JR Manning

It’s finally over, and I was able to sleep in this morning. Nowhere to be at a specific time, no appointments, not even a scheduled call to my boss. A real, honest, day off.

Why? My hyerbaric oddyssey is officially over. My 30th, and final dive, was completed at 4:30 yesterday afternoon. My surgery was last week. I do have to go see the surgeon to have a follow-up exam, on Friday, but that’s not today.

My boss is eager for me to return, he has lots for me to do - but that’s not today, either.

Now that it’s all over, would I do it again? Absolutely. The more I’ve been diving, the more I’ve learned about HBOT.

At normal atmospheric pressure, at sea level, the pressure of air is 14.7 PSI, or 1 ATA. 1 ATA is the weight of a 1″ column of atmospheric air, about 50 miles high, which weighs 14.7 pounds (at sea level.) The level of 2 ATA is the weight of that same 1″ column of air, if it were 100 miles high, or 29.4 PSI. Since it is not possible to increase the Earth’s atmosphere to a depth of 100 miles from 50 miles, we do it by mechanical means, with an air compressor.

Why? Injured tissue begins to heal when oxygen reaches it. Oxygen reaches tissue through blood cells, blood plasma, cerebral-spinal fluid and other body fluids. In order to promote healing, more oxygen promotes more tissue growth and the ability to carry away disease. It also promotes growth of new capillaries.

At 1 ATA, in normal atmosphere, the body inhales about 6 pounds of oxygen per day. At 2 ATA, the body is forced to inhale more deeply and by introducing a pure oxygen atmosphere, the body will inhale 2.4 pounds of oxygen! Red blood cells pick up this extra oxygen immediately and carry to the body.

When I come out of the tank, my skin is pink, so I know this is true.

Hyperbaric Oxygen Therapy is used to benefit those who are at risk for infection, as I am. Other theraputic uses include stroke patients and those who have suffered industrial accidents by inhaling toxic fumes. It also benefits those with Lyme disease and traumatic brain injuries.

HBOT is also being used, and very successfully, for autism, cerebral palsy, multiple sclerosis, mitochondrial disorders, even chronic fatigue and migraines.

You can read more about it at the website of the International Hyperbarics Association.

I’m a believer!

And I’m also enjoying my day off.

The surgery is over. I wish I could tell you what it was like, but I don’t really remember much about it. Between nitrous oxide and whatever it was they pumped into my veins, I was on a mini-vacation. I also remember the surgeon kept calling me “George.” That’s okay, I’ve been called worse.

I’m more than 2/3 of the way through this sojourn, having completed 20 of 30 dives and competed the surgery.

How was the surgery? Like I said, I don’t remember much. It would have been nice to stay right there in the chair for a few hours, with the same drugs of course, because the afternoon wasn’t a whole lot of fun. The front of my face felt like I had been kissed by Hiawatha.*

Between a Vicodin script and some well needed sleep, I was able to weather the afternoon pretty well.

One more thing - toward the end of the procedure today, the surgeon said, “Look at this! There really is something to this hyperbaric oxygen therapy!” The doctor was referring to my ample blood flow, much stronger than some people in my circumstance are known to have.

Tomorrow, back into the tank.

* The Hiawatha was a high-speed passenger express that ran from Chicago to Seattle on the Chicago, Milwaukee, St. Paul & Pacific Railroad, better known as The Milwaukee Road. The stunning train was designed by legendary Brooks Stevenson. Today, the Hiawatha runs 6 times a day between Milwaukee and Chicago.

Brooks Stevens’ famous observation car on the Hiawatha 

The more I go diving, the more I want to know about what’s actually going on in the tank. I’m no expert, far from it. I’m just the guy in the tank, sucking oxygen at 2 ATA, or, 2 atmospheres, whatever that means.

So, I set out to try to figure out what it all means.

