Revitalize Your Memory With HBOT Therapy

Mohammed Elamir, MD, FACP

Thank you for having me. It’s a pleasure.

Dale Bredesen, MD

Talked a little bit about the initial work. How did you guys decide? I know you’ve done some work with diabetes and things like that. How did you decide that this was a good idea for cognitive decline? Then tell us about some of the results that you’re getting, even beyond the paper, and what you are seeing.

Mohammed Elamir, MD, FACP

Hyperbaric oxygen, as you mentioned, has been around for a long time and has traditionally been used in wound care, diabetes, scuba diving accidents, and the bends. When you take the principles of hyperbaric, it involves breathing 100% oxygen in a pressurized environment and taking us back to high school Boyle’s Law, Henry’s Law. It states that a gas under pressure can increase the concentration of that gas delivered to the cells of the body. When we talk about diseases,  a foot wound from diabetes, it’s a lack of blood flow, a lack of ability to heal, and, of course, a lack of oxygen because of the lack of blood flow. It’s a wound. There’s necrosis; there is cell death. But when we think about cognitive decline, in the end, the brain is an organ just like anything else. It needs blood, and it needs oxygen. Whether it’s aging, cognitive decline with aging, vascular dementia, or even Alzheimer’s, it comes down to a lack of blood flow over time. In some cases, a lack of blood flow to the brain causes cell death. You don’t have it suddenly, like a stroke. But you have it gradually. If it’s vascular dementia, you’re having a shrinkage of the brain or atrophy; you’re having that loss of brain tissue, and that causes cognitive issues. When you apply the principles of hyperbaric to any organ, in this case, the brain, we know, hey, we have this technology that can help; we can address the causes of the cognitive decline by hyper oxygenation. More specifically, over the last 15 years and through our research, we’ve discovered that if we fluctuate these oxygen levels in a specific protocol, we can trigger the body to grow new blood vessels and new cells in the brain. Once, it was thought impossible.

Dale Bredesen, MD

Great point. Your colleague presented, as I mentioned before, we got on here a few years ago at an Amazon Summit where he and I were both there as well as others, and we talked about the idea of relative hypoxia being essentially normoxia. I’ve taken from his work the idea that, How low do we want to go? Here’s my big concern: We often use, exercise with oxygen therapy as another way to get more oxygen into the brain. Some groups like to create hypoxia as well as hyperoxia. My concern is always that these are people who, as you just indicated, are already suffering from too little. We’re trying to get them back to normal. Your colleague then pointed out that, well, just cycling for five minutes to normoxia and then going back to hyperoxia seems to do very well. My question for you then is: when do you worry if you go too low, especially in people where that’s the problem to begin with, as you pointed out, and when is it enough to just go to normoxia as relative hyperoxia to trigger these trophic factors and the support that you want?

Mohammed Elamir, MD, FACP

The work of Dr. Shai Efrati, and Dr. Amir Hadanny, my colleagues who have been doing this for the past 15 years. You have to go back to human physiology. The human body wants to repair itself when it’s in duress or distress. Hypoxia is a dangerous state. The body knows if there is low oxygen, cells will die. In a low-oxygen state, it will release factors to grow new stem cells to replace the cells that will die from this low oxygen. It will trigger the growth of new blood vessels to help usher in better blood flow to the organs that might be starving of oxygen. But to your point, we don’t want to put you in a low-oxygen state because then you’re going to have cell death. If you’re already compromised before that, that could worsen your condition. It turns out that these factors get released in relative hypoxia, as you mentioned. What that means is, let’s get you to a very high oxygen level and then get you to normal. That normal oxygen is, of course, safe because it’s still normal oxygen, but it is perceived by the body as a low oxygen state relative to the high. Now, it took 50 years of research to figure out what that delta of oxygen to sustain enough trigger for those factors to be released. You think,  maybe I’ll just get an oxygen tank at home. I’ll put that oxygen on and take it off. Of course, that’s not enough of a delta. We’re going to go back to those physics principles. You need that oxygen under pressure. When you’re breathing oxygen in a pressurized hyperbaric chamber, your oxygen level is up to 17 times higher.  if you go to 2.0 atmospheres now, that’s good. In some ways, you’re giving high oxygen to the cells that need it. But more importantly, you could just take the mask off after 20 minutes and keep it off for five minutes. Again, it’s a normal oxygen state inside these large multi-chambers. You put the mask back on. Our protocol is 20 minutes on, five minutes of 20 minutes on, and five minutes all. We do that for two hours a day, five days a week, for up to 12 consecutive weeks.

