CITV Technology Review: HBOT USA

Transcription:

– Hello, and welcome to this episode of CITV. Today I’m joined by Dr. Jason Saunders who took the flight down here because he’s helping us set up the Carrick Institute’s hyperbaric oxygen therapy unit. We just took receipt of it today, and we’re super excited to have it. Dr. Saunders, thank you so much for coming down. We really appreciate it.

-Thanks for having me, Freddys.

-Awesome! We also took the opportunity to shoot this video because we want to educate you guys and let you guys know as we learn about HBOT as well. So Dr. Saunders, my first question for you is a lot of our scholars have heard of HBOT, but a lot of them also haven’t. What does HBOT stand for, and how long’s it been around for? Great question.

-So hyperbaric oxygen therapy is what it stands for, it’s been around for a really long time. It’s been around for over 300 years. It’s kind of come and gone in you know usage and interest over that period of time. But more recently, I’d say the last 50 plus years, it’s been used pretty heavily more clinically. But really in the last I’d say 20, 20-25 years, it’s really started to explode in terms of interest, and involvement, and research, and developing you know all the clinical applications.

-I’m assuming the research drives the interest, right, as the more research gets performed, people become more interested in it.

-Yes, just generally, and hopefully we’ll clarify a lot of this, but I think it’s generally been misunderstood for most of its 300 plus years of existence. So as people start to understand it a little bit better, they start to pique their interest and now they’re starting to study different areas, and yeah, exactly, as research drives it, people, clinicians are starting to use it more often.

-Neat! So talking about clinicians, what are the types of clinicians who utilize this type of technology in their practices? Who’s using it?

-There’s a lot of different types of chambers out there. And so there’s soft chambers, which are considered mild hyperbaric, all the way up until hospital-grade chambers, so different chambers and different technologies for different patients with different health issues. So, you know, right now there’s about 14 classified diagnoses that are let’s say insurance-reimbursable in the hospital. Those are things like osteonecrosis, gangrene, radiation burns, really bad conditions for people to have. In those scenarios, you’re going under high pressure, 100% oxygen, and you need that type of treatment for those types of issues. At the same time, scaling that down to something like mild hyperbaric, you know, this is a way that you are increasing oxygenation still but at a much lower level, but still clinically significant. Things like TBI and concussion, other neurologic issues, dementia, things like that, we’ll talk more about that later, but those are some of the conditions people are utilizing, so all kinds of different functional medicine, functional neurologists, all kinds of different docs, are starting to utilize this technology in their office as a way, because they understand that as you increase oxygen you’re increasing fuel, so for a lot of those patients that really need that increased level of oxygen for healing, this is a great way to do it.

-You can’t get away that oxygen’s pretty important for our patients. So speaking of the clinicians, it sounds like it goes all the way from the hospital all the way to the private practice. I’m going with the assumption that depending on where you go get this type of therapy, the technology will change. You said that this is a soft unit. Can you tell us about the different types of units that are available? This is the one that the Carrick Institute chose, and I think an element of that is the size and portability of it. But what else is out there?

-Not only the size and portability, but also because of what Carrick Institute is interested in working with, those conditions are really best suited for this type of technology anyway. In our office we use soft chambers like this. We also use hard chambers. It just depends on what you’re treating. So to answer that question, you could say that there’s soft chambers and hard chambers. Soft chambers are capable of less pressure, but still significant amount to get the oxygenation. Soft chambers also could have oxygen concentrators, but you can’t put 100% medical oxygen into those. Hard chambers are able to go to higher pressures, and in certain conditions that’s important, and hard chambers could have 100% oxygen. And then hospital chambers are literally the entire chamber is just filled with 100% oxygen. You are literally bathing in the oxygen. And again, certain conditions, it really requires it. Gangrene, or open wound, something where it’s really important that your whole body is bathing in that, that’s why you would seek that type of care.

-That makes a lot of sense.