Air in the atmosphere exerts 14.7 psi. That means that a one inch square column of air, the height of the atmosphere (about 50 miles) weighs 14.7 pounds. That unit of measure is called an “atmosphere” and the pressure of one square inch (described above) becomes one atmosphere. If it were possible to double the height of the atmosphere to about 100 miles, the weight of the 1 square inch column of air would weigh 29.14 psi and the unit would be two atmospheres. Of course, that isn’t possible but it explains what the units mean.

Conversely, when you rise above sea level, the weight of the air is reduced as the air gets thinner. You experience the thinner air as you climb to altitude in an airplane, even in a car climbing a high hill or a mountain.

Air is relatively light but water is much heavier. One cubic foot of water weighs 62.5 pounds while one cubic foot of air weighs only 1/12 pound. The force exerted by water, at depth, increases much faster than air. At the surface, water exerts 1 ATA but as we go below the surface, the pressure increases quickly. The force of 2 ATA is reached at a depth of 33 feet.

When diving, the most impact on the body is within the first 15 feet of the dive. In those first few feet, a diver experiences the squeeze of pressure on body parts with air - intestines, lungs, ear canals - as they are reduced to half their normal size.

In the hyberbaric chamber, air is compressed by mechanical means (a compressor) rather than water. The controls are simple - there is a valve that allows compressed air into the chamber and one that releases the compressed air from the chamber. Across the top of the chamber are several valves that regulate the air flow.That’s it - that’s really all there is to it.

The tech turns on the oxygen flow to my helmet, turns on the air flow from the compressor, closes the valve and shuts the hatch behind me. Nature takes over and does the rest.

In the chamber, I feel the same thing the diver feels in those first 15 feet, especially in my ears. You feel the same changes in pressure in an airplane.

As my “dive” starts, the door to the chamber almost slams shut from the compressed air that is already filling the chamber. I always have two plastic water bottles in the chamber with me, one full and one empty. The empty bottle collapses, to about half its normal size, almost immediately as the pressure increases. I used to loosen the cap and let it inflate, but now I let it collapse to use as a pressure guage. The full bottle doesn’t collapse as quickly because water does not compress, however, I do open that one periodically to balance the pressure. (I don’t need my water bottle bursting at the start of a dive.) What happens to the plastic bottles is also happening to me and I mostly feel it in my ears. Lots of yawning, swallowing and otherwise trying to balance the pressure in my ears.

Once past that “first 15 feet” the dive becomes easier and the same is true in the chamber. In fact, those last few minutes of reaching the specified pressure of 2 ATA is comparibly uneventful. Conversely, when the chamber is depressurized, the initial change in pressure is obvious to my ears, then it is relatively easy until the last few minutes of depressurization.

It is difficult for my tech to get the hatch open. Even the slightest bit of pressure holds it snugly closed, and even the oxygen flow has to be turned off to help balance the pressure enough to allow the hatch to open. It opens with a “WHOOSH!” and I can feel the pressure drop, especially in the my ears, when the air rushes out of the chamber. The water bottles feel it, too, as the empty comes back to full size. The one with water hisses like a Coke can when you open it.

Tomorrow, I cross the halfway point of my sojourn.

When I was a kid, the space race was in full swing. Project Mercury was over and done with, Project Apollo was still in the future but NASA still had to practice teamwork and docking in space. The learning exercise was a two-man capsule dubbed Project Gemini. It was my favorite era of the race to the moon.

Every day, twice a day, when I climb into my tank, I think about the brave men, with the right stuff, that climbed into pill bottles smaller than the one I’m in every day. The big difference is that my capsule never leaves the floor while theirs were launched into space.

My best friend in those days was Jim. We admired our brave astronauts, so much so, that we wanted to be astronauts ourselves. Every kid did in those heady days. We went so far as to find some large sheets of cardboard and make our own space capsule simulator. We flew simulated missions and called our endeavor, “Project Jim and I.”

