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17
2020,03月
 2015 / 08 / 07 醫師變危急病患 劉建明康復感恩慈濟家人 https://taichung.tzuchi.com.tw/news/4/685 劉建明醫師要病床?他的病人怎麼了嗎?應該去內科加護病房吧?」從不解到確定是醫師成了病人到病況危急快要休克,馬上得進開刀房!臺中慈院外科加護病房主任江俊廷醫師獲知劉醫師病灶是發生在會陰部的壞死性筋膜炎,心情當下一沈,「這個病致死率極高,『九死一生的機會』,我們能做些什麼?」醫護團隊幾乎是即刻啟動,要拉住一線生機……      劉建明醫師是臺中慈院的胸腔醫師也是亞急性呼吸照護病房主任,五月中旬突然感覺屁股痛痛的,卻沒想到幾天內演變成可能致命的疾病,在加護病房度過驚濤駭浪的兩個星期,才轉普通病房。透過醫護團隊努力,終於再回到工作崗位,胸腔內科主任邱國樑感受特別深。 邱國樑主任回想:劉建明醫師周末傳來簡訊,說有膿瘍要住院,當時想想,這是小問題,也認為醫護同仁會好好照顧劉醫師,沒想到,周日晚上突然接到另一簡訊說,已經是壞死性筋膜炎!邱國樑形容,他的心馬上浮過黑雲,想起實習時最怕碰到這個病,周一聽到劉建明在麻醉過程血壓往下掉,憂心與壓力一起衝上胸口,直到清瘡完到加護病房探視,他形容,劉醫師的傷口之嚴重不亞於八里塵暴傷患。 事實上,劉建明醫師在開刀前三天,只感覺屁股痛到坐不住,次日發燒,但未發現明顯傷口與紅腫,隔天起床屁股上已有硬塊,他自知不對勁,到急診做完電腦斷層檢查,還是先查房看完住院病人才去看報告,檢查影像看到明顯的皮下發炎,身為醫師的他分析「該不會中了大獎,得到會陰部壞死性筋膜炎吧?」不論答案是什麼,這個情況都必須馬上開刀。醫療團隊即刻聯手啟動。 劉建明醫師住院,臺中慈院很多同仁探詢「我們還能做什麼?」醫療問題仍得交給專業。謝登富醫師、大腸直腸外科邱建銘醫師對會陰部壞死性筋膜炎的治療方式了然於胸,除了適當抗生素就是要不斷清瘡,十四天內密集清瘡八次,一路追殺從肛門附近往上下左右四方蔓延的細菌,於是,劉建明醫師兩三天就得進開刀房一次,傷口大到超過卅公分,簡直像個大窟窿,謝登富醫師形容「整隻拳頭都能放得進去」,而每次換藥紗布得用去四十片,一天換三次藥,換一次就是劇痛一次,全是要人命的煎熬。 劉建明醫師不敢增加同仁心理壓力,最痛時只能緊抓床板,咬牙苦撐,痛到整張臉脹紅、抽搐,就算沒有叫出聲,同仁也都心知肚明「真的很痛!很痛!」麻醉科團隊使出渾身解數,各種止痛方法一個一個用上去。謝登富、江俊廷兩位醫師跟劉建明是同班同學,一個在加護病房的關鍵夜晚,主動陪在病榻邊拼過生死關,另一個是下班後,親自替他換好睡前的藥,才安心的回家。 謝醫師描述,劉建明意識不清的當下,還喊著「我馬上把報告打好。」讓他既心酸又心疼,想著:你自已都病成這樣,還把病人放在第一優先!他含著淚哽咽,當時只能咬牙拼下去「這麼好的醫師,絕對不能讓他掛掉」。 剛開始幾天,每次清瘡後的傷口,隔天就變黑,醫護同仁心裡都十分沈重,清瘡、換藥勢必要做得徹底,再痛也得做,但紗布更換也勢必拉扯傷口,又會讓劉醫師疼痛到接近昏厥。謝醫師絞盡腦汁,想到處理燒燙傷的盆浴方式,大家集思廣益出現轉機,克難而創意的泡盆讓劉建明治療的方式峰迴路轉,加上跨科專業人員啟動高壓氧治療、新陳代謝控制,病情終於走到愈來愈好的方向。加護病房護理長何玉萍一路看劉醫師因為止痛藥作用時昏時醒,乾脆請他寫日誌,醒著的時候就紀錄他生命住院的每天情況,何玉萍時而還要像個老師批註一下鼓勵與加油的心情,建設鼓勵他。終於,進一步檢查數據過關,劉建明醫師才終於可以從外科加護病房轉入普通病房。                生死關前走一回,劉建明醫師主動聯絡公傳室,希望用自己的個案現身說法,除了衛教大眾,更多的是讓大家知道慈濟醫護團隊的專業,絕對值得信賴,同時也感恩慈濟家人團隊的付出。講到醫師脫下白袍,也是個平凡人也會生病,曾經跟死亡如此接近,劉建明泛淚道來的是劫後餘生的心情。 劉建明說,在慈濟工作有可能跌倒,但是一旦跌倒,一定有很多人用力要拉你上來,兩位好同學不必多說,胸腔內科邱國樑主任告訴他「安心養病,其它都不要多想。」大腸直腸科團隊與邱建銘主任的貼心,整型外科的專業技術,新陳代謝科、麻醉科及外科加護病房使盡全力幫忙,還有同仁、師兄姊的卡片、紙鶴,能從生死關前被救回來,是那麼多他知道的、不知道的菩薩,牽著他一路走來的。 劉建明醫師平安回到工作崗位,簡守信院長終於能放下沈重,每天他要聽團隊醫療報告,病況膠著時跟著掛慮,轉趨穩定時隨著放鬆。因此他感恩有團隊努力,還有來自各方善心匯集祝福的祈禱,才能有圓滿的結果。簡院長說,劉醫師神志不清時想到的是病人的不是自己、看到疾病過程換藥的辛苦刻骨銘心,相信這些過程對所有參與照顧的同仁,都是永難忘懷的經驗與學習,他不忘勉勵,期待大家把照顧劉醫師的經驗,化為對病人的照顧,也把醫師罹病過程的心情,化為照顧病人更貼心的動力,影響醫院其他同仁,更能同理重症的病人。 (文、圖/曾秀英) 資料來源:公共傳播室 more
18
2020,02月
加拿大Judy Dan使用範美高壓氧艙 https://ontariowoundcare.com/treatment/hyperbaric-medicine/?fbclid=IwAR2w8zUP7plDjR9mI6PuNWrhT1WBNsfSJSzEYwKFgx4F3XlelIwQFaTB_4A Save a Leg SAVE A LIFE. Hyperbaric Oxygen Therapy (HBOT): How it works Hyperbaric Oxygen Therapy (HBOT) involves administering 100% oxygen to patients in a specially constructed chamber. The atmospheric pressure is increased two to three times normal for 90 minutes per session. This has the effect of: Increasing vastly the oxygen concentration of the patient’s blood. Saturating the wound with oxygen. Enabling cells to function that fight infection and repair wounds.   more
06
2020,02月
https://www.youtube.com/watch?v=78PXByMI5J8&t=12s more
06
2020,02月
https://hbot.com/the-secret-to-growing-new-brain-cells-sleep-exercise-and-hyperbaric-oxygen-by-veronica-fern-mcelarney-stanford-university/   The Secret to Growing New Brain Cells: Sleep, Exercise and Hyperbaric Oxygen?By Veronica Fern-McElarney, Stanford University  September 15, 2012 Category: News, Press No Comments A 33-year-old drunk driver wraps his pick-up truck around a tree and is brought to the emergency room at a small, community hospital in Slidell, Louisiana. His emergency room doctor, Dr. Paul Harch, recalled the scene. “You know, high-speed, straight into a pick-up, no seatbelt, and the flexion injury rendered him paralyzed immediately. By the time they got him off the floorboard of the truck…he had a flicker of movement in his one big toe; within forty minutes he was densely paraplegic. At three in the morning the neurosurgeon, radiologist and myself looked at each other…and the only explanation was that he had a vascular injury to his spinal cord. And almost in unison we said, “Gosh, I wonder what he could do with a little oxygen?” I put him in the hyperbaric chamber and he moved his toe. When we took him out, he had sensation down in the foot. Incrementally, every time I put him in, he got more and more sensation. In seventeen days, he walked out of the hospital. That just blew everybody away.” Harch, a physician at the Louisiana State University Medical Center and Inaugural (past) President of the International Hyperbaric