Oxygen is essential to every one of the tissues in the body and any tissue
injury requires oxygen for healing. Recent research in the University of
Dundee has shown that, in the inflammation that is typical of MS, the
transport of oxygen is severely limited by tissue swelling. It has been
shown that, despite the blood flow increasing many times, there may be a
severe lack of oxygen in the affected area so that, just when oxygen is
needed most, it cannot reach the tissue in sufficient quantity.
Oxygen therapy, where the normal amount of oxygen in the air is many
times exceeded, is now being widely used in medical practice, notably in
the USA, Europe Japan, Russia and China primarily to treat carbon
monoxide poisoning and aid the healing of injuries and wounds of
different types. It is being used increasingly in neurological diseases
such as stroke and in head and spinal core injury. Its use in multiple
sclerosis has been controversial, largely because its function and the
expectations of its effects have been widely misunderstood. However,
studies have shown that it is beneficial.
The process by which damage to the nervous system is caused in MS clearly
cannot be prevented by oxygen therapy, but, as already discussed, the body
normally heals itself using oxygen from the air - giving additional oxygen
extends the body's ability to heal and can limit some of the damage which
the disease causes.
Why should this be? Breathing oxygen under pressure causes the dilated and
leaky blood vessels in MS to constrict back to normal size and reduces the
swelling, due to fluid gathering, which can lead to cells dying.
Paradoxically, at the same time, more oxygen is delivered to the bloodstream
so the net effect is to improve and accelerate the normal healing process.
Drugs can also constrict blood vessels but, in doing so, they actually
reduce the available amount of oxygen. It is obvious they cannot replace
oxygen.
The aim of oxygen treatment in MS is thus to minimise the amount of damage
being caused, promote rapid healing and limit the scar formation which can
prevent nerve function being restored. Clearly this is most appropriate as
soon as possible after symptoms become apparent. The main objectives of any
useful therapy in the established disease is to limit further damage rather
than expect to cure existing scars. Prevention is not only better but more
realistic here, than cure, and, while there are many accounts of improvement
or stabilisation in the variety of neurological functions by Hyperbaric
Oxygen (HBO) treatment in MS, it has been in bladder function that positive
results have been most frequently described by researchers.
Measurement of bladder capacity and emptying have shown that oxygen
treatment has a distinctly beneficial effect and a two year study at Glasgow
demonstrated the importance of maintaining regular HBO treatment to prevent
the progressive deterioration in bladder function commonly found with MS.
The value of such prevention of irreversible bladder nerve damage is
measured not only in terms of comfort and well-being for an MS person, but
also in the minimising of the tendency toward chronic bladder infection and
the kidney damage which may have long-term consequences
HBO treatment is available at almost all Multiple Sclerosis Therapy
Centres. The equipment in the Centres is fully and regularly tested,
maintained and insured, and the equipment operators are comprehensively
trained in its use. The initial course of treatment lasts for fifteen or
twenty days, with each session lasting one hour. Patients sit together in a
comfortable multi-place chamber. Pressure in the chamber does not exceed
twice the atmospheric pressure (deep sea divers have experienced up to
seventy times ambient pressure) and pure oxygen is breathed by face-mask.
After treatment a short rest with a cup of tea is recommended. Patients are
monitored during the initial course and at its conclusion. After this, a
regime for follow-up treatment is determined, ideally this would be once per
week
Remember, HBO is NOT a cure for MS. Whilst many MS people report
improvements in their symptoms, the main aim is to stabilise the patient's
condition and it has been shown that this can most often be achieved in the
bladder function. There are no side effects of the treatment, but before
commencing a course GPs will be advised of their patient's intention to take
oxygen therapy and if they would like more information about the therapy and
how it may help their patient, they can contact the Association.. Any
physical condition other than the MS must be declared (e.g. it is essential
that the ears can be cleared under pressure). During the last twenty years
almost one and a half million treatment sessions have been carried out in
this country alone without significant incident.
Articles about
HBO
The Multiple Sclerosis Resource Centre on HBO
Hyperbaric oxygen therapy for Multiple Sclerosis
William S Maxwell, MD., FACNM, Journal of American Physicians and Surgeons, Vol 10, no 4, winter 2005
Long-term hyperbaric oxygenation retards progression of multiple sclerosis
(International Journal of Neuroprotection and Neuroregeneration), Vol 2, Issue 1, October 2005, P45-48 Perrins DJD + James PB
(NOTE:- This last article gives contact details for Dr Philip James at Ninewells Hospital, Dundee. As he has now retired from his work there,
any queries should be made via individual MS Therapy Centres, who are
still in contact with Dr James and his colleagues.)