September is National Traumatic
Brain Injury Awareness Month
Have you had a Traumatic Brain Injury?



Traumatic brain injury (TBI) is an insult or trauma to the brain caused by external mechanical forces. Chronic Traumatic Encephalopathy (CTE), another form of TBI is a progressive degenerative disease of the brain found in people with a history of repetitive brain trauma (often athletes). This includes symptomatic concussions as well as asymptomatic subconcussive hits to the head. An estimated 10 million people affected annually by TBI in the world: 1.7 million in the U.S., causing mortality and morbidity is a dramatic imposing event on society. TBI is a pressing public health and medical problem. According to the World Health Organization, TBI will surpass many diseases as the major cause of death and disability by the year 2020.(1) Brain Trauma can effect a single or multiple area and be mild moderate or severe and can cause significant cognitive, behavioral, and communicative disabilities. Immediate therapy can support reversing damage to the brain. With delay, a chain of events and secondary injury occur where there is ongoing injury to the brain through edema, hypoxia and ischemia secondary to raised intracranial pressure, release of excitotoxic neurotransmitters and impaired calcium homeostasis. (2) The longer a person waits to receive therapy, will determine their longterm outcome.
A Beneficial Treatment for TBI, CTE, PTSD, PCS and for
Post Concussion does exist: Hyperbaric Oxygen Therapy (HBOT)

Hyperbaric Oxygen Therapy (HBOT) is a painless, outpatient, physician referred, healing therapy. Our exclusive, medical grade, hard chamber technology increases the “oxygen gradient” in damaged, oxygen starved tissues, acting as a “cellular energy catapult.”
Hyperbaric Oxygen Therapy is an effective method of treatment.

• • Reduces cerebral edema and any swelling to the body (in sports or other related head injury (6)

• • Reduces neuroinflammation (7)

• • Increases oxygen saturation to the brain (8)

• • Promotes new blood vesel growth (Angiogenesis) (9)

• • Can create a 8-fold increase in your own stem cell production (10)

• • Reactivates idling neurons within the most oxygen-deficient areas of the brain

• Inhibits bacterial infection

Because insurance and Medicare does not cover HBOT for bain injury, HBOT is considered “Off-Label

The yellow to red areas show increase of oxygenation.

These videos give more insight into successes and science with HBOT:
Joe Namath Please watch: (3) , (4), (5)
Sergeant Rotenberry and Wife (6)

For more investigational reporting about sports related HBOT,
please read more….



Julia, R.N. Suffers a stroke
At Advanced Hyperbaric Recovery, we provide HBOT to people in need. We are learning that even years after a trauma to the brain, there is hope. More research is needed, but the quality of life for an individual can be the difference between life and death. (11)



Falling tree limb Post Concussion Recovery
At our award winning facility, we charge a fraction of the cost using the same medical grade hard chambers and following the same standards of care as a hospital based Hyperbaric unit.
We would love for you to come and tour our facility. We will prepare the most recent research for your specific diagnosis whenever available.
If YOU or anyone in your family
or anyone in your community might be a candidate, whose quality of life may be greatly improved for with Hyperbaric Oxygen Therapy, Please consider this remarkable medicine today.
Call us today for more information or to schedule a consultation with our Medical Hyperbaric Physician.
415-785-8652

Jacqueline S. Chan, DO
Hyperbaric Physician is Board Certified in Neuromusculoskeletal Medicine and Family Practice

Advanced Hyperbaric Recovery, Inc is an award winning facility located just 10 minutes north of the Golden Gate Bridge in the beautiful San Francisco Bay Area.
We use hard steel chambers with acrylic windows that are pressurized with 100% medical grade oxygen.

Just last month a study was published stating that Erectile Dysfunction (ED) is caused by microvascular or macrovascular insufficiency in the majority of patients. Studies have shown that hyperbaric oxygen therapy (HBOT) can induce angiogenesis in different body organs, and that …
HBOT can induce angiogenesis
and recover erectile function.(1)
Angiogenesis is the physiological process through which new blood vessels form from pre-existing vessels(2) If tissues are damaged as a result of injury or hypoxia, this also results in damage and destruction of the supporting blood vessel structures. The healing process relies on blood supply and the blood nutrient structures to carry out healing as well as to remove damaged cells, debris and foreign micro-organisms.