Medicine Association, has been treating patients in hyperbarics since 1985. Patients are dosed with high-pressure oxygen by placing them in a decompression chamber, a treatment usually associated with scuba divers with decompression sickness. Harch, 53, who trained at Johns Hopkins University had “some very high aspirations.” Unfortunately, after starting his internship in general surgery, he was hit by a car and badly injured in the accident, derailing his career plans. He ended up doing emergency medicine in Slidell, 90 miles from the Gulf of Mexico. Disappointed with the direction his career was taking, he nearly quit medicine. He gave notice and told his colleagues he was looking to make his mark elsewhere. But after he “decided to quit my pissing and moaning,” he realized that he was intrigued by decompression illness, and curious about the fact that there was no literature on diver neurology. “Everybody thinks of decompression sickness as the bends –joint pain, bent over, and so on. In fact, three-quarters to four-fifths of all decompression sickness is neurological—mostly spinal cord, but a good proportion of that is brain-based. Eight and a half decades of diving medicine and nobody could answer some simple questions about what was going on in the brain…an opportunity was being presented to me that I couldn’t walk away from – to change and revolutionize the treatment of brain injury.” Until recently, most scientists believed that the brain contained a finite number of cells, depleted over the course of human life. However, recent research has overturned that idea. The most important findings have implied that two factors are required for brain cell growth – not crossword puzzles and not advanced math, thankfully – but sufficient sleep and exercise. Dr. Astrid Bjørnebekk found that exercise stimulates the production of new brain cells (reported in ScienceDaily, June 29, 2007). Bjørnebekk’s study aimed to decrease depression through exercise, which increases blood flow to the brain. Scientists believe this sea change signals future relief of human suffering for a variety of “incurable” neurological ailments – Stroke, Parkinson’s disease, Alzheimer’s, and chronic Traumatic Brain Injury (TBI). So how did Harch reach his seemingly zany conclusion? In the late 80’s, Harch realized divers were coming to him with symptoms of decompression sickness long after diving, and no longer had the nitrogen bubbles in their systems that cause decompression illness. Further study led him to believe that what he was observing was low blood-flow brain injury. Harch conducted experiments using lower-pressure hyperbaric oxygen treatments (HBOT) over longer time spans. Soon Harch was using the new protocol to treat a variety of neurological problems, including chronic TBI, Cerebral Palsy, Autism, and Stroke. Time after time, Harch saw improvement in the cognitive function of his patients and in brain blood flow scans (SPECT images) of patients’ brains. Harch put his clinical procedure under an experimental protocol for six years: a SPECT scan, one hyperbaric treatment, followed by another scan, to compare for improvement in brain blood flow. Then he treated people in blocks of forty treatments, to assess response, and indexed it to imaging and other clinical indicators. He found that the imaging predicted who would improve. After a while, he didn’t even need imaging because so many people responded to the treatment; it was reproducible. As Harch began to present his research, he realized that scientists didn’t want to believe his findings “because they violated 100 years of neurology.” Seeking to silence his critics, Harch embarked on a series of animal studies. His funding was minimal and came in the form of a $50,000 gift from Louis Ross, a patient’s husband who owned a dairy. In the first twelve rats studied, the team had statistically significant results, but the physiologist who designed the research model refused to publish it, believing the data was “flukey.” Harch’s team repeated the study with thirty rats, but a malfunction of the lab equipment nixed the results. They then planned a study using five times the original number of rats. This study coincided with a heat wave in New Orleans in July 1998. The rats were shipped in an un-air-conditioned van and expired before they reached the lab. Finally, in 2001, the team’s animal research generated very powerful results, even more so than the previous pilot trial. “But they sat on it for a couple of years trying to find what we had done wrong—-it was like the O.J. trial, you know?