The Myth of Invisible Wounds of War: A Primer on Hyperbaric Oxygen Treatment

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The Invisible Wounds of War

Blast exposure is the equivalent of a decompression illness because of the tremendous over pressure and quick release

What Is Hyperbaric Oxygen Treatment

In listening to the radio and on TV very frequently there is referral to the problem of the invisible wounds of war and we keep hearing about the increased incidents of suicide in our vets. What is not understood is there can be brain damage causing abnormal function of the brain and yet still have normal anatomical pattern which is what we look at when we do the standard CT and MRI of the brain. There is an additional test that is called a Single-Photon Emission Computed Tomography (SPECT) Brain Scan that looks at the function of the brain. As the consultant to a number of Hyperbaric Oxygen Therapy Programs across the country, I have had the experience of reading the SPECT Brain Scan on these vets that are told their problems are all psychological (the invisible wounds of war) whereas when we do a SPECT brain scan their brain function is markedly abnormal. What is not understood also is that if you go back in the medical literature from the 1930s when they were digging the subways of Europe, they had a high incidence of Caisson’s disease which is a decompression illness. That group of patients had a high incidence of suicide. What people do not think about is that the blast exposure is the equivalent of a decompression illness because of the tremendous over pressure and quick release. Experimental animal data has shown that machine gun and antitank fire can cause air bubbles in the blood that then damage the brain. Therefore to me it is the blast exposure that causes the increase in suicide in the vets. We do not see increased incidents of scuba divers that have an episode of the Bends because they almost always get Hyperbaric Oxygen treatment.

Single-Photon Emission Computed Tomography (SPECT) Brain Scan

Single-Photon Emission Computed Tomography (SPECT) Brain Scan

SPECT Brain Scans Establishes Baseline

A good example of the problems that we see is a young man that had no physical injuries but had experienced 40 blast exposures. He was so psychologically mixed up that he was on 7 different psychiatric drugs and still attempted suicide. He was told by his physicians that his problems were all psychological, but when we did a SPECT brain scan on him his SPECT brain scan was markedly abnormal. There is a developing technology called Fusion MRI that is supposed to delineate brain function but I have not seen a correlation between the Fusion MRI and the SPECT brain scans. Therefore to me, the SPECT brain scan is still the best way of documenting abnormal brain function. What we have seen in the vets is that with Hyperbaric Oxygen Therapy the brain function comes back to normal as noted clinically and objectively documented on the SPECT brain scan that we obtain after their completion of Hyperbaric Oxygen Therapy. For instance, the mother of the young man that had 40 blast exposures told us “Thank you for giving me back my son”. We treated this vet more than 4 years ago and he has been off all of his psychiatric drugs since his completion of Hyperbaric Oxygen Therapy, has not again attempted suicide, and has graduated from college with Honors.

Hyperbaric Oxygen Therapy

Therefore to me, the term Invisible Wounds of War is a misnomer and is just that people don’t know the correct way to look for the injury to the brain which causes

Hyperbaric Chamber

SPECT brain scans objectively document the clinical improvement these patients have had with Hyperbaric Oxygen Therapy

function problems but does not cause anatomical damage to the brain region. This is the pattern of idling neurons described years ago by Richard Neubauer, MD. Our experience has been with the Hyperbaric Oxygen Therapy and the use of SPECT brain scans, we have had an excellent response to the injury to the brain due to the blast exposures. To my knowledge, none of the patients that have received Hyperbaric Oxygen Therapy have again attempted suicide even though that is a frequent problem in the ones that we have treated.

In summary, the functional abnormality in the brain due to blast exposure can be documented by SPECT brain scans and does respond very well to Hyperbaric Oxygen Therapy. The follow-up SPECT brain scans objectively document the clinical improvement these patients have had with Hyperbaric Oxygen Therapy, so I think we should drop the term ‘invisible wounds of war’.

About the author

Therapeutic Nuclear Medicine Radiology Hyperbaric Oxygen Expert Witness No. 106

Familiarity with hyperbaric medicine during active duty with the US Navy while teaching nuclear medicine to medical officers and medical technologists for the USN nuclear sub program, and as a member of the Plutonium Decontamination Team. In the late 1960’s, hyperbaric oxygen was installed while I was Chief of Radiation Therapy at the Ochsner Foundation Hospital. I became a member of the Underseas Medical Society in 1979 and established two hyperbaric oxygen therapy programs with two monoplace chambers in September 1980 at the Gulf South Radiation Therapy Center, Largo, FL. Currently Hyperbaric Medicine consultant to monoplace hyperbaric oxygen chambers, at Ocean Medical, Lauderdale by the Sea, FL. Senior Medical Director Hyperbaric Oxygenation Corp., Abbotsford, British Columbia, Canada. I was an invited participant for the March 1997 Wake Forest Medical School Conference on Hyperacute Hyperbaric Oxygen for Acute Stroke and am a member of the international committee working on the protocol for the use of hyperbaric oxygen in acute stroke. Through my clinical practice of hyperbaric medicine and as consultant for other centers, I have had extensive experience in the use of hyperbaric oxygen therapy for stroke, brain injury, Lyme disease, cerebral palsy, multiple sclerosis, other neurological conditions such as chemo brain and HBOT in cancer care. Consultant in hyperbaric medicine.

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