook says he only ended up missing 14 and a half days of work overall. He gratefully credits the five-person HBOT team he worked with at Essentia Health.
"There were two weeks where I didn’t miss any work, and two more that I was able to get back by 9 a.m. (each day), so I only missed an hour," he said, adding, "I hate missing work. The team was amazing at working around my schedule."
Ajayi says that's something they try to do for all their patients. "Everyone is treated the same," he added.
His team's mantra, Ajayi said, is to look at every case as if they were the patient — to flip roles and ask themselves if they, as the patient, would be happy with their treatment.
"That's how we approach our patients — we put ourselves in their shoes, which means we have to look out for them and what's best for them," Ajayi said, adding that "being flexible" and showing up at the hospital every day at 5 a.m. to start his treatment was "what was best for Josh."
A deep dive into HBOT
What exactly is hyperbaric oxygen therapy? Essentially, Ajayi said, it involves breathing pure oxygen under pressure. Inside a hyperbaric chamber, the air pressure is higher than normal, allowing your lungs to take in more oxygen than they would otherwise be able to. And when your blood carries this surplus of oxygen throughout the body, it helps fight bacteria, as well as stimulates growth factors and stem cells, which help with the healing process.
A person's body tissues need enough oxygen to function; when you’re injured, your body requires even more oxygen. That’s where HBOT comes in: It can make a pronounced and positive impact on a person’s recovery. Consistent treatments in a hyperbaric chamber increase the amount of oxygen an individual's blood can carry.
Each day, Cook said, he would show up about a half-hour before the session started, to get his vitals checked. Then, he would enter the HBOT chamber, a process he says the team described as "a dive," because it "was like going down in a submarine." The end of each session was likewise described as "coming back up."
The inside of the chamber he described as "a very clear tube," from which he could see outside so clearly that he didn't really feel claustrophobic, as he had feared he would. He was able to talk to the members of his care team throughout the two-hour process.
The hardest part, Cook added, was that he had to remain "pretty much stationary" for the entire two hours of his treatment.
"That's not something you do too often in a teaching role," he joked.
He completed his last session on Nov. 12, Cook added — the only day of his treatment that he ran into bad weather.
"The treatment has furthered my healing to the point that every time I have a checkup, it progresses," Cook says, adding that his wound is now "about the size of a pencil eraser."
Last summer, Essentia Health in Fargo became the first hospital in the region to offer HBOT treatment, and this fall, a second chamber was added, enabling Ajayi's team to schedule up to five patients per day rather than just two or three.
The second HBOT chamber, which was funded in part by the Dakota Medical Foundation and Swanson Foundation, will have its use split 50-50 between treating patients and doing clinical research, in a partnership with the University of North Dakota School of Medicine and Health Sciences.
“We are excited to pioneer hospital-based hyperbaric medical services in the area and provide this care in emergent, inpatient and ambulatory settings,” Ajayi said.
“There is strong scientific and clinical evidence of HBOT’s effectiveness as either the primary treatment option for conditions such as carbon monoxide poisoning and air bubbles in the arteries, or an added option for other conditions such as tissue damage due to radiation, poor wound healing and ‘stroke’ to the retina (or back of the eye),” he added.
Currently, Essentia Health-Fargo uses HBOT to treat 14 conditions approved by the U.S. Food and Drug Administration, as well as the Centers for Medicare & Medicaid Services. These include facilitating healing in diabetic patients with foot wounds, thus preventing amputations; treating tissue damage resulting from radiation therapy; and reducing heart and brain damage in carbon monoxide poisoning.
Individual treatments — or dives into the chamber — typically last between 1-2 hours. The number and length of treatments depends on the nature of the condition being treated, Ajayi said.
And while Essentia Health is thrilled to offer this treatment to its patients, he noted, his team was just as excited to partner with UND to advance research around the benefits of this form of therapy — and thankful for the support of the Dakota Medical Foundation and Swanson Foundation, which are committed to advancing health care across this region.
“We are so grateful for these generous gifts to bring a new and vital service to our community,” said Susan Omdalen, executive director of the Essentia Health Foundation-West. “This new HBOT, and in particular Dr. Ajayi, make a huge impact on the care we provide our patients. We could not offer this expanded service without the support from our community partners.”