Research has demonstrated that treatment with hyperbaric oxygen therapy significantly increases the number and actual size of blood vessels in damaged tissues and wounds. This allows an improved blood flow and the healing process to occur faster, speeding the recovery of the injury or wound.(3)

At Advanced Hyperbaric Recovery, we treat men daily for many reasons. Hyperbaric oxygen therapy (HBOT) is a medical technique which delivers 100 percent medical grade oxygen at ambient pressures. This will increase the amount of dissolved oxygen in the blood and increase oxygen distribution to the tissues. There are several beneficial properties of HBOT concomitant with elevated oxygen distribution in tissue including anti-inflammation, angiogenesis through vascular endothelial growth factor proliferation, augmented fibroblast activity through fibroblast growth factor proliferation, tissue and wound repair, enhancement of lymphocyte and macrophage activity, increased male testosterone secretion, and bacteriostatic as well as bactericidal activity.(4)
Some diagnoses that we treat are non-healing diabetic wounds, osteoradionecrosis, osteomyelitis, post radiation treatment (part of a total of 13 FDA approved conditions). (5)

These indications are mostly covered by insurance. We treat “off label” concerns as well, such as post-concussion, stroke, post-surgical procedures, athletic exercise recovery, erectile dysfunction and more. Hyperbaric Oxygenation has also been shown to improve erectile dysfunction of penile nerve injuries. (6)
Hyperbaric oxygen therapy for radiation induced proctopathy in men treated for prostate cancer, had good overall response rate to hyperbaric oxygen for radiation induced proctopathy after other attempts at management had failed.
Hyperbaric oxygen is generally well tolerated and it remains an important treatment option for managing this common and difficult disease.(6)

For further reading of the advantages of Hyperbaric Oxygen Therapy and men’s genitourinary health, please read:

• Recovery of Erectile Function after Posterior Urethral reconstruction (8)
• Clinical Utility of Hyperbaric Oxygen Therapy in Genitourinary Medicine (9)

We are Contracted with: Kaiser Permanente, Blue Cross, Blue Shield, United Health Care, and more.
We have an insurance billing specialist who may be able to assist you in getting your Insurance to cover your addroved condition.

If YOU or anyone in your family, your medical practice,
or anyone in your life might be a candidate for relief with Hyperbaric Oxygen Therapy, Please consider this remarkable medicine today.
Call us today for more information or to schedule a consultation with our Medical Hyperbaric Physician.
415-785-8652
Advanced Hyperbaric Recovery, Inc is an award winning facility located just 10 minutes north of the Golden Gate Bridge in the beautiful San Francisco Bay Area.
We use hard steel chambers with acrylic windows that are pressurized with 100% medical grade oxygen.
Hyperbaric Oxygen therapy is FDA approved to treat 13 indications. It is considered “off label” to treat any other diagnoses not on this list. HBOT does require a physician’s prescription.
We are more than happy to consult with you.

Jacqueline S. Chan, DO
Hyperbaric Physician, Medical Director of our Brain Care Program

Dr Jacqueline S. Chan, DO is Board Certified in Family Practice, Board Certified in Holistic Medicine, Board Certified in Neuromusculoskeletal Medicine, including Osteopathic Medical Board of California.

Call for an appointment with Dr. Chan
415-785-8652

Strokes are an Emergency Concern.
Think F A S T
One moment life is organized and naturally wonderful, The next, sudden moment, a person can’t smile or see or speak or think clearly.
Please watch this short 5 minute video to see a demonstration of a stroke and emergency care. (1)

Description of the condition

Stroke may be defined as a sudden neurological deficit of presumed vascular origin (2). Often, a stroke is described using the analogy of a heart attack. Similar to the heart becoming blocked and injured due to less or no oxygen during a heart attack, something has dislodged itself and is blocking a vessel preventing oxygen from getting to the brain. Understanding signs and symptoms are important to determine the emergency nature and getting a patient to the Emergency Room as soon as possible.
Time and the brain during a stroke are essential for intensive stroke management.