Of course, our capsule never left the ground. Neither does my tank, but that doesn’t stop me from comparing my hyberbaric chamber to the capsules of the 1960’s. The big difference is NOT that my tank doesn’t fly. (Neither did the freezer box simulator.) The big difference is the realization that I would never allow my ass to be strapped to a roman candle.

Since Friday, though, my left ear just won’t pop. I’m pretty sure the eustachian tube (my friend, Jim, the other half of Project Jim & I, used to call it the Earie Canal) is inflamed or clogged. I’m going to take two Sudafeds tonight and see if it clears overnight.

I’m reading in the tank as I am allowed to take in a book. I read large print versions because reading through the helmet is like reading through the back window of an old convertible.

10 down - 20 to go. I’m 1/3 of the way there!

7 down, 23 to go - but who’s counting?

I’ve got a brief break before I go for my second, and last, dive of the day and this week.

The worst part of this is the solitude. Funny, I like my solitude and I enjoy driving long stretches of old highway with no one in the car with me - like in 2003 when I drove the Lincoln Highway from New York to San Francisco in a Model A, with no radio and no companion.

The difference here is that the solitude is forced - no radio, no companion, and no gas station just ahead where I can stop for a quick pit stop and maybe get a glass of milk.

Once the door shuts, that’s it for almost two hours of solitude. And I’m not in control, the guy outside with his hand on the air compressor control is the guy in charge and I’m at his mercy until the pressure goes back down.

I finished Diane Setterfield’s The Thirteenth Tale today, in the tank. I highly recommend the book but I finished it before the dive ended. Luckily, I have another book to accompany me on the this afternoon’s dive.

I wish I could sleep in there, but the collar that holds the helmet on is not exactly a bastion of comfort, especially for getting comfortable. Reclining is impossible with that (*&^%#! helmet, so I’m going to try a different type of pillow today and see it I can snooze for awhile. An old pastor of mine, Bob Jones, once said, “The shortest distance between two points is a good snooze.” As long as someone else is driving, and when I dive, Dave is doing the driving.

I’m also having trouble with my left ear not balancing, or “popping” when I go up and down in pressure. I hope it’s not a symptom of some other problem that I am not aware of.

Well, off into the wild, blue not-so-yonder.

The late columnist of the Los Angeles Times, Jack Smith in his syndicated column once said, “Everything comes with practice except getting up in the morning.”

So it is with HBOT. Each dive gets a little easier.

Digging back in my cobweb addled brain for memories of Freshman Year in college, back to Physics for Dummies, it came to me that there is a relationship between hyberbaric pressure and heat. As compressed air fits into a combined space, there are more molecules to vibrate and the energy creates heat. Which is why the tank gets hot until the compressor is shut off and normal air has slower molecules so it gets colder.

It’s getting easier with each dive but, I can assure you, there are a lot of places I would rather be than in the tank.

The worst part of this is the solitude, coupled with not being in control. I am at the mercy of the tech who operates the controls - sort of like being in jail. The air pressure holds the hatch tightly shut, so there is no way out of this thing when the pressure is even slightly above the normal barometric pressure. My water bottles begin to collapse within seconds of the hatch closing.

Another thing that drives me crazy is not being able to write - computer, pen or even pencil. For a creative soul like me, it is literally, like being in jail except that I know I’ll be out soon.

The last thing that drives me crazy is that there is no way to measure the time passage. No clocks are visible from the portholes. Dave, thankfully, raps on the window every 20 or 30 minutes to let me know how much time is left.

Well, break’s over. Back to my tank.

Today is the beginning of a new experience for me, something I never dreamed existed, let alone, thought I would need. This morning, I am going diving, the first of 30 dives I must make.

Diving?

Yes, like scuba diving except that I am not going to get wet. I’m diving in a hyberbaric chamber. Yes, that tank they put people in who have the bends. I’m going to undergo something called hyberbaric oxygen therapy or HBOT. The idea is to breathe pure oxygen under pressure. For me, that will be at 2 atmospheres, the equivalent of diving to a depth of about 33 feet. HBOT increases blood oxygenation and promotes capillary growth. You can read more about it, if you want to, at my HBOT clinic’s website.

