Elevated Healing: The Power of Hyperbaric Therapy

Hi, everybody.

I'm Dr. Sandhya Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body. As we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy, so take care of it in the most natural way. Welcome, everyone, to today's show. My name is Dr. Sanda, your host, and I'm excited today to talk about hyperbaric oxygen, because I think there's just so much confusion around it. People still don't know what exactly it does. And there's so much more research coming out about hyperbaric oxygen disclosure. I actually have a tank at home. I have one of those soft shell tanks, you know, chamber. Should I say, not tank that. It's for two people that I've had actually for years, and when I had an ankle surgery, really helped me with the healing, especially with everyday use. But with me today, I'm excited to introduce Nicole Garrett, who's a certified hyperbaric technician. Welcome, Nicole.

Hello. Thanks for having me. Yes.

I'm excited to talk to you today. You know, I know you have a background. You own your own hyperbaric clinic in Los Angeles, correct?

Yeah. Here in Beverly Hills.

Yeah, Beverly Hills. Okay. Excellent. And you actually have a background in commercial diving and, like, dive medicine. How did you get involved with that? Were you a diver yourself?

Yeah, I was a diver. My big goal was always to, like, train dolphins. That's why I moved out to San Diego and not really living wages on that. So I went to commercial dive school and really just fell in love with the dive medicine and kind of how physics affects your physiology. So jumped in with dive medicine and started doing some research with hyperbarics and kind of just took off from there.

Very interesting. I mean, I love diving myself. I started diving in college. I think I was, like, right after college. And the pressure underwater, it's pretty incredible. And I remember having these hyperbaric chambers in locations where people would get actually maybe go too deep underwater, and then they would need to go into a hyperbaric chamber. What actually happens and why do you need to do hyperbaric after a deep dive?

Yeah. So there's a couple of reasons you would have to do it after a deep dive. One, you're just diving really deep, and when you come back to the surface, you have to do what's called a decompression stop. You stop at 20ft and just let your air off gas from your body, you don't want to do that. You could come all the way to the surface and get back down in the chamber really quickly. And you can decompress a lot faster on oxygen in a hyperbaric chamber. That's what commercial divers do is they don't decompress very much in water. They come straight to the surface, decompress in a dry, sterile environment, much more comfortable, much more quickly. For the not so good reasons to need a hyperbaric chamber, if you get the bends, it's because you came up faster than you could decompress. And those little bubbles come out of solution in your body and create a blockage. So usually it's like an elbow or a knee and you gotta use the hyperbaric chamber to squish the bubble back down and, and kind of breathe it out like it should have been the first time.

That's pretty amazing because that's really the only thing we have that I know of, the only tool that can actually help our bodies decompress.

Yeah, yeah, we're just, we're kind of going back to pressure and doing it the right. Right for our physiology.

Yeah. So you started your career at UCSD hyper ver chamber, treating pretty much a bunch of different things. What kind of conditions were you treating there?

So it was a level one trauma center. So we would treat everything from crush injuries. Quite a few like foot got run over. Or we treated one girl that had every bone on the right side of her body broken from a motorcycle injuries. We did a lot of limb salvage. We did treat a lot of burns. And then we treated a lot of the traditional diabetic wounds, radiation, things like that, but very trauma based there.

And were you combining hyperbaric therapy with other therapies or was this pretty much the go to therapy for these injuries?

No, most, for most indications, at least that insurance pays for. In the US it's an adjunct of therapy, so we use it in conjunction with other therapies. If we're treating a bone infection, we're still using antibiotics. If we're using, you know, if it's a diabetic wound, we still have standard wound care or advanced grafting for radiation injury, it's about the only thing you can use. So it is a standalone therapy.

So let's step it back a little bit and tell us what is high hyperbaric oxygen therapy, because a lot of people don't even know what it is listening to this. Like, wow, you can use it for a multitude of things, even bone infections. You mentioned, you know, Gum healing. I use it a lot for oral surgery, for injuries. But what is it exactly?

