We cure some patients, not others. We do not promise false hope but give comprehensive treatment.
"We must ensure the community as a whole remains healthy with physically and mentally healthy people."
In an era where people are exploring new options for healthcare, many may have heard about oxygen therapy and the restoration of health through pure oxygen, which aids in the recovery of tissue injuries and various wounds.
In this edition of MedPark Stories, you will learn about Oxygen Therapy and meet Dr. Sethasiri Sangsuwan is a preventive medicine physician specializing in marine medicine and an expert in hyperbaric medicine. He emphasizes the importance of knowledge, understanding, and maintaining the safety standard of the equipment, as well as the proficiency of the medical team.
Dr. Sethasiri Sangsuwan has been a consultant from the beginning of the design and construction phase to the system setup of the Hyperbaric Oxygen Therapy Center at MedPark Hospital. He also laid out the guidelines for treatment and services, which led to the center passing the Joint Commission International accreditation survey. In 2022, Dr. Setthasiri was honored as the Outstanding Preventive Medicine Physician by the Preventive Medicine Association of Thailand. Get to know more about Dr. Sethasiri through this article.
The tsunami disaster shifted his focus from 'treatments' to 'preventions.'
After graduating from Phramongkutklao College of Medicine, Dr. Sethasiri Sangsuwan joined the Royal Thai Navy as a naval doctor. In 2004, a devastating tsunami hit the coastal provinces along the Andaman Sea.
"Serving as a naval doctor, I accompanied a large team on a mission to locate the missing, retrieve the deceased, and offer medical assistance to the wounded. Witnessing our team working relentlessly at sea around the clock, I pondered how to protect their health and ensure their continual readiness to assist the community."
This pivotal moment drove Dr. Sethasiri to pursue further studies in preventive medicine, specifically in Occupational Medicine, at the Faculty of Medicine, Chulalongkorn University. He applied his knowledge of occupational health to care for the well-being of those working on ships. He then extended this by collecting data and collaborating with doctors from the Thai Naval Medical Department to successfully develop a residency program in preventive medicine with a focus on maritime medicine.
"Preventive medicine involves a broad, population-level perspective. We must ensure that the community remains healthy with physically and mentally healthy people. The preventive medicine curriculum focusing on marine medicine emphasizes caring for coastal communities and those capitalizing on the sea, such as tourists, divers, tour operators, boat owners, and offshore rig workers. The curriculum also includes hyperbaric oxygen therapy, a treatment endorsed by the Thai Medical Council."
Hyperbaric oxygen therapy and the expectation of patients
Hyperbaric Oxygen Therapy (HBOT) involves treating patients inside a pressurized chamber resembling a transparent capsule, where they inhale 100% pure oxygen under higher atmospheric pressure than at sea level.
"In the past, Underwater Medicine leveraged hyperbaric oxygen chambers to treat diving-related illnesses. The discipline has now developed into Hyperbaric Medicine with expanded indications, such as chronic wounds, diabetic ulcers, and difficult-to-heal wounds secondary to radiation therapy for cancers, recently. It also addresses vascular disease wounds, carbon monoxide poisoning, sudden hearing loss, and sudden, unexplained vision loss."
Dr. Sethasiri is pleased to see many healthcare facilities adopting hyperbaric oxygen chambers to broaden their uses. However, he emphasizes the importance of genuine knowledge and understanding of operating the equipment under the supervision of specialized marine medicine physicians and specially trained nurses, adhering to academic and safety standards.
"Hyperbaric oxygen chambers are now leveraged for conditions beyond their primary indications, such as sports injuries, chronic fatigue syndrome, and anti-aging treatments. Patients should receive advice from doctors about potential impacts or drawbacks and understand the treatment mechanisms. If the outcomes do not align with expectations, it could harm the credibility of other hospitals that use these chambers for their intended purposes. Hospitals could suffer a decline of trust."
Treating hard-to-heal wounds with pure oxygen: safety considerations
Some patients with chronic wounds believe that oxygen therapy involves applying oxygen only to the wound area. However, this is a misconception.
"We need to treat the whole body. The healing process does not occur because oxygen diffuses into the wound. Instead, it involves inhaling oxygen, which diffuses into the bloodstream and circulates throughout the body, triggering various reactions that enable the body to create new blood vessels and tissues. The therapy requires breathing 100% pure oxygen under appropriate pressure. It is essential to know the pressure limit of the chamber while ensuring the patient receives sufficient oxygen."
Ensuring patient safety and the expertise of personnel operating the hyperbaric chambers are equally important. Even though accidents have never occurred, there is always a possibility. It is essential to communicate the restrictions to patients, particularly concerning flammable items.
“We must instruct patients on proper conduct during treatment. Electronic devices, mobile phones, or tools emitting currents causing sparks or containing batteries are contraband items in the chamber. Patients should refrain from using cosmetics and perfumes due to potential flammable compounds.”
Dr. Sethasiri added that MedPark Hospital is well-prepared, offering two high-standard single-person hyperbaric chambers.
“MedPark Hospital hyperbaric chambers are of high standard for treatment quality and safety certification. The chambers are spacious, accommodating patients of all sizes. Additionally, we have specialist nurses trained in hyperbaric medicine by the Naval Medical Department. They have extensive experience using monoplace chambers, making them some of the top experts in the country.”
Difficult-to-heal wounds are amenable to hyperbaric oxygen therapy
Many cases in which Dr. Sethasiri treated involve difficult-to-heal wounds, where outcomes vary widely among patients.
“For instance, there was a 7-8-year-old child with a nearly severed finger. His father was distraught, measuring the finger length daily, but eventually found solace in seeing the finger lengthening. We explained that it is not bone or the finger itself growing, but rather the tissue being healed and regenerated. He came to understand and eventually came to terms with it. Another case was a diabetic patient with a wound almost the size of a palm. We treated it until the wound was reduced to the size of a thumb, avoiding amputation. There was also a patient who had received treatment elsewhere for nasopharyngeal cancer, resulting in a radiation wound on the neck that became infected. Continuous hyperbaric oxygen treatment reduced the wound to a small hole, which we stitched up, allowing the patient to return home happily."
Dr Sethasiri told everyone on the team, whether doctors, nurses, orderlies, or interpreters, must be compassionate and maintain calm dispositions when interacting with patients. Patients come from various countries with distinct cultures and beliefs.
"When it comes to treating difficult wounds like diabetic ulcers, some patients heal while others do not. We do not promise false hope, but we provide comprehensive treatment. At the very least, after treatments, they should leave happy."
In terms of his happiness, apart from experiencing the delight of patients, it involves spending time at sea, which influenced his choice to pursue a career as a naval doctor.
"I love the sea dearly. When feeling troubled or stressed, I seek solace in the sea. Any sea will do — Just gazing at the waves is calming and uplifting. If I cannot be by the sea, engaging in sports helps. Waking up early at 4 AM for a run is my routine. Running a marathon in Germany, covering 42 kilometers, remains my most memorable moment. Running lets me be alone with my thoughts. I enjoy golf, swimming, and cycling, and had competed in a triathlon. Plus, I adore dining and travel."
