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INTELLIGENCER JOURNAL (Lancaster, Pa.)
Cover, Business Monday

Breathing Room:  Lombard Medical Center is county's best kept secret
From where she sits in a sunken nurses' station, Connie Waltz carefully monitors patients in the four hyperbaric oxygen (HBO) chambers at The Robert M. Lombard Hyperbaric Oxygenation Medical Center, which some patients call the county's best kept secret.

Hidden away in Columbia, PA, a small town along the banks of the Susquehanna River, the Center is unknown by many within the community. Yet patients travel from out of state and out of the country to receive HBO therapy.

The idea for the Center dates back to the late 1970s when Waltz's dad, Robert Lombard, M.D., a family physician from Columbia, learned about using 100 percent pure oxygen at increased atmospheric pressure for healing wounds and for treating patients with multiple sclerosis (MS), strokes, and other conditions.

Lombard studied the physics behind HBO therapy and was excited about its healing potential for his patients. Intrigued, he then examined the approach first hand and was hooked. Quietly, without fanfare, a family business was born.

"My dad was a true visionary, who learned of an idea, explored it, and imagined how it would be in the future," said Waltz, director of nursing at the Center that her dad opened in May 1979.

"He brought HBO to life, even before the rest of the professional world accepted it."

Newly graduated from Widener College School of Nursing at the same time, Waltz joined her dad at the Center and has been here since the day it opened. She and her sister Meredith Lombard, who is business manager, became co-owners of the small six-person facility when he retired in 1999.

Kind and compassionate, Waltz infuses a family atmosphere at the center as she warmly welcomes her many patients and fusses to meet their needs. On this particular morning, she opened the Center at 6:00 a.m. for Lorna King, Millersville, PA.

King has poor circulation in her foot from diabetes. She developed a sore that wouldn't heal and it was threatening the possible amputation of her foot.

"That was a wake-up call, so I was open for something unusual," said King. "I'm 82, but I still value my limbs!"

King started treatments in August and her wound is steadily decreasing in size. Changes occur at the cellular level, so it takes a series of treatments for healing to occur. Delighted with the results, King said that the therapy is well supervised and she is never alone.

"This is extremely relaxing too," she added. "I can pass the time by watching a movie, or listening to tapes. Today I took a nap."

Breathing pure oxygen
Hyperbaric oxygenation therapy is an unfamiliar, mysterious-sounding term to many people. It simply means having a patient breathe an increased percentage of oxygen at a higher than normal barometric pressure.

"This is not to be confused with topical oxygen therapy," Louis Neureuter, M.D., pointed out. Neureuter, board certified in undersea and hyperbaric medicine, serves as supervising physician at the Lombard Center.

"With hyperbaric, patients actually breathe in the oxygen," Neureuter said, explaining that the individual sits or lies in a bed-sized chamber, receiving high levels of oxygen for an hour or two.

There is one Vickers chamber and three Sechrist chambers at the Lombard Center.

A patient sits in the Vickers chamber, which is somewhat like a one-man submarine. It is made of metal, but has a big acrylic bubble over the individual's head so he or she can look around.

In contrast, a patient lies in the Sechrist chamber, which is all acrylic, allowing lots of visibility too.

"Oxygen is a basic fuel," Neureuter said. "We need food and oxygen to fuel our bodies.

"The amount of oxygen in the air, however, is only 21 percent oxygen, so we increase it five-fold by giving individuals pure oxygen. Then we increase the pressure 1 to 1-1/2 times that of normal air pressure."

According to Neureuter, the high oxygen and high pressures allow therapeutic effects to occur beyond ordinary life processes such as metabolism and respiration.

These effects include an increase in blood vessel formation as well as an activation of additional white blood cells, our body's defense against infection.

In this environment, oxygen-thirsty tissues soak in pure oxygen like a dry sponge soaks in water, allowing wounds to heal.

HBO, in fact, is all about healing wounds, external wounds and internal wounds.

Internal wounds include dozens of conditions such as cerebral palsy, autism, stroke, Lyme disease, and traumatic brain injury from accidents.

While there has been considerable research using HBO for healing diabetic ulcers and delayed radiation injuries, little formal research has been done in other areas, where effects are difficult to measure and still under investigation.

"The extent to which people respond to treatment varies," Neureuter said. "You can't predict who will get better, which is why these things are investigational. With many patients, however, if you give them enough oxygen, it can improve their function."

Insurance companies will not reimburse for HBO therapy for any investigational disorder, nor can hospitals provide this therapy for such disorders.

These limitations explain why patients come to this free-standing facility from hundreds, even thousands, of miles away. On this particular morning, most of the patients are from northern New Jersey, about three hours from Columbia.

A time to heal
The brown paneled walls and the many couches throughout the user-friendly facility have the feel of home. Almost half of the patients here are youngsters, so there is a box of blocks here, a walker there.

Colorful kite-like decorations hang from the ceiling. A teddy bear stretches his arms in a great big hug. And Winnie-the-Pooh's friend Tigger perches cheerfully on an exercise machine. Children's videos sit on shelves, while photos of youngsters hang in collages on the walls.

Families come regularly for treatments and become acquainted, sharing stories of hope.

The stories are endless: The family of five, who arrived in the middle of the night with carbon monoxide poisoning, recover. A baby, who almost drowned, lifts her head after an HBO treatment. An autistic child plays with his sibling for the first time. A teen with cerebral palsy makes dramatic improvements in fine motor coordination and speech, within three weeks!

"The patients who excite us the most are the children, of course," Waltz said. "You see them come in and they are not doing much of anything.

"Then they get the hyperbaric therapy, plus a lot of love and other therapies from their parents, and you can just see the change it makes. This is what we care about. This is why we are here."

Neureuter agreed. "Hyperbaric therapy gives people hope. People have exhausted the simple modalities. If something is able to help them that they weren't aware of, it's quite a Godsend."

According to Neureuter, HBO is safe for almost everyone.

"There are few absolute reasons not to do this, although we do screen people to make sure their hearts aren't too weak and they don't have severe lung disease.

"With certain adjustments and cautions, however, most people can still get an effect. Patients may tire from HBO or experience slightly fuzzy vision, temporarily."

Playing it safe
Choosing a reputable center is key to reducing risks and staying safe, Waltz said.

"The center should be staffed by a physician and other health care professionals certified by the Hyperbaric and Undersea Medical Society, who understand that oxygen is a fuel source for a fire and take the necessary precautions to avoid a problem.

She pointed, however, that you must have a source of ignition plus something to burn, in addition to oxygen, or fires cannot exist.

"We are very, very careful. Patients wear 100 percent cotton clothing to avoid static electricity and take nothing into the chamber. We have never had an emergency."

"No one in this country has ever had a problem with HBO therapy," Neureuter added. "There have been some problems abroad, however, where people foolishly took things like hand warmers into chambers that they shouldn't have."

"A good center will also require a doctor's prescription," Waltz explained, "and there should be two or more staff members in the building at all times, in the event one of them has an emergency."

With these considerations in mind, Waltz believes HBO is safe for everyone, even a baby right out of the womb!

Home away from home
"We treat our patients as if they are family," Waltz said. "So many are away from home for a month or more and can be lonely. By the time they get to know us, we are the family that they left at home."

Eduardo Pace, 42, Cream Ridge, NJ, who is being treated for reflex sympathetic dystrophy, a sympathetic nervous-system disorder that causes agonizing pain, vouches for the caring atmosphere of the Columbia. He says everyone who comes here is so fortunate.

"I cannot speak highly enough about this facility, for the staff and doctor are extraordinary and kind.

"This therapy has made a dramatic difference in my life. I am so grateful."