Yeah. So the true definition is an increased partial pressure. So we increase the pressure of 1 1/2 atmospheres or greater with oxygen. So an atmosphere here in Los Angeles, we're sitting at sea level, so that's one atmosphere of pressure that's sitting above us. So you want to go one and a half times the pressure we're sitting at now. To be a true hyperbaric therapy, less than that would be considered mild hyperbarics. And what happens is, if I were to put you or I on oxygen just sitting here at sea level, we don't get a lot of benefit. When we put you in a hyperbaric chamber and we increase the pressure and now you breathe that oxygen, we're dissolving all that oxygen into all your body fluids. We can dissolve so much oxygen in your fluids, you don't even need your red blood cells anymore. And then your body can take that oxygen and use it everywhere. So it's a systemic treatment. We put you in the chamber, your whole body is getting therapy. We may put you in for a gun graft you did yesterday, but your knee and your toe are also getting that increased oxygen.

Yeah. So people probably notice, hey, my joints are feeling better. Because joints typically just don't have a lot of vascularity, a lot of oxygenation. Do you see that?

Absolutely. We have patients go off their arthritis medications when they're here daily. It's really potent anti inflammatory. Most people think when they come in, this is terrifying, I'm going to be claustrophobic. I can't do this. And then by a week into treatment, they're like, I never want to stop. How do I do this forever? I feel amazing.

Can somebody do that every day forever? Or is there like a overdose, so to speak?

On hyperbaric, there can be an overdose. So there are some side effects. Most of them are acute. But if you wanted to do it forever, you have to worry about the long term repercussions of the high partial pressure of oxygen on your lungs. So there is a point at which where we usually force people to take a break for a little bit just to give their lungs a break. It's the same that if you were in the hospital on a ventilator on 100% oxygen and get some pulmonary scarring from too much oxygen.

Yeah, makes sense. So are you using like oxygen tanks, like purified oxygen to put in the chamber, or you're just condensing like ambient air?

No, we use Hospital graded oxygen. We purchase it from a vendor. So it's 100%. Yeah.

So compared to like a home unit, you know, there are some home hyperbaric units, like kind of the one I mentioned that I have. Can you tell us like, what is the difference between the unit you have and like say somebody who was thinking maybe of buying a home unit?

Yeah. So I call ours kind of hospital grade for lack of better definition. Once you get up to 2 atmospheres of pressure, you are and that's where we treat all clinical indications is 2 to 3 atmospheres of pressure. That's also where you can introduce side effects. So that's where you want someone who's qualified running the equipment. You want to make sure that everything that's going in that chamber, the air or oxygen, is medical grade because you're increasing the potency of anything you're breathing. So if you put your oxygen chamber next to a car exhaust, you could increase carbon monoxide in there and it would be obviously not very good. Yeah. So once you get into those higher pressures, you can treat a lot more effectively. It's a lot more potent. But with that comes some side effects. That's where you want your skilled people to know what to look for and how to handle that.

What are some of the common side effects?

You see, the most common thing is just people having trouble clearing their ears. And that's the most similar sensation for those that aren't divers would be if you've flown in a plane. It's the exact opposite of flying. So it's like landing in the airplane. First you're going to feel that pressure on your middle ear. You kind of leave your jaw, yawn, drink some water. That's the most common thing. You have to do that the entire time you're compressing. So about 10 to 15 minutes. And then after that our chambers have a TV on the outside. So you're not as bored per se as some of the ones that don't have that option. You have something you can watch or you can take a nap. Yeah. Beyond that though, if you go a little bit deeper, you can overstimulate the nervous system with oxygen. And so there are some side effects that we look for. You can kind of get double vision ringing in your ears. You can kind of get some muscle twitches. It's just your body trying to burn off that extra oxygen. The treatment's more. It's really simple. You just give them an air break. So you switch out the oxygen for air and it kind of lowers that oxygen Tension and the symptoms subside.

Oh, okay. Wow, that's cool that you could do that. So let's go back to this claustrophobia because this treatment is, I think, is really amazing. Just. And it's totally natural.

Right.

You're using oxygen, you're using your body's potential to heal by creating an environment that's conducive to healing. So how do you get rid of like this claustrophobia or people that come to you and say, you know what, I'm really terrified to get in this chamber. How to get around that?

Yeah. So we have great technicians here. Everyone comments about how much they feel at ease with them. That helps. Our chambers are all acrylic, so you can see out of the whole thing. So that helps lower people's anxiety. We can talk to you the whole time. It's not like you're locked in a steel cage with us. And then, you know that TV's great distraction. So.

