Jan. 23--MMore than two years ago, Lordell Ivey got horrible news: his leg had
A small wound on his right shin had worsened rather than healed over more than
two years. His doctor told him amputation was necessary to keep it contained.
"I didn't want to give up," Ivey said recently at Southeastern Wound Healing
Center in Lumberton, where he sought a second opinion.
Two months ago, Ivey walked out of the clinic on 27th Street, his leg healed.
Ivey received a long series of treatments to close the wound that had caused him
pain, but he and his doctors credit hyperbaric oxygen therapy with pushing him
over the top in healing the troublesome spot.
The treatments, which place patients in pressurized chambers while periodically
breathing pure oxygen, are approved for a number of conditions, including carbon
monoxide poisoning, decompression sickness, severe anemia, radiation injury,
acute thermal burns, and other skin and wound problems.
But some feel that a lack of awareness among the medical community and the
general public about hyperbarics and other wound care means some patients don't
get the specialized help they need.
Dr. Andrea Simmons treated Ivey at the Wound Care Center, an affiliate of
Southeastern Regional Medical Center.
"He would have lost his leg if the Wound Care Center was not here," Simmons
Ivey was relatively healthy, but as a smoker, he had poor circulation that
affected his wound's ability to heal. He had surgery in 2011 to open a narrowed
artery. His wound had almost healed when doctors there referred him to a surgeon
for a skin graft. But his wound never healed as he started smoking again, and
Ivey got lost in the referral process.
When he came back to the center last March, the wound was not terribly large --
2 by 2.4 centimeters -- but it had grown down to the bone of his shin, which had
Ivey quit smoking, had another surgery to insert a stent into his artery and had
a number of traditional treatments for the wound at the center. Meanwhile,
Simmons and other center staff repeatedly appealed to Medicaid to cover the
hyperbaric treatments in a last-ditch effort to heal the wound and save his leg.
Ivey was finally approved for 15 sessions beginning in August.
"It's really amazing," Ivey said. "You feel so good when you come out of there."
During hyperbaric treatments, patients lie in a mostly transparent cylindrical
chamber almost 4 feet tall and nearly 9feet long, according to Healogics Inc.,
the company that manages the Wound Care Center for Southeastern.
The air inside the chamber is pressurized and pure oxygen is pumped in. Under
pressure, the oxygen molecules become smaller and can be more easily transported
through the body and to the wound to promote healing.
With pure oxygen being pumped into the chamber, patients must wear 100percent
cotton garments and are restricted as to what they can bring inside to reduce
the risk of sparks.
According to Ivey, patients inside the tubes cannot hear what is going on
outside. Speakers that can play through the machine allow them to hear the TV
mounted on the wall above them or instructions from center staff members.
"Your mind just wanders off to another dimension," Ivey said of his time in the
chamber, typically called dives.
By October, his leg was nearly healed, and a final treatment with a skin
substitute and topical honey sealed it.
Simmons said a lack of awareness among patients and even other physicians, who
don't get much wound care training in medical school, can be a problem.
"A lot of doctors don't know these wound care centers exist now, and if you
don't have the certain type of training, a lot of patients may end up with
amputations and unnecessary procedures because a lot of physicians don't know
what to do," Simmons said.
She said she would not know what to do with complicated wounds had she not
undergone specialized training through Healogics.
The Jacksonville, Fla.-based company operates most of the wound care centers
that offer hyperbaric oxygen treatment in the region. Jessica Taft, a
spokeswoman for the company, said Healogics operates more than 30 locations in
North Carolina and more than 550 nationwide. At the end of last year, the
company opened its first international location in the United Kingdom.
"We are definitely growing," Taft said, "and I think it has to do with raising
the awareness of the chronic wound problem in general."
Taft said that increases in obesity and diabetes rates and a growing aging
population means more people suffer chronic wounds.
But there is no recognized subspecialty for advanced wound care, leaving
companies such as Healogics to take on the specialized training.
"People just didn't know there was an answer for this," Taft said.
In addition to Southeastern's center, Healogics operates wound care centers at
Scotland Memorial Hospital in Laurinburg, Betsy Johnson Regional Hospital in
Dunn and Sampson Regional Medical Center in Clinton.
The company serves FirstHealth of the Carolinas at its hospitals in Pinehurst
and Rockingham and will soon begin a partnership with FirstHealth at its new
specialty offices in Raeford.
Cape Fear Valley Health System is a former Healogics client, but the
organization struck out on its own at the end of the year and now independently
operates its Wound Care and Hyperbarics Center on Robeson Street.
John Dickerhoff, service line director for rehabilitation with Cape Fear Valley,
runs the center.
The center can see as many as eight patients a day in its two chambers.
Treatment tends to last two hours a day, five days a week for about four weeks,
Dickerhoff said, so they typically see only about eight patients a month. When
one patient is healed, another falls into the rotation.
Despite keeping a full rotation, Dickerhoff said the center has not seen the
need to add a third chamber, which would allow 12 patients to be treated per
Taking hyperbaric treatment is a big time commitment, and many patients opt to
stick with the more traditional wound treatments, Dickerhoff said. But the
infrastructure has already been installed to support another chamber in case
Denise Mercado and her husband, John, own Fayetteville Hyperbarics on Boone
Trail Extension, a free-standing clinic that offers hyperbaric dives for an
expanded list of ailments. Because their clinic is not part of a hospital,
Denise Mercado said, they can offer hyperbarics for more than the 13 indications
approved by the U.S. Food and Drug Administration and treat such conditions as
traumatic brain injury, multiple sclerosis, Lyme disease, and autism and other
She said nonverbal autism patients have begun speaking after seven to 12 dives.
A cancer patient uses the treatment to help him make it through radiation and
chemotherapy treatments, she said, and a diabetic man who had three toes
amputated saved his other foot.
While the FDA has cautioned against using hyperbaric dives in place of
traditional treatments and therapies for conditions it has not approved, Denise
Mercado emphasized that hyperbarics is an adjunct therapy.
"It's not a magic pill," she said. "Somehow, this helps push it and get better
Staff writer Paige Rentz can be reached at email@example.com or 486-2728.
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