Ischaemic heart disease and stroke are the world’s biggest killers, accounting for a combined 15 million deaths in 2015. These diseases have remained the leading causes of death globally in the last 15 years.(3), and a leading cause of disability. About one-third of survivors require significant assistance in daily life at one year after the event (4).
Every 40 seconds in the United States, someone has a stroke. One of the common myths about stroke is that it only affects older people. While it’s true that stroke risk increases with age, anyone can have a stroke at any time. (5)
Strokes fall into three subgroups: ischemic (impairment of blood flow), which account for 87% of all stroke cases and hemorrhagic (when a weakened blood vessel ruptures causing bleeding within the brain) accounting for 23%, and TIA’s or transient ischemic attacks which are mini “warning” strokes and must be taken very seriously. The former has lower case fatality rates than hemorrhagic strokes. (6)
Early assessment will lead to the greatest outcome post stroke. Neuroimaging (preferably using computerised tomography (CT) scan) is required for optimal management.(7)

At Advanced Hyperbaric Recovery, we have an

Advanced Brain Care Program

Improved Brain Blood Flow Pattern with HBOT
by Harch P, Fogarty E, Staab P, Van Meter KHyperbaric Oxygen Therapy (HBOT)

• Reduces cerebral edema (8)
• Reduces neuroinflammation (9)
• Increases oxygen saturation to the brain (10)
• Promotes new blood vesel growth (Angiogenesis) (11)
• Can create a 8-fold increase in your own stem cell production (12)
• Reactivates idling neurons within the most oxygen-deficient areas of the brain (13)

Treating with Hyperbaric Oxygenation for brain injuries such as strokes is considered an “off label” indication, meaning, most insurances will not reimburse for brain injuries, there are many studies validating using HBOT post stroke, showing that increasing the level of dissolved oxygen by Hyperbaric Oxygen Therapy (HBOT) activated neuroplasticity in patients with chronic neurologic deficiencies due to stroke even 36 months later. (13),(14).

ICU Nurse suffering from post stroke effects regains
quality of life with Hyperbaric Oxygen Therapy!

Because, during a cerebral ischemic event, neurological tissue suffers hypoxia, breathing 100% oxygen in a Hyperbaric Oxygen chamber at 2 atm,(approx. 14.5 PSI or 33 Feet of Sea Water) can double oxygen to the body. The deeper a patient is prescribed to “dive” will increase their PaO2 (which is the lung alveolar oxygen), even more. This treatment done as soon as possible, may prevent irreversible changes which result in unavoidable cell death in the brain, neurologic improvements and a better quality of life following treatment compared to patients studied in a control group not receiving HBOT. (15)

If YOU or anyone in your family, your medical practice,
OR anyone in your life might be a candidate for relief with Hyperbaric Oxygen Therapy, Please consider this remarkable medicine today.
Call us today for more information or to schedule a consultation with our Medical Hyperbaric Physician!
who only consults with the patient for indications, contra-indications and the feasibility of doing Medical Grade Hyperbaric Oxygen Therapy
415-785-8652

Jacqueline S. Chan, DO
Physician, Medical Director of our Brain Care Program
Dr Jacqueline S. Chan, DO is Board Certified in Family Practice, Board Certified in Holistic Medicine, Board Certified in Neuromusculoskeletal Medicine, including Osteopathic Medical Board of California.
Call for an appointment with Dr. Chan
415-785-8652

Michael J. Fox in 2018
At age 30, Michael J. Fox Fox was diagnosed with young-onset Parkinson’s disease. Later that year, he launched The Michael J. Fox Foundation for Parkinson’s Research, which the New York Times has called “the most credible voice on Parkinson’s research in the world.” Today the largest nonprofit funder of Parkinson’s drug development in the world, the Foundation has galvanized the search for a cure for Parkinson’s disease, and Michael is widely admired for his tireless work as a patient advocate. (1)
U.S. Senate and Local Governments Recognize April as Parkinson’s Awareness Month, bringing attention to the disease and the needs of patients.
2018 marks the 201th anniversary of Parkinson’s disease (PD). (2)
While 201 years is far too long for patients and their loved ones to wait, there has been significant scientific progress in the last few decades alone and there is tremendous cause for optimism. This Parkinson’s Awareness Month, learn how Hyperbaric Oxygen can get involved to help improve the quality of life for a Parkinson’s patient.

image credit; www.modup.net/
Parkinson’s disease is a progressive nervous system disorder that affects how the person moves, including how they speak and write. Symptoms develop gradually, and may start off with ever-so-slight tremors in one hand. People with Parkinson’s disease also experience stiffness and find they cannot carry out movements as rapidly as before – this is called bradykinesia. The muscles of a person with Parkinson’s become weaker and the individual may assume an unusual posture.