Oh yeah, for sure.

Zone into your TV show and you forget that, you know, you're sitting in the chamber and once you get through the first one, it becomes easier. You're just, oh, that wasn't so bad. And your ears start clearing on their own because it becomes kind of autonomic and it really subsides. For those that are really, really nervous, they can take some anti anxiety meds if they really need it. But most find it pretty benign once they start.

Yeah, that's pretty amazing that you have clear chambers nowadays. So it makes you feel you're not enclosed, which is great.

Yeah.

So how long is a session? Typically?

Between one and two hours. We dose the treatments with time and pressure. When people come in, we do a full intake, figure out exactly what they're coming in for, and then make sure we tailor the treatment to their needs. If you're treating something like a skin flap or a soft tissue injury, you can do that at maybe an hour to 90 minutes at a lower pressure, maybe 2 atmospheres. When you're looking at something like bone infection or radiation injuries, we need to go a lot deeper. It's a lot denser tissue. We need to match that density to get the oxygen into that dense tissue. And we'll go for a little bit longer to give it time to absorb. So that's usually a two hour treatment.

Yeah. Let's talk a little bit about the bone infections because now with the use of, let's say, osteoporosis medication, we have an increased side effect of osteonecrosis of the jaw, especially orally. Let's say somebody like I go to a dentist, they forget to tell them, hey, maybe I had IV bisphosphonates when I had, you know, prostate cancer. And now, you know, the extraction site just is not healing. So in that case, that would be an indication where actually I would refer. That would be the first thing I would do. Well, first I would make sure I know the patient's medications. But very, very important to tell your doctor that if you had any kind of bisphosphonate drugs because of this risk of osteonecrosis. So now if somebody comes to you, let's say they have osteomyelitis. Even worse, because osteonecrosis, meaning dead bone or unhealing BO can turn into a bone infection, osteomyelitis. So how successful is it to treat osteomyelitis, which is actually a very difficult condition to treat in itself?

Yeah, it's actually very successful for both bone necrosis and bone infection, but it is one of the longer healing treatments. So we start with a minimum of 30 treatments, and most go upwards of 60 treatments. So kind of just tell people, plan on being here every day, two hours a day for the next three months. Just like with ozone, the oxygen, when you're at a deep enough pressure in the chamber, it becomes bacteriostatic. It has some antiviral, antifungal properties. With the bone infection, you can use it in conjunction with the antibiotics to really attack that infection. Then the primary use of hyperbarics, clinically, for most indications, is actually to revasculate. It's the only thing we have in medicine that grows through blood vessels. We can get that bone reperfused, and the parts that are not dead or fully necrosed will actually liven back up. So early in my career, I would tell people, you know, ORN and osteo radionucrosis of the mandible was actually what got radiation approved in general for hyperbarics. And I would tell people, you have a dentist that knows about hyperbarics. You go to get a tooth extraction and only your tooth comes out because you did pre hyperbarics. You have one that doesn't, your whole job comes out. Now you're looking at reconstruction and hardware, and it's still going to be hard to close because the tissues not perfused.

Yeah. So do you recommend some hyperbaric treatment prior to the extraction? Let's say.

Absolutely, Absolutely, I would. How long before the extraction if, you know you've got necrosis in that area? I would do the bulk at least 30 before. And actually that's the standard protocol is 30 prior and then at least 10 post extraction.

Yeah, I actually have, we have a patient that in the last couple of years he. I actually diagnosed him with tongue cancer. So he had to have radiation on the jaw. And surely from radiation he developed dry mouth and a lot of the teeth started to get severe cavities to the point where I had to now remove some of the teeth because what do we do? The option is, okay, let's do a root canal, try to cap it somehow. But the problem is it traps all that bacteria in there, so at least in some area of the jaw. I talked to the oncologist and she said, well, it's kind of like at your own risk if you want to take this out. And he actually, you know, I talked to him about it and we were looking at his basically front teeth. They were all decayed. There was nothing to do with them. And it just so happened that, you know, in the path of radiation, he had radiation on the side of the jaw on the tongue, because it was in the lateral dorsal aspect of the tongue. It kind of that, that front of the jaw was a little bit missed from the beam of the radiation, but it still got some radiation. So we ended up doing exactly that. I didn't do the pre treatments because I didn't know about it. I don't know for the next patient, but it really helped for him to heal. And we were able to take out the teeth and put two implants and a bridge and yeah, definitely he went in regularly for his hyperbaric treatments and it definitely helped him heal. Yeah, yeah. Now one of the things that I love to use also with osteonecrosis or osteomyelitis, bone infection is ozone. And you do some EBOO treatments in your office.

