To Your Health

The Magic of Hyperbaric Medicine

It's not a miracle cure for cancer, but for sports injuries, hyperbaric medicine has an almost mystical healing power. Maybe that's why Bode Miller, one of the best competitive skiers in the history of the sport, is a fan.

By Ted Katauskas November 1, 2015 Published in the Holiday 2016/2017 issue of Vail-Beaver Creek Magazine

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Dr. Joel Dekanich offers encouragement to a patient undergoing HBOT treatment in Edwards.

One bit of kismet followed Bode Miller’s gruesome crash at the 2015 FIS Alpine World Ski Championships in Beaver Creek last February: a friendship has evolved between Miller and Jonathan Rotella. As CEO of NexGen Hyperbarics, one of the event sponsors, Rotella was watching the men’s super G races from the VIP stands on February 5 when the six-time Olympic medalist, posting the fastest splits and picking up speed, hooked a gate with an arm and somersaulted down the injected course.

“I was there, and like everyone I didn’t realize the severity of it,” says the 40-year-old Rotella, sipping cinnamon tea in the great room of the outsize Beaver Creek ski chalet he tongue-in-cheekily dubbed Casa Di Montagna della Rotella. “Bode basically walked off the course.”

But all was not well: as Miller ejected from his bindings, the razor-sharp edge of his left ski sliced through Lycra, skin, muscle, and tendon, severing the hamstring of his right leg. Following reconstructive surgery (requiring some 50 stitches) at Vail Valley Medical Center, Miller was referred to Rotella, whose NexGen manages an ever-expanding chain of Hyperbaric Oxygen Therapy (HBOT) wound-healing centers across the country.

 “Obviously it was unfortunate for Bode when he went down,” says Rotella, “but it was an opportunity for us to speed his recovery and enhance public awareness of hyperbaric medicine and how it works.”

Wanting to break away from the nine-to-five grind with a high-growth venture that would leverage his expertise in the medical devices and pharmaceutical industries, Rotella founded NexGen in 2006 in his hometown of Naples, Fla., as an outpatient clinic primarily focused on Type 2 diabetics with chronic nonhealing wounds. Knowing that 9.3 percent of the U.S. population suffers from the disease, Rotella looked for an underused technology that could address one of its most serious complications: due to poor circulation, 73,000 diabetics each year lose a lower limb to amputation.

The solution he settled on was HBOT, originally developed as a treatment for divers experiencing the bends after ascending too rapidly from the high pressures of the deep. In HBOT therapy, a patient intermittently breathes pure oxygen while enclosed in a hyperbaric chamber that’s pressurized to more than one atmosphere. The pressurized oxygen, which under normal circumstances can be delivered only by red blood cells, is dissolved into all of the body’s fluids and can thus be transported to areas of the body where blood circulation is diminished or blocked altogether, creating a sort of highway bypass for oxygen delivery. Once oxygen reaches damaged tissues, the body’s own healing process takes over: white blood cells kill bacteria, swelling reduces, and ultimately new blood vessels grow and restore blood flow to chronically nonhealing wounds.

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NexGen’s Jonathan Rotella with lab Brunello

Image: Nancy Denike

“We know we can make a difference,” says Rotella, who plans to open a NexGen hyperbaric treatment center in the Vail Valley in 2016. “Our company motto is simple: we save lives and limbs.”

Since 2006, NexGen has expanded from that single HBOT wound-care clinic in Florida to a network spanning 48 states, treating 14 FDA-approved conditions from carbon monoxide poisoning and radiation sickness (at Englewood’s Swedish Hospital, one of NexGen’s newest and largest facilities with seven hyperbaric chambers, a Chernobyl victim recently was treated along with a Denver resident who had nearly died from carbon monoxide poisoning) to NexGen’s bread-and-butter: diabetics at risk for amputation. 

For that disease, the usual treatment protocol requires anywhere from 30 to 90 two-hour sessions in the chamber, which depending on diagnosis is covered by Medicare and most major insurance plans. Rotella monitors every one of his centers remotely via smartphone; in his living room, he calls up a live video feed from Swedish Hospital, summoning a scene right out of Star Trek: a stark white room where white-garbed attendants monitor a bank of futuristic acrylic tubes manufactured by Sechrist Industries (and approved by the Undersea and Hyperbaric Medicine Society), each with a prone patient inside, aglow from the screens of flat-panel televisions.

“It’s kind of a nice experience,” says Rotella, who, as a characteristically hands-on CEO, has undergone treatment for the sake of quality control. “All of our chambers have flat-screen TVs with Netflix accounts, so our patients can relax and watch the news or a movie, read a book, or sleep, knowing that nice things are being done to your body.”

With that in mind, Rotella sees the real promise of HBOT—and potential growth of companies like NexGen—in an increasing demand for “off-label” treatments for illnesses and conditions that have shown promising results but have yet to receive FDA approval, involving everything from traumatic brain injury (“I can show you  MRIs of what someone’s brain looks like before and after HBOT that will blow your mind!”) to autism to physical rehabilitation. After hours, many NexGen clinics cater to professional athletes who are willing and eager to pay out-of-pocket for HBOT treatment to speed recovery when sidelined by injury.

“When a player with a multimillion-
dollar contract is not on the field, team physicians and trainers and coaches are going to do everything they can do to get that athlete to come back as quickly as possible,” says Rotella. “They wouldn’t continue to seek treatment if  HBOT didn’t work.”

In fact, while working at a preseason NFL training camp over the summer, Joel Dekanich, a sports medicine specialist at Vail Integrative Medical Group (VIMG), discovered that a growing number of NFL players own portable hyperbaric chambers that they use to speed muscle recovery after grueling practices and games. One of the athletes, who played for the New York Giants and Washington Redskins, had an extra soft-walled portable chamber for sale. 

Dekanich bought it and installed it in a treatment room at the VIMG clinic in Edwards, then obtained a more rugged nonportable hyperbaric chamber for the group’s primary clinic at the Vitality Center in Vail Village. In addition to providing HBOT treatment for the 14 FDA-approved medical conditions like NexGenVIMG offers “off-label” HBOT treatment to visitors from lower elevations with signs and symptoms of altitude sickness (“One of the biggest needs we saw in the Vail Valley was guests coming here and having a difficult time with the altitude”) and endurance athletes seeking to enhance performance by supercharging plasma and red blood cells with oxygen before competition and speeding recovery afterward.

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Bode Miller at a NexGen hyperbaric wound-healing clinic in California

“One of the top athletes in the valley just left here an hour ago,” Dekanich says between appointments in his Edwards office, noting that athletes, like all patients, must undergo a thorough physical exam before being cleared for HBOT, billed at $125 to $250 per hourlong session. “With professional athletes, this is an increasingly growing modality for recovery after a hard training day. ... If HBOT can help heal a diabetic wound, think of what it can do for a healthy athlete.”

Or an injured one. Back in Beaver Creek, Rotella puts his cell phone on speaker and dials Bode Miller.

“Bode! It’s Jonathan ...”

The Olympian, currently in Maryland, reports that he’s doing well. But he’s more interested in talking about horse racing than skiing—he attempts to interest Rotella in buying a share in another thoroughbred. (The newfound friends are co-investors in a horse racing concern.)

“I’m trying to get him to come back and race,” says Rotella, hanging up after agreeing to mull Miller’s pony proposal.

Regarding the efficacy of the HBOT treatment Miller received at one of NexGen’s clinics in California, all that Rotella will say is this: he’s planning to open the largest HBOT clinic in the Vail Valley, and his friend, one of the fastest men on skis, is building a hyperbaric chamber for his racehorses. 

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