Diabetic Ulcers & Wound Healing 

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Hyperbaric oxygen therapy restores 3x the oxygen to damaged tissues so the cells can repair themselves instead of becoming infected. Hyperbaric is extensively used in hospitals for wound care and burn victims because it accelerates healing so well.

  • ​Oxygen is the fuel that cells use to do repair work, such as healing wounds and for recovery from surgery.
  • ​Ulcer development is often due to a combination of diabetic neuropathy and peripheral vascular disease, which decreases the supply of oxygen to the affected extremity. Hyperbarics floods the damaged areas with readily available oxygen to speed up healing. 
  • ​Hyperbaric oxygen therapy increases the amount of oxygen dissolved in the plasma, allowing tissues to achieve levels of oxygenation that would otherwise be impossible.
  • ​By getting the area of the wound highly oxygenated, the cells can repair themselves at an accelerated rate. The oxygen can also help prevent the wound from becoming infected.

Helping the Body to Heal
Patients with inadequately controlled diabetes have too much glucose (sugar) in their bloodstream due to dysfunctional insulin production/utilization. Over time, this excessive amount of sugar can damage nerves and blood vessels, which can constrict blood flow. The pain associated with damaged nerves is called neuropathy and it can be severe enough to create mobility issues in the affected areas, which may further decrease circulation. In cases of diabetes, most patients experience neuropathy and decreased circulation in their extremities; this is due to how far away these areas are from the heart. Some patients with advanced diabetes experience injuries to their extremities, usually in the feet, resulting in open wounds or ulcers. With insufficient blood flow to the injury, it can become very difficult or impossible for the body to heal itself. The inflammatory process will be triggered but may not be followed up with the necessary responses from the immune system to repair the injured tissue. Diabetic ulcers can last for years and continue to worsen over time. These non-healing wounds are the main cause of foot and hand amputations for diabetic patients.

Diabetic ulcers and other non-healing wounds are some of the most studied conditions for hyperbaric oxygen therapy. Hyperbaric therapy can help push blood and oxygen much deeper into the body, even through areas that are damaged and inflamed. By flooding the ulcer with oxygen, the body can quickly initiate its healing response and fight to restore the injured tissue. Multiple studies and anecdotes have shown complete recovery from mild ulcers and injuries as well as ones that have progressed into severe infections and for patients who were scheduled for amputation. Hyperbaric therapy has also been proven to create new blood vessels, a process called angiogenesis. For diabetic patients, this can result in brand new routes for improved circulation to extremeties. This means that patients may be able to utilize hyperbaric therapy to prevent ulcers as well as to treat them. The mechanism of action for healing diabetic ulcers may also work to heal damaged nerves and end the painful symptoms of diabetic neuropathy.

Diabetic Ulcers and Hyperbarics: Studies, Articles and Videos
Hyperbaric oxygen (HBO) therapy in treatment of diabetic foot ulcers: Long-term follow-up Majid Kala
Adjunctive HBO therapy can be valuable for treating selected cases of hypoxic diabetic foot ulcers. It seems to accelerate the rate of healing, reduce the need for amputation, and increase the number of wounds that are completely healed on long-term follow-up. Additional studies are needed to further define the role of HBO, as part of a multidisciplinary program, to preserve a functional extremity, and reduce the short- and long-term costs of amputation and disability.
 
To read full study, click here

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Diabetic Ulcers & Wounds: Articles, Research Studies & Videos

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Healing in a Hurry
Wound healing is one of the things hyperbarics is most known for. Burns, internal injuries, ulcers, lacerations, bruises, crush injuries, broken bones or any other infliction that triggers an inflammatory response can be considered a wound. This includes disease and other internal dysfunctions as well. Inflammation is often the cause of the worst symptoms and tissue damage experienced with diseases and injuries. The inflammatory process is very dynamic: it’s designed to be the body’s damage control system, responsible for responding quickly to any kind of wound. Unfortunately, collateral damage to healthy tissue often occurs from the process.

