Hyperbaric Oxygen Therapy

An Insiders Look at Hyperbaric Oxygen Therapy and Post Concussion Syndrome.

Bryan Johnson is a wonderful hyperbaric oxygen therapy (HBOT) clinician who I have been personally treated by many times. I found amazing results within my first few visits with Bryan including: clearer thinking, better focus, higher energy, desensitization of my scalp, headache evaporation, an overall sense of well being, and many other improvements. Bryan has conducted thousands of HBOT sessions in Los Angeles at his clinic O2 UP (o2underpressure.com). I have had such a success story with Bryan and HBOT. Because of this, I wanted to pick Bryan's brain regarding HBOT and head injuries and share it with all you that may be interested. Here's what Bryan had to say. 

Bryan Johnson - a HBOT Clinicians perspective. 

I’ve seen some great healings occur at O2 UP. The patients we’ve helped, range from those suffering from the effects of chemotherapy, to those with migraine headaches, patients with Parkinson’s, chronic fatigue, lyme disease, autism, professional athletes healing after an injury, and so many others.

 While I’ve seen impressive healing within these groups of conditions, traumatic brain injuries (TBI) and mild traumatic brain injuries (mTBI) is where I see the most consistent healing occur.

 Yet with all of the results I see firsthand, I’m continually confused by the fact that more doctors don’t  educate their patients  about HBOT as an option after a TBI. If nothing else, I hope that this post can at least educate you about what HBOT is, how it works, why there are discrepancies in reporting its efficacy, and what I’ve seen firsthand.  


What Is Hyperbaric Oxygen Therapy?

  To put it simply, HBOT has two main components -- pressure and concentrated oxygen.  During treatments the patient is usually lying down in pressurized chamber breathing concentrated oxygen. The pressure created by the chamber helps the body to become saturated with oxygen.  You can think of this process as being somewhat analogous to creating soda water.  To create soda water you need carbon dioxide, water, and pressure.  The pressure pushes the CO2 into the water giving you a fluid that is holding a gas.  In HBOT, the gas we use is oxygen and your body, being made up of mostly water, becomes the vessel for that oxygen.  This process is grounded firmly in physics and is pretty simple for most people to get their heads around.  How the body then uses the oxygen towards its advantage becomes a more hotly debated topic.  

How does Hyperbaric Oxygen Therapy Work?

To those that see HBOT work on a daily basis, we would tell you that hyperbarics super-saturates the body with oxygen, decreases inflammation, promotes stem cell growth, and helps to grow new blood vessels (a process called angiogenesis).  What all of this is basically saying is that HBOT promotes healing!  Whether this healing happens with a wound that won’t heal on a diabetic patient’s foot, or a wound that can’t be seen since it’s internal, like the bruising you might find on a concussed brain; the benefit is all the same.  Oxygen helps the cells to promote healing in these areas.  

Doctors don't prescribe HBOT. Why?

Surprisingly enough, many doctors don’t feel that hyperbarics provides much benefit to patients.  The feeling is often that the body is already delivering enough oxygen through its normal respiratory process to provide the oxygen needed for healing.  Many doctors also feel that the studies done on hyperbarics for many conditions have not conclusively proven that there is benefit. This is why they won’t tell their patients about it or they flat out discourage its use.  

However, to gain better perspective on this difference in opinion I think we should look at the principles of how oxygen would support the brain after an injury, how some of the studies on HBOT and brain injuries were conducted, and some first-hand experiences.  From there you can make your own conclusions.  


Your Brain needs oxygen

  Many people aren’t even aware of how energy-intensive of an organ their brain is.  We can better understand this by looking at the sheer amount of oxygen that it utilizes. Your brain uses 20% of the oxygen your body takes in, this is a huge amount for an organ that only weighs about 3 pounds. When an injury to the brain is sustained, there are a chain of events that ensue, directing blood-flow, releasing chemicals throughout the brain, and processes meant to deal with the shock of the injury.  However, due to these reactions and the inflammation that takes place, your injured brain isn’t necessarily getting the oxygen it needs to adequately heal.  This is the theory on why getting oxygen to the brain through the use of hyperbarics is thought to work.  Even without an injury your brain needs 20% of your body’s oxygen intake, so after an injury wouldn’t it make sense to give it even more to help with repair work?  Many people would intuitively arrive at this reasoning and in fact, there are a good number of doctors that believe HBOT is effective for these reasons.  However, there are still a large number of doctors who don’t see hyperbaric oxygen therapy as being beneficial for brain injuries.

