Oxygen Therapy For Foot Ulcers

Canadian diabetics with non-healing foot ulcers face a double barrier in access to a healing therapy that could prevent a significant number of amputations of toes, feet and legs.

Although hyperbaric oxygen therapy (HBOT) is a cost-effective means to help heal stubborn ulcers, thus decreasing amputations, few family doctors know much about the therapy and consequently it’s not being prescribed often or early enough, says Dr. Wayne Evans, chairman of hyperbaric medicine for the Ontario Medical Association. As well, there’s a national shortage of HBOT equipment.

About three million Canadians have diabetes and it’s estimated 300,000 of them will develop diabetic foot ulcers. Of those, about a third will have amputations because wounds will not heal. In 2007, an analysis by the Canadian Agency for Drugs and Technologies in Health (CADTH) showed the amputation rate drops by nearly two-thirds—to 11 per cent from 32 per cent—when HBOT is used along with standard treatment. Cost of care also drops by 18 per cent to $40,695 from $49,786 over 12 years.

In HBOT therapy, a patient lies in a pressurized chamber and breathes 100 per cent oxygen. This increases oxygen levels in the blood, boosting the immune system and improving wound healing and vascular tone.

Amputation costs are upwards of $75,000 for surgery, rehabilitation and prosthetics; the 30 to 40 treatments generally needed to heal a diabetic ulcer cost between $8,000 and $12,000, CADTH notes.

Surgeons and family physicians each refer about 35 per cent of HBOT patients, but better results and higher savings are possible if family physicians were to refer patients earlier on in their treatment, says Evans, lead author of a research paper on physicians’ knowledge and attitudes towards HBOT published in the Canadian Family Physician. By the time a surgeon sees the patient, the wound is more serious and more difficult to treat.

Waiting lists can be long since CADTH estimates 179 additional single or 19 seven-person chambers are required in hospitals and medical clinics to treat existing cases of foot ulcers. This has caused an increase in the number of privately run HBOTs clinics, but Evans warns people with foot ulcers to thoroughly check out these operations.

While some clinics have well-qualified medical teams attending the treatment, others have operators with no medical knowledge. It’s a “reckless risk” seeking treatment at a clinic not staffed with medical personnel, he says, because HBOT treatments can cause problems with the lungs and heart, particularly in elderly patients or those with lung or heart problems. There’s a danger providers without medical knowledge will be unable to respond appropriately in an emergency, so be sure to ask about medical qualifications of staff and how they would respond should something go wrong.

Eat Broccoli For Joint Relief

British researchers have found a compound in broccoli blocks the enzymes that destroy joints in osteoarthritis, the most common form of arthritis affecting one in 10 Canadians.

Eating broccoli and other cruciferous vegetables increases the level of sulforaphane in the blood. Scientists haven’t yet discovered just how this works to prevent degeneration of the joint, but when they do, you can bet development of a new drug will smartly follow.

That would be good news: treatment now concentrates on relieving pain or replacing the joint. Arthritis costs the Canadian economy over $17 billion
annually and is a leading cause of disability, with more than 600,000 Canadians unable to work due to this painful disease.

So chow down on more vegetables like cauliflower, Brussels sprouts, bok choy, kale, turnip and for Martha Stewart fans, arugula.

Can’t bear the taste? Try this simple glaze: blend together 50 millilitres (1/4 cup) balsamic vinegar, 15 millilitres (1 tablespoon) honey, 5 millilitres (1 teaspoon) each minced garlic and fresh ginger, 5 millilitres (1 teaspoon) olive oil, salt and pepper to taste. Boil the mixture a few minutes until it’s syrupy. A tablespoon has 22 calories, 1 gram of fat, 4 grams of carbohydrates and 2 milligrams of sodium (without adding more “to taste”).

Though there’s no clinical research yet to back it up, many people believe nightshade vegetables—tomatoes, potatoes, eggplant, peppers—cause flare-ups, so try avoiding or limiting those to ease symptoms.

Enjoy The Coffee—Skip The Cigarette

Researchers in Boston have discovered drinking caffeine does not make healthy people hoarse—not even if they’re professional singers.

Researchers studied 16 adults, eight with a history of professional voice training and eight without. Participants drank matched controls of caffeinated and decaffeinated beverages before being tested 35 and 70 minutes later. The results found no negative effects of caffeine on voice over time.

So, if your voice quality goes down after that coffee and cigarette, blame it on the smoke. Then butt out. (This is a health column after all—and nixing nicotine has many more health benefits than just making your voice sound better).

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