-Like in a hospital setting, they wouldn’t even treat a TBI or a concussion, it’s not even available as an option. You couldn’t pay, in the States, a hospital to treat that condition.

-Interesting. So I see a versatile amount of clinicians that are using this technology. What are the types of conditions are you seeing being treated by those clinicians? What type of conditions are they supporting? From the private doc, all the way to the hospital. I guess at the hospital, it’s those really serious conditions that you listed about. So what about the private doc who’s gonna say “You know what, I’ve been thinking about getting this for my practice,” what are the type of things that patients may find them for, for support? What are they looking for?

-Again, we’ll cover this later, but the mechanism is the same regardless. So the mechanism whether you are in a soft chamber with air only, you’re in a soft chamber with mixed air and some oxygen, or you’re in hospital-grade chamber, 100% oxygen, the mechanism of how it’s working is identical. The thing is this, you know, why are we waiting for a patient to have a really terrible infection or literally osteonecrosis, or bone infection, where the process to get hyperbaric covered even in those settings, you have to do multiple rounds of antibiotics over months of time before they’ll even say “Hey, why don’t we try some oxygen to see if that’s gonna help”? and so I think what’s happening is that you’re seeing these functional medicine doctors or functional neurologists are saying, “There’s a whole realm of conditions that we know of, that if they had more fuel, if they were able to get more oxygen, we would probably be able to help these patients a little bit faster, a little bit sooner, get them to help them recover.” So in those settings, those doctors are looking at things like, I’ve said already, TBI and concussion, MS, dementia, Alzheimer’s, Lyme disease, a lot of auto-immune, inflammatory, inflammatory bowel disease, RA, Lupus, pretty much when you’re looking at the system, if you’re needing to either help balance the immune system, reduce inflammation, increase mitochondrial function, or promote healing either in a joint or a tendon, or in the nervous system, extra oxygen is an absolute necessary tool for really driving that.

-And I think that makes a lot of sense. We’ll go backwards a second and maybe explain this fundamental principle in neurology. At the Carrick, we teach people that to have a healthy nervous system, you need two things, you need fuel and activation. If you’re working with a clinician that’s giving you receptor based therapies or brained based therapies, they’re going to provide your brain the environment, activate the right receptors to change that brain, that’s the activation portion. And the fuel, we’re left with thing like oxygen and glucose, so you need somebody that has appropriate fuel delivery, maybe reducing inflammation could also effect fuel deliver, so anything that effects fuel delivery has a chance of hindering– Recovery. The patient’s nervous system. The other half of that is oxygen though. There are certain things that can affect oxygen and at a simple level, we’re saying anemia, maybe ever a rib constriction can effect oxygenation, maybe lack of lordosis. So it makes sense to me from a neurological or physiological perspective how improving oxygenation in some patients can be very beneficial for them. So if you carry that concept forward, then I go all right, how do I find the patients that need this? How do I know which patient this would serve? Is there a way to kind of figure that out?

-I think there’s two aspects to that. One is there are those patients that especially in clinical neurology where you’re really trying to rehab brain through a certain series of exercises and those patients are tapping out early. Part of the reason that they may be tapping out early is that they’re not able to deliver that fuel source the way that they need to. There might be a way of pretreating those people, load them up with some excess fuel prior to going to those therapies, so that they have more gas, more fuel in their system so that they can actually have a longer, more intense treatment, if that’s appropriate. It’s like putting fuel in the gas tank before they go. Or do their brain exercises.

-Exactly. Okay, very cool.

-On the flip side of that, there are the people who can get through the therapies pretty well, maybe they’re starting to tank a little bit towards the end, but they’re able to really get through a pretty intense therapy session, but then they’re toast after, they don’t have the capacity to now have a normal, functioning day. They may really start to dive or have to take a nap or whatever happens to those folks. The other side of that spectrum from prefeeding it is recovery. When you start to basically load that system up with oxygen after the fact, now you’re basically setting the stage for healing, recovery, repair, tissue repair, all of that.