A rebuttal to those who say HBOT is not effective. 

  Studies done on hyperbarics and brain injuries that were deemed somewhat inconclusive.This has fueled the disagreements on the benefit of oxygen therapy for brain injured patients.  Some of the “conclusions” from the studies done on concussions, PTSD, and TBI being treated with HBOT have said that the results prove that hyperbaric oxygen does not conclusively benefit these conditions.  This has caused many doctors to automatically write-off hyperbarics as a treatment.  However, if doctors were to look deeper into these studies, they would find a whole slew of problems with the application of studies themselves.  Dr. Paul Harch, who is one of the world’s leading experts on HBOT in use with brain injuries, talks about the tragic faults of these studies here:  http://www.hyperbaricmedicalfoundation.org/.  Basically, these studies were either headed by doctors with little to no HBOT experience, the treatment pressures were too high for brain injuries, the sham (or placebo) treatment was not actually a true sham treatment, or results were not properly represented.  This has led to a lot of miseducation about HBOT, that has kept many brain injured patients from even knowing that HBOT could be a viable option for them.  

Stories from patients themselves

As I’ve stated earlier, I have treated people with such a wide range of conditions at our clinic.  But truly, some of the stories that I love most have been of the effect HBOT has had on brain injuries.  Now, this is one issue that many naysayers of hyperbaric medicine have.  They say that many of the evidence is purely anecdotal.  However, having already discussed the issues with many of the studies, I think it’s important to share some of the firsthand accounts that I’ve had with brain injured patients.  The healing that has taken place has been clear and can be attributed to nothing but the oxygen sessions they are doing.  I’m not giving these stories as a foretelling of what you can expect from the therapy.  Rather they are to just show what can be possible.  

David - four concussions in five years...

The first story is of a gentleman that we’ll call David.  David was 82 years old when he first came in and had suffered from four concussions within a five year span.  It had been two years since his last concussion and he was plagued by continual headaches, brain-fog and fatigue that was keeping him from partaking in his once very active life.  The funny part of this story was that David actually had a long history with hyperbarics, but that focused more on its use in underwater medicine applications.  It was only recently that he realized that HBOT could be beneficial for his post-concussion symptoms.  After a number of phone calls with David, he finally came in to start his HBOT protocol.  After only five sessions, David’s constant headaches that he had had for two years completely went away and his thinking was much clearer.  David also noted that his energy levels were much improved and this caused him to want to continue with HBOT as a part of his general health routine.  Now more than 18 months after his first sessions David has happily been headache-free.  

Andrea 10 months post injury 

The second story is of a 15 year old girl that had a head injury from being hit by a car that caused her to be in a coma for two weeks.  The girl, who we'll call Andrea, came to me 10 months after her injury.  Luckily, Andrea had already made significant progress in her rehabilitation, but she was still suffering from headaches, lack of ability to concentrate, and anxiety due to her accident.  While she was able to slowly integrate back into school, she was not able to read or focus on her studies.  After a couple weeks of hyperbaric treatments Andrea’s mother called and said that Andrea wanted to tell me something.  As soon as Andrea took the phone I could sense the excitement in her voice.  She went on to explain that before her accident she loved to read.  However, after her accident she wasn’t even able to finish a single page because she just couldn’t focus.  Since starting her treatments though she had now finished one book and was part-way through her second book.  This was all within about 15 sessions of hyperbaric oxygen therapy.  Both Andrea and her mother attribute this change to HBOT, because Andrea wasn’t pursuing any other new therapies and there was such a rapid change.  

Brad could only see in black and white after his injury...

