Weighing the Results: Patients and specialists share stories
about Hyperbaric Oxygenation Therapy
By Patricia McAdams
While Hyperbaric Oxygenation Therapy (HBOT) promises relief
to many individuals with Reflex Sympathetic Dystrophy (RSD)
and Complex Regional Pain Syndrome (CRPS), everyone's experience
with this therapy is different.
Glenn J. Shamdas, 48, who has had CRPS for seven years, tried
HBOT because of a recommendation from a friend after she received
a complete remission. He was not helped.
"I had a total of 20 sessions in four weeks - which is
a commonly prescribed schedule. Unfortunately, in my case,
no significant improvement was experienced."
Dana Marsolino, 52, who was in two bad car accidents and is
still in a lot of daily pain, found no relief either. "I
tried the hyperbaric chamber four times and had to quit due
to my bad shoulders and neck," she says.
"I could not tolerate lying inside [the chamber] for
that length of time, no matter how they adjusted the pillows."
Laura Rentsch, 45, has a somewhat complicated story. She
had 20 sessions over four weeks, but endured considerable
"During the dives I would experience deep pain in my
RSD leg that would subside when we got to the final depth.
I would also experience vertigo frequently after the treatment."
Rentsch said that her swelling calmed down and she had better
range of motion in her foot for some time, but she had also
been given two Pamidronate treatments prior to the HBOT. Pamidronate
helps with constant deep bone pain and she believes this drug
did help her.
"Ultimately I cannot say the HBOT helped me, but I can't
say that I would not recommend it to others. It may very well
have helped me, but other contributing factors that lead to
less swelling and better range of motion need to be considered.
My treatments occurred during the summer and I generally have
lower pain levels and better range of motion during warmer
weather. And the Pamidronate did reduce the bone pain."
Susan Rodriguez, who has been a certified hyperbaric specialist
from San Bernardino, Calif., for many years, says that she
has not heard of this problem before. Vertigo is an extremely
unusual side effect. She suspects it may have been triggered
if a patient had an underlying vestibular problem to begin
with. It may have been a result of Rentsch's reaction to the
Pamidronate. It could also be the result of compression or
decompression or other underlying factors.
Indeed, Rentsch had a severe reaction to the Pamidronate.
It caused sudden hearing loss and extreme tinnitus - a loud
roaring motor sound in her ears. Certain powerful medications,
particularly those given by IV, as Pamidronate was given to
Rentsch, can literally poison the ears of genetically susceptible
individuals. Ear poisoning can affect one's hearing or balance,
or both. In this case, it is possible that an underlying vestibular
problem may have been present.
A more common side effect of HBOT is claustrophobia. For
some, like Deb Brown, 60, of north central Florida, claustrophobia
was too big a hurdle to overcome. One session was quite enough,
she says. There were only two very small sections of clear
plastic in the particular chamber she was in that she could
look out of during the session.
"I dare say it felt like it had done some good,"
says Brown. "Perhaps had I been sedated with an extremely
light sedation, I would have handled it better."
According to Allan Spiegel, M.D., Palm Harbor, Fl., the claustrophobia
problem is minimal for most of his patients, because his chambers
are like clear glass. Still, about 10 percent of his patients
struggle with this problem, as Brown did. He gives them sedation,
however, if they need it. "Mild sedation works wonders,"
"But one of my patients overcomes the problem by closing
her eyes after she lies down on the cot, before being wheeled
into the chamber. For some reason that makes a difference,"
he says. "And then we put some calming music on."
There are several kinds of chambers used for HBOT. Spiegel
uses Sechrist chambers in his medical center. Rodriguez, however,
prefers Gulf Coast chambers, which she says are somewhat larger.
Patients can sit in these chambers and they will be very comfortable.
These chambers are 13 feet long and five feet around.
"No one has ever become claustrophobic in our chambers
because of the large size," she adds.
While the effectiveness of this therapy may vary from individual
to individual, for some, it has been a Godsend.
Tanya Kee, now 33, had a knee injury in 1999, followed by
surgery, which made the knee worse. She developed RSD in her
leg, which put her into a wheelchair.
About three years after her original injury, Kee learned
about HBOT and went through 56 sessions with success for her
right lower leg and foot.
"Probably within a half dozen dives, I noticed a difference,"
she says. "Even my friends said that I looked amazing,"
she added, noting that oxygen affects so much of the body.
Kee's leg improved slowly, but steadily. "After about
two months I went from being in a wheelchair for the most
part, to walking and being able to lead a much better life."
Unfortunately, she had to stop therapy because she sustained
a new injury to her arm at this time that caused her RSD to
spread to her arm, neck, back, neck and right side. She said
that HBOT increases blood flow in muscles and makes her muscles
"Prior to that, though, it was a great experience,"
she says. "My leg has not worsened since then. It's still
painful, but I don't use my wheelchair unless we go to Disney
or places where we do a lot of walking."
Elsie Eten, age 57, had suffered with RSD for nine years
before she learned about HBOT. Eten, who Spiegel calls his
"Poster Child," (See: Hyperbaric Oxygenation Therapy:
Can it relieve your pain?) had endured years of medical procedures
before she met Spiegel and began treatment.
"I was at a point in my life with the RSD and pain that
I was ready to try anything, or I was ready to die, because
I could not take the pain anymore.
"After the first few days I could feel the difference,"
she says. "I was feeling better, the pain was less, and
I was taking less pain medication.
"After four weeks, I was pain free for the first time
in eight or nine years. I slowly quit taking Oxycontin, Loratab,
and Zanax. About two weeks later - six weeks after I began
therapy - I was pain free and drug free. I could not believe
"I wanted to go back to nursing so badly that I think
I went back too soon. As soon as I was off my medications
I went back to work without getting my body back into shape
and strong. After a month at work, my pain started to come
back. After three months, I had to quit my job because of
my pain. I had to start taking Laratab again too."
Eten says she goes for HBOT treatments every five or six
months and it still helps. She is unable to work, but she
is able to go out with her husband sometimes and see friends.
"Even though I am not cured of RSD, I feel like I got
some of my old life back. I recommend HBOT for RSD. My doctor
told me when you have chronic pain, it takes a lot of different
modalities to keep the pain at a manageable level and I believe
Connie Waltz, director of nursing at the Robert M. Lombard
Medical Center in Columbia, Pa., where Eduardo Pace is being
treated (See: Beyond Pain: Some hope for healing), has treated
a number of individuals with RSD.
"Absolutely, I would recommend Hyperbaric Oxygenation
Therapy for RSD," she says, adding that the sooner a
person starts HBOT after they have been diagnosed, the better.
Patients who have had RSD for a long time are tough to treat.
The two patients they had, who were newly diagnosed, had especially
"One person stopped after 10 treatments, because of
financial reasons," says Waltz. "She saw amazing
results. She could open her hand and use it. The swelling
went down. The natural pink color returned, instead of a dusky
"The other person had it in his shoulder," she
says. "Within 20 treatments, he had range of motion."
Hyperbaric Oxygenation Therapy appears to be one more tool
in the toolbox of managing chronic pain for many individuals.
Like Spiegel and Waltz, Rodriguez is passionate about the
ability of Hyperbaric Oxygenation Therapy to make a difference
for patients with RSD.
"RSD can shatter your life," she says. "Mothers
can't be mothers. Husbands can't support their families. Kids
can't lead normal lives. And no one believes you about the
"People's lives depend on this therapy," she says.
"Integrated with other ongoing therapies, it holds real