Ed Nemeth HBOT NFL: Healing Powers

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Ed Nemeth tells his personal compelling story abut hyperbarics and how he discovered the benefits of HBOT. His exploration into HBOT led him to open his own clinics in Sacramento where he met and treated retired football player George Visger.

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Ed Nemeth HBOT NFL: Healing Powers

  1. 1. NFL Brain Injuries, Treatments & Medical Rights<br />Ed Nemeth<br />Rebecca’s Dad<br />Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />
  2. 2. Who am I?<br />The loving and faithful<br />father of Rebecca, <br />a severely disabled child! <br />Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />
  3. 3. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Who am I?<br />Rebecca’s Dad!<br />Trained as a scientist - objective<br />Researched nerve regeneration / plasticity<br /> Department of Neurobiology,<br /> University of Vermont Medical School <br />Businessman / Entrepreneur - pragmatic<br />
  4. 4. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Our Journey Birth, Death & Resuscitation<br />
  5. 5. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Our JourneyComa<br />
  6. 6. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Our Journey~~ The Journey! ~~<br />
  7. 7. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Our Journey~~ The Journey! ~~<br />
  8. 8. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Our Journey<br />Hypberbaric Oxygen! <br />Dismissed HBOT in 1998 <br />Struggled to get help for Rebecca<br />Mouth-to-mouth rescusitation 9 times<br />1-hour long static gran mal seizures monthly<br />Bronchitis & pneumonia 6 times a year<br />Weak, myriad challenging problems<br />Then…. Surgical Neurology, vol 10 Oct. 78<br />Ischemic Penumbra reversed @ 7 years post injury<br />HBOT “had to” work!<br />
  9. 9. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />What we did!<br />Went to Dr Neubauer’s HBOT Clinic in Florida<br />For Hyperbaric Oxygen Therapies - HBOT<br />40 Sessions in 2 months July-August, 2000<br />Great immediate responses<br />Horrible SPECT scans<br />2nd SPECT’s showed great response!<br />
  10. 10. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Fantastic Changes!<br />Went seizure and drug FREE for 6 years!<br />Could maintain own body temp. at night!<br />Pneumonias and bronchitis STOPPED!<br />Feeding time dropped from:<br />1 hour 10 minutes to 20 minutes!<br />Gained coordination (had NONE!)!<br />Gained endurance and strength (had NONE!)!<br />
  11. 11. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SPECT Scans Single Photon Emission Computed Tomography<br /><ul><li>Uses Ceretec radio-isotope
  12. 12. Crosses blood brain barrier (BBB)
  13. 13. Binds to active neurons
  14. 14. Objective
  15. 15. View function, not structure
  16. 16. Compares CNS metabolism </li></ul> before & after HBOT<br />
  17. 17. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SPECT ScansSingle Photon Emission Computed Tomography<br /><ul><li>Uses Ceretec radio-isotope
  18. 18. Crosses blood brain barrier (BBB)
  19. 19. Binds to active neurons
  20. 20. Objective
  21. 21. View function, not structure
  22. 22. Compares CNS metabolism </li></ul> before & after HBOT<br />
  23. 23. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Clear Benefits - SPECT ScansPre HBOTPost 36 HBOT<br />
  24. 24. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Clear Benefits - SPECT ScansPost 36 HBOTPost 4 Month Rest<br />
  25. 25. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Clear Benefits - SPECT ScansPost 4 Month RestPost 32 HBOT (add’l)<br />
  26. 26. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Clear Benefits - SPECT ScansPre HBOTPost 72 HBOT<br />
  27. 27. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />HBO Effect on Blood O2 Content<br />at 2.4 ATA HBOT delivers O2 = HbO2 desaturation<br />HBOT creates high O2 gradient & O2 activity<br />
  28. 28. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />DepthApplication<br />0 fsw; 1 ATA<br />16.5 fsw; 1.5 ATA<br />33 fsw; 2 ATA<br />49.5 fsw; 2.5 ATA<br />59.4 fsw; 2.8 ATA<br />66 fsw; 3 ATA<br />165 fsw; 6 ATA<br />Sea level<br />Chronic Brain Injury<br />Burns<br />Diabetic Wounds/Osteo<br />CO Poisoning<br />Acute Cyanide Poisoning<br />Acute Decompression Illness<br />
  29. 29. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />HBOT Mechanisms<br />Multiple mechanisms<br />Angiogenisis <br />Neural re-activation *<br />Normalization of oxygen deficit <br />Re-establish neuronal metabolism<br />Neuronal Regeneration<br />Increase natural stem cells 800%<br />* Ischemic penumbra is now accepted as the <br /> primary cause of deficits<br />