Dale Bredesen, MD

Is that there are two atmospheres.

Mohammed Elamir, MD, FACP

That’s a 2.0.

Dale Bredesen, MD

2.0.

Mohammed Elamir, MD, FACP

That’s what’s been discovered. By the way, the Nobel Prize was awarded for the discovery of this molecule, a hypoxia-induced factor. This is the factor that gets released, whether it’s in a low oxygen or relative normal state, and it takes that degree of delta of oxygen concentration to trigger. You don’t have to worry because I share the same concern. I don’t subscribe to going to a low-oxygen state. I think that can be dangerous in different ways. I think you need to tweak the body, so to speak, get it high, get it normal, and it takes that protocol to be enough to trigger the body.

Dale Bredesen, MD

I’ve always thought, if you’re a 35-year-old Olympic cyclist and you’re going to want to go through the Alps or something, or if you’re going to some major race, that’s one thing. But for some, we’re seeing people who have cognitive decline. As you indicated, there’s already something wrong. So we want to be very careful about making them even more hypoxic. But here’s the thing: when I heard Dr. Efrati, your colleague, present this several years ago, the thing that fascinated me was, we think of, here’s someone who’s got this chronic state. There they are; we think of them in a synaptic plastic state; they are pulling back. Their signal is to pull back. We’re going from connection to protection. Now, in the same link, we’re making amyloid beta to deal with various insults, etc. The surprise to me was that you’re doing this, as you said, for two hours a day. How is it that the other 22 hours aren’t? In other words, that seems to be enough. I would have thought you would have to live in the machine to have this improvement. Yet, as you guys very clearly showed, it seems to be enough to have a burst for 1/12 of the day. Then somehow, the rest of the day seems to be better. These people are improving, even though they’re not living in that hyperactive environment. Why is that?

Mohammed Elamir, MD, FACP

It’s a great question. In the end, the body needs that trigger, and it needs time to respond to the trigger. It’s almost like I have two young children, and I notice that if I’m yelling at them all the time, it kind of loses its effect. But if I fade for the moment, it works, and it’s the same principle. Your body needs time to respond. It needs time to gather the resources to rest and to have enough energy to produce those new stem cells and those new blood vessels. That’s why it’s been studied.  What if we do it four hours a day? You spent two hours here. two hours there? Is that it? Compound the results. It doesn’t do anything; it tapers it down. We even do our protocol where it’s two hours a day, five days a week for 12 consecutive weeks. Some people say,  why can’t I just work through the weekend? Do it through the weekend. It’s the same principle. You’re not giving your body a chance to respond and have the appropriate energy reserves to produce those cells. It’s critical to give and take. Often, many athletes will tell you, that a rest period in between your workouts is critical for muscle growth. It’s the same principle for everything else.

Dale Bredesen, MD

It’s interesting for people who are doing this or who are setting up to do it. You’re saying two hours a day, 20 minutes on, five minutes off? I do it five days a week. How many total sessions do you want?

Mohammed Elamir, MD, FACP

It has 60 dives. 

Dale Bredesen, MD

60 Dives. You’re talking about 12 weeks. There are 12 weeks in a row?

Mohammed Elamir, MD, FACP

In a row. Ideally, it’s consecutive. Of course, flat tires happened, weddings happened, and funerals happened. If you were there, we could make those up. But it should be possible.

Dale Bredesen, MD

Then, once you’ve finished that, now that you’ve finished 12 weeks, how long do you wait before you repeat that?

