HyperMED Newsletter August 2006 Welcome to our monthly newsletter. Each month we will provide a short informative read regarding the latest developments in Hyperbaric Oxygenation and emerging products we believe important to facilitate and enhance your health and recovery. In addition several current patient testimonials will keep you up to date with the benefits of HBOT saturation. Australian FIRST - LOKOMAT to arrive November 2006!! HyperMED has finally secured the first Lokomat Robotic Walking Device for Australia and New Zealand. HyperMED will also represent the Swiss company Hocoma International with both Lokomat and other exclusive neuro-rehabilitative products for the Australasian market. “This has been a quest of mine since the first clinical trials were published back in 1999. Robotic rehabilitation has emerged as a major breakthrough in the management of neurodegenerative disorders. Spinal Cord Injury, Stroke, Cerebral Palsy, MS, Motor Neuron Disease, Parkinson Disease and all forms of progressive neurodegenerative disease can be greatly influenced with robotic rehabilitation.” says Dr Hooper. Lokomat has emerged with considerable success across Europe and America. The USA has 14- hospital based Lokomats’ with the FDA now providing funding for robotic assisted neuro- rehabilitation programs including Lokomat. The Chicago Rehabilitation Hospital (www.ric.org) has 2-Lokomats and recently featured a quadriplegic 13-year old girl who suffered spinal cord injury after diving into a swimming pool and hitting her head. The young girl only moved her big toe on one occasion within the 3-month period after her injury. After considerable lobby and financial support she was transferred to Chicago Rehab for an intensive rehabilitation program using Lokomat over a 2-year period. This story was featured on the NBC program across the USA; she walked out of the hospital! Subsequent to this story Christopher Reeves had begun using Lokomat as well. Recent study published in the Spinal Cord Inj Rehabil 2005: 11(2): 34-49; Robotic powered gait rehabilitation improved in excess of 80% of wheelchair bound patients suffering incomplete spinal cord injury; participants of the program gained significant functional returns including functional walking ability after robotic training! “Without going into technicalities, robotic rehabilitation can alter the course of a disease process and ultimately the individual’s quality of life. You do not have to just live and cope with disability. The mantra of Chicago Rehab and other progressive facilities is - use it or lose it and if you’ve lost it then get it back!! says Dr Hooper. Lokomat is being used world wide however has not yet developed in Australia due to lack of Medicare funding. Lokomat has featured on numerous medical documentary programs across Australia. The USA FDA has approved Lokomat for a multitude of conditions and we are confident that Medicare funding will follow. The Lokomat provides "gait training" by moving the legs in a normal physiological pattern that helps the spinal cord and brain to relearn the walking process; this is referred to as ‘neuroplasticity and functional restoration’. A harness supports the patient's body weight over a sensory assisted treadmill. The patient’s legs and hips are strapped into the Lokomat robotic exoskeleton, which simulates a ‘fluid walking motion’. A computer records precise movement measurements and plots them on a graph, which is displayed in real time on a nearby monitor and allows patients and therapists to track progress. Lokomat robotic functional training is driving CNS (central nervous system) reorganization and regeneration (neuroplasticity) in both the damaged spinal cord and injured brain. Functional MRI and brain SPECT scans confirm increased metabolic activity in damaged areas indicating neurovascular salvage. Incorporation of Lokomat is unique to Hyper-MED Australia The combination of hyperbaric oxygenation, whole body vibration and other stimulatory treatment has already provided amazing results with vast numbers of patients attending our Melbourne facility. In excess of 75% of attending patients are from interstate and many from overseas. We believe the addition of Lokomat has the potential to provide further benefits. Patient welfare and quality of life can be further improved. Lokomat success overseas can be mirrored, and in fact be significantly enhanced by combining hyperbaric treatment and other proprietary measures. HyperMED Institute Is your doctor interested in being a part of HyperMED? We are seeking designated HyperMED practitioners and clinic facilities. The HyperMED Institute has registered all intellectual property and intellectual capital developed under Dr Hooper. The Institute grants head licence in terms of the commercial application to HyperMED Australasia Pty Ltd which is the existing Melbourne Hyperbaric and Spinal Rehabilitation Group at 15 Collins St Melbourne. The purpose of the HyperMED Institute is to move towards the development of other HyperMED recognised facilities across Australia and Asia. This requirement is essential. The cost associated for patients attending from interstate and OS is excessive not withstanding the fact that many patients require the ongoing benefits of Hyperbaric Oxygenation and certainly Lokomat when available. Hyper-MED Australasia will grant sub-licenses to various practitioners with the emergence of HyperMED designated clinics. All practitioners and clinic facilities will be required to comply