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Article
published Monday, April 4, 2005
Center offers alternative therapy for
area victims of brain injuries
By JENNI LAIDMAN
and JANE SCHMUCKER
BLADE STAFF WRITERS
WAUSEON - Sara Burkholder's death had the makings of a lawsuit.
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Bryan Coger, an emergency
medical technician at Sara's Garden in Wauseon, demonstrates
how the plastic hood that delivers pure oxygen fits over the
head of a patient in the hyperbaric chamber behind him.
( THE BLADE/DIANE HIRES ) |
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The athletic,
25-year-old English teacher died of internal bleeding during the
birth of her first child. Amniotic fluid flowed into her
bloodstream, robbing her blood of its ability to clot. The traumatic
birth left her son, Jackson, now 3, with cerebral palsy. He cannot
talk. He cannot walk.
Yet instead of going to court, her family - the Burkholders and the
Rycheners - went to churches and community groups with a dream. They
would create a nonprofit, alternative medical center in Fulton
County to offer a treatment they believe is helping Jackson.
This morning that dream comes true with a ribbon cutting for Sara's
Garden in Wauseon, where children and adults suffering from brain
injuries can receive treatments called hyperbaric oxygen therapy.
But the therapy, which supplies pure oxygen to people during a
simulated deep-sea dive, is unproven for neurological treatment in
the eyes of medical experts, said Don Chandler, executive director
of the Undersea and Hyperbaric Medical Society, the premier medical
association for hyperbaric therapy.
"We've always been very cautious. It's still looked on as
experimental, and we don't have enough scientific evidence,'' Mr.
Chandler said.
There is scant published research addressing the use of increased
atmospheric pressure to treat strokes, cerebral palsy, and similar
injuries.
In fact, research supports the use of hyperbaric chambers in only a
few areas, including wound care, carbon monoxide poisoning, therapy
for the bends in divers, and treatment of tissue damaged by
radiation therapy.
But don't make that argument with Judy Burkholder, a registered
nurse and Jackson's paternal grandmother. Medicine is full of
treatments with doubtful benefit to patients, she says.
She points out that insurance and other assistance will pay for only
short bouts of physical therapy for Jackson. "I would challenge you
to find any studies that prove that occupational and physical
therapy for 20 minutes a week will make a difference in my child,"
she said. Yet hyperbaric oxygen therapy brought profound
improvements in her grandson's life, she said.
"He was a year old, and he could do nothing. If you stood him up in
a toddling position, he couldn't lift his legs. He was falling off
the growth chart. A neurologist told us he would probably be
mentally retarded and need a feeding tube, orthotics, lifts,
wheelchairs, all these appliances,'' she said.
But on his third day of hyperbaric treatment, his lagging appetite
surged. The 1-year-old ate three meals that day instead of one.
"In nine months, he gained 7 inches and 7 pounds. He's in the 50th
percentile in weight and over 100th percentile in height. Contrary
to what the neurologist believed, he is not mentally retarded,''
Mrs. Burkholder said.
He cannot speak, but he can touch cards that provide the appropriate
responses to questions.
When Jackson began hyperbaric therapy, he could see, but he wasn't
aware.
"That has changed. That's huge,'' Mrs. Burkholder said.
"The medical community would say all these things are anecdotal. I
would tell them I don't care. … I'm a nurse. I was very careful when
we first went to get treatment, and I documented all the changes
that I saw. There was no doubt in my mind the changes that took
place could not be attributed to development. Developmental things
take time. This happened overnight," Mrs. Burkholder said.
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'There was
no doubt in my mind the changes that took place could not be
attributed to development,' says Jackson's grandmother, Judy
Burkholder, inside the hyperbaric chamber.
( THE BLADE/DIANE HIRES ) |
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That belief fueled
a fund-raising campaign that prompted northwest Ohio residents - and
strangers as far away as Florida - to donate more than $1 million in
cash, labor, and materials to create Sara's Garden.
The biggest donation came from Dorothy Biddle, who was well-known in
Fulton County for her philanthropy. Mrs. Biddle, who died in January
at age 106, left $500,000 to Sara's Garden, making it the largest
bequest among about $1.4 million donated in her will.
Despite the confidence organizers of Sara's Garden have in
hyperbaric "dives," no one is making big promises. Instead, they're
offering hope that maybe, just maybe, this will make a difference
for others too.