Parkinson’s disease, PD, first characterized extensively by an English doctor, James Parkinson, in 1817, is a chronic, degenerative neurological disorder that affects one in 100 people over age 60.(3) While the average age at onset is 60, people have been diagnosed as young as 18. There is no objective test, or biomarker, so it is important to be diagnosed by a specialist.

Estimates of the number of people living with the disease may vary, but recent research indicates that at least one million people in the United States, and more than five million worldwide, have Parkinson’s disease.
Parkinson’s disease belongs to a group of conditions called movement disorders. (4) Movement disorders describe a variety of abnormal body movements that have a neurological basis

The exact cause of PD is unknown, although research points to a combination of genetic and environmental factors.
For most Parkinson’s patients, the cause lies somewhere in the middle. While many PD patients report one or more family members with the disease, it is not always clear that one or several genes are the cause. Similarly, while some patients suspect that exposure to one or another chemical or environmental toxin caused their PD, this also cannot be conclusively proved. Scientists currently believe that in the majority of cases, genetic and environmental factors interact to cause PD. Research into this subject continues aggressively every day. Unfortunately, however, it is generally impossible to determine what specifically caused an individual’s PD. (5)
Symptoms:
Keeping in mind that Parkinson’s symptoms are different for different patients. Many patients experience some symptoms and not others, and the pace at which the disease worsens varies on an individual basis. Only a doctor can make a PD diagnosis and that any one symptom of PD could be caused by other conditions
Motor Symptoms: Noticable from the outside

• Bradykinesia (slowness of movement)
• Rigidity — unusual stiffness in a limb or other body part
• Resting tremor — uncontrollable limb movement at rest
• Postural instability – Uncontrollable problems with standing or walking, or impaired balance and coordination

Non-motor Symptoms of Parkinson’s Disease

• Cognitive impairment — decline in ability to multi-task and/or concentrate and potentially decline in intellectual functioning
• Mood disorders — depression and anxiety
• Problems sleeping — REM Sleep Disorder, where individuals act out their dreams
• Low blood pressure when standing
• Constipation
• Speech and swallowing problems
• Unexplained pains, drooling and smell loss

Hyperbaric Oxygen Therapy

Why is Parkinson’s Disease amenable to oxygen therapy?

Extensive animal research on Parkinson’s patients has demonstrated a non‐specific chronic inflammatory condition in the substantia nigra of the brain. Hyperbaric Oxygen Therapy (HBOT) has been shown to be an anti‐inflammatory drug in many conditions. HBOT increases oxygen in the body and reduces inflammation as seen in anecdotal evidence of many patients with well established PD who have been treated with HBOT for other conditions such as diabetic foot ulcers. For example, a patient with advanced PD who is confined to a wheelchair may get up and walk across the room after a series of HBOT.
In this Chinese study, HBOT has been shown to improve symptoms and quality of life for individual with Parkinson’s.
http://en.cnki.com.cn/Article_en/CJFDTOTAL-TSYX200903016.htm

4 Case Studies
Performed at a Hyperbaric Facility in Dallas, Texas

Case 1: This physician’s 86 year old mother with a 15-year history of PD and tremors at rest, bradykinesia, sleep disturbance, and depression taking 5 medications for PD underwent a course of 10 HBOT at 1.5 ATA. She reported an improvement in well-being and was observed to have a decrease in tremors. She underwent an additional 3 hyperbaric oxygen therapy at 1.5 ATA. The beneficial effects of the treatment appeared to be sustained over the course of the next 4 months.

Case 2: This 75 year old former corperate vice president with a 6 year history of PD taking dopaminergic drugs with resting tremors, difficulty with balance, and insomnia underwent 20 HBOT at 1.5 ATA and 3 treatments at 1.75 ATA. There was a significant improvement in tremors, balance, and insomnia, which has been maintained for 5 months. The tremors began to return, and the patient underwent 5 additional hyperbaric oxygen treatments with an improvement in symptoms.