What is he who stands for? Extracorporeal blood oxygenation and ozone. So we take ozone and unlike a 10 pass where they take out a pint of lead and inject it with ozone and then re infuse it, it's a closed circuit machine. So we take out the blood, we put it through a very powerful filter. So filter alone catches a lot of biofilms and a lot of fungals. You can see them collect in there. And then we oxygenated and then we can dose the ozone based on your indication because you can get too much ozone, especially when you're doing half of your blood volume in one sitting, which is what we do. So it's, it's just a closed Circuit ozone through your veins now.

And what indications do you use that for?

So we were using for a lot of post viral fatigue, mold exposure, a lot of candida overgrowth. Lyme disease is a big one. I mean, you know, because you use ozone, but when you have that O3 molecule and you put it in the body, it's very potent at stripping biofilms off bacterias and it helps your immune system take it out. And so if you've got any kind of blood infection or chronic inflammation, we can kind of get in there systemically from the inside and calm it all down.

Yeah, I think it's so amazing because we don't have anything else that's antifungal or anti parasitic like we do ozone. And you know, as we go through life, I think a lot of us accumulate those microbes in the blood. By all means, our blood is not sterile. A lot of people think, oh, you know, my blood is sterile and not at all. Especially, you know, just from the mouth. Every time someone's gums are bleeding, there's a chance that bacteria, parasites, fungus from the mouth enters the bloodstream and catches a ride in the blood vessel. And you know, our immune system is just not perfect. It oftentimes misses the microorganisms, so. And they can accumulate it. Especially if someone's, let's say, immune system is not ideal or they're, you know, that you don't nourish yourself with good food and you're not nutritionally fit, you know, then these organisms take advantage in a way. So then all of a sudden I hear from patients, oh, I felt really good up until one day when I just collapsed and I didn't feel good at all. It's like the bucket fills with microbes until the one day when we cannot keep up with it anymore. Yeah, so how do you. The thing is, if somebody comes and it's sick or is it chronically fatigued, do you usually start them slowly to see what their reaction is like, or do you usually want to start high to get rid of as much as possible? What's your approach?

No, so we do a pretty extensive intake and kind of a history to try and battle what it is and maybe do some blood work. We don't like to hit it too hard because if we take you in and just start you on full hour of ozone, you know, through the evil, we could kill off way too much. And then your lymph nodes and your kind of waste pathways may get clogged and you'll get what's called A hertz reaction. So then you're going to feel like you have the flu and feel terrible just from, you know, all the die off. So we may start with hyperbarics, which is a little bit gentler form. We may do some IV therapy, some chelation therapy to help pull some of that stuff out of the tissue. So when we do the ozone, it can actually flush it out. But it's pretty individualized. And that's what we kind of like to know where you came from. If you just had Lyme, Repstein Barr or something like that, you know, those viruses weaken your immune system and let some of those little microbes that have been hiding, circulating for a while come to light. And so now you're battling both. Yeah.

It's so nice that you're incorporating both, because usually, you know, we find hyperbaric centers and then you got to go somewhere else for ozone or for the iv. So it's nice that you kind of have everything together. So how did your practice grow from being a technician at UCSD to where you are today?

Yeah, so after ucsd, I did traumatic brain injury research with the Department of Defense for a while. I really enjoyed that. And then I got recruited to work for a company where I flew around the country opening new centers, doing everything from the install to the teaching, the certified hyperbaric course to the doctors and nurses. And after doing a full startup and kind of seeing the limited population of patients that all the hospitals would treat, I just wanted to open my own so we could expand that. There's so much more than the kind of rigid 14 indications that insurance pays for that hyperbarics can offer. So I called up my now medical director, Dr. Som, and he was wanting to open a surgery center at the same time. So it was perfect synergy because I knew how to run the facilities. And we opened our first center here. So now we're open to open several more, but this is our flagship.