"In some eyes, it can be experimental,'' said Scott Frederick, a
Wauseon physician who is medical co-director of Sara's Garden with
Alan Rivera, a physician in West Unity in Williams County. "This is
kind of like a new frontier. It may be a possible therapeutic
regimen for these people. This is just the beginning."
Drs. Rivera and Frederick, both internal medicine specialists, will
provide pretreatment physicals to make sure patients are healthy
enough for a hyperbaric dive.
Hyperbaric oxygen therapy is not without risk. The most common
injury is a ruptured ear drum, a risk that may be elevated in
children.
Hyperbaric patients are also at risk for collapsed lungs, so each
prospective Sara's Garden patient will require a screening chest
X-ray.
Once chamber pressure is increased for the simulated dives, it can
be decreased only gradually, so a patient who would have a medical
emergency during treatment, such as a seizure, would have to wait
until proper pressure is gradually restored.
Hyperbaric patients are at a slightly increased risk for seizure. At
Sara's Garden, a nurse will accompany divers in the chamber.
Patients undergoing this therapy at Sara's Garden duck into what
looks like a big propane tank and take a seat. Air pressure is
raised to no more than 29 pounds per square inch - the equivalent of
diving to 33 feet - but people in the tank feel nothing more than a
little pressure in the ears, like what is experienced in flight. The
patient wears a clear plastic hood that looks as if were borrowed
from the animated movie character Buzz Lightyear. The helmet, which
delivers pure oxygen, is sealed so the oxygen cannot escape into the
chamber. Chamber sensors will detect an increase of oxygen above the
normal 21 percent level. The chamber depressurizes in the event of
an oxygen leak.
The gravest risk is of fire or explosion from the highly combustible
oxygen, so various precautions are required to protect against such
a possibility, including a fire inspection of the facility.
Sara's Garden will charge $100 per dive, a price leaders hope will
cover operating expenses. Because treatments can require multiple
dives, that $100 adds up quickly. Jackson has dived 96 times.
The Burkholder and Rychener families are not the first to open a
nonprofit hyperbaric facility after sending a child for such
treatment.
"How do you think these places around the country have opened?"
asked Paul Harch, who practices hyperbaric medicine in New Orleans.
"They're all over the place, and they're started by parents."
In 1970, there were about 30 hyperbaric centers, said Mr. Chandler
of the hyperbaric medical society. "Now there are over 500 that we
know about, and there are a lot . . . we don't even know about. We
know it's going on. We refer to it as the cottage industry."
A study by researchers at the University of Mississippi using rats
seemed to suggest promise for hyperbaric therapy. The work,
published in the journal Brain Research in 2002, subjected rat pups
to oxygen loss. Some of the rats were treated with hyperbaric oxygen
therapy after an hour of diminished oxygen. Animals treated with
hyperbaric therapy suffered less brain atrophy and cell death,
researchers said.
But a study published that same year in the journal Developmental
Medicine and Child Neurology provided 40 sessions of hyperbaric
oxygen therapy to children diagnosed with cerebral palsy. A second
group of children received oxygen therapy at only slightly elevated
atmospheric pressure. Children in this Montreal study all showed
improvement in attention and working memory, but there was no
difference between the children under higher atmospheric pressure
and those under only slightly elevated pressure.
But the Burkholder and Rychener families aren't worried about these
debates. They're busy making Sara's Garden grow.
The Sara's Garden board hopes to build a house just east of the
1950s vintage office building that Sara's Garden occupies on West
Leggett Street. This would be called Jackson House and serve as a
home for out-of-town families during hyperbaric treatments. The
board also hopes to offer other therapeutic services at Sara's
Garden.
But the family's most profound desire for Sara's Garden is that it
will give glory to God. They feel, they said, that God used Sara
Burkholder's death to call them to help others through Sara's
Garden.
"If Sara hadn't died, if Jackson didn't have cerebral palsy, would
we have been motivated to do this?" Judy Burkholder asked.
And if the family had sued the local hospital and used such proceeds
to build Sara's Garden, would that have been an appropriate start to
such a mission? The Burkholders say the blessing of community
donations is far better than the heartache of a lawsuit - and far
more in keeping with the life Sara Burkholder lived.
"Sara would have gladly died and had her child have cerebral palsy
if it could bring one person to God," her husband, Jay, said.
Contact Jenni
Laidman at: jenni@theblade.com
or 419-724-6507.
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