-That makes a lot of sense, very cool. One of the things that… I go and I talk to all the clinical neuroscience docs that are leveraging this type of technology, and they all said one thing, that one, they’ve had a lot of success with this, with their patients, but two, they also expressed, and it’s not a concern, but they always said when you start teaching people about this, how to leverage this, always make sure they’re working with somebody who’s properly trained and knows how to do a good reassessment. And the reason they said that, multiple doctors said this, they said you have the opportunity to super charge this patient’s nervous system, but some times, you don’t want to super charge, meaning it could be a bad pathway or something that’s creating a negative response. So you want to know, when you provide this much oxygen to a patient, whether you are improving good things, or strengthening bad things. I think that’s where doctors need to be properly trained in regards to leveraging this type of technology. Do I know if I’m actually creating something good for this patient as opposed to just giving a blanket solution. I think that’s part of the things that your company, by the way, you company name is again? HBOT USA. Right, and one of the reason that we went with you guys is that you guys support the people that you sell this technology to.

-Right, that was our frustration with it. We got into this 12 years ago and we bought a tool, and that was it, how do we use it? There was nothing else after that. How often do we use it? It showed up and then you’re like figure it out. Exactly. I bought it for myself, I was treating myself initially, after that, when it was time to actually bring it to the office, I said, “Wow, this thing’s great, I want to start treating people,” it was like I don’t know, what are the protocols? There weren’t any at that time. What are the programs? How do I know if I’m using this properly? Am I giving it too much? Not enough? All those things, so we’ve really, over the last 12 years, we’ve really dialed in the clinical aspect of that, the training, the understanding, the physiology, and then also the protocols and the procedures for how to implement and why to implement, and again, are you having the effect that you’re trying to have, or not, and if not, how do we course correct? I think especially with functional neurology, you know you’re testing something, you’re testing a system, you’re doing an adjustment, you’re doing some eye movements and you’re retesting and saying, hey, here’s the test, here’s the baseline, we did these two therapies or this one therapy, here’s the next test, was this the therapy they needed or not? And so you would utilize this the same way. You would do some baseline testing, you’d implement some oxygen, at one point you might implement that oxygen earlier in their care because you’re seeing that they have a fuel issue, and then you would post test and say hey, what was the result of that? And other times you’re going to do recovery. What’s their recovery like post, okay, let’s add some oxygen to that, and how’s their recovery? Are they improving as a result of this tool? It just depends, you know this, every single case, it doesn’t matter, 100 people with a TBI need 100 different therapies, everyone’s got their own story, their own causes, their own issues– They’re all unique.

-They’re all unique and so putting the right steps together, this is just one more piece of that puzzle for those people that happens to be a really big one, especially when it comes to neurologic healing. That’s why we went with you guys because we wanted that support and say all right, let’s really learn this. Where does it fit into the arsenal of tools we’re providing for clinical neuro science practitioners and we see value in this, but we also see value in being properly trained and being given the appropriate literature so you can really understand what this is all about. Let me ask you a different question if I can. What does it look like in private practice leveraging this type of technology? How long do they go in? I haven’t even used this yet, I think I’m going to hop in it today, what does that look like? If a patient goes in for a session, and let’s ignore the brain based therapy, let’s say they’re coming in to do this either before or after, how long do you go in for?

-So typically the answer is basically usually 60 minutes. But, that being said, sometimes, if you’re really just trying to fuel before going into some therapies, it might only be more like 30 minute sessions. From a recovery aspect, it’s typically 60, it’s sometimes 90, and in some cases, you guys know better than most, sometimes you’re doing intensive therapies with some people, and in those cases, depending on the amount of time you have access to the patient, you might also do morning, take a break, and do afternoon, or do morning, do some therapies, take a break, do some therapies, and then another session in the afternoon. Sometimes it’s twice a day, sometimes it’s once a day, and then the timeline, again, that’s why we’re doing this this way, because it does vary so much and you want to make sure you’re delivering exactly what you were hoping to deliver for that patient. It runs the gamete from lets say 30 minutes to 90 minutes to double sessions.

