If he wasn't seeing results, Jim Cummings wasn't going to stick around.
Having dealt with diabetes for 16 years but avoided wounds the disease can cause, he paid close attention to what looked like a harmless scratch that appeared on his ankle. But when the cut quickly got worse and didn't begin to heal, Cummings sought help at Mercy Wound Care and Hyperbaric Medicine in Joplin.
He painstakingly researched Dr. Brad Pontani and eventually asked the wound care specialist if he could help.
"I had made my mind up, wherever I had to go, I was going to go to get it fixed," Cummings said. "I wasn't going to lose my foot."
Cummings and Pontani participated in a demonstration and discussion of hyperbaric oxygen chamber treatments Tuesday at the Mercy clinic as part of National Diabetes Awareness Month, which is November.
After six weeks of two-hour treatments five days per week in a hyperbaric chamber, Cummings' wound, which otherwise could have required the amputation of his foot, had healed.
Pontani said hyperbaric chambers have been used to treat wounds since at least the 1980s, but the practice has gained significant traction in the past 10 to 15 years. The treatments are being to help heal wounds that otherwise can linger and necessitate lower-limb amputations because of blood glucose levels, poor circulation, infection and other diabetes-related complications.
Hyperbaric treatments have been available as part of Freeman Health System's wound care services for the past 11 years, media relations coordinator Shannon Bruffett said. Approximately 29,000 people with diabetes-related wounds have been treated in hyperbaric chambers at Freeman in that time, Bruffett said.
Via Christi Hospital in Pittsburg has used hyperbaric chamber treatments since June 2015 and treated 24 patients with them in the program's first year. Via Christi has a dedicated wound care physician and two hyperbaric chambers.
"I did take pictures myself with my phone from day one," Cummings said. "Because I was going to watch it, and if I didn't see progress, I was going to Dallas, is where I was going to go. And after the hyperbaric, I instantly started seeing difference in it. Couple weeks, I think it was. And then toward the end it was big-time change."
A hyperbaric chamber compresses oxygen and pressurizes it to 2.5 times the atmospheric pressure at sea level, which is 14.7 pounds per square inch. That means the pressure in a chamber is 36.75 psi