with the protocols, procedures and rules as determined by Hyper-MED Institute. This protects the protocols registered ensuring the safest, optimal and cost effective approach to patients attending using the merits of the HBOT application. For more information on the latest development in Hyperbaric Oxygenation, Stem Cell Therapies and functional rehabilitation; visit our web site at www.hypermed.com.au Do you have a specific question then email email@example.com and Dr Hooper will reply. If you would like to speak with our staff or to arrange a consultation to discuss Hyperbaric for your condition then call us on +61 3 9650 3136 (Melbourne). Are you suffering Chronic Back Pain? Do you have Tarlov Cysts? – You would be surprised how may are missed! Tarlov cysts are spinal nerve root lesions filled with spinal fluid, found most often below the L5/S1 disc at the sacral level through additional MRI scanning. Tarlov cysts can be asymptomatic presenting with no symptoms or may be ‘triggered’ (infection, post operative scarring, trauma, inappropriate manipulation, etc) causing serious pain and progressive neurological complications called Tarlov disease. Many individuals suffering chronic ongoing back pain may in fact have undiagnosed Tarlov cysts. MRI is required of both the lumbar and complete sacral spine. CT Scans and traditional MRI are generally limited to the lumbar spine and at the L5/S1 level. However Tarlov cysts are typically BELOW the L5/S1 level and often not diagnosed! Hyperbaric Oxygenation (HBOT) and Tarlov Cysts HBOT pioneered by Dr Mal Hooper for the treatment and management of Tarlov cysts has been innovative. Many patients with failed back surgery often have the finding of Tarlov when MRI investigation is taken below the level of the disc operated i.e. L5/S1 level. Surgery to a degenerative and bulging disc in an attempt to alleviate chronic pain is often unsuccessful simply because the pain is NOT coming from the disc. Hyperbaric Oxygenation is a method of breathing 100% oxygen at levels greater than normal atmospheric pressure. HBOT dissolves greater amounts of oxygen into the brain and spinal cord structures. The cerebral spinal fluid oxygen levels are greatly elevated which immediately reduces chronic inflammatory hypoxic induced irritation to the cord and nerve roots. HBOT is safe and non invasive; providing an effective measure to control Tarlov pain and in instances - reduction in the size of the fluid filled Tarlov cyst. Katie Coates - Tarlov Cysts Katie has suffered a 30-year history of complex back and leg pains. She grew up on the family farm riding horses, mustering cattle, performing heavy farm work and for relaxation she competed in horse riding events and played competitive polo cross. She had a long history of horse related falls and injuries. Katie sought a multitude of treatments and therapies over the years including manipulation, physiotherapeutic supports and even cortisone injections. Over more recent years she has suffered pins and needles and progressive weakness in her legs. On several occasions Katie requested an MRI of her back but informed by her various doctors that MRI was not necessary and her condition could be ‘fixed’. On referral to HyperMED; Katie was immediately referred for a full spine MRI which revealed a large tear of the L4/5 disc and an extensive Tarlov sacral cyst. Manipulation is contraindicated and this also explained why the “cortisone injections to the inside of her sacroiliac joints made my back worse!” Intensive saturation was commenced and within 40-hours of HBOT combined with specific immune stimulating injections and appropriate physical therapy resulted in dramatic reduction of her back and leg pain. “I am pain free for the first time in years – this is unbelievable! The constant swelling in my back is gone; I have no pins and needles and none of the constant pain I had been suffering” says Katie. Kite-surfing Champ ‘Kaos’ alias – Richard Milne Kite-surfing champ ‘Kaos’ suffered terrible back and spinal cord injury and lost temporary use of his legs after ‘looping’ his kite and being pile driven in shallow water in 50kmh plus winds. MRI revealed a massive disc rupture compressing his spinal cord; incidentally an old fracture in his lower back was also detected. After an initial intensive saturative period of Hyperbaric Oxygenation – ‘Kaos is back’ on the water and ‘boosting’ 15 meter high jumps and landing without problem. Chris Beckett T11-12 Paraplegia “During 2005 I was practicing for an up coming motocross race when I swapped bikes with a friend. Before I knew it I was upside down in the air and landed on my backside. I was carted off in an ambulance and after x-rays and various other scans they told me I had burst fractured my T12 vertebra and that it would have to be fused in an operation. They fused from T11 to L1. Although I only had two bone fragments logged in the spinal cord it was enough to paralyze my legs with no feeling and this stopped both my bladder and bowel function. After spending 4 months going through the Austin spinal ward and the Royal Talbot, they sent me home and told me to have more physio therapy and occupational therapy. After about a month of being home my dad told me about the rehab program at Melbourne Hyperbaric and Spinal Rehabilitation Group using Hyperbaric Oxygenation, acupuncture, vibrations and other stuff; I started the treatment without any great expectations. Before starting Hyperbaric I could move my left foot a little but after 20-30 hours