Since 1986 Dr. Harch's hyperbaric medicine practice has progressively expanded to include HBOT for off-label indications as well as the 13 "accepted" and five "non-accepted" Medicare/Medicaid indications (see discussion on HYPERBARIC OXYGEN THERAPY INDICATIONS). In the late 1980's Dr. Harch applied the "sensible notion of Cunningham" to assess the responsiveness of acute spinal cord injury to HBOT. The "sensible notion of Cunningham" was Dr. Cunningham's investigation of HBOT effects on various diseases in the 1940's that was guided by asking the question, "If HBOT works for Disease X which is characterized by low oxygen and blood flow and Disease Y has the same underlying low oxygen problem why shouldn't HBOT work for Disease Y? This is the same question asked by every physician in their everyday practice when applying an FDA approved drug or device to a non-approved indication and is known as the clinical practice of medicine. It is also the question asked by every lay person who attempts to obtain HBOT for a non-accepted or off-label indication. When Dr. Harch applied the sensible notion to acute spinal cord injury in 1989 he found success in certain types of cord injury and failure in others. Over the course of the next few years Dr. Harch applied this to nearly 20 acute spinal cord injured patients in conjunction with, and later, on demand from his neurosurgical colleagues. This was expanded to treatment of the first chronic decompression sickness divers described above and eventually hundreds of patients with a large variety of different nervous system disorders. To date this is the second largest accumulation of HBOT for neurological disorders in North America, second only to the experience of Dr. Richard Neubauer, the grandfather of HBOT in Neurology.
Currently, Dr. Harch performs consultations on any patient seeking HBOT for any indication, "accepted" or off-label. He provides second opinions, assesses patients with any type of central nervous system disorder, evaluates patients' potential to rehabilitate with HBOT, and accepts patients regardless of their involvement in litigation. Physician referral is desirable, but not required; no patient is excluded because of lack of physician referral. Typical evaluations over the past 10 years have consisted of detailed history and physical exam, video exam if patient desires, and SPECT brain blood flow imaging on a high-resolution Picker Prism 3000 triple-head(camera) before and after a single HBOT. SPECT brain imaging was mandatory when patients were on an experimental protocol, but is now OPTIONAL. SPECT is desirable for patients seeking proof of efficacy of treatment when attempting to obtain reimbursement for HBOT from third party carriers, for referring and primary physicians who similarly seek proof, and for patients with unusual neurological problems. The scans are also very helpful for any patient who wants to "see" their neuropathology and remains one of the most powerful tools to demonstrate brain injury, damage, or dysfunction. Children and patients who are unable to cooperate require conscious sedation by hospital-based anesthesia to obtain the motionless high quality scans seen on this website. Some patients desire a single scan or none at all while most others request two scans. Again, they are OPTIONAL and not necessary for HBOT. No patient is refused HBOT for a lack of SPECT. Dr. Harch maintains a large group of normals to which patients can be compared and is willing to discuss this in detail with any prospective patient.
HBOT is delivered according to protocols developed by Dr. Harch since 1986 and individually customized to each patient’s condition. These protocols are the basis for nearly all off-label neurological HBOT in the United States today and many of the research trials. These protocols have been applied to over 50 different chronic neurological disorders across the broad categories of vascular, traumatic, ischemic/hypoxic, toxic, degenerative, convulsive (seizures), autoimmune, dementia, and pediatric. A particularly large experience has been generated in stroke, trauma, carbon monoxide, seizure, and pediatric brain disorders, especially CP. Since HBOT is a drug, proper dosing is necessary to avoid toxicity that has been identified by Dr. Harch's research and clinical practice. In addition, every HBOT (medical treatment) is physician-attended. Details on costs, housing, logistics, and other matters can be obtained from Dr. Harch's office staff at the address and phone number listed on the contacts page.