-Got it, and then once they go in there, what do they do? Do people just relax?

-In these scenarios, especially the way we have it here set up, this is basically air only, but air only, and we’ll talk about the mechanism later, but air only also has a massive increase in oxygenation, but there’s no flammability issue. So let’s say in the hospital setting, you have to wear 100% cotton, you can’t have any static electricity spark, it’s basically you’re climbing into a green tank of oxygen is really what it’s like. So there’s a lot of precautions that need to happen in order to go into that environment. This environment, even though it’s pressurized, it’s still only 21% oxygen, so there’s no flammability issues, there’s really no safety issues that way, it’s also somewhere between 12 and 15 feet deep underwater, so in terms of pressure, it’s not that much pressure, almost everybody can tolerate that level of pressure on their ears, and so, people can bring a book, you can bring music, you can bring your phone. People just relax. People just either relax and breath or people try to do some work. In our office, if they’re undergoing certain therapies, we might have them bring that in, like an iPad to do eye movement or motor patterns, we might actually have them do that in the chamber as a way of actually saying… because obviously whatever you’re activating is where fuel is going to go, whether that’s glucose or oxygen or fatty acids, whatever you’re using for fuel, so if you create this activation while you’re basically bathing in oxygen– In that super oxygenated state– It’s just going to flow to that place, right? Okay, interesting. So sometimes we do that as well.

-Awesome, I love it. So they go in there 30, 60, 90 minutes, depending on what you’re going to do, they can kind of relax in there, what does it feel like for the patient while they’re in there? Can you describe that?

-Yeah, the conversation we typically have with a new patient, it feels like you’re in an airplane, from the standpoint that as you’re taking off, you feel some pressure in your ears, once you’re at altitude, you wouldn’t have no idea that the cabin was even pressurized, and once you’re coming back down, you start to get that same experience. That’s really… it’s actually backwards, because in here you’re going down first, pressure is… it’s not altitude, you’re actually going below the surface. If you notice in an airplane, your ears basically almost self correct as you’re going up, and as you’re landing, you need to actually manually clear them, so in here, you’re going down, your initial part of the therapy, you’re manually clearing your ears. You can control the speed, so some people go right down, they can barely even notice it, they clear it once or twice and they’re good to go. Other people have a hard time equalizing, and so you can control the speed of that descent, make sure they’re comfortable, make sure they’re doing well, that they’re equalizing. Once you’re at pressure, you have no idea that anything, you don’t feel any pressure, you don’t even know that you’re under pressure. At that time, again, you’re just either doing certain exercises, relaxing, watching some Netflix or listening to some music, depends on what you’re doing, you know? So you’re there for an hour, and then on the way back up, your ears pop again, but at that time, it’s like the airplane going up, so they self regulate.

-So it seems the most they feel is in their ears, you don’t feel anything in the rest of your body-

– Nothing in your body, you wouldn’t know. People will talk about a deeper inhalation, they feel like they’re actually able to get more air in, there’s to four times more air inside that chamber that’s how it pressurizes, you’re putting a lot more air into a smaller space. People report feeling that, but in terms of pressure, you would have no idea that that was actually happening.

-Interesting, I would have speculated that it felt like something on you. A lot of people think, yeah. In private practice, how difficult is it to manage having one of these? We put it together in minutes, and I think we’re going to splice that video in at some point because it was fun to do, we want to show you guys how easy it was and it was pretty easy, but using this on a daily basis, is it a pain, for lack of a better word, is it difficult to use all the time?