of Hyperbaric Rehab I noticed I had a lot more activation, strength and control. At about the 50-60 hour mark I noticed my gluts (which were very weak) were starting to activate. By the 90-hour mark I noticed I could lift my right foot and another 10 hours later I could lift the left one slightly. Most recently I have noticed that I have regained control over my right foot and I can move the foot up and down. I’ve almost got all my feeling back, also my balance has improved 10-fold. And I’m back riding my motor bike again!” says Chris. Anita Sousa - C5/6 Quadriplegic Anita was left paralyzed after a tragic horse riding accident but believes that miracles can still happen! Anita and her family have been down this road before; her brother suffered a terrible work related injury resulting in him being left paraplegic 10-years ago after a steel beam fell across his back. Anita attended Melbourne because Hyperbaric is not available for spinal patients in Perth. “After 80-hours of intensive HBOT therapy I have higher energy levels; better temperature control; able to breathe deeper; my transfers are easier as I am able to assist with the transfer; my trunk control and has improved and overall my body has become more supple: my fingers are definitely more active, supple and responsive; my arms are stronger and have greater directional control; muscle tone in the legs has increased; sensation and feeling in my arms and hands have also improved dramatically; my posture in the chair is better; I have more awareness of body position and comfort whilst in the chair or bed; I have increased sensation all over body especially along my lower back and buttock regions; I am now able to fully stretch fingers straight; when relaxed my fingers are now in a more neutral position and definitely not as clawed.” says Anita. Anita is also looking at going overseas for stem cell therapies to assist her recovery! Horses and Hyperbaric Oxygenation Horses and Hyperbaric has become main stream in the veterinary industry. It is common to read about race horses undergoing intensive hyperbaric to speed recovery, reduce chronic swelling, and enhance performance. It is also common to read about AFL footballers and NRL rugby players gaining the hyperbaric advantage. But did you know that HBOT is also being used to increase horse fertility and offspring outcomes. HBOT increases sperm count, HBOT diminishes risk of spontaneous abortion. As brood mares age their ability to fall pregnant diminishes; and the risk of offspring complications are increased. The older brood mare loses vital function in the placenta which becomes deprived of oxygenated blood; placental hypoxia causes inadequate blood flow to the developing brain of the foal. Hypoxic injury to the foal’s brain results in a condition known as ‘Dumb foal’ with all International Veterinary colleges teaching and recommending the use of – Hyperbaric Oxygen Therapy. However if the mother is human and if the baby suffers an ‘hypoxic injury’ often referred to as ‘Cerebral Palsy’ ‘Delayed Development Syndrome’ etc then why isn’t Hyperbaric Oxygenation recommended as the first line of therapy? Botox injections used to control spasticity in CP children does not correct or alter brain hypoxia! Chloe Block – Near Drowning (Anoxic Encephalopathy) “Hi Mal - Here is a little story thing for Chloe. Chloe was involved in a near drowning at the Cook and Philip Park Pool Sydney on the 23rd December 2005. Chloe died at the pool and was resuscitated and taken to Sydney Children's Hospital. After 8 days in a coma, Chloe woke on New Years Day and we thought that Chloe was back. Little did anyone know that this was not the movies, where you just spring back to normal after you wake up. The ramifications of this tragedy are that this vibrant little 3 year old angel can no longer, walk, talk, sit, and is fed through her stomach. Since being released from hospital on the 12th April, we have worked very hard with a team of family and friends on an intensive rehabilitation program for 6 hours a day on Chloe. Chloe is showing signs of improvement. The medical world in Australia does not offer much hope. One doctor told me to go home and make Chloe comfortable. Chloe is 3 not 90! Anyone who knows Chloe will not stop working with her until she is back how she left the house on the morning of the 23rd December. We decided to try HBOT after reading many success stories from America with Children who have suffered a near drowning. Chloe has done 60 sessions of Mild Oxygen Therapy and seen some improvements, but due to the extent to her condition felt that she would benefit from a much stronger form of oxygen – Hyperbaric Oxygenation. We decided to make the trek to Melbourne for two weeks in July 2006. During this time we completed 56 hours of treatment. After about the 20th treatment Chloe's thumbs stared to move a lot more and her hands were staying open longer. During the second week, Chloe also seemed to realize where she was and would put on a sad face when we told her it was time to go back into the chamber. Our happiest moment though was on the last Saturday when my mum stood at the chamber and looked in and Chloe looked straight at her and smiled! Overall we feel that the chamber has been beneficial and have booked to go back again for 30 more treatments next month and then 60 treatments the following month. The changes that we have seen so far since starting Hyperbaric Oxygenation have been amazing! • Chloe is now able to roll over • Chloe's hands are