Many people think of the word “injury” and think of a cut, a bruise, or brain injury. However, any type of trauma to tissue is considered an injury. The ingestion or inhalation of a toxic chemical, an audio blast insult to the ears, an infection, an immune response, an allergic reaction, a low oxygen event (stroke, near-drowning, etc), or any event that causes pain, redness, or swelling internally or externally will trigger the inflammatory process. Immediately following the injury, blood vessels that feed the injured site become dilated to allow for an increase of blood flow to flood the area with white blood cells. The excess fluid from the dilated blood vessels leak through the tissue and causes edema (swelling). The goal of the white blood cells is to stop the initial bleeding if there is any and to “clean up the mess”. They release toxins called oxygen-free radicals to metabolize dead tissue. Unfortunately, the oxygen-free radicals oxidize some healthy cells in the process, which can lead to further pain and damage. Toward the end of the inflammatory process, genes activate or deactivate to release needed hormones to heal, rebuild, and create scar tissue.

There are many conditions that may inhibit the body from properly repairing itself from a wound. Diabetes is a prime example of how slow or non-healing wounds may become an issue. Due to a decrease in circulation from chronic high blood sugar, the body may not be able to initiate an adequate healing response on wounds. If left untreated, these wounds remain open and prone to infection and complete tissue death.

Research in emergency hyperbaric medicine has shown that, if a patient can get into a hyperbaric chamber within a couple of hours of their injury, up to 90% of the inflammatory process can be prevented. Increased pressure, increased oxygen, and the combination of the two have been shown to affect the expression of over 8,000 different genes: that’s about 40% of the entire human genome. According to Dr. Paul Harch, a genetic expression is responsible for every process in the body that sustains life. With hyperbaric therapy, anti-inflammatory genes are upregulated as well as genes that stimulate stem cell growth, tissue repair, and prevent cell death. Simultaneously, genes which trigger the inflammatory process are downregulated. If a patient can receive hyperbaric therapy immediately following an injury, the inflammatory process can be bypassed while still promoting quick healing and rebuilding of the damaged tissues.

Fortunately, if a patient is unable to access hyperbaric therapy immediately– or even decades after their injury– they may still see benefits from treatments. The same process of stimulating growth and repair still applies, as does the anti-inflammatory power of oxygen. Chronic inflammation can be greatly reduced and can relieve the symptoms caused by inflammation and residual injury.

Arm Being Wrapped with Bandage by gloved hands

Healing faster through hyperbarics
For the past two decades, HBOT has been used in wound-repair mostly for the treatment of foot ulcers associated with diabetes (Mason et al., 1999). In line with these results, we present evidence that the wound-healing time was less when diabetic individuals were subjected to HBOT than when no treatment was given. Furthermore, diabetic mice subjected to the combined-treatment improved faster than those under other treatments. Specifically, the wounds of the diabetic mice subjected to HBOT plus WJ-MSC seeded scaffolds recovered significantly faster and with fewer sessions than the sham control group. Most likely, HBOT increased the tissue oxygen content and improved collagen synthesis, angiogenesis, and epithelization in the wound bed. 

See study here.

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Here's What I've Learned

New medical research Reveals most powerful treatment yet

From: Dr. AJ Ludlow
Stronglife Physiotherapy

There is a big difference between being alive and thriving.

To me thriving means living a capable, strong, independent and exhilarating life. Thriving means avoiding debilitating illness, aches and pains. This can be a challenge as we age. Wouldn't you agree?

As the owner at Stronglife Physiotherapy I have a rare opportunity to bring revolutionary medical technology to help those working toward this kind of life. This therapy will help my patients have an unfair advantage to living a healthier life. As you'll see below, this treatment offers hope and healing for a wide range of conditions including many that don't have many other treatment options. 

See Testimonial Videos Of Patients' Experiences

Recovery For Athletes:
✅ 75% faster recovery from marathons, intense workouts, surgery, illness, weightlifting and more!
✅ Concussions, headaches, amazing for traumatic brain injury
✅ More energy, stamina, go longer, harder
✅ More mental clarity, eliminates brain fog, better focus even for ADD and autism
✅ The edge for athletes, try it a day before and after a big race!