Mohammed Elamir, MD, FACP

That’s a good question. Before anybody even starts treatment, we do a full assessment first, we do advanced brain imaging, both functional and structural. We’ll do the cognitive evaluations, and we’ll do the whole medical and cardiovascular workup. We have that baseline before we start because we know we want to know where that baseline is and how hard we need to push. In addition to the hyperbaric, we will also do cognitive training, physical training, and medical follow-up. After they do the full 12 weeks, and of course, we’re following them clinically along the way, we’ll repeat that assessment. That’s our first checkpoint. We see those improvements in the brain, and they manifest clinically in cognitive testing. We’ll follow up month after month. Now, depending on the condition, if somebody already has the diagnosis of early dementia or Alzheimer’s,  that’s a progressive disease. We want to get ahead if we see an improvement in stabilization. That stabilization continues. It’s a progressive disease. Eventually, you can still progress, and we want to catch it at that point. Often, whether it’s a six-month follow-up or a one-year follow-up, we want to catch it as it’s plateauing and perhaps declining so that we can do it again.  We need to be in the full 12 weeks; it could be an eight-week protocol, depending on the individual scenario.

Dale Bredesen, MD

Then some people will say, What about superoxide? Are you increasing the superoxide? Are you increasing other free radicals in the brain? Is there going to be some potential damage? Are you looking at this as some degree of hormesis, or what is that? What’s your sense about that? Given this, there’s hyperbaric oxygen.

Mohammed Elamir, MD, FACP

Hyperbaric oxygen is a medical treatment. It’s not completely benign. If it’s done incorrectly, it’s oxygen toxicity, free radicals, etc. Those are all considerations. that’s another reason why two reasons. You’re on oxygen for 20 minutes at a time, and you have that five-minute air break. That mitigates the potential for oxygen toxicity. Another reason why we do it is that we work two hours a day, not 4 hours a day, and then we have those breaks in between on the weekends. That’s something that was considered and looked at, and that’s how we got to this protocol. It was the most effective kind of dose without compromising or risking medically.

Dale Bredesen, MD

Very interesting. Then the other thing that comes up is, with all the experience you now have, it’s important to know, where are you seeing the best results. Where are you seeing fewer results? Let’s go through these because, again, for anyone who wants to do this, they wants to know when it is likely to help. Because many people are making and publishing lots of things, you probably saw the combined metabolic activators, on which they get some nice results, various lipids that people have used, and other approaches. Let’s first ask about the various approaches here. For people who have vascular-related cognitive decline, I assume that that would be high on the list. Is that fair to say?

Mohammed Elamir, MD, FACP

Correct. Because, whether it’s an aging process, I mean, there are vascular changes. Everybody who gets an MRI of their brain, if they’re an adult, assuming you’re okay, we’ll say no stroke or bleed, no matter the cancer. But you have microvascular changes consistent with aging. That is the highest on the list. The earlier you intervene, the better, of course, the results could be.

Dale Bredesen, MD

Is there a time when you say it’s too late?

Mohammed Elamir, MD, FACP

If somebody has significant atrophy as a result of that vascular change?  I’ve seen brains lose a third of their mass at the cognitive-testing DBS, where their vocal scores are in the single digits. Those are cases where I say, I wish I had met you yesterday.

Dale Bredesen, MD

It’s a good point. That’s one of the things that always comes up. Is there hope for people with single-digit MTOs? So it sounds like what you’re saying is that you’d like to catch things before that. Do you see this for people who come in and say, My mother died of Alzheimer’s; I’m now 45? I feel fine; I’m scoring pretty well. But I know I have two copies of APOE4. I know I’m at high risk, and maybe even my PTAU17 is borderline high. How early do you start?

Mohammed Elamir, MD, FACP

A favorite statistic that I like to quote is that the process of Alzheimer’s disease can start in the brain up to 15 years before you notice your first symptom. I tell people that my favorite Alzheimer’s patient is the one who doesn’t have a diagnosis and has a family history of it. That’s what I want to tell you. You, that 45-year-old, are having the right time to have that discussion about whether I should do this treatment now? You need to get ahead of it.