-It’s pretty simple, you saw me fill it up anyway, we’ll do a session later, but it’s basically getting somebody to lay down, relax, it’s two zippers and a valve, an on off switch, so in terms of the actual usage, it’s actually really, really simple. The chamber itself, once you’re at pressure, it self regulates, and because it self regulates, you’re really not needing, once it’s at the pressure, nothing’s going to change in that environment for the patient, so there’s really no need to be with them at all times, so typically we have a staff person at this point doing that for us, they bring the person down, they’re with them the entire time that they’re going down to pressure. Once they’re at pressure, we check on them periodically, make sure they’re doing well. A lot of times at some point, they fall asleep, and then when it’s time to come back up, the technician is again with them on the way back up. That process, depending on how sensitive they are, that process of going to pressure could take from five to eight minutes, and the same thing, five to eight minutes coming back up. So yeah, clinically it’s very simple.

-Pretty simple, and you guys have somebody doing that, but when it was just you, was it manageable? Was it manageable to do, just trying to gauge how much time does this take to kind of bring it to a practice?

-If it was just me, solo doing it all myself, which at one point it was, what we would do is we would block 10 minute increments out of my schedule, on either end of the session. In some cases we would block 20 if I was going to take somebody out, put somebody else back in, if it was a repeat going in like that, but yeah, we would put these 10 minute blocks right into my schedule, and I’d be able to get them in and out in that time pretty efficiently.

-I think everybody at home can see the unit here and what it looks like, and it’s kind of like a hot dog shape and it’s really hard right now because of all the pressure inside, but there is also a compressor, I guess is what this is. Between this and the compressor, how much upkeep is necessary for it? How much does the compressor need to be serviced, and how much service needs to happen for this?

-Very little. There’s one filter slash muffler inside the chamber, and there are two filters outside. One of the filters outside will never exceed its life. It’s a pretty massive industrial HEPA filter. The other one, maybe three years, basically if you’re using it seven to 10 hours a day, five or six days a week, every two years, three years, you’re going to have to change those filters. Other than that, it’s literally– Probably wipe it down, keep it clean– Change a sheet, change a pillowcase. It’s pretty simple and pretty low maintenance. The only other piece that isn’t here that we use sometimes and maybe we’ll add this to yours at some point, is an oxygen concentrator. The compressor is basically putting room air in, and we’ll talk about mechanism, but as a result of that increased air, you’re able to increase more oxygen, you can also add an oxygen concentrator through a mask, so instead of breathing 21% oxygen, you could be breathing 94-95% oxygen while under that same pressure through a mask. That’s one way that you can take the same concept and sort of step up its clinical application, because you can get that much more oxygen.

-Interesting. So I guess this is a mild way to do it, and then you can add the oxygen concentrator making it a little bit more powerful, but again, since every patient’s unique-

– Some people need that, and honestly, even though we have the capacity to do air only in mild, all the way up to high pressure 100% oxygen. But just because we have the capacity to do that, not everybody… so some people are getting air only in a 1.3, some people are getting 100% oxygen at 2.0. So it really just depends what the needs of the patient are and what kind of thing you treat. Our office, we don’t specialize only in neurologic conditions. Neurologic conditions primarily respond the best to this. If you’re treating other types of conditions outside that realm, higher pressure and more oxygen might be appropriate, but for most folks, this is perfect.

-So let’s talk about the physiology. What’s actually happening, I guess as close as you can explain at the cellular level, when somebody’s in there? Let me hear it.

