A Memorial Day Message for Veterans with Traumatic Brain Injuries

This Memorial Day, we are another step closer to achieving access to hyperbaric oxygen therapy (HBOT) for veterans with brain injuries.

Christmas 2001, my wife and I were plunged into a parent’s worst nightmare – a car accident resulting in our teenager’s traumatic brain injury.  After a month-long coma, our son Bart gradually emerged with disabling cognitive, emotional, and physical deficits. Eight months of grueling hospital therapies and the verdict was in – Bart was not ready to return to a classroom and would be better served by placement in an institution.  We railed against warehousing our seventeen-year-old son in a convalescent home and fought to win Bart a chance to struggle, heal, and make progress.  Then, we began exploring safe alternative therapies.

My wife and I cobbled together an unofficial ‘medical board’ of trusted physicians. ‘Members’ didn’t know each other or that they served on a ‘board.’ When we found a promising alternative therapy, we’d ask them whether they thought it might do any harm. Some exciting approaches failed this Hippocratic test. Others, like hyperbaric oxygen (HBOT) therapy, craniosacral therapy, neurofeedback, and mega-doses of Omega-3 fish oils, were remarkably successful, gradually transforming Bart’s life prospects.

A lot was riding on these therapies. Bart had been allowed to return to school provisionally for half-days, in special education classes, and accompanied by a dedicated aid to assist in class and assure safety. He’d fall asleep every half hour or so, nodding off midsentence. We jokingly referred to these as ‘power naps.’ Humor was vital to the healing process; and we’ve clung to it like a life preserver. But sleeping the day away was no laughing matter. Bart would be removed from school if he failed to keep up in class. An extreme extrovert, he desperately needed to be around familiar faces, among people who loved him, to have even a fighting chance at recovery. Imagine our excitement and relief when, after only four sessions of HBOT, he was able to make it through the entire day without a nap! Successes were anecdotal, but a neuro-psych exam several years after the accident reported that the examiner had hardly ever seen such improvement in someone so severely injured.  

Bart was a lively, charming young man, living nearly independently in his own apartment, holding a part-time job, making new friends, and moving on. How different the outcome would have been if we had heeded the advice of well-meaning busy bureaucrats? Bart passed away last year, 21 years post-injury, but not before making a remarkable recovery driven by alternative therapies, especially HBOT. He lived a whole and meaningful life dedicated to encouraging and inspiring others on similar journeys. 

For survivors of severe TBI, safe alternative therapies are not merely a reasonable option; they are often a necessity. Best practices of conventional medicine only take us so far, often ending at the nursing home door or heavily medicated at home, facing long empty hours and overwhelming families.

TBI will remain a tragic legacy of wars in Afghanistan and Iraq for a generation. According to The Woodruff Family Foundation, there are 320,000 TBI survivors among combat veterans. The sheer weight of numbers and astronomical costs of life-long care for the wounded present a unique opportunity to improve outcomes for TBI survivors, military as well as civilian.   

HBOT is safe and effective, easy to deploy, and quickly scalable, and it is increasingly becoming the standard treatment for TBI overseas in places as diverse as Israel and China. This brief article I wrote for Brainline.org succinctly makes the evidentiary case:  https://www.brainline.org/story/time-right-alternative-therapies

You may wonder why, if HBOT is safe and effective, it is still not approved by the FDA and thus not covered by insurance. That may never happen since no entity, drug company, or medical device manufacturer is willing to spend millions to drive the FDA approval process when there is no way to obtain a return on their investment. HBOT chambers are already in ample supply. Despite that bureaucratic log-jam, HBOT is increasingly endorsed by prestigious medical journals, such as World Neurosurgery.  https://www.thebartfoundation.org/hbot-for-mild-mod-tbi/ Their conclusion: “HBOT using 1.5 atmosphere absolute in increments of 40 sessions was found to be a safe and effective modality in managing the long-term sequelae of TBI. HBOT should be considered in the management of this patient population.”

Another recent article in Psychiatric Times by a prominent physician concludes: “HBOT can bring about dramatic improvement in many neurological conditions for which we have had very little to offer other than palliative care. Considering the high incidence of many of these neurological conditions, the safety of treatment, and the simplicity and relatively low cost of mild-HBOT, it is unfortunate that it is not more widely available.”  https://www.psychiatrictimes.com/view/treatment-traumatic-brain-injury-hyperbaric-oxygen-therapy

Obstacles to adoption in the States seem to be bureaucratic: doctors, hospitals, and insurers have yet to sort out reimbursement protocols in the absence of FDA approval.  Still, a grass-roots movement is emerging. TreatNOW.org coordinates a nationwide network of clinics that offer free HBOT to injured veterans. Texas, Indiana, Arizona, Kentucky, Florida, North Carolina, Maryland, Virginia, and Wyoming are following Oklahoma’s lead in providing state-funded access to HBOT for veterans who are survivors of TBI. Along with other grass-roots groups, The BART Foundation is petitioning the New York State legislature to join the movement.

To do nothing and ignore safe alternative therapies is to make a decision fraught with risk since survivors are already more liable to several conditions, including Alzheimer’s, Parkinson’s, suicide, substance abuse, and subsequent TBIs. The financial and human costs to survivors, families, and communities are vastly greater than that of providing HBOT. Faced with such an existential dilemma, our family chose to try for a better outcome. Military families of wounded heroes who have already sacrificed so much deserve no less. Please ask representatives in your state legislature or your congresspersons to join the movement to provide life-saving hyperbaric medicine to veterans.  To find out more, contact https://treatnow.org/  or www.thebartfoundation.org

Joel Goldstein is the father of a TBI survivor, author, advocate, and Executive Director of the Brain Alternative Rehabilitation Therapies Foundation (BART Foundation), a 501(c)(3) public charity.  Author of “No Stone Unturned: A Father’s Memoir of His Son’s Encounter with Traumatic Brain Injury” (University of Nebraska Press, 2012), Joel has written about brain injury for Brainline.org, Exceptional Parent Magazine, Adoption Today and Rehab and Community Care Medicine.