Oh, that's beautiful. Where's your center located?

We're in Beverly Hills, just north of Wilshire on Robertson Boulevard. So just outside the triangle.

Oh, great. Yeah, really close back to our office. That's why we refer our patients to you, because, you know, I think it's so important to just help the body detoxify, especially when it comes to, you know, ozone and ibu, you know, in the mouth, I can only do so much, and I talk about, you know, detoxifying the mouth and detoxifying the body cavitations, for example. You know, we're looking at, you know, Inside the jawbone, we can have microorganisms. But, you know, those microorganisms, we don't know. I mean, yes, I take them out of the jawbone, I biopsy them. We look to see, you know, what's there. 70% of the time, there's. It's parasitic activity, but we know bacteria and microbes travel. They don't stay put. So that's why anybody thinking of having cavitation procedure, or if you are told you have a cavitation, I highly, highly recommend to do, you know, evo and hyperbaric. I think they both complement so well in cavitation procedures in terms of healing.

Yeah, I agree. And it's actually something I talk with a lot of our cancer patients. We do. I mean, Beverly Hills is kind of breast reconstruction capital of the world, and so we do get a lot of breast cancer patients here. But it's something I discuss with a lot of them, is you also need to look at what's going on in the mouth, because a lot of times there's root canals and cavitations and things that are trapping bacteria that are just not letting your immune system do anything. With the cancer, with the treatments, you kind of have to look at everything when you're going through that.

Absolutely. Now, you know the good news about your treatments and not. Not about evo. I don't think evo is covered by insurance yet, is it?

No, it's not. It's pretty.

But, yeah, hopefully soon. I mean, you know, ozone has been around since 1898. It's amazing to me that such a. Such a great treatment is not yet covered. However, the hyperbaric treatment is covered by insurance. So what are some of the indications for those people out there listening, you know, there's hope with coverage. What kind of indications?

So skin grafts and flaps. If you recently had a surgery and you're having complications, or if you have to have a repeat surgery, there was a complication before. They'll actually do it before.

By the way, I have to stop you. So skin grafts and flaps. That includes the mouth. Yeah, right. Because I do a flap every time. Yeah, okay.

Yeah, absolutely. Bone infection, radiation injury from cancer treatments, carbon monoxide poisoning. That tends to be more of an inpatient thing. We do a lot of crush injuries, so a lot of, you know, motorcycle accident or, you know, catastrophic accident, and they're told they have to amputate. A lot of times we can save those limbs because we can get that blood flow re established.

Wow, that's huge.

And then most of the other diabetic wounds is another big one. You know, as you have chronic diabetes for a long time, your blood vessels kind of start to crystallize and you just don't heal anymore. So we can actually regrow the blood vessels, especially in the feet, some arterial wounds. So anything with lack of blood flow, and then there's a few more that tend to be inpatient based.

Yeah. So patients that like people that cannot have this treatment, are there an absolute no's to this treatment?

The only absolute, absolute no is an untreated pneumothorax or you know, a collapsed lung. So if you happen to be that diver and you shoot to the surface and you collapse your lung, we have to fix that before we can treat the bubbles in your body. There's some relative contraindications too. If you have middle ear damage, you know, we wouldn't want to worsen that. Obviously the pressure is going to affect your ear. And then there's a handful of medications that can be contraindicated, of which are chemotherapy drugs. So that's all stuff, you know, when you go to a hyperbaric center, they should be doing a clearance on you going through all of this and making sure that there's no hidden things that could cause damage. Also, if you have any internal electronic devices like a pacemaker, insulin pump, spinal stimulators, we need to know the pressure rating on those. Most have pressure ratings, but we need to know so we don't go deeper than device and crush it.

You know, that's interesting because somebody getting a pacemaker would never think of asking, hey, it's my pacemaker. Good for hyperbaric chamber, right? Nobody would ever think of that.

Yeah, that's okay. That's our job to ask you. So.

So what do you think is the, the future here of hyperbaric oxygen therapy? You know, especially with this increased awareness on holistic medicine. It.