  30. 30. How it works - 5,769+* ways* Oxygen-sensitive outcomes and gene expression in acute ischemic stroke. Rink C, Roy S, Khan M, Ananth P, Kuppusamy P, Sen CK, Khanna S. J Cereb Blood Flow Metab. 2010 Feb 10. <br />Up-regulates growth factors<br />Reduces edema<br />Increases neuronal ATP<br />Enhances Mitochondrial: <br />Replication<br />Energy Production (ATP)<br />Promotes neural pathway growth<br />Stimlates aging neurons<br />Down-regulates inflammation<br />Reduces reperfusion injury<br />Indep. Football Veterans Conf. March 25, 2011<br />
  31. 31. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />HBOT Benefits - SPECT Scans<br />Pre HBOTPost 72 HBOT<br />
  32. 32. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />HBOT Is Very Safe<br /> From a 10 year study of 1,505 patients receiving 52,758 2-hour HBOT sessions at 2.4 ATA once or twice daily.<br />    inability to equalize middle ear pressure 0.37%<br />     paranasal sinus blocks 0.09%<br />     confinement anxiety 0.05%<br />     oxygen convulsions 0.009%<br />     pulmonary oxygen toxicity 0.00% <br />     permanent ocular refractive changes 0.00% <br />
  33. 33. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Comparative Drug Safety<br /><ul><li>USA Today 1998:
  34. 34. 16,500 died from gastrointestinal bleeding taking NSAIDs (1997)
  35. 35. …...yet is fully accepted.</li></li></ul><li> Different HBOT Chambers<br />Multi-place Chamber<br />
  36. 36. Hyperbaric Oxygen Therapies<br /> Different HBOT Chambers<br />Mono-place <br />Chamber<br />
  37. 37. Different HBOT Chambers<br />Home Chamber<br />
  38. 38. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SPECT ScansSingle Photon Emission Computed Tomography<br /><ul><li>Uses Ceretec radio-isotope
  39. 39. Crosses blood brain barrier (BBB)
  40. 40. Binds to active neurons
  41. 41. Objective
  42. 42. View function, not structure
  43. 43. Compares CNS metabolism </li></ul> before & after HBOT<br />
  44. 44. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />War Veteran TBI<br />Before & After HBOT<br />
  45. 45. NFL Player: TBI impact assessment<br />Fibers passing through areas<br />Area of Tissue change<br />Enlarged Fiber Tract showing fibers from concussive event<br />NFL football player with concussion <br />Loss of about 2% of the fiber tracts in the region of the corpus callosum. <br />Courtesy Dr. Walter Schneider, <br />U Pittsburgh<br />
  46. 46. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />NFL Veteran TBI<br />Before HBOT<br />
  47. 47. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />NFL Veteran TBI<br />After HBOT<br />
  48. 48. Case Presentation<br /> Alzheimer’s Disease<br />Scan #1<br />Scan #2<br />
  49. 49. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />
  50. 50. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Medicare Reimbursed IndicationsHBOT increases tissue O2<br />Compromised Skin (Acute traumatic peripheral ischemia)<br />Compromised Skin Grafts<br />Burns<br />Chronic Refractory Osteomyelitis<br />Diabetic Wounds<br />Clostridial Myonecrosis (Gas Gangrene)<br />Progressive Necrotizing Infection (Meleney’s Ulcer)<br />Soft Tissue Radiation Necrosis<br />Osteoradionecrosis<br />Acute Peripheral Arterial Insufficiency (ulcers)<br />Actinomycosis<br />Acute Cyanide Poisoning<br />Carbon Monoxide Poisoning (acute)<br />Intravascular Gas Embolism<br />Decompression Illness<br />
  51. 51. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Non-healing Wounds<br />1 year mainstream medicine<br />26 HBOT’s later<br />50 HBOT’s later<br />
  52. 52. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />HBOT for Burns<br />Summary:<br />ControlHBOT<br />Burn (%) 48% 61.8%<br />Days Hosp. 108 51.8<br />Surgeries 7.8 2.1<br />Costs $391k $215k<br />Scarring (reduced 95%)<br />Textbook on Hyperbaric Surgery<br />Bakker MD, Cramer MD<br />
  53. 53. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SB2046 Mandates HBOT Reimbursement<br />California SB 2046 in its amendments to:<br /><ul><li> H&S Code 1367.21;
  54. 54. W&I 14105.26;
  55. 55. Insurance Code 10123.195 </li></ul> Mandates reimbursement for FDA Approved, “off label” drugs, that meet specific criteria - HBOT qualifies under those criteria.<br />
  56. 56. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SB2046 Mandates HBOT Reimbursement<br />California SB 2046 <br />“prohibits a health care service plan contract, and specified disability insurance policies, from limiting or excluding coverage for a drug on the basis that the drug is prescribed for a use different than the use for which the drug has been approved for marketing by the federal Food and Drug Administration (off-label use) if specified conditions are met, including that the drug prescribed is for the treatment of a life-threatening…chronic and seriously debilitating conditions.”<br />