Case 3: This 63 year old former fire fighter with a 6 year history of PD like symptoms diagnosed with PD 4 years ago had discontinued his dopaminergic agents, but continued taking amantadine for his tremors without effect. He underwent 30 HBOT at 2.0 ATA and had a complete resolution of his right hand tremor, which has been maintained for the last 5 months.

Case 4: This 69 year old practicing physician with a 3 year history of PD on dopaminergic medication had discontinued driving and reported difficulty in writing, episodes of rigidity, and always feeling “washed out”. After one HBOT treatment at 1.5 ATA, he reported feeling like “his own self again”, and after 7 treatments resumed driving. The treatment benefit appeared to last for 24 to 48 hours- the end point of the benefit strongly related to stress experienced at work. The patient underwent 13 additional HBOT treatments at 2.0 ATA (20 treatments total. He reported a complete resolution of symptoms for 1 month. The “washed out” feeling returned and after undergoing an additional 2 HBOT treatments, he felt “well,” again.

All 4 patients reported a decrease in tremors and an improvement in general well-being. The patients under went an initial course of 10 treatments and were allowed to continue treatment as needed until they perceived a plateau in benefit.

HBOT is a safe, easily administered, and relatively inexpensive treatment. K.H. Holbach reported that HBOT treatment at 1.5 ATA resulted in a balanced cerebral glucose metabolism, which indicated an improved oxygenation and energy production of the injured brain. In this preliminary study to determine if HBOT could play a role in treatment of PD, patients were treated, depending on the severity of their symptoms, from 1.5-2.0 ATA. The protocol of treatments were determined by the patient symptoms in relation to their subjective perceived benefit of treatment and the observations of the patient’s spouses or care givers. The positive preliminary results reported in this small group of patients may be due to a placebo effect.

Further evaluation in the the role of HBOT in the treatment of PD should now be considered.(6)
In this video, a patient speaks about the improvement of her life with HBOT after 18 treatments.
https://www.youtube.com/watch?v=GpAdwiveM4w
Because insurance and Medicare does not cover HBOT for PD, HBOT is considered “Off-Label and investigational.”

If YOU or anyone in your family, your medical practice,
OR anyone in your life might be a candidate for relief with Hyperbaric Oxygen Therapy, Please consider this remarkable medicine today.
Call us today for more information or to schedule a consultation with our Medical Hyperbaric Physician!
who only consults with the patient for indications, contra-indications and the feasibility of doing Medical Grade Hyperbaric Oxygen Therapy

415-785-8652

Jacqueline S. Chan, DO
Physician, Medical Director

Dr Jacqueline S. Chan, DO is Board Certified in Family Practice, Board Certified in Holistic Medicine, Board Certified in Neuromusculoskeletal Medicine, including Osteopathic Medical Board of California.

Call for an appointment with Dr. Chan
415-785-8652

In 2017, at Advanced Hyperbaric Recovery, a large number of our patients seen were effectively treated for traumatic brain injuries (TBI).
These are 2013 stats for Traumatic Brain Injuries in the United States:

•An estimated 2.8 million people sustain a TBI annually.
Of them:
• Nearly 50,000 people die,
• 282,000 are hospitalized, and
• 2.5 million, nearly 80%, are treated and released from an emergency department (EDs).
• TBI is a contributing factor to a third (30%) of all injury-related deaths in the United States. (1)

• In 2012, an estimated 329,290 children (age 19 or younger) were treated in U.S. EDs for sports and recreation-related injuries that included a diagnosis of concussion or TBI.(2)
• From 2001 to 2012, the rate of ED visits for sports and recreation-related injuries with a diagnosis of concussion or TBI, alone or in combination with other injuries, more than doubled among children (age 19 or younger).(2)

A Brain Injury consists of a range of life events that compromise the health and function of our brain. A few examples are:

• dementia
• cognitive impairment
• near drowning
• autism
• cerebral palsy
• epilepsy
• traumatic brain injury
• stroke

In this Newsletter, we will explore the benefits of Hyperbaric Oxygen Therapy (HBOT) for those with traumatic brain injuries.

What is Traumatic Brain Injury?

Traumatic brain injury, often referred to as TBI, is very different than most other acute events or injuries. One moment the person is normal and the next moment life has abruptly changed.