For the last story, let me start by saying that I was supposed to have this article finished a couple weeks ago.  However, as I was writing this I had another client come in with post concussion syndrome.  I decided to hold off a couple weeks to see how my client does.  It just seemed like rather serendipitous timing to have a new client with a concussion right at the same time I’m starting this article!  So here’s what has happened.  This last client is a 43 year old named “Brad” that had his last concussion three years ago.  He was biking in the desert and hit his head in a crash against a rock that had him seeing in only black and white.  Since the accident Brad has been on the prescription drug Tramadol to take the edge off the CONSTANT headaches that he says are usually between a 7-9 in severity on a scale of 10.  After living with these headaches for three years Brad finally heard of hyperbarics and decided to give it a try.  At the point of writing this article, Brad has not taken Tramadol once in four days.  Brad says that he used to try going one day without taking Tramadol to see how it would feel.  When he did this he would need to take a nap on the floor of his office just to deal with the pain of his headaches.  Now HBOT he has not had to take Tramadol at all!   Brad still has more sessions to go with hyperbarics, but even this early into his treatment he’s already another positive story on the effects of hyperbaric oxygen with head injuries.


With my experience, no one can tell me that hyperbaric oxygen therapy isn’t beneficial to those with head injuries.  I see the results too frequently and consistently to not be confident in this healing modality.  However, with that said, it’s up to each individual to chose the therapies they want to incorporate into their healing journey.  My hope is that this article at least gives added perspective into the possibilities of hyperbaric oxygen in use with head injuries.  Talk to people whose lives have been touched by HBOT, do your research, and I wish you the best in your healing!


This article is purely informational. I am not a doctor, though I am a patient. This is not advise. 

Diving into Hyperbaric Oxygen Therapy


I missed 80 days of school my senior year due to my post concussion syndrome. By the end of the year I was recovering from my nerve pain and many symptoms associated with PCS. I took a gap year to fine tune my recovery and set out on a life changing journey. Part of my gap year was spent doing a program called SeaMester, a hands on sailing, leadership, oceanography, and scuba diving program. I had an incredible experience traveling all over the Caribbean on an 88 ft schooner for 3 months. A huge part of the program was focused on scuba diving. I needed to get an "ok" by my doctors prior to going on this trip because of my severe condition the year before. I was in a much better place, and they agreed I could safely go on this adventure.  


I had no diving experience prior to this journey, but by the end of the program I attained my open water, advanced open water, and rescue diver licenses. Something stood out to me when I was diving, I had much more energy when I finished the dive than when I started. It was like clockwork, every time I dove, especially on the deeper dives, I would come up with more energy and clearer thinking. I certainly was noticing a pattern, and I wanted to figure out why. 


I had known that hyperbaric oxygen therapy had been used in concussion recovery, but the treatment was cutting edge, expensive, and not many doctors were using it in there tool kit at the time. I thought there must be a correlation here between diving and hyperbaric O2. My hypothesis was  breathing oxygen at pressure while diving may have a similar effect on me as hyperbaric oxygen therapy.


Hyperbaric oxygen therapy brings pure or nearly pure oxygen at higher than normal atmospheric pressure into your blood plasma, tissues, and body. Your body needs oxygen to survive, and giving your body pure oxygen under the right pressure and conditions may reduce inflammation, detoxify cells, improve circulation, and promote stem cell production. Many reported benefits include mental clarity, alertness, stress and anxiety relief, quicker injury recovery, improved sleep, and heightened energy levels. 


I had great effects from breathing normal oxygen under pressure with recreational diving, and I really wanted to see if pure oxygen administered under pressure in a medical facility would have an even greater effect. Once I returned from my gap year, I spoke with one of my doctors at the Boston Children's Hospital about my experience diving. She thought it was incredible, and said I should look into hyperbaric therapy. I looked into it more and more, finding a large number of positive studies and testimonials for head injury patients and post concussion victims. When I went to school in California, the first thing I did was look for a hyperbaric oxygen treatment center. I found one in Los Angeles called O2 Up, a great company run by an amazing man. I reached out to him, got an appointment, and started on this journey. He recommended that I do 40 sessions of 1 hour each, using a general protocol for head injuries.


 After that first session in the tank I was amazed! I could feel the oxygen going into my brain and bringing me much more energy. I got out of the session feeling even better than coming up from a dive. I knew I was onto something that could help fix my fatigue. So, I pursued it. I did the 40 sessions and then some. Each time, I felt more energized and was thinking clearer. I can honestly say hyperbaric oxygen therapy was an amazing treatment for me. It lifted the fog that surrounded my thoughts, giving me more energy to enjoy my life to its fullest. 


This article is purely informational. I am not a doctor, though I am a patient. This is not advise. 

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