…Here we had all these positive results, but they just knew something had to be wrong with the methodology. It was a fifteen-year-old model when we started in 1994. It finally got published and that was last year (2007).” Finally, after 17 years, the findings were published in Brain Research.[i] They describe a ground-breaking improvement of chronic brain injury in animals. Results were impressive, and reconfirmed their treatment outcomes with human patients. The researchers measured the vascular density of the rats’ brains where the injury occurred, and correlated this with the rats’ cognitive performance. In comparison to the two control groups, the group treated with HBOT showed markedly improved vascular density in the injured area, which was associated with improved cognitive performance. In other words, Harch and his colleagues found that HBOT significantly increased blood volume and flow to the affected brain areas and that helped the rats regain some of their lost function. Dr. Gary K. Steinberg, Chair of the Department of Neurosurgery at Stanford University School of Medicine warns, “I would be cautious about drawing any definitive conclusions regarding the efficacy of hyperbaric oxygen for treating neurologic disease, including TBI. The preclinical (animal) results are equivocal and the clinical reports only anecdotal. Although the treatment appears safe, further controlled studies in patients are required before it can be recommended as beneficial therapy.” Insurgents drove a truck laden with 2,000 pounds of explosives into the building where the Marines were holed-up in the middle of Ramadi. Most of the guys in the detachment were knocked out by the massive explosion. In no time, they were under attack and outnumbered by seventy-eight insurgents to their thirty-three – needing help, some of the soldiers were shaking a young man to rouse him from his unconscious state. He regained consciousness, sat up, and they were hit with the second explosion – a rocket-propelled grenade against the wall. The Marine lost consciousness for the second time in fifteen seconds. “Whenever there’s an explosion like that, on the opposite side of the wall, everybody’s knocked out. It’s similar to what happens with concussive explosions and hollow viscouses in our body, lungs and intestines; the shock force does greater damage at the air-tissue interface. So he wakes up and he’s in the middle of a fire-fight…a minimum of seven hours or so… cerebral dysfunction is not appreciated because you’re in a war zone—it’s heightened awareness, poor sleep…hyper-vigilance. It’s not until they get home that…the effects of the brain injury become manifest.” Apart from giving drunk drivers a second chance, Harch’s findings have important implications for Iraq War veterans. As many as 400,000 veterans have been exposed to concussive force and possibly suffered a TBI. According to one patient—a Marine—every man in his thousand-man battalion has been exposed to IED’s and a minimum of 50% have been knocked unconscious. Harch: “It’s considered a non-injury. You’re a wimp if you have symptoms. Unless you’re bleeding or have had an appendage blown away, or lost an eye, you’re not considered injured.” TBI affects over 1.4 million Americans annually. The leading cause is falls, followed by motor vehicle crashes.[ii] Moreover, blasts are a leading cause for active duty military personnel. Called the “signature injury” of the Iraq War, some accounts estimate that up to 60% of injuries related to roadside bombs in Iraq are TBIs. Symptoms include memory loss and communication problems; even worse, perhaps, are the behavioral and psychological ramifications. Formerly balanced, responsible and mature adults may become impulsive, irrational, and depressed. Harch recounted several stories about patients who had become psychologically dysfunctional, “demented,” “suicidal,” “violent” and “a throw-away.” Some patients were institutionalized, diagnosed as untreatable. One commercial diver was refused medical coverage by