The chamber itself is not pressurized with 100% oxygen (that’s what killed the astronauts of Apollo 1) but uses ambient air. To get the oxygen therapy, I’m going to have to wear a helmet that looks like the ones the aliens wear in The Simpsons.

Doncha love all the little fishies on her scrubs?

No, I’m not doing this for the fun of it - it’s in anticipation of surgery I’m having later this month. There are couple of things you need to know about this. One, there are no electronic devices allowed in the chamber - so no MP3, Walkman or computers. No books, magazines or printed materials are allowed in the chamber - inks release toxins under pressure. No mechanical devices, like puzzles, pens or pencils and no note pads. Oh, and as you might guess, there are no toilets inside the chamber, either! (Don’t ask to borrow my water bottle when I come out, if you get my drift, but give me a call next time urine town.)

I have two dives scheduled today - a couple of hours each while I’m locked inside a little tank. I don’t think I can locate a Tupperware small enough to contain my enthusiasm, but this must be done. I’ll let you know how it goes.

UPDATE!

Well, I’m out of the chamber after number 1, only 29 more to go. I squirted out of that tank like toothpaste when you accidentally step on the tube.

I had a little anxiety attack when the door slammed shut the first time and I made them let me out for a minute to compose myself. The tech, Dave, is a great guy (we’re contemporaries, too, so that helps) and he helped talk me back down. In fact, I think Dave is a little more to this place than a techie. I’ll let you know.

It wasn’t really claustrophobia of being in the tank, it was that gosh darned helmet. It isn’t really a helmet as much as it’s a big plastic bag with rim that seals like a Tupperware. It was reminiscent of the mask I had to wear for radiation and you don’t want to know about that.

The helmet filled up with oxygen and my head started to float away like a hot air balloon - but once the pressure started to come up in the chamber, it balanced out. It’s really not much different from flying in a pressurized airplane except there’s no movies, no music, no guy in the seat next to me to annoy and no flight attendent offering a bag of peanuts and a beer. And, it gets awfully warm and humid in that helmet. (I’m hot stuff, ya know.)

The chamber is what I told you it is, a tank, it’s a little like being inside an air compressor except it has windows. It’s larger than I anticipated, I would guess that it’s 7 feet long and 42″ in diameter. I was able to sit up in it, except there’s no lumbar support so my back hurts now. Anyway, it’s bigger than a garbage can. The biggest thing for me is being incommunicado for two hours.

I’m trying to decide if I’m uncomfortable right now or not. I do know that I could use a nap.

Oh, yes…I took a book in with me. Diane Setterfield’s The Thirteenth Tale. Apparently, it’s okay to have a book along - that really, really helps.

UPDATE TOO!

UPDATE: The second dive was much better than the first one.

First of all, I went to the Lands’ End Inlet and found a nice, light jersey knit t-shirt and a pair of light, all cotton pants. That alone made a big difference, because the first dive was very warm.

Dave had an ice pack prepared for me, and that made a big difference, too.

Just the same, for some reason, the last twenty minutes seemed like twenty hours.

Some observations on the day…

The sound of oxygen flow gets very old very fast. The only feeling of high pressure comes when going up to pressure or coming back down to normal pressure, because, like in an airplane, ears pop. Going up to pressure, my water bottle begins to collapse. On the way back down, he bottle hisses when the cap is opened. Otherwise, at pressure, the only thing I noticed was the hiss of the oxygen flow into my helmet, the hiss of ambient air flowing into the chamber and the sound of the pump, just outside the chamber, that provides the pressure.

I got a lot of reading done today, but it’s a challenge to do so. The helmet fills up with oxygen and warm breath, so it acts like a hot air balloon and wants to float around. So, I have to hold it in place if I want to read.

That’s my first day was like. I suspect it can only get better with each dive.