Since our brain defines who we are, the consequences of a brain injury can affect all aspects of our lives, including our personality.

Most brain injuries do not heal like other injuries such as a broken limb or punctured lung which most often heal and regain their previous function.
TBI can result in physical, cognitive, social, emotional, and behavioral symptoms, and outcome can range from complete recovery to permanent disability or death.
Symptoms may appear right away or may not be present for days or weeks after the injury. Symptoms range from the more acute to mild. More acute with loss of consciousness and paralysis, psychosis, depression, neurological impairment to mild occurrences, where the patient often doesn’t know they have experienced a trauma at first.

image credit; www.modup.net/
One of the consequences of brain injury is that the person often does not realize that a brain injury has occurred. (3) Symptoms can also overlap with migraine symptoms as well as symptoms that may be confused for behavioral issues in younger populations.

Symptoms of TBI range from mild to moderate, then severe. Medical Practitioners will use the Glasgow Coma Scale “GCS” (4), for estimating and categorizing the outcomes of brain injury via a scale of 1-15. The GCS score is determined by measuring values of Motor response, Verbal response and Eye opening and adding them up as the basis of overall social capability or dependence on others.
Glasgow Coma Scale in (parenthesis)

• MIld TBI; (13-15). Typically defined as a head injury with a temporary loss of brain function. Symptoms may include headache, trouble with thinking, memory, or concentration, nausea, blurry vision, sleep disturbances, or mood changes. Some symptoms may begin immediately, while other may appear days after the injury. Fewer than 10% of sports-related concussions among children are associated with loss of consciousness. It is not unusual for symptoms to last up to four weeks.
• Moderate TBI; (9-12). Loss of consciousness greater than 30 minutes. Physical or cognitive impairments which may or may resolve. Benefit from Rehabilitation
• Severe TBI; (3-8). Coma: unconscious state. No meaningful response, no voluntary activities

by Harch P, Fogarty E, Staab P, Van Meter K
Improved Brain Flow pattern with HBOT
Dr. Paul Harch tells us that “hyperbaric oxygen therapy
is a treatment for wounds in the body at any location.” (5)
We now know that even years later, HBOT will be effective.
Doctor Harch has been doing research for treating wounds
in the brain for almost 30 years.

Brain SPECT scan of a traumatic brain injury
before and after Hyperbaric Oxygen Treatment

DEFINITION

The application of hyperbaric oxygen therapy (HBOT) to chronic traumatic brain injury (TBI) can be traced to clinical practice and research in South Florida and New Orleans, Louisiana. It is well known that the practice of HBOT in chronic neurological conditions was pioneered by the late Dr. Richard Neubauer in the 1970s.

For more information visit HBOT in the Treatment of Chronic Traumatic Brain Injury

Hyperbaric Oxygen Therapy is an effective method of treatment.

• Reduces cerebral edema and any swelling to the body (in sports or other related head injury (6)
• Reduces neuroinflammation (7)
• Increases oxygen saturation to the brain (8)
• Promotes new blood vesel growth (Angiogenesis)(9)
• Can create a 8-fold increase in your own stem cell production (10)
• Reactivates idling neurons within the most oxygen-deficient areas of the brain

Because insurance and Medicare does not cover HBOT for bain injury, HBOT is considered “Off-Label and investigational.”

Recovery is defined as “functional recovery,” which deals with issues associated with “functioning” or the performance of daily activities that are required for self-maintenance (earning an income and maintaining a residence), as well as social activities, based on mechanisms that remain uncertain. No two brain injuries are alike and the consequence of two similar injuries may be very different.

If YOU or anyone in your family, your medical practice,
OR anyone in your life might be a candidate for relief with Hyperbaric Oxygen Therapy, Please consider this remarkable medicine today.
Call us today for more information or to schedule a consultation with our Medical Hyperbaric Physician!
who only consults with the patient for indications, contra-indications and the feasibility of doing Medical Grade Hyperbaric Oxygen Therapy

415-785-8652

Jacqueline S. Chan, DO
Physician, Medical Director

Dr Jacqueline S. Chan, DO is Board Certified in Family Practice, Board Certified in Holistic Medicine, Board Certified in Neuromusculoskeletal Medicine, including Osteopathic Medical Board of California.

Call for an appointment with Dr. Chan
415-785-8652