the company doctor who ruled that his injury as a result of diving was inconclusive. The patient loaded two pistols and went to the company headquarters in New Orleans. Luckily, he called his brother to say good-bye; his brother intervened and put him into treatment with Harch. The patient is now functional and Harch was able to prove his medical case to the company with SPECT imaging. The U.S. military command does not appear to be interested in HBOT. Harch and a colleague submitted separate grant proposals to the military and were turned down. Harch said, “We went to the top guy in the Army who oversees the brain injury program…and it was a very depressing yet enlightening discussion. It went nowhere…it was surprising, the response we got.” Brigadier General Patt Maney was told he is the highest ranking soldier wounded in Afghanistan by a roadside bomb to survive a TBI. A state court judge in Florida, Maney was called up to service in his capacity as an Army Reservist. Maney said that in addition to TBI, soldiers frequently suffer other physical injuries, like wounds from shrapnel, loss of limbs, burns, and broken teeth –“polytrauma.” Maney was treated one year after his injury using the Harch-prescribed HBOT protocol at George Washington University Hospital. Describing his experience, Maney said, “The treatments are easy if one doesn’t have a problem with claustrophobia. Some hyperbaric facilities have multiple person chambers but GW uses one-person chambers. The chambers are clear cylinders with closed ends. A patient is slid into the tube and the end is closed. A technician or physician stays outside the chamber but with the patient the entire time. Initially, I watched television during the [one-hour] dives but as I got more accustomed to the dives, I frequently napped.” Maney said that his wife noticed improvements in his cognition following 8-12 dives, while he observed improvements after 12-14 dives. After 20 dives, his friends commented that he seemed more socially engaged. “From my experience, I believe that HBOT should be the foundational treatment for all soldiers with a TBI. It’s really disappointing that some military medical practitioners decline to recognize the documented scientific advances, possibilities and results of HBOT. The TBI wounded and their families need effective treatment now.” A 2006 study (Finkelstein et al) states that costs related to TBI totaled $60 billion in the year 2000 – actual medical costs as well as lost productivity. This includes over 5.3 million TBI survivors who need ongoing help to carry out the daily activities of living. One of the major advantages of HBOT is its relatively low cost; 40 sessions of HBOT cost about $4,000. Compare this to the financial and human costs of institutionalizing a young person for 40 years. In 2002, Harch testified to Congress about the costs of HBOT relative to taking care of the untreated. “Forty percent of my practice is neurologically injured children…who cost on average, 2.1 times as much to educate as a non-injured child. There are 6.548 million…children in the nation…[which cost taxpayers]…a total of $55.7 billion. For many of these children, if they had been treated immediately upon injury, the costs drop to often less than $1,000.”[iii] Of the many who suffer a TBI annually, 50,000 die, 235,000 are hospitalized, and 1.1 million are treated and released from hospital emergency rooms. The typical person affected is young and male. One patient who fits the profile is 17-year-old Curt Allen, Jr., injured in a 2004 automobile accident. Video details the young man’s presentation following rehabilitation in “the best residential facility in the state of Louisiana,” from which he was dismissed for failure to progress. As he receives HBOT, Allen’s condition improves from practically non-responsive to walking, joking and talking. Harch is currently involved in a ten-year stroke study while he continues to pursue funding to conduct human trials for chronic TBI. “The most important thing to know is that this is a generic drug for growth and repair of brain injury—both acute and chronic. Don’t wait for your doctors to come around to understanding this. It’s a low-risk treatment. Go out and seek a physician at a facility who will do this. Get this treatment for you or your loved one.”   more