  57. 57. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SB2046 Mandates HBOT Reimbursement<br />1367.21. (a)…. provided that all of the following conditions have been met:<br />(1) The drug is approved by the FDA.<br />
  58. 58. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SB2046 Mandates HBOT Reimbursement<br />1367.21. (a)…. provided that all of the following conditions have been met:<br />(2)(B) The drug :<br />is prescribed by a physician<br /> for treatment of a debilitating condition,<br />is medically necessary<br />is on the plan formulary.<br />
  59. 59. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SB2046 Mandates HBOT Reimbursement<br />1367.21. (a)…. provided that all of the following conditions have been met:<br />(3) The drug has been recognized for treatment of that condition by one of the following: <br />(D) Two articles from major peer reviewed medical journals supporting the proposed off-label use as safe and effective.<br />
  60. 60. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SB2046 Mandates HBOT Reimbursement<br />Two articles from major peer reviewed medical journals supporting the proposed off-label use as safe and effective.<br />Golden ZL, Neubauer RA, Golden CJ, et al.: Improvement in cerebral metabol-ism in chronic brain injury after hyperbaric oxygen therapy. Int J Neurosci 2002, 112:119-131.<br />Harch PG, Gottlieb SF, Van Meter KW, Staab P. HMPAO SPECT brain imaging and low pressure HBOT in the diagnosis and treatment of chronic traumatic, ischemic, hypoxic and anoxic encephalopathies. Undersea & Hyperbaric Medicine, 1994; 21(Suppl):30. <br />Harch PG, Fogarty EF, Staab PK, Van Meter K. Low pressure hyperbaric oxygen therapy and SPECT brain imaging in the treatment of blast-induced chronic traumatic brain injury (post-concussion syndrome) and post traumatic stress disorder: a case report. Cases J. 2009 Jun 9; 2:6538.<br />Lin JW, Tsai JT, Lee LM, Lin CM, Hung CC, Hung KS, Chen WY, Wei L, Ko CP, Su YK, Chiu WT. Effect of hyperbaric oxygen on patients with traumatic brain injury. ActaNeurochir Suppl. 2008; 101:145–9. <br />
  61. 61. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SB2046 Mandates HBOT Reimbursement<br />Two articles from major peer reviewed medical journals supporting the proposed off-label use as safe and effective.<br />Lin JW, Tsai JT, Lee LM, Lin CM, Hung CC, Hung KS, Chen WY, Wei L, Ko CP, Su YK, Chiu WT. Effect of hyperbaric oxygen on patients with traumatic brain injury. ActaNeurochir Suppl. 2008; 101:145–9. <br />Low pressure hyperbaric oxygen therapy and SPECT brain imaging in the treatment of blast-induced chronic traumatic brain injury (post-concussion syndrome) and post traumatic stress disorder: a case report Paul G Harch, Edward F Fogarty, Paul K Staab and Keith Van Meter<br />Neubauer RA, Gottlieb SF, Pevsner NH: Hyperbaric oxygen treatment of closed head injury. South Med J 1994, 87:933-936.<br />
  62. 62. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SB2046 Mandates HBOT Reimbursement<br />Two articles from major peer reviewed medical journals supporting the proposed off-label use as safe and effective.<br />Palzur E, Zaaroor M, Vlodavsky E, Milman F, Soustiel JF. Neuroprotective effect of hyperbaric oxygen therapy in brain injury is mediated by preservation of mitochondrial membrane properties. Brain Res. 2008; 1221:126–33. Epub 2008 May 11.<br />Rockswold SB, Rockswold GL, Defillo A. Hyperbaric oxygen in traumatic brain injury. Neurol Res. 2007; 29:162–72.<br />Shi XY, Tang ZQ, Xiong B, Bao JX, Sun D, Zhang YQ, Yao Y. Cerebral perfusion SPECT imaging for assessment of the effect of hyperbaric oxygen therapy on patients with post brain injury neural status. Chin J Traumatol. 2003; 6:346–9. <br />
  63. 63. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SB2046 Mandates HBOT Reimbursement<br />Two articles from major peer reviewed medical journals supporting the proposed off-label use as safe and effective.<br />Tinianow CL, Tinianow TK, Wilcox M. Effects of hyperbaric oxygen on focal brain contusions. Biomed SciInstrum. 2000; 36:275–81.<br />UHM 2009, Vol. 36, No. 6 – Treatment of mild traumatic brain injury with hyperbaric oxygen<br />391 Case report: Treatment of mild traumatic brain injury with hyperbaric oxygen<br />Colonel James K. Wright, Eddie Zant, Kevin Groom, Robert E. Schlegel, Kirby Gilliland<br />
  64. 64. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />SB2046 Mandates HBOT Reimbursement<br />California SB 2046 <br />“A willful violation of the provisions <br />governing health care service plans <br />is a crime. ”<br />
  65. 65. Indep. Football Veterans Conf. March 25, 2011<br />Hyperbaric Oxygen Therapies<br />Rebecca <br />Thanks you!<br />

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