Hyperbaric oxygen therapy has helped this patient: 
✅Migraines/headaches, less intense, less of them
✅Pain relief
✅Recovery from exercise and injury
✅Helps with achy joints from aging
✅Boundless energy, feel vibrant!
✅More mental clarity, less overwhelmed
✅Relaxation, less anxious and stressed

Stroke recovery in these ways:
✅Faster recovery
✅Restore feeling and movement in affected limbs
✅Restore connectivity to muscles
✅Hair growth
✅Eliminate Lupus rash
✅Improves natural feeling and sensitivity
✅Improvements in strength
✅Improved mobility
✅Improved brain function and confidence
✅Brain fog

Using hyperbaric made a huge difference for
✅Neuropathy pain, pins and needles
✅Being able to wear shoes again, stand for extended periods of time
✅Sore feet including plantar fasciitis pain (from other patient testimonials)
✅Nerve recovery, restores natural feeling and sensitivity
✅Improved sleep quality, deeper and longer
✅ Improved quality of life

What is Hyperbaric Oxygen Therapy?

Diabetic foot - Hyperbaric chamber effects

Diabetic foot affects 1 in 11 patients suffering from this pathology. The hyperbaric chamber accelerates the healing of ulcers and may prevent or limit amputation.

About Our "Stronglife" Hyperbaric Oxygen Clinic

About Dr. AJ Ludlow, DPT

About Dr. AJ Ludlow, DPT

Dr. AJ Ludlow is passionate about finding the most innovative ways to keep his patients from being in pain and struggling with debilitating disease for years. He wants to bring the best medical technology the world can offer to the state he loves and the people he wants most to help.

A California native, but has lived a total of 15+ years in Utah between receiving his undergraduate at Brigham Young University and his doctorate at the University of Utah, he now calls Utah his home!

He has traveled and researched extensively to find the most effective solutions for injury and pain. What someone would have once had to travel outside the US for, is now available right here in Provo, UT. 

Dr AJ Ludlow Hyperbaric Oxygen Therapy (HBOT) Provider in Provo Utah, stronglife physiotherapy AJ ludlow doctor of physical therapy physical therapist in provo Orem utah

Frequently Asked Questions

What type of hyperbaric chamber do you use?
We use soft chambers that reach 1.3 atmospheres of pressure. This is considered mild hyperbaric oxygen therapy and has several advantages over hard chambers. When it comes to pressure with HBOT, more is not necessarily better. Most chronic or non-emergency conditions respond better to lower pressures. You still get a healing dose of oxygen and pressure without the higher risks that come with higher pressure chambers. It is much more affordable than hard chamber sessions and it is even available for home use for those who have a hard time coming into the office for the recommended number of treatments.   
 
Am I a good candidate if my Doctor doesn’t think it will help?
A study found that 75% of medical schools offer little to no education on hyperbaric oxygen therapy. Most doctors have very limited understanding of hyperbarics. A practitioner with specialized knowledge of hyperbaric oxygen therapy will be better suited to answer your questions. When you consider how safe, natural and powerful hyperbarics can be, it is worth doing more research and seeking a second opinion from a knowledgeable practitioner. Many doctors who do educate themselves on hyperbaric oxygen therapy end up being very supportive and even change their practice of medicine to offer it. 
 
How does hyperbaric oxygen therapy help? 
Hyperbaric oxygen therapy delivers up to 3x the normal amount of oxygen throughout the body. This helps with healing, reducing inflammation, energy production, digestion, detoxification, concentration, recovery, etc. Many parts of the body do not receive sufficient oxygen, are damaged, or “turned off” because of an illness, or injury. For example tendons do not receive as much blood flow as muscles and are often more likely to be injured or strained. Hyperbaric oxygen therapy gets more oxygen to all parts of the body, reawakening cells, such as brain cells after a stroke, or heart cells after a heart attack. It gives the body a huge advantage to heal, repair and regenerate itself. As a result of the increased oxygen, the part of every cell in your body that produces energy (mitochondria) becomes stronger and more efficient, many negative symptoms from health conditions and aging disappear, and you have more energy and mental clarity. The more sessions you do, the more these changes become permanent. It positively affects your DNA and can turn some negative DNA markers off and turn positive ones on. For example, eliminating many allergic reactions and even putting some diseases into remission.
 