-Okay so the easiest way I think to explain this is we all know that we’re about as oxygenated as we can be right now, so we’re sitting here, we’re hopefully 97-98% saturated with oxygen in our blood cells. The way I explain this to my patients is say, “Hey listen, if you had 100 red blood cells, 98 of them have oxygen, two of them don’t. If you have access to that oxygen concentrator, or a green tank with a mask, you could basically breath let’s say 100% oxygen, and you can go from 98 to 100.” Now, that’s not that meaningful. People feel that, people go to oxygen bars or something, you can feel that two or three percent difference, but it’s not going to change your life. Somebody who has emphysema or COPD and they’re at 84-85%, that’s life altering. That’s managing their issues in a big way. But for a relatively healthy person or someone who’s not hypoxic in anyway, but still trying to increase their oxygen, that’s just not gonna do it. And so we really have no physiologic mechanism for increasing oxygen carrying capacity outside of that red blood cell management system. Some people might go, not for a treatment, but you go to Colorado, right, spend time in Colorado, that increases your red blood cell mass, if you could increase your red blood cell mass and then go back to Florida, for a short period, you’d have more oxygen, right? But that’s really the only natural mechanism we have for oxygen maintenance and increasing that capacity. The biggest difference here is that under pressure, because of Boil’s Law and Henry’s Law, you’re basically taking air, and you’re compressing it, so as you compress it, you can create a smaller volume, which is inside that chamber, and then as a result of that increased pressure and decreased volume, you can now increase the absorption of a gas into a liquid. In our bodies, what that means is we’re compressing air into a chamber, and as we breath, we can dissolve that into a liquid, which is our plasma. So typically, plasma doesn’t carry oxygen, it’s just the liquid medium for carrying all of our blood cells, but under pressure you can dissolve oxygen directly into the plasma and now all of the sudden, the plasma becomes an oxygen carrying device that our body now uses for delivering oxygen. The really important part about this is if you’re 98% saturated right now, and god forbid you had a TBI, you’re going to have injury to a part of your brain. Any time that there’s injury, there’s damage to the microcirculation. If you have damage to the microcirculation, what we know is that red blood cells need to get to an area, to a capillary, that’s where they’re going to release their oxygen, collect carbon dioxide and keep moving through the system. But if there’s damage to the microcirculation, red blood cells can’t get through. So you get this area of brain tissue that basically becomes dormant because it can’t get the fuel that it needs. Just because the red blood cells can’t get through, but plasma can, and plasma’s been getting there, but it’s not meaningful, because typically, plasma doesn’t carry any oxygen. But if you can diffuse oxygen into the plasma and now carry it through the body, it’s now going to be a delivery system of getting oxygen to a hypoxic area. Systemically, you’re not hypoxic. Systemically, you’re 98% saturated, but locally– At the site of injury. That is hypoxic, and there’s literally no mechanism for getting oxygen to that, other than through pressure, because through pressure and dissolving the oxygen through the plasma, the plasma’s able to go everywhere, now you can refeed.

-It’s like a Trojan horse, you found a way to sneak it in.

-That’s exactly it. But to do good, which is awesome.

-I enjoyed that, you taught me something. That was very, very cool.

-Two pieces to that, the first one is in the short term, that’s the story. So in the short term, immediately, as soon as you’re in this environment, you’re absorbing that oxygen into the plasma, and it’s going wherever it needs to go, especially to these traumatized areas, in the long term, angiogenesis is a long term benefit of hyperbaric. So after 20 or 40 sessions of hyperbaric oxygen, you’re going to rebuild that entire network of capillaries. And so once that actually occurs, you’re not even needing this anymore to feed that system. You’ve created a new network of capillaries that’s now going to be able to self sustain its own oxygen levels and just continue the function that’s been delivered.

-That was excellent. It was useful for me and very useful for a lot of scholars at home who are learning this for the first time. Dr. Saunders, this is fascinating. I think what I’d like to do next is find out what it looks like to be in this. Can I jump in?

-Absolutely.

-All right, let’s do it.

-Let’s do it.

-All right, Dr. Garcia, so we’re going to do your first hyperbaric therapy session, so come on over, we’re going to depressurize the chamber here and get you ready to role.

-All right, Dr. Garcia, we’re going to open this up. Come on over.

-It’s a big hole.

-Climb on in sir.

-Let’s see here. All right, let’s try this, give this a go here. So I just hop in this thing?

-Just hop right in.

-Nice soft mattress for you.

-Oh yeah, there we go. Nice and squishy, I forgot the pillow.

-Ah, the pillow would have been nice, a finishing touch.

