OxyFile #538

A Dream Come True

By Robert A. St. Genis
Source: City - April 17 - May 15, 1995


In October, 1990 a friend of Michelle Reillo's came to her 
asking for help.  He had zero CD4 cells and was suffering from 
the severe fatigue associated with HIV.  Reillo, aware that 
fatigue, which often gets confused with depression, is one of 
the more debilitating symptoms of HIV and causes people to 
stop working and socializing, was concerned.  But, what was 
the answer?

That night she had a dream.  In the dream, Reillo sent her 
friend on "dives" in a hyperbaric chamber to relieve his 
fatigue.  Initially, she wasn't sure as to why it would work, 
but the dream was inspiring enough to try it.  Her friend, 
absolutely desperate, agreed and Reillo brought him to The 
University of Maryland Shock Trauma, where she was then a 
nurse, to begin treatments.  Reillo had her friend dive at the 
equivalent of 33 feet below the water surface three times a 
week.  Within a month, the man's fatigue disappeared.

Reillo then went through the procedures to be granted a study 
at the University of Maryland.  The three-year study involved 
25 patients who were treated with 100 percent oxygen at 33 
feet three times a week for two months, then twice a week 
thereafter.  The results showed that 13 patients had a 
statistically significant decrease in tumor necrosis factor 
(TNF), which is one factor that causes fatigue in HIV-infected 
individuals.  In addition, these patients all had an increase 
in appetite and thus in weight.  If nothing else, Reillo's 
study made her confident in saying she had improved the 
quality of life in her patients.

Despite the results of the initial study, the University of 
Maryland abandoned funding future studies or treatments for 
HIV-positive individuals in 1993.  Reillo says that the 
National Institutes of Health was contacted while she was at 
the University of Maryland on a number of occasions.  She 
notes that Dr. Anthony Fauci was faxed by Search Alliance and 
urged to examine hyperbaric oxygen therapy (HBO) in 1992.  Dr. 
Michael Gottleib of the UCLA Medical Center was also contacted 
and spoke with Reillo.  The University of Maryland submitted 
three grant applications to NIH, none of which were approved.  
The University of Southern Alabama separately applied for a 
grant to continue their research on hyperbarics and was also 
denied.

Reillo and some patients who were part of the University of 
Maryland study believe it's because of the lack of financial 
incentive.  "The politics of AIDS around pharmaceuticals are 
horrible," Reillo said.  "Hyperbarics should not be a threat."  
Determined to continue her research, Reillo used her own money 
along with bank loans to open Life Force in Baltimore at 1006 
Morton Street.  After purchasing and having a chamber 
installed, completing all other construction, and providing 
the facility with the necessary office equipment and 
furnishings, Reillo opened her doors in August, 1993.

Since then, she has continued treating 13 of her original 
patients, in addition to about 130 others.  She maintains 
about 50 "compliance patients," explaining that many quit the 
treatments after they feel better.  Reillo's persistence has 
led her to surmise that HBO treatments reduce the viral load 
in patients by a biochemical reaction whereby oxygen binds to 
an amino acid and zinc peptides, which are required for RNA 
replication of HIV.

In addition, Reillo has concluded that HBO therapy, along with 
medication, helps reduce the recovery time for PCP.  A study 
on the latter discovery was written in the April, 1995 issue 
of AIDSPatient Care.

While other research is limited, Reillo is not alone.  At the 
International AIDS Conference in August, 1992 in Florence, 
Italy, a study was released by Drs. Brazelle, Ryan, and Harley 
which determined that oxygen under pressure reduces the viral 
load in patients systems.  Laer, at the August 1994 
International AIDS Conference in Tokyo, Dr. C.R. Steinhart, 
Dr. I. Montoya and M.R. Kaiser of Mercy Hospital, Miami, noted 
that "in three of four patients with mid to late stage 
disease, HBO subjectively improved quality of life and reduced 
fatigue."  In 1993, The Israeli Naval Hyperbaric Institute 
conducted a single exposure study in non-HIV infected human 
subjects and found that HBO causes T-cell subpopulations to 
shift.

A 1994 study at the Israel Navel Medical Institute conducted 
on non-HIV infected rats indicated again a shift in T-cells, 
with there being a decrease in the blood, but increase in the 
lungs, lymph glands, and spleen.  Their hypothesis for this is 
that they "may represent the activation of protective 
mechanisms against the toxic effect of oxygen or the early 
stages of pulmonary oxygen toxicity.

Toxicity is one concern that is often voiced about HBO 
therapy.  At Life Force, Reillo makes sure that her patients 
receive antioxidant medications as part of their treatment and 
none of her patients have faced any problems with toxicity.  
Further, a 10 year study showed that out of 1,505 patients, 
non suffered pulmonary oxygen toxicity or ocular refractive 
changes and only .009 percent suffered oxygen convulsions, 
which ceased after removing the masks from the patients.  
However, it should be noted that the Under Sea Hyperbaric 
Medical Society has not yet endorsed hyperbarics for treating 
HIV.

