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Efficacy of using Hyperbaric Oxygen Therapy In treatment for Chronic Lyme Disease

A compilation of patient files

Robert M.. Lombard, M.D., F.A.A.F.P.

Lyme Disease is caused by an infection of the spirochete Borrelia burgdorferi that is generally known to be spread by a tick bite. The B. burgdorferi spirochete is an anaerobic bacteria, meaning that the organism cannot exist in oxygen. Treatment with hyperbaric oxygen has been used successfully in treating anaerobic infections and is recognized for such by The Journal of American Medicine.

Antibiotic therapy alone is not always effective against Lyme Disease. Most of the patients have had long courses of antibiotic therapy including IV therapy and yet the symptoms persist. In many patients, their quality of life has been diminished and in some cases the patient has become completely dependent. Neurological damage, pain, loss of muscle function, fatigue, arthralgias and a myriad of other symptoms plague the chronic Lyme patient. Hyperbaric oxygen therapy forces oxygen deep into the cells in all parts of the body including the brain and central nervous system.

To date, our Center has treated 43 patients diagnosed with Chronic Lyme Disease. The data from those patients' files reveal 36 patients (84%) showed improvement after their initial hyperbaric treatment. The results were further broken down and analyzed by the following categories: length of time patient had been ill, number of treatments, atmospheres of pressure, duration of treatment, period of time over which treatment was given, gender, age, and antibiotics taken during hyperbaric treatments. In all the above considerations, the one category that established a significant pattern in this patient population was length of time the patient had been ill prior to hyperbaric treatment. This category shows that patients who had been ill a shorter period of time experienced the most improvement. However, the ranges were quite diverse and one patient who had been ill 15 years experienced a 64% improvement in symptoms. The tables and charts below express the outcomes after the initial Hyperbaric series. Some patients returned for further treatments and some did not. Some patients returned follow-up information on their symptoms and while that information is relevant, it is too sparse to interpret by chart. For example, one patient reported being 10.87% worse after the initial series, but was improved by 55.80% after one month. Another patient reported a 19.47% improvement after the initial series, a 78.76% improvement after one month, but had escalation in symptoms to 27.43% worse than the original baseline. The table is included to show the diverse nature of the responses that were returned.

One aspect of hyperbaric treatment than can be determined is that most patients respond and initially most of them had an escalation of symptoms before they saw improvement.

While the greatest majority of patients used the treatment protocol believed to be followed in the Fife study of 60-minute treatments at 2.4 ATA (equivalent to 45 feet underwater pressure), some patients tried a variety of different methods hoping to find a protocol that assured better results. Some tried two treatments daily while others tried one treatment daily for more days. Some tried pulsing pressures by using lower pressure one day and a higher pressure the next. Treatment duration varied from 60 to 90 minutes and pressures ranged from 1.75ATA to 2.85 ATA. Some took an initial treatment series and then returned for follow-up or monthly boosters of 2 to 8 treatments. Some repeated the initial series or went longer than previously. While the variations of treatment for initial series did not produce any particular trend in results, the long-term results could not be assessed. .

Equally as innovative were the various antibiotic therapies and adjunctive therapies used during the treatments. Some of the adjunctive therapies included antibiotic "cocktails" where IV, IM, and oral antibiotics were combined. Some patients did aerobic exercises daily. Some did hyperthermia treatments, using saunas and hot tubs to get their body temperatures up. Some used Methylene Blue, bovine colostrum, various painkillers, antidepressants, sleeping pills, herbs, vitamins and homeopathic remedies. One pattern that emerged from the results of antibiotic use show that no patients on IV reported that symptoms were worse at the end of the initial series.

The patient population included two people who reported being diagnosed with co-infections subsequent to hyperbaric treatments. The outcomes of these patients was that one diagnosed with babesiosis reported a 23.6% improvement in symptoms and one diagnosed with erlichia showed a 16% escalation of symptoms after the initial series and only a 4% improvement 3 months later. Patients who are considering hyperbaric as an adjunctive therapy may want to consider getting treated for co-infections prior to hyperbaric since the co-infections are not anaerobic.


Overall Patient Outcomes

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 Symptoms
Escalated
Improved
0% to 25%
Improved 26% to 50%Improved
51% to 75%
Improved
76% to 100%
No. Patients 7 15 12 7 2
% Patients 16.28% 34.88% 27.91% 16.28% 4.65%


Length of time of illness

The range of time from the date patient became ill to the start of HBO was 10 months to 38 years with the mean at 8 years. The range for patients in this category who improved more than 50% was 8 months to 15 years with a mean of 4.9 years. The range of time from the date patient became ill to the date of diagnosis was 1 month to 35 years with a mean of 5 years.

Years between date became ill and HBO

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 Symptoms
Escalated
Improved
0% to 25%
Improved
26% to 50%
Improved
51% to 75%
Improved
76% to 100%
Minimum4.41.60.60.90.8
Mean 10.119.35.536.011.2
Maximum21.038.822.415.21.6



Treatment Protocols

Treatments were administered in varying atmospheres of pressure ranging from 1.75 ATA to 2.85 ATA with the mean of 2.41 ATA. Duration of treatments ranged from 60 to 90 minutes with a mean of 61 minutes. Patients received either one or two treatments per day to a maximum of 120 minutes per day. Treatment periods ranged from 5 days to 292 days, mean 72 days. Total treatments per patient ranged from 10 to 53 with a mean of 29.