Yeah, I really see it being used a lot more often adjunctively for everyday treatments. Not just the extreme wait till the bone's so badly infected we're going to get you in or wait till your foot's about to be amputated. Maybe let's get in at the first signs. But there's also a tremendous amount of resource going into anti aging. So there's a pretty famous study that came out in 2020 where the goal was to kind of see if we could halt the degradation of our telomeres on our DNA. So every year that we age, the little tails of our DNA get shorter and they put, I think it was 40 people with a median age of 65 years old in a hyperbaric chamber for 40 treatments. And when they came out, they had actually regrown the tails of their DNA out to a median age of 40. So they reversed aging by 25 years on a DNA level.

That's pretty incredible. That's not. For how many treatments?

40 treatments.

40 treatments. That's pretty incredible because. And for those of you that don't know, we actually have tests today. We do have blood tests to test for telomere length, if you're interested. You know, what is my age really? My biological age? That's how we test it based on these telomere tails at the end of the chromosome. So it's actually an easy test to do if people are interested. You could do it before, do 40 treatments and test it again.

Yeah. Then there's a tremendous amount of research in using it for anti cancer. Cancer doesn't really like oxygen, so it can be used adjunctively. That's actually how radiation initially got approved was they would put you in a hyperbaric chamber, and then within 15 minutes, they radiate the tissue, and it would protect all your healthy tissues. You wouldn't get the side effects that we see now. For some reason, over the years, they just went to. Well, not everyone has side effects, so we'll just treat the ones that do after. So prevent it. But I'm hopeful that we'll get back into a preventative mode one day.

Yeah, I mean, that makes total sense. And I know there's a center down in Irvine. You know, they focus very much on cancer prevention and detecting it really, really early, you know, through. Through regular blood tests. And I think that is exactly the right time, you know, to use it more like a prevention. So for prevention, how often do you recommend people to come and use it? Like once a month, once a week?

Yeah, it depends on what kind of your family history I would do. I mean, at least once a month, ideally, just to get some oxygen in there. If you're someone who's got chronic inflammation. I do at least once a week. So, you know, we like our arthritis patients, they do a run of 20, 30, whatever number of treatments that they usually hear to heal a wound or something. And after that, you kind of find your maintenance dose and you just keep that inflammation down by coming in once a week versus having to take a bunch of medications with side effects. That's. It's just a much better quality of life.

Yeah, exactly. And also, I think for cognitive decline, I think there's there's quite a few studies.

Huge. Yeah, we. I mean, we've had patients come in and wheelchairs. They don't feed themselves, they don't really speak anymore. You know, the family's like, we don't know what to do. By the time they finish their treatment course, they're walking in, they're back into their hobbies. They dress themselves that day. We get primary care doctors that call and say, what? What? Who is this? And what did you do to our patient? Like, oh, that's just the oxygen, you know, doing what it does.

Remarkable. How long does it take for somebody like that to see results? Like, a few months or.

Yeah, most patients, I would say minimum would be to start with 30 treatments. I mean, what we're doing is regrowing the blood vessels. So it's not. It's not a magic pill. It doesn't happen overnight. We're just giving your body the extra boost in oxygen, and it has to kind of figure out how to do what it needs to do. But usually about 30 to 40 treatments is where we start to see that change.

Yeah, that's pretty incredible because we don't have anything else, you know, for cognitive decline except lifestyle changes. But those are slow, typically. Yeah. Oxygen is a big, big part of healing. I wrote about it in my book Heal Up. I have a whole chapter on healing with oxygen because I think it's so overlooked even by the medical field. Do you see a lot of referral doctors? You know, is a lot of the medical community using hyperbaric or. You're still maybe seeing more and more?

It's definitely increasing. It takes, you know, it usually takes one patient to change people's minds. That one that can't, you know, came in on the gurney and then left and moved back home to live on their own.

Or.

A lot of our referring surgeons, they always give you the worst of the worst. Like, I don't know what to do with this person. It's just falling apart. We have to redo everything. And when you save all that tissue and heal them, they're just like, okay, this really works. And now I'm a believer. So, yeah, it's slow, but it's increasing. Yeah.