The costs of hyperbaric oxygen therapy is another 
consideration.  Life Force charges $125.00 per session for 
visits.  This fee is considered low compared to other 
hyperbaric clinics, but a "maintenance patient" will face over 
$1,200 a month in charges for the therapy.  Many insurance 
companies will cover hyperbaric if prescribed by the patient's 
physician.  Reillo says she will not turn anyone away because 
of their inability to pay.  "If people don't have any 
insurance, we will work something out."

Dr. Mark Smith of Tucson, Arizona, feels that "cost is all 
kind of relative in this disease.  Depending on what the (HIV) 
patient is facing, they can expect $10,000 to $15,000 a month 
at times (for treatment and care)."  He continues, "For what 
[HBO] does in comparison to AZT, it's relatively low."

Smith, infected with HIV and with zero CD4 cells, has 
purchased his own hyperbaric oxygen chamber and has been 
administering HBO treatments since May, 1994.  Smith has had 
tuberculosis and PCP and only weighed 110 pounds when he 
started.  Today, he weighs 160 pounds, is able to work out 
three times a wee, and claims "if it weren't for hyperbarics, 
I probably wouldn't be here today."  Smith doesn't want to 
speculate why more people aren't investigating hyperbarics, 
though he explains that "the theoretical negatives are far 
more unproven than the positives we have proven to date."

Reillo's patents are equally enthusiastic.  Tim Good, 47, HIV 
positive for eight years, claims, "The has stopped the 
progression by about 83 percent since I started.  This is a 
great deterrent.  This is one of the great unknown 
treatments."  Tom, 38, HIV positive for 10 years and a patient 
of Reillo's for the past four also believes that HBO 
treatments have stopped the progression of the disease, 
stating, "I have tried a dozen types of experimental therapies 
and this is the only one that has worked.  The proof is I'm 
doing nothing else right now, no drugs or anything and my 
counts remain stable."

Doug Garriott, 52, HIV positive since 1982 and one of Reillo's 
first patients doesn't understand why more people aren't 
coming for treatment, stating, "I certainly think [HBO 
therapy] kept me alive for the last four years and I know it 
can do that for other people."

Hyperbarics are not new to the world of medical science.  For 
more than 30 years, the U.S. Navy has used hyperbarics for 
treating deep sea divers suffering from the bends, a 
potentially fatal condition that is cause by surfacing too 
quickly.  Dr. John M. Alexander at Northridge Hospital Medical 
Center in Los Angeles, once a Naval medical officer, now uses 
hyperbarics to treat such patients as diabetics with foot 
ulcers that don' heal, cancer sufferers with radiation-induced 
tissue damage, and victims of carbon monoxide poisoning.  
Hyperbaric treatments for non-diving diseases date back to 
1950s when surgeons used the treatments to carry out 
cardiovascular procedures that required stopping blood 
circulation.  They were abandoned for this purpose with 
introduction of heart-lung bypass machines and widely 
disregarded in general in the mid 1970s.  Yet, while there 
were only 37 facilities operating in the United States in 
1977, there are nearly 260 today.  Still, despite evidence 
showing positive effects of hyperbarics in areas outside of 
HIV, hyperbarics "remains an ill-defined field, and HBO data 
often consists of small (test) series without standardized 
patient populations or treatment schedules," according to a 
1990 article in the Journal of The American Medical 
Association.

Most organizations involved with HIV also remain uninformed 
and in certain cases simply disinterested.  The AIDS 
Information Clearinghouse, operated by the Centers for Disease 
Control, had no information available regarding HBO therapy, 
stating that they only tend to hold information regarding 
pharmaceutical-based options.  The National Association of 
People With AIDS was not able to locate any information on 
hyperbarics.  Project Inform and The Gay Men's Health Crisis 
did not respond to inquires regarding the form of treatment.

Contrarily, the National Institute of Allergies and Infectious 
Diseases, who did have access to some material including 
Reillo's studies, stated, "At the current time, we are not 
supporting research in hyperbaric oxygen therapy nor have we 
seen a formal submission of data.  We do, however, always 
welcome interesting data and would look forward to the results 
of additional research."  The AIDS Treatment Data Network was 
able to reply with the above mentioned Steinhart and Bitterman 
studies, in addition to Reillo's and has voiced an interest in 
more information.

For hyperbarics to gain any real recognition, whether it be in 
treating food ulcers or symptoms associated with HIV, it is 
evident that controlled studies need to be conducted.  The 
health care profession is, at best, skeptical about treatments 
that have not been sufficiently researched and most patients 
are comforted knowing that doctors do not prescribe treatments 
that may not benefit their patients.