Does insurance cover hyperbaric oxygen therapy?
Hyperbaric oxygen therapy is FDA approved, covered by insurance, for 14 conditions, even though many other conditions benefit from this treatment. It is used for over 200 different conditions in other countries with extensive research supporting its use. If hyperbaric oxygen therapy is used for any condition other than the 14 approved conditions it will be considered “off label’ and therefore not covered by insurance companies. Hyperbaric oxygen therapy is a regenerative treatment and insurance companies, unfortunately, have a bad track record of covering regenerative medicine. The FDA approved conditions are: air embolism, gas embolism, acute traumatic ischemia, burns, carbon monoxide poisoning, smoke inhalation, diabetic foot ulcers, exceptional blood loss, decompression sickness, gas gangrene, necrotizing infections, severe anemia, skin grafts and flaps and wound healing. If you have one of the FDA approved conditions it is recommended that you seek care at a facility that can bill insurance for the treatment. 
 
Is hyperbaric oxygen safe? 
Hyperbaric oxygen therapy is extremely safe, especially the type offered at Stronglife. Our chamber goes to 1.3 ATM which is the equivalent pressure of being 10 feet under water. We also provide supplemental oxygen directly to you through a nasal cannula instead of pressurizing the entire chamber with 100%. This means there is no risk of oxygen toxicity and no risk of a small spark causing a fire or explosion, with higher pressure and higher oxygen levels the risks go up. 
 
The main risk with any form of hyperbaric oxygen treatment is the (small) risk of damage to the ear drums. While the chamber is being pressurized, you will notice pressure building in the ears (similar to when on a plane or when under water). It is important to be able to equalize the pressure in your ears by yawning, pinching your nose and swallowing or pinching your nose while yawning. Most people are easily able to equalize the pressure. We will be standing by the whole time to assist with the process, and can pause the chamber or release pressure for those few who have a difficult time. 
 
While the majority of people notice they feel better after their HBOT session, there is at times a detox reaction also known as a Herxheimer reaction. This can result in flu-like symptoms including body aches, mild fever, fatigue, nausea or other symptoms. This is caused when harmful microorganisms die off and move towards elimination in the body. While this can be an unpleasant experience it is actually a good thing because the treatment is helping the body excrete these harmful mircoorganisms from the body like Lyme bacteria, Epstein-Barr Virus, mold toxins and others. After several treatments these symptoms will fade and are replaced by higher energy levels and a greater feeling of wellbeing. 
 
 
Does hyperbaric oxygen therapy interact with medications: 
Very few medications are of concern (listed below).
Bleomycin
Cisplatin
Doxorubicin
Sulfamylon
Disulfiram
Mafernide Acetate
 
Can I do hyperbaric oxygen therapy if I am claustrophobic: 
Yes, we are standing by the entire time to turn off the chamber and let you out at a moment's notice. We have had many claustrophobic patients do the full treatment reporting afterwards that they had a pleasant experience and felt quite relaxed. The hyperbaric oxygen stimulates a relaxation response in the body, and most just read, use their phones or take a nap. Most are also surprised by how roomy the chamber feels on the inside. 
 
What does it feel like to do hyperbaric oxygen therapy? 
When asked, patients relate that it is a very relaxing experience. Before you get in we recommend using the bathroom. Then you remove any sharp objects from your pockets and remove your shoes. You climb into the chamber, it is on a platform, for those who have a hard time getting down on the floor. You will have an oxygen tube feeding oxygen directly to your nose.You lie down and relax on a thick pad and pillows. In the first 5 minutes the chamber comes up to pressure during which time you clear your ears multiple times, like when you are on an airplane or going over a summit while driving. After that, you’ll hear fresh air coming in and going out, like white noise. Many patients can sit up if they choose, but most prefer to lay down and relax. The last 5 minutes when it is depressurizing, you can feel some mild pressure on your ears, but most don’t even need to clear or “pop” their ears. Once it has depressurized, we unclasp it and you climb out. Most patients say they feel very relaxed afterward, “like walking on a cloud all day, “ chronic pain patients have told us, “it was the first time in months I wasn’t in pain.” There is no downtime, no need to take off work, you can immediately resume your normal activities. 
 
Are there times it is not advised to do hyperbaric oxygen therapy?
For the following situations, it is not recommended.
Untreated Pneumothorax (punctured lung)
Serious sinus congestion
Sickle Cell Anemia
High Fever
Hereditary Spherocytosis
COPD
Pregnancy
 
For any questions not addressed here please call or text us, we are happy to answer your specific questions regarding your unique health concerns.
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