Friday, October 25, 2013

Immune hyperstimulation, Lyme disease, lymphoma, hyperbaric oxygen therapy (this post has an identity crisis)

My patient today is a 60 year old female who has suffered with severe Lyme disease for more than 3 years. At one point she was mistakenly diagnosed with tertiary syphilis.  Most recently symptoms have included: burning sensations, numbness, twitching, palpitations, flulike symptoms, difficulty walking with leg weakness, double vision, forgetfulness, brain fog, joint pains and mood swings. At this time she is very troubled by symptoms of head and ear fullness.

I will tell you a little bit more about my patient.  She suffers with chronic hepatitis C contracted from a blood transfusion in 1989. Several years ago she was diagnosed with Waldenstrom's macroglobulinemia -- before the Lyme diagnosis. This was treated with chemotherapy and plasmapheresis and she has done quite well.  Waldenstrom's is a type of B-cell type non-Hodgkins lymphoma.

A paper published in 2008, Archives of Internal Medicine, Koshiol et al, reviewed the relationship between WM (Waldenstrom's) and chronic immune stimulation.  Persons with autoimmune diseases had a 2-3 fold increased risk of developing the disease. In addition, certain infectious diseases were also linked to an increase risk of the disease. Prominently the authors mention Hepatitis C and rickettsiosis.  Autoimmune diseases listed include rheumatoid arthritis, Sjogren's syndrome, and MS.

WM is a rare type of lymphoma. Although incurable, it can have a rather indolent course. Suffering with Hep C, lymphoma and Lyme, my patient is most troubled by Lyme.

One might wonder if chronic Lyme disease might itself be a risk factor for the cancer.

Hyperbaric oxygen therapy has been somewhat helpful but she still experiences a fullness in her ear and head which are very bothersome symptoms. She has only been treated for one month and we are hopeful that additional treatments will provide additional relief of symptoms.  She has only had 20 sessions.  My patients have done better with 40-60 sessions.

There is a high pressure vs low pressure HBOT controversy. Many believe that HBOT for Lyme is only effective with the higher pressures typically available with hospital grade chambers. Pressures of 2.4 ATA are generally recommended. This equates with a diving depth of 49 feet underwater. Others have suggested that lower pressures, typically 1.5 ATA, equal to about 17 feet under water may be adequate or better.

Soft portable chambers on the market generally employ a pressure of 1.3 ATA, about 10 feet under water. This is the FDA approved pressure for such devices. Many patients report excellent results with these devices and pressures.

My Hyperbaric device is a bit of a hybrid. Some portable devices are built to handle higher pressures although they are not licensed by the FDA for pressures above 1.3. My portable, extra-strong chamber has 3 settings: 1.3, 1.5 and 1.6. The highest pressure, 1.6 is the equivalent of diving 20 feet down. I have found that all three pressures are effective but the higher 1.6 pressure seems to be the most effective. As an example, it worked well for this patient.

16 comments:

vtherbalist said...

Can you clarify what hyperbaric oxygen action is in Lyme? What is happening cellularly or refer to information that supports this treatment. Thanks!

Lyme report: Montgomery County, MD said...

HBOT therapy is complex and not the mechanisms of action are not entirely known.

On a cellular level oxidative stress and mitochondrial dysfunction are a major part of the pathophysiology of Lyme disease and other chronic illnesses.

Oxidative stress is related to excess free radicals, largely reactive oxygen species. Reactive oxygen species are not necessarily bad. They have antibiotic effects and are involved in molecular signaling pathways.

In the setting of HBOT, perhaps more at low pressures, a proper balance of reactive oxygen and reactive nitrogen species are formed with a net anti-oxidant effect

HBOT exhibits germ killing effect, improves oxidation, mitochondrial dysfunction and promotes the removal of toxins. HBOT decreases inflammation and allows oxygen to permeate areas of poor blood flow.

HBOT also helps antibiotics to better penetrate tissues.

It heals hypoxic damage and for example seems to have the ability to "train" brains cells traumatized by ischemia to function better in the absence of therapy.

HBOT has been used in a wide array of illness including autism, CFS, traumatic brain injuries. Patients with Lyme disease suffer with similar pathophysiology. The direct killing of pathogens and parasites may make this therapy particularly helpful.

Jeera said...

Great to know mild hyper chambers work too, but i am concerend about co infection, are not they will trive in oxygene rich body?...like babesa, bart?
Couple of patients report of babesa , bart symptoms increased, pre hyperchamber babesa negative, but post hbot babesa positive and severe fatique and pain in legs...
I am anxious to know your views on these...

Lyme report: Montgomery County, MD said...

I know this answer is a bit long-winded. This question keeps coming up over and over again. I do not know here this myth came from. But is absolutely false. I fear it may be keeping a lot of patients away from a treatment which might be very helpful.


If this were true nobody would get better since virtually every Lyme patient has co-infections. People do Herx with HBOT so getting worse for a while is part of the process. Oxygen does not act like a fertilizer to promote the growth of various aerobic pathogens/parasites. What is important to hear is that HBOT creates a milieu of: a natural antibiotic, decreased swelling, improved immune function overall, healing of diseased tissues, increased glutathione and improved mitochondrial function. HBOT is used to heal severe non-healing wounds in diabetics, patients with gangrene and other non-healing surgical wounds. All of these infections have a combination of anerobic and aerobic bacteria. The treatment kills both. And very importantly, HBOT helps break down biofilms.

Jeera said...

Now, thats what I call real doctor's answer.
I Hope people now realise it more that Hbot is indeed helpfull in fighting this lyme complex. But consistent long term use only can help. Not the few sessons.
Thanks for the answer doctor.

cdnsmith said...

So would pressures of 1.3 ATA be effective enough against Lyme and coinfections? How much would a portable chamber cost?

cdnsmith said...

Also how does it break down biofilm?

lymie said...

Is it possible to get any benefit from mHBOT if herxing is avoided. Can herxing be avoided? In some lyme cases, this causes more inflammation which does more damage.

Phoiph said...

Dr. J...

I just want to thank you for dispelling the "babesia loves oxygen" myth. I have been arguing this point with LLMD's and patients for a long time now.

Nobody to date has been able to show me any research that supports this argument, and, unfortunately, I talk to many people with babesia who are being dissuaded from pursuing hyperbaric by their LLMD's.

As we have discussed, I had full blown babesia and bartonella, along with severe neuro-lyme for 8+ years (5 years completely housebound), and am now well thanks to mHBOT...I have my life back completely...very active, no restrictions, drug free...

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