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Out of 277 children, ten were picked for the project. Caroline was one of them. There was no charge to the children involved because this was a research study.
Now Dr. Barrett's waiting list is too long to count.
The cream-colored chamber at UTMB-Galveston is daunting. Patients enter a claustrophobic submarinelike tube and have clear plastic hoods clamped over their heads. Oxygen is delivered through hoses attached to the hoods during the dive. Kids' ears hurt because of the depressurization, and most end up having tiny holes put in their eardrums or tubes inserted. Because of the fear of fire from the oxygen, patients can wear only certain types of clothing (no synthetics) and cannot wear makeup or use hair spray or carry newspapers into the chamber with them. As many as 12 patients can be treated at a time. A "tender," who is certified to handle hyperbaric conditions, goes in with them.
While an adult will usually go down 40 feet below sea level for 90 minutes of treatment, children go to 16.5 feet, which is the equivalent of half an atmosphere, for an hour, says senior technician Travis Kilpack. This means the oxygen they receive comes in at 150 percent. Adults, at their depth, receive 220 percent oxygen, he says.
The UTMB center did its first hyperbaric oxygen study on patients with closed-head injuries. The study was funded by the Moody Foundation. (Bobby Moody's son was in a Jeep accident years ago and was treated for the brain injury he suffered.) At the time of the first study, accepted medical advice was that by three years after a closed-head injury, "what you see is what you get," says Kevan Corson, technical director of UTMB's hyperbaric center. After lengthy hyperbaric oxygen treatments with a group of patients out that long or longer, "We proved there is function. We can get some of the stuff back.What we found out is, even many years out, the brain can still heal itself."
At 100 percent oxygen, the body is not absorbing any toxins, Kilpack says. The pressurized oxygen also shrinks the "bubble" of toxins already there, allowing oxygen to move in and take away inert gases. The body moves through its normal metabolic processes, but sooner than it would without the special mix of "air" it is receiving. "This is allowing the body to heal itself by giving it the things it uses to heal," Kilpack says.
A second study was under way on chronic stroke victims when Dr. Barrett, a research physician on loan from the Transitional Learning Facility with the Moody Foundation, began to be approached by parents who had read anecdotal evidence of the benefits of hyperbaric oxygen treatments on the MUMS National Parent to Parent Network (www.netnet.net/mums/Whyhbo.htm).
Since cerebral palsy is an unspecified form of brain injury, it was logical to do a study on it, Barrett says, which ultimately involved 15 children. As it turned out, at the same time UTMB was doing its study, McGill University in Canada was doing a similar one. They discovered each other at a medical conference last September in Atlanta. Their conclusions mirrored each other. Nearly all of the children got better. There was less spasticity, while gross motor function improved.
Caroline cried the first week she had to go into the chamber. Elizabeth would drive her to Galveston every weekday afternoon, leaving at two-thirty, returning at seven. Her three other children were left behind. "I hired people to watch my children, to cook for my children," she says. "We were going to suck it up for three months. There were days it was hard. Somebody was home crying."
Elizabeth's mother went with her. The first four weeks went by, and nothing happened. As she was driving along during the fifth week of treatment, from the back of the car Elizabeth heard the word "mama."
"I almost had a wreck." At about the 24th dive, Caroline started getting on her hands and knees. She could stay sitting up straight. They completed 60 dives. One of Elizabeth's dreams, that Caroline would come walking out of the chamber one day, is yet unrealized. And she readily admits she was very disappointed about that. But Caroline is back in her regimen of PT and OT and speech therapy and continues to progress. Nothing seems to be lost from what she gained from the dives.
Caroline has a chance to be in another hyperbaric study group at UTMB, and it would seem that her mother would jump at the opportunity.
"But I don't know if she should be in there and take the place of another child who might need this treatment more," Elizabeth says.
Medical research aside, the costs of hyperbaric oxygen treatments are not inconsiderable, and in most cases insurance companies will not pay for the treatment if it is applied to cerebral palsy. Use of a chamber is approved by the Food and Drug Administration for the treatment of a diabetic's wounds or carbon monoxide poisoning or to counter the effect of the bends. But that blessing has not been conferred upon it for use with cerebral palsy patients.