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Oxygen treatment eyed for PTS/TBI

Oxygen treatment eyed for PTS/TBI
Dr. Paul Harch gives a presentation of the use of hyperbaric oxygen chambers to treat post-traumatic stress and traumatic brain injuries to the Legion's PTS-TBI Ad-Hoc Committee. Photo by Steve B. Brooks

The American Legion’s Post-Traumatic Stress/Traumatic Brain Injury Ad-Hoc Committee was created last October to, according to its mission statement, “investigate the existing science and procedures, as well as alternative methods, for treating TBI and PTS currently being employed by the Department of Defense or Department of Veterans Affairs.”

During the Legion’s 51st Annual Washington Conference, members of that committee were given an in-depth presentation on one of those “alternative methods.”

Dr. Paul Harch of New Orleans briefed the committee about his use of hyperbaric oxygen chambers to treat TBI and PTS, commonly regarded as the signature wounds of the war on terrorism.

Harch has used hyperbaric oxygen treatments for dozens of U.S. veterans who suffered injuries resulting in TBI and who have developed PTS. He recently finished up a study on 15 patients who showed improvements in several physical and mental tests after a series of hyperbaric treatments, which involves patients breathing pressurized oxygen inside a sealed chamber.

Patients went through a battery of pre- and post-treatment tests. Test subjects showed an average IQ improvement of nearly 15 points. Thirteen of 15 saw a reduction in headaches, while nine of the 12 who reported sleeping issues cited an improvement. Seven of 11 subjects on prescription medication for their conditions began using that medication less frequently or discontinued use of the medication following the treatment plan.

Harch also used the military’s PTS checklist and scored all of subjects before and after the treatment plan. The subjects showed a 30-percent reduction in how they scored after being treated.

“All of the data and statistics I showed you is necessary,” Harch told the committee. “But these were real people. These were brain-injured men and women whose lives are literally destroyed by these injuries. What is not shown here, and what I can’t quantify, is the impact (hyperbaric oxygen) has had on them and their families.”

Harch cited as an example U.S. Army Reserves Brig. Gen. Patt Maney, who was injured by a roadside bomb in Afghanistan. A judge in Florida, Maney was undergoing cognitive therapy at Walter Reed Army Medical Center that “helped a little bit,” Harch said. But Maney’s condition was still so bad that he was unemployable.

Maney underwent 80 hyperbaric oxygen treatments and is back to the bench in Florida, functioning as a judge once again.

But Maney is just one of several success stories, Harch said. Yet there remains reluctance on the part of DoD and VA to use the procedure for wounded veterans. The primary reason is pretty clear to Harch.

“It’s the price tag,” he said. “I firmly believe that’s No. 1. We charge $200 an hour at our clinic. The Medicare rate is about $275 an hour. This is billed in hospitals at $2,000 an hour. DoD has thrown out a figure that you need $500,000 lifetime to treat a brain-injured veteran for these symptoms and problems. First of all, there’s no evidence for that. Secondly, if you even took the 80-treatment protocol that I developed, that’s $160,000 at the billed hospital rate … The reality is the treatment with drugs and all these other therapies is doubly expensive.”

Harch said the other issue is an out-of-date perception of the procedure.

“What was I taught at (Johns Hopkins University)?” he said. “This is my generation of doctors. We were taught that (hyperbaric oxygen treatment) is a fraud, and the reason is nobody understood how it worked. It got a bad name when it was applied to multiple sclerosis. People stood up and claimed it affected impotence, balding and cancer.   There is so much misinformation. In my generation of doctors, we have been led to believe this is a scientifically disproven, fraudulent type of therapy. We’re working against this past body of misperceptions.”

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pharch

March 21, 2011 - 1:29pm

Dear Mr. Ireland, I agree with your desire to continue to use PTSD instead of PTS. It is a medical condition. I think that taking the "disorder" out of PTSD minimizes the problem. Everyone has "stress" in their lives, but most of us do not have "stress" to the level that warrants constant medical therapy. When stress reaches this threshold we call it a "disorder", as in PTSD. The HBOT billing differential above is a dysfunction in our healthcare system. Hospitals inflate charges to compensate for indigent care. For some therapies the actual billing is rapaciously inflated, as in HBOT, imaging studies, etc. The reality is that the insurers often negotiate bulk contracts with the providers so that their actual payment is about half of the charge, or $1,000-$1,500/treatment in the case of HBOT. This is still ridiculously over cost compared to the freestanding center. In the military HBOT can be delivered for about $50/treatment. Dr. Harch.

Bob95490

March 21, 2011 - 10:26pm

Thanks Doc for your reply. I'm still serving with the American Legion and your response might help me explain the change in nomenclature to other vets. At least I hope it will. On the other hand, I'm sure your response to the fiduciary amounts will result in a WTF moment for most of us. Your honesty about the rapaciousness involved in billing is sure to raise many more questions than it answered. This outrageous inflation of cost is something all taxpayers and voters should be addressing both with their Congresspeople and through their service organizations. I'll do my part and begin writing letters to my Representatives and Senators, and will ask my Post to add their voices to mine. Keep up the good work; we need more people like you on our side. Robert Ireland - Post 174 (PUFL)

Bob95490

March 20, 2011 - 10:36pm

While I have real time intimacy with the Medicare / Medical system and understand that adding $75 to the amount charged helps to achieve the $200 an hour billing the addition of $1800 to hospital costs, considering the taxpayers already pay for veteran treatment in VA/Military hospitals, seems to be so much over-the-top as to be completely unjustified. Thus the question arises, where is the $1800 figure generated from? I may be subject to nasty remembrances and associated crap but that doesn't impair my ability to do mathematics. WHAT IS GOING ON? Robert Ireland - Post 174 (PUFL)

Bob95490

March 20, 2011 - 10:19pm

Thank you Dr. Harch for your presentation but more importantly thank you for your efforts on our veterans behalf. As a combat veteran that receives service connected disability for PTSD (I'm not really comfortable with the new PTS designation - it seems to attempt to sweep under the rug the disorder to ones life post traumatic stress causes) I wish that your research had been available upon my return from Vietnam. Please continue to provide this service (your presentation) to the Department of Defense and Veterans Administration despite their reluctance. Now to the fuduciary numbers; I am at a loss to understand why it costs $200 an hour at your clinic, $275 an hour for Medicare but $2000 an hour in hospitals. Since wounded veterans are treated by the government at government hospitals and TBI/PTSD are wounds received by participating in combat it seems to this poor old soldier that there shouldn't be such a discrepancy in the amounts billed. Robert Ireland - Post 174 (PUFL)

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