-So, what you’re going to notice, it’s pretty soft right now, the edges of the chamber, so as its filling, you’re going to notice that it goes from being soft, to taking shape, and ultimately the walls are going to get pretty stiff. As soon as you notice that happening, you’re going to feel some pressure in your ears. As soon as you feel it, just pinch your nose, blow it out, or yawn, whatever you normally do to clear your ears. Try to stay ahead of it. If you’re staying ahead of the pressure, it’ll never build up, it won’t be an issue. As I’m checking on you, I’m going to give you a big thumbs up through the window over there, if everything’s good, give me a thumbs up back. If you’re having an issue, just point to your ears, I’ll know what that means, I can control how quickly or not you’re descending. So if you’ve having trouble equalizing, point to your ears, I’ll slow the pressure, you’ll equalize, and one you are, give me a thumbs up, we’ll head on down, okay?

-Sounds good.

-Enjoy.

-All right, here I go. I’m in the chamber, the chamber’s still soft right now, they haven’t really started the process yet, but we’ll give it a few minutes and see what this feels like.

-Okay, so I’ve been in here for maybe two minutes or so. I can already feel a little pressure in my ear, so I’m going to kind of pop them I guess a little bit.

-Okay, that was pretty easy, but that’s all it feels like. I do see the walls getting firmer, because before the bag, for a lack of a better term, was kind of saggy, but now it’s definitely becoming firm. I see the pressure gauge moving up little by little. It’s not even to one, I guess four is full pressure. So I’m going to just kind of relax and see what happens. All right, so I’ve been here for a little bit. I eventually reached a point of pressure, I think about four on this little valve, where the air is cycling out and coming in, keeping it at constant pressure. It doesn’t feel bad, it doesn’t feel good, It just feels like you’re kind of sitting in a slightly… like an airplane, exactly what it feels like, and there’s a little bit of noise because of the valve, but for the most part it’s kind of like white noise, kind of relaxing, just kind of hanging out here. It’s pretty interesting for the first time being in here. That’s the report.

-Welcome back Friend. How’d you do?

-Whoa.

-Not bad in there?

-Feel like an astronaut coming back into space. That was pretty good, pretty relaxing once I got in there.

-Yeah, good.

-Dr. Saunders, thank you so much for showing me this, I really appreciate it, it was fun. Dr. Saunders, thank you so much for coming down, helping us set up the hyperbaric oxygen therapy unit and teaching us about it and recording this video. I had a lot of fun hopping in there and experiencing it for the first time. One of the reasons we went with HBOT USA is because they were supporting us in this process and educating us and teaching us how to leverage this type of technology for excellent patient care, but there’s many types of clinicians that find you guys. First of all, where do they find you, and what are you doing for these clinicians to get started with HBOT?

-Sure, so the company is HBOT USA, hbotusa.com is our main website. We have a clinic in New Jersey, it’s New Jersey HBOT, we have one in Pennsylvania, it’s hbotpa.com, you can feel free to take a look at our sites, learn more, we have a lot of great information, obviously, on those sites, so feel free to take a look through and have a look, and as well, we’ve set up a few different structures for people, because some people like what we did initially, we just bought a chamber and said, “We’ll figure it out.” So that’s fine, too. We cover anything from here’s some equipment and you can run with it with a little bit of support, to literally I want to be a hyperbaric oxygen center, and I need everything, what do I need to do know and marketing and materials and consent forms– And you help them with the systems and all that stuff. All the systems all the way straight through. So anywhere from straight equipment to literally opening a hyperbaric center, we can help with all those things and everything in between.

-And we fell in the middle for the support to get us going, we really appreciate it, and to us that made a difference as opposed to just having four boxes dropped off and saying, “Well figure it out.” We don’t want to figure it out. We want to know how to do it well the first time around. And do it right. Exactly, we really appreciate you doing that with us, thank you very, very much. Again, if you want to find Dr. Saunders and learn more about HBOT, you go to hbotusa.com, did I get that right?

-That’s right.

-And Dr. Saunders again, thank you very much

-For coming on this episode of CITV, we’ll catch you next time. Take care.

-My pleasure.