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 Symptoms
Escalated
Improved
0% to 25%
Improved
26% to 50%
Improved
51% to 75%
Improved
76% to 100%
Minimum # Tx1710202120
Mean # Tx26.7125.3333.8332.8631.50
Maximum # Tx4642534543


Atmospheres of Pressure Used during HBO

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 Symptoms
Escalated
Improved
0% to 25%
Improved
26% to 50%
Improved
51% to 75%
Improved
76% to 100%
Minimum ATA221.7522
Mean ATA2.412.412.402.412.36
Maximum ATA2.852.852.852.852.4



Duration of Treatment in Minutes

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 Symptoms
Escalated
Improved
0% to 25%
Improved
26% to 50%
Improved
51% to 75%
Improved
76% to 100%
Minimum Duration6060606060
Mean Duration60.0460.7762.3261.9160.00
Maximum Duration9075909060


Period in Days over which treatments were administered

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 Symptoms
Escalated
Improved
0% to 25%
Improved
26% to 50%
Improved
51% to 75%
Improved
76% to 100%
Minimum Period235151912
Mean Period41.5762.4794.8385.5757.50
Maximum Period124166292169103



Gender

Of the 43 patients, 25 were female and 18 were male. Range of improvement for the male group at the completion of the initial series of treatment was 157% to 77% with a mean of 13% while the female group was 22% to 97% with a mean of 30%.

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 Symptoms
Escalated
Improved
0% to 25%
Improved
26% to 50%
Improved
51% to 75%
Improved
76% to 100%
Males45441
Females310832


Age

Ages ranged between 5 and 64 with the mean of 36.

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 Symptoms
Escalated
Improved
0% to 25%
Improved
26% to 50%
Improved
51% to 75%
Improved
76% to 100%
1 to 20 22321
21 to 40 26520
41 up37440



Antibiotics

Of the 43 patients, 35 were taking antibiotics during their Hyperbaric Oxygen Treatments. 18 patients used IV antibiotics. Of these 10 also took oral antibiotics and 2 took intramuscular antibiotics. 30 patients total took oral antibiotics and 4 were taking intramuscular antibiotics.

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 Symptoms
Escalated
Improved
0% to 25%
Improved
26% to 50%
Improved
51% to 75%
Improved
76% to 100%
IV Only 02300
IV with Other08320
Oral only63351


Improvement for patients by antibiotic.

Note: This table does not take into account that some patients were on combinations of antibiotics.

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Antibiotics Used During HBOMinimumMeanMaximum No Patients
Amoxicillin-7.47%4.01%15.49%2
Bactrim-16.04%26.40%68.84%2
Biaxin-157.14%-10.92%64.06%9
Ceftin39.39%49.70%60.00%2
Cipro34.73%55.83%76.92%2
Doxycycline-16.00%16.71%56.67%5
IM Bicillin-96.88%3.64%64.06%5
IV Doxycycline22.22%63.38%39.39%2
IV Primaxin16.67%30.81%34.73%3
IV Rocephin6.82%18.25%34.19%6
IV Vancomycin2.65%43.36%64.06%3
IV Zinacef0.00%0.00%0.00%1
Suprax42.11%42.11%42.11%1
Zithromax-21.89%27.73%73.53%10

The chart below shows the number of patients taking each antibiotic. It does not take into account that some patients were taking more than one drug.

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DescriptionNumber Patients
Amoxicillin2
Bactrim2
Biaxin9
Ceftin2
Cipro2
Doxycycline5
IM Bicillin5
IV Doxycycline2
IV Primaxin3
IV Rocephin6
IV Vancomycin3
IV Zinacef1
Suprax1
Zithromax10



Results of Patients who returned follow-up surveys

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 After1 Month3 Months6 Months
1-96.88%-43.75%25.00%
2-16.00%0.00%4.00%
3-10.87%55.80%
42.65%-26.49%
55.17%35.34%
615.49%-167.61%
719.47%78.76%-27.43%
819.83%33.62%45.69%
926.04%23.08%
1027.27%31.82%31.82%
1139.39%90.91%
1239.39%52.53%54.55%
1342.76%84.87%
1447.59%66.31%
1555.88%27.94%
1668.84%84.78%94.20%
1773.53%73.53%78.43%

My Thanks for the hard work of Rea and Connie and the memory of a fine physician, Dr. Lombard, who did this initial work. It is being continued by Dr. Glenn Burkland and myself. We are working on a follow-up study to evaluate the success of these patients years after their treatment. Lead author and expert researcher and clinician, Dr. Glenn Burkland, of Exton, Pennsylvania has done past cancer research with me, and is a tireless patient advocate, helping many people in ways that go unseen. He is a Renaissance scientist and clinician in the truest sense of the word, and I suspect he will follow the lead of this initial clinician, Dr. Lombard, in a way that is honoring to this man's memory.

In Your Service,

Dr. J.



Bank Towers, Tamiami Trail, Naples, FL
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