05
2020,02月
Hyperbaric Oxygen Therapy as an Adjunct to Plastic Surgery http://healthandwellnessfl.com/hyperbaric-oxygen-therapy-as-an-adjunct-to-plastic-surgery/ Undersea Oxygen Clinic Hyperbaric oxygen Therapy (HBOT) involves inspiration of pure oxygen at greater pressures than normal. For the past 20 years, administration of HBOT and its potential benefits in management of diseases have been more clarified. HBO for the first-line treatment of several conditions and a superb helping (adjunct) therapy for many medical conditions. In the early 1960s, HBOT was widely used in a variety of medical indications. (1) Numerous studies have revealed how well HBOT works. HBOT has been shown to be an effective method for treating complex wounds as well as burns and now is being researched to improve the results of wounds and burns caused by elective surgeries. The way HBOT stimulates response is by helping your body create collagen (the building blocks of cells and organs), reduces pain, reduction of swelling, hyperoxygenation (super oxygenating cells) as well as angiogenesis (the development of new blood vessels). HBOT increases the ability of your own blood to upload, carry, and deliver oxygen to tissues. Wounds treated with HBOT therapy are improved and have more rapid wound healing. Wound healing is a primary interest area for patients as well as the collective health care industry so much so that physicians modify surgical techniques, pharmaceutical companies spend millions of dollars on research and development, and some patients use anecdotal home remedies in their care to facilitate a more rapid recovery. A better, more effective solution exists with HBOT. Complex wounds are challenging to manage, with many associated problems. The main problems appear to include having to deal with underlying diseases such as diabetes, vascular problems, history of radiation therapy, low oxygen and wound infection. Low oxygen content in cells affects tissue metabolism and reduces PH, which prohibit wound healing. In a previous study it was shown that low oxygen around the edge of a wound was associated with a 39 folds increased risk of early healing failure. (2) Another study (3) concluded that tissue oxygen shortage was directly related to wound failure rate. Lack of oxygen can lead to many chronic wounds. HBOT increases oxygenation of tissues and supports wound healing. Clinical outcome seems to improve after HBO treatments, even though traditional wound treatments had been unsuccessful. At the Undersea Oxygen Clinic Hyperbaric Center (located on Westshore Blvd in Tampa) we have established a protocol that has patients oxygenate a few times before a surgery and then several times afterwards to maximize healing. We have partnered with local area surgeons to facilitate better healing for their clients. One such symbiotic relationship exists between us and the Tampa Eye Clinic. Dr. Scheiner is board certified in Ophthalmology and performs facial plastic surgery. “I have a practice in Laser Eyelid and Facial Plastic surgery and we have used lasers to help improve past sun damage in our patient for many years. The healing after the treatment usually takes 10-14 days. We were introduced to Hyperbaric Oxygen as an option to help speed healing from our laser treatments and have seen impressive results. The Hyperbaric Oxygen has sped up healing 30-40% after our laser treatments. The Undersea Oxygen Clinic has been wonderful in working with our patients and I feel very comfortable having my surgery patients work with such a caring and expert group.” Adam J. Scheiner, M.D. While the lasers are used to burn the skin and improve the overall look of the patients (as evidenced by the photos), the pre and post HBOT prepares the skin for the work and speeds healing time significantly. Another study showed that HBOT offers patients a statistically significant, perioperative therapy that decreased bruising in patients undergoing face-lift by 35%. (4) HBOT is effective, ethical and safe procedure. Its use for pre and post-surgical care has very promising results.     more
  • 呼吸器PAH-V1 Hyperbaric Ventilator
  • 高壓氧艙PAH-S1-3800
  • 高壓氧艙PAH-S1-3200
  • 方型多人輕高壓氧艙PAH-WM
  • 動物高壓氧艙PAH-A1
台北市中山區龍江路329號四樓
02-25172232
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