Well, I'm glad to hear that because we definitely need more awareness. Even in the dental community, if, you know, for those of you listening who are dentists and hygienists, we need to bring awareness because we're not utilizing enough. We actually perform so many surgeries that are exposing the bone that could lead to problems and I think utilizing this as, you know, as a prescription. Let's say a dentist is listening. They have no idea how to send a patient to you. Like, how do they do that?

For the most part, just send us their name, their phone number, and why they're coming in. And we can take care of everything. I mean, we have on site medical directors, so we do all the clearance, the prescription, everything. We don't. We actually prefer you don't write the prescription because we usually have to change it anyways. But, you know, some centers, if they don't have on site medical direction, might need you to write the prescription. But for us, it's pretty easy. We just need to know who and what they're coming in for, and then we'll kind of, like I said, tailor the treatment based on what their needs are.

Yeah. And I think also for the dental surgeons who are doing big bone reconstructions, for example, the number one thing we need is blood vessels growing into the bone graft. And we do. Sometimes I do sinus grafting and I have to add 10 plus millimeters of bone. And that waiting period can be eight to nine months. So if a patient would actually start to do every day HBRT treatments, that'd be amazing because we can really increase the blood vessel formation inside and get the vascularity that we need to the bone.

Oh, yeah, absolutely. And you're keeping infection down because you're keeping oxygen in there.

Yeah, absolutely. If somebody has like a stuffed sinus, is that a contraindicate? I guess because they can't equalize their ears.

Yeah, it depends on each patient for that. But if someone comes in stuffed up or says, I have allergies today, we come on like hawks when they get in the chamber. Because it is so close to your eustachian tubes, it can affect how you clear your ears. And so we have afrinone sight. We can recommend a decongestant. Or sometimes we say, skip a day or two. Let's not push it because we don't want to damage the ears and put you out for a month. If we could just wait two days.

And have it calmed down. Yeah. And lastly, I want to talk to you about. Maybe you can give us some tips, quick tips. How do we get our body ready so we can get the most out of hyperbaric therapy?

Yeah. So first I would say eat something before you go in. So the hyperbaric oxygen therapy does boost your metabolism while you're in the chamber. It's not like a diet plan, but your body takes all that Oxygen and it starts putting it everywhere. So you may have had surgery yesterday on the mouth and it's going to heal there, but you also stubbed your toe last night. It's going to try and heal that. So it uses a lot of your free glucose and energy to do so. So make sure you eat something before two is avoid caffeine two hours before treatment. That's one most people don't know about. Caffeine's a really potent vasoconstrictor. We are trying to get as much oxygen into the tissue as possible, so we don't want that constriction taking place. And then three, I would just say make sure you come clean. Showered, no oils, lotions, deodorants. You want to try and keep that off. Just because we are in an increased oxygen environment, we don't want to stimulate any. Anything that could create a fodder. We'll give you scrubs to change into and stuff like that, but we don't want heavy perfumes on.

Yeah, makes sense. Nicole, this was amazing. You gave us such great information. I think now everybody's going to be rushing to find your practice because, you know, you are so knowledgeable. You know, a lot of hyperbaric technicians are not as knowledgeable as you, especially in the holistic space and all the indications. And what is your website where people can find more information?

Yeah, it's under pressure.com where you can find us on Instagram at Underpressure Hyperbarics.

Yeah, and we're going to post the link to your website in the show notes below. I think hbot. Now I'm thinking I have to come in and do some sessions because, you know, as in my late 40s, I think it's time to, you know, the anti aging, taking care of ourselves become very, very important. Rejuvenating my joints from all the surgery I've done now for the past 20 years. We all need that to take care of ourselves.

Yeah, yeah, definitely. Come in and you'll notice a difference in the high pressure chamber versus the load. Be interesting to get your input for sure.

All right, Nicole, thank you so much. And thank you everyone for listening and we will see you next week. Thank you so much for joining me this week. Please make sure you check out the show notes for any link mentioned in the show. If you like today's show, please invite your friends to listen as well. That would mean a lot to me. Do you have a question you'd like me to answer? Message me on Instagram. Rsanda, this is Dr. Sandha and remember, your mouth is the gateway to your health. So take care of it in the most natural and best way possible.