staying open and she is able to grip and release objects when you ask her to. This is hard work for her but she really tries to do this • Chloe's eyes are starting to focus more and if you ask her to try and find your face she can get there • Chloe is smiling a lot more. She could smile before we had the treatment but this was really only if you asked her to. Now she is smiling when she is happy • Chloe is also laughing which is very special We returned to our Physio, OT and Speech Therapy today which is done with all 3 therapists at the same time. They were impressed with the results that they could see and how Chloe was starting to understand what she was being asked to do. We plan to have a stem cell transplant in November and feel that the Hyperbaric Oxygenation will help prepare the brain for the best environment possible for the stemcells to take effect. The changes that we have seen so far are very promising and we have only done 56 treatments. We hope to keep seeing more improvements”. Michelle (mother of Chloe) Cerebral Palsy – Spastic Diplegia (Periventricular Leukomalacia - PVL) Daniel suffers cerebral palsy with spastic diplegia. His mother states that she suffered late pregnancy complications - preeclampsia resulting with Daniel being delivered 12-weeks premature. He was not diagnosed until after 12-months of age because he was behind the normal development milestones. Daniel received corrective hip surgery and a course of several botox injections without sustained improvement. MRI investigation prior to commencing HBOT revealed T2 hyperintensity in the deep white matter adjacent both lateral ventricles consistent with periventricular leukomalacia related to prematurity. Daniel’s mother says ‘After only 12-sessions of HBOT Daniel is now standing upright when attempting to walk with his crutches. Before therapy he was unable to walk independently more than a few steps at a time. Even with his crutches he would tend to lean forward completely supporting his weight over his crutches. He is now able to walk with his heels down. Before commencing HBOT he only ever walked on his toes or some times on the toes and ball of his foot. Daniel is normally very weak in his trunk and tends to lean to one side when sitting for any period of time. When sitting in the car, he tended to fall over from side to side. Since starting HBOT he is now able to sit more upright. Previously he would lean backwards when seated on the toilet seat, now he can sit upright without requiring support. Daniel’s walking with his crutches has also become a lot quicker. Daniel dresses himself in the mornings even though it is a big effort for him to do, but this is also becoming a lot quicker and less dramatic task for him to do. Another amazing change is Daniel used to be a bed wetter; before HBOT he had this problem every night. Since starting HBOT he is now only having an accident at night approximately once per fortnight. After 18-HBOT sessions the parents reported that Daniel is ‘now walking in excess of 18-minutes without the use of crutches. Before commencing HBOT treatments he was completely incapable of this accomplishment. Walking has become a lot smoother, his legs are not as stiff and he is no longer walking like a ‘robot’. Daniel is now capable to lift his legs high enough to get himself into the car'. His grandparents have also reported that they have observed he is now capable of using his hand and fingers with greater dexterity. Daniel had difficulty with upper limb dexterity easily fatiguing when attempting to feed himself using a spoon and bowl. He is now capable of independently finishing his meal from a bowl. According to his grandparents’, this ‘activity has improved considerably’. Baby Jessi Rae Clarke - Cerebral Palsy Dystonia [Feed-back from Aunty Deb about Jessi Rae’s progress after 40 hours of HBOT at HyperMED | Melbourne Hyperbaric]. “You don’t want to get your hopes up too high, but I am pleased to report that changes were noticeable after only 16 hours of treatment. Normally Jessi’s fists were constantly clenched, but we all noticed they were much more relaxed after the first week. Angela told me that for the first time as a Mum she felt Jessi’s hand open and resting on her hand. I then noticed a week or so later while putting socks on her, her feet were not pointing straight down like a ballerina’s. I was able to put socks on her feet in the normal position, and her feet have continued to be more relaxed. The most dramatic change has been the use of her eyes and head. In the past unless you were in Jessi’s sphere she did not respond to you, now she seeks you out by using her eyes or if you are out of range she now physically moves her head to check you out. Jessi is coming back to Melbourne for another block of HBOT and we are hopeful of further improvements! If you would like to talk to other parents about Hyperbaric Oxygenation for your child then email Dr Hooper and we will send you the HyperMED Cerebral Palsy Support Group which provides a detailed list of parents, children and contact numbers to help you in this journey. Key changes consistently observed: Typically parents report improvement in gross motor function (reduction spasticity), reduction of seizure patterns, improved coordination (eye and hand patterns), gait (crawling; walking) neuro-cognition including attention, communication, vocalization and behavior; improved sleep patterns; improved bowel and bladder function; significant reduction in the number of colds and infections.