Only one local source for ‘off-label’ treatment

Hyperbaric oxygen therapy began as a treatment for deep-sea divers suffering from “the bends,” expanded in use for wound care and a few other conditions and gained notoriety as one of pop icon Michael Jackson’s bizarre habits.

Professional athletes such as Tim Tebow and Terrell Owens have embraced hyperbaric chambers for injury recovery, and the therapy is steadily gaining a following among patients who see it as an effective treatment or cure for a host of ailments – without the support of widely accepted science.

The Spokane area offers two choices for this therapy. One is the Regional Hyperbaric Center that opened in 1998 at Deaconess Hospital. Three single-person hyperbaric chambers are used to treat patients with radiation injuries, diabetic foot ulcers and a short list of other conditions covered by Medicare, Medicaid and most private insurance.

“When we started doing this, we made a very conscious decision that we were not going to treat patients ‘off label’ primarily because we wanted to stick to the indications that have the science, the controlled studies, the authoritative research that prove that hyperbarics works for those indications,” said Dr. Greg Jones, the center’s medical director. “And so we have steadfastly stuck to those indications for 17 years.”

The other option is the private, independent Spokane Hyperbaric Center in Spokane Valley, where a large hyperbaric chamber can seat up to 16 patients at a time.

“We treat people that generally have pretty devastating diseases, that are pretty involved physically with their maladies,” owner Al Griffone said.

The clinic treats patients for about 70 conditions, he said, including autism, cerebral palsy, multiple sclerosis, Crohn’s disease, Parkinson’s and traumatic brain injuries.

On a typical day, Spokane Hyperbaric will treat 12 to 15 patients. Some are referred there by their doctors; others come on their own.

The clinic touts the benefits of the therapy in promoting blood vessel growth, decreasing swelling and inflammation, increasing the body’s ability to fight infections, helping the body discharge toxins and metabolic waste products, and accelerating the rate of healing.

“When you take an aspirin, the aspirin doesn’t know if you have a headache or you sprained your ankle. All of a sudden your headache is gone or your ankle stops hurting. Oxygen is the same way – it’s systemic,” Griffone said. “It doesn’t know if you’ve got a problem with traumatic brain injury or you’ve got Crohn’s disease. In both cases you probably have a lack of oxygen, either to the brain or to the intestines. And it works systemically.”

The U.S. Food and Drug Administration has not cleared hyperbaric oxygen therapy as an effective treatment for cancer, autism, diabetes, Alzheimer’s disease, asthma, heart disease, migraines, multiple sclerosis, Parkinson’s, stroke, cerebral palsy, AIDS and several other conditions for which patients have sought the treatment.

Many patients are drawn to it through testimonials they find on the Internet, Jones said. But other than the 15 conditions approved for insurance coverage, “none of those have been substantiated with enough rigorous scientific evaluation to become accepted indications,” he said.

Take, for instance, multiple sclerosis – a popular condition for off-label hyperbaric oxygen therapy.

“It’s very clear that some people get some improvement for a limited period of time, and then they lose that improvement,” Jones said. “And that’s been proven by studies for decades…. It doesn’t cause measurable, durable improvement in patients’ symptoms, so there’s really no point in going further with that.”

He said he regularly speaks with people interested in off-label hyperbaric oxygen therapy and explains why Deaconess cannot accommodate them.

“If the science isn’t there, then I can’t in good conscience say we’ll give it a try,” he said. “It’s just far too expensive, and I cannot bill their insurance companies for those treatments.”

Jones said while he would not encourage anyone to pursue treatment likely to have no effect, he has told many patients to call Spokane Hyperbaric Center and talk with them about payment options if they want to get treated there.

Griffone said, “We have parents particularly that come to us and have children that have just devastating things that happen to them. … They don’t have an awful lot of hope. And they would like to get their children into the hyperbaric chamber because we have had success treating those conditions.”