Dale Bredesen, MD

Do you have evidence that the person who’s 45 and is there for prevention did get a preventive effect?

Mohammed Elamir, MD, FACP

In the end, those are the studies we have to do, those long-term follow-ups. That 45-year-olds did two years ago, four years ago, and we’re following up, and so far, so good. I would say that the best study is if I had a cloning machine and I went and had one person go through it and whatnot and then see what happened in 30 or 40 years. But when you see those vascular changes on the skin, when I see angiogenesis, I see the growth of new cells on the DTI and the MRI. I know that is significant because your logic change will clinically improve.

Dale Bredesen, MD

That’s a good point. What is your preferred approach to looking at these sorts of outcomes? Is it functional? Is it DTI? Is it PET? What sorts of things do you like to see?

Mohammed Elamir, MD, FACP

As every clinician loves to have as much data as possible. But for me, you want to get the data that will give you the real evidence without the noise around it. Functional imaging of the preferred consistent method that we use as SPECT, SPECT-CT is a great way to see those metabolic changes. Then the MRI with the DTI sequence tells me density changes. I can see new cells, improved density within the fibers of the brain, and the strength of signals going up and down the nerve fiber tracks. The combination of those two types of scans, along with the full cognitive testing, is a great way for me to kind of assess, track, and predict outcomes later on.

Dale Bredesen, MD

So we’ve talked about the vascular system as an important one. We’ve talked about especially early Alzheimer’s, not so much the single-digit ones. Let’s move to frontotemporal dementia. That one has been tough in terms of medical approaches. Do you see such patients, and do you see improvements in them?

Mohammed Elamir, MD, FACP

We do see those patients. You’re right; I agree. Those are tough cases because, of course, with frontotemporal in addition to memory, there are a lot of personality changes. Know spouses that bring them and say, my spouse is not the same person that I married. It’s the same principle: the earlier we can intervene, the better. With frontotemporal, it’s almost a similar physiologic process that we see with vascular, where we see those vascular changes and volume loss. It just tends to stay in that frontotemporal region. We see improvements, and often, in addition to the memory and cognitive improvements, we also see some personality movements, speech, and auditory processing. But again, the earlier you interview, the more impact you can have.

Dale Bredesen, MD

Then what about Lewy body disease?

Mohammed Elamir, MD, FACP

Lewy body, has Parkinson-like syndrome where specific proteins are growing, but the critical manifestations are similar to Parkinson’s. I say that the class of Parkinsonian diseases—this one class—if I go to Parkinson’s itself, I see less potential outcomes and less improvement. But for Parkinsonian, again, it’s better outcomes, especially,  if it’s a result of a traumatic brain injury because then there’s a specific wound in a specific injury. If it manifests on its own Lewy body, it’s kind of in between, not as bad as Parkinson’s outcomes but not as good as some of the vascular damage.

Dale Bredesen, MD

That brings up, of course, CTE, and Chronic Traumatic Encephalopathy. What sorts of results do you see with CTE?

Mohammed Elamir, MD, FACP

We’ve had retired NFL players come through, and people with car accidents. It’s a phenomenon. We’re having more and more press coverage. Unfortunately, all these children who have played peewee by day,  are now going to succumb. We’re seeing more evidence of CTE in young children, teenagers, and young adults. It’s a process, as we’re learning more about it. But it also comes down to those sheer forces destroying the axons as well as the vascular changes. They almost present as a hybrid of vascular dementia and some of these other protein vasculopathies. We are seeing improvements in those ex-players. But the best results I’ve seen are those for younger adults where we intervene early. I must say I’m proud of some of these athletes that they know, maybe they’ve heard, they’ve been educated, and they say, I want to get ahead of this. I don’t want to end up like that. Those are the cases. We have had the best success.

Dale Bredesen, MD

Often it points us in the right direction to listen to what they say after a treatment, whatever your treatment happens to be. Tell us a little bit about some of the things that people have said, whether it’s the CTE people or others, to say, Here’s what I can do, here’s how I feel different, or Here’s what I can now do that I couldn’t before. Talk a little bit about the experiences, because I think that’s something that teaches us so much. When you’re going in the right direction, you’re hearing the right feedback, and when you’ve got people who are just kind of, maybe there’s a little placebo effect, but it’s not a striking change. You have to kind of recalculate. Talk a little bit about the outcomes of these patients subjectively.

Mohammed Elamir, MD, FACP

Where we’re in the scientific field, data is important, research is supported, and studies are great. But I’m a clinician, and we spend a lot of our time every day with the clients, talking to them, and seeing how they’re feeling. My mentor has always taught me to treat the patient, not the test. Those examples come up all the time.  I had somebody with early Alzheimer’s who, when we assessed her, said that if you told her something today, she would forget it tomorrow. Midway through her treatment, she was talking to one of the nurses on a Friday, and the nurse looked a little distraught. The quiet asked, “Hey, what’s going on?” The nurse said, “My son has a football game over the weekend. We’re a little stressed about it.” The following Monday, when the client came in, the nurse asked, “How did your son do in that football game?” When the husband heard this, he was ecstatic. The fact that she can remember something over the weekend, midway through the treatment, means we knew we were in the right direction. That always smiles at us when we see those moments. 

Dale Bredesen, MD

That’s fantastic. There’s nothing better than hearing improvements in people who are told they have a terminal illness. That’s fantastic. then let me go on to another one. We think of this as a whole panoply of neurodegenerative conditions. Macular degeneration is yet another one of these. Do you treat people with macular degeneration? If so, what kind of outcomes have you had there?

Mohammed Elamir, MD, FACP

That’s a great question. It’s something that affects so many of us as we get older. Being in central Florida, in the villages, it’s something we see a lot of as well. Physiologically, it should work better than we’ve witnessed, and what we’ve seen in the end, is the angiogenesis and creation of new blood vessels, whether it’s the optic disc or the retina. We see some improvements in that. But for whatever reason, the data hasn’t backed it up as much. That’s something we’re ongoing, and they’ll do more studies. Maybe it needs to be a slightly different protocol. Anecdotally, I’ve had a lot of clients go to their ophthalmologist and see improvements, but the clinical studies and data haven’t shown the same effect as cognitive decline, 

Dale Bredesen, MD

It’s important to know.  then have you seen any patients,  with PSP, Progressive Supranuclear Palsy? You have things like up-gaze problems, and you did mention Parkinson-like things that don’t respond as well. Would you include PSP and CVD in that group?

Mohammed Elamir, MD, FACP

I would. We’ve had quite a few clients, and we tell them we don’t have the data to back it up and that we could help as much as some of these other conditions. But they still see the value in coming through the full treatment, and they’ve gone through; they’ve had some improvements and some coming through testing. Our post-testing is now underway, and so far, the preliminary results are promising. The PSP is still there. They still have some of those restrictions. But if we can make any impact on their quality of life, it still might be worth doing.

Dale Bredesen, MD

What do you tell people who have a soft shell at home, which I guess they can go up to? What about 1.3 atmospheres or something? Do you tell them, Look, this is preferable, but that’s better than nothing? Or, do you say, that doesn’t do anything? Or what? What is your data showing?

Mohammed Elamir, MD, FACP

It depends on the condition we’re treating. If somebody has some kind of systemic or inflammatory process, it could potentially help a little bit with that if they are using it for workout recovery.  we could see some improvement there if we’re talking about cognitive decline, vascular dementia, or those kinds of things. I say, you might be putting yourself more at risk, and that would outweigh any benefit you could get. In addition to the lower atmosphere level, sometimes these soft chambers can’t fluctuate the oxygen. then if they can’t do the protocol, they’re missing out on a lot of tangible.

Dale Bredesen, MD

When you look at inflammatory parameters, do you see them go up or down or remain the same during and after these treatments?

Mohammed Elamir, MD, FACP

We do a thorough blood and other imaging to kind of assess for inflammation. We see a significant reduction in CRP. A lot of these inflammatory markers do go down after the treatments are complete. The best thing is to try to correlate that with a reduction in signs of inflammation in another organ or another form of testing. We often see the correlation between the two.

Dale Bredesen, MD

I think we’re all now living in a world where, for the first time, we can get very accurate blood tests: P-tau217 GFAP, NFL. I think that’s going to be the gold standard for your following people in the future. Did you make their P-tau go back to normal or go down toward normal, whereas it tends to continue up as you are progressing? Have you yet had time to look to see whether you have changed or whether you have improved any of these new blood parameters?

Mohammed Elamir, MD, FACP

We’ve had a few clients have them done before they come in and have them done after, and they’ve seen some improvements in lowering those values we are looking into. What can we implement across the board for all of these clients? Stay tuned. That data will be coming out soon.

Dale Bredesen, MD

That’s exciting to hear. First of all, how to get to you, so you’re in the villages in Florida. It’s a fantastic place. I’ve been there; it’s a beautiful place and a great place to be treating many people in need. How do people get to you? Do you only take people who are in the villages, or do you take people who are referred from outside?

Mohammed Elamir, MD, FACP

We take people from anywhere. Surprisingly, half of our clients are outside the villages, whether they’re somewhere else in Florida or even internationally. One of the newest disease processes that we treat is long-COVID. People are cognitively and physically affected by the complications of COVID, and we’ve made a big impact on people in the Netherlands. We have a huge group of people from the Netherlands coming to treat their long COVID. Because The Village is a retirement community, a lot of these houses are vacant and up for rent. People who rent a home in the villages will take the golf cart that comes with it to the clinic, do their treatments, and live here for three to four months. It’s how we treat anyone willing to come. We do Zoom consultations all the time. If you’re not in the area and you want to speak to us, you go to our website aviv-clinics.com. Contact us, and we can set up a Zoom appointment that’s complimentary with one of our physicians and see if we’re right for you.

Dale Bredesen, MD

I guess, important to tell everyone. If someone comes in and signs up for 60 of these treatments, what can they expect to pay for them?

Mohammed Elamir, MD, FACP

We have different prices for different aspects of the program. For some people who want to do just our full frontal assessment, that includes aspects of the MRI, DTI, cognitive, or physical testing. It’s a three to five-day assessment that could be $12,500 if they want to do everything, all included. The pre-assessment and the 12 weeks of treatment. In addition to hyperbaric treatment, they’re getting physical therapy, psychology follow-up, medical follow-up, physical training, and cognitive training. They do the post-testing, the monthly follow-ups, and a six-month reevaluation. That’s kind of everything included. That is $55,500 for an individual. that could be discounted if you do it with a spouse or family member. I heard you on the podcast together. Let’s do this together. You could get a discount if you come with somebody else.

Dale Bredesen, MD

About half of what it costs for one year in a nursing home. If you can keep people out of a nursing home for years, you’re going to save them a lot. That’s why I think that’s critical for people to know. Of course, you’re also going to go to save their interaction with their family, etc.; that’s important. The other issue I guess, would be in terms of the negative side effects. Are there any negative side effects that you worry about? You mentioned a little bit about oxygen toxicity. Are there other issues that concern you? I guess perhaps you could also discuss what about the people who have Lyme disease or who have underlying drivers. We see so frequently that a pro-inflammatory state is part of cognitive decline. You see it with leaky gut, chronic sinusitis, changes in the oral microbiome, and tick-borne illnesses. many of these things. Is there any concern about doing hyperbaric therapy on those patients?

Mohammed Elamir, MD, FACP

That’s a great question. it’s,  the process of inflammation is always important to figure out what is causing it. A lot of these tick-borne illnesses are dependent on oxygen. A Lyme could create itself in a biofilm and protect itself from antibiotics or other immunomodulators. But being in a high-pressure, high-oxygen environment that can penetrate and destroy the biofilm, but that hurts by the reaction that we see sometimes when you treat life, can happen as you do the treatment because you’re destroying the spiral key; you’re disseminating what it has. I tell my live patients that you could get worse before you get better. You could get that reaction. But it is a sign that you’re destroying the organism. Now, in terms of general side effects, the most common side effects of any hyperbaric treatment are barrier trauma and peer pressure. If you’ve ever been scuba diving, you have to equalize when you’re diving, or if you’re on an airplane, you just feel that popping sensation in your ears.

In the first 10 minutes of our treatment, we are building pressure up to get to 2.0 atmospheres. You must be able to equalize as long as you’re able to pop, chew gum, or swallow you’re going to be fine. If you don’t pop; you’re going to have a stretch of your eardrum, and that will be painful. There are different levels of perforation or stretching of the eardrum that we see. But to mitigate that, we have these large multiple chambers on the inside; there’s an inside attendant, so it’s usually a nurse trained in hyperbaric, and they will make sure you’re equalizing as long as you can equalize or you tell us you can’t. We just start building the pressure up, lower it, and give you a chance. The problem comes when somebody has a brave soul. It doesn’t want to tell us they can’t pop it. They just push through it. Those are the issues, but those are those that are better very rare are few and far between.

Dale Bredesen, MD

For all of us who’ve been diving, the 2.0 atmospheres would be equivalent to how deep a dive is.

Mohammed Elamir, MD, FACP

Great question. 33 feet. If you’re an open water diver certified, that’s the level we go to.

Dale Bredesen, MD

So that’s not so bad. You’re not talking about 80 or 90 feet, so that is more than that, so that’s very helpful. 33 feet, that’s not a bad dive. How many people simply cannot achieve that equilibration and have to stop?

Mohammed Elamir, MD, FACP

Since we’ve been open here in Florida in June of 2020, we’ve had over 800 clients come through. I’ve only had four clients where we weren’t able to train them and equalize, where they had to see AT&T and get a temporary hearing. It had to be tubes—only four out of 800. It’s very, very rare. If you can’t, we still have a solution. It’s temporary tubes. They come out when you’re done, and there’s no damage to your eardrum after that. But it makes it seem as though they keep the pressure equal the entire time. You don’t have to worry about it.

Dale Bredesen, MD

If you take those hundred people with cognitive decline, let’s say none of them have single-digit markers. They’re still relatively early. What would be, say, similar to what Lacombe has used,  which is the MCI for early dementia patients? In those patients, about what percentage would you imagine and expect to see some improvement with this treatment?

Mohammed Elamir, MD, FACP

I would say at least 65% of those at that stage will have improvements. Of the 35 that are left, I’d say half of those will see stabilization. They were those who did not improve but did not decline. then the other half of those will probably still have some decline, but it will be a slower slope of decline depending on exactly where they are. Other comorbid conditions, but the majority will improve at that stage.

Dale Bredesen, MD

For those with claustrophobia, as I understand it, yours is nice and open, which is great. How’s the size of this chamber that you have people in?

Mohammed Elamir, MD, FACP

These are large, multiple chambers. We have four of them, and each one can hold up to 14 people. I’m six feet three. I could stand with plenty of headroom. It’s like a first-class seat on an airplane. Most people say it’s like sitting in an air-conditioned first-class cabin on any airline. I feel very comfortable. We have little tablets inside. We’re the only company that has electronic tablets inside the hyperbaric chamber, and we do brain training exercises. But there is a Spotify app. If you want to listen to music, you could learn a new language with Duolingo. Read the New York Times. We have different ways to kind of entertain you while you’re in there.

Dale Bredesen, MD

That sounds great. This is a delight. Thank you so much, Dr. Mohammed Elamir. It was great to talk to you. As I mentioned, I heard Dr. Elamir speak several years ago. It’s very exciting to hear the developments, and it’s very exciting to hear that you’re making people who have cognitive decline better, who for so many years have had no hope that you’re making them better. great to hear. Thank you very much for taking the time to talk with us. I look forward to future data, future publications, and future discussions.

Mohammed Elamir, MD, FACP

It was an honor and a pleasure to speak with you today, and I look forward to future conversations.

Dale Bredesen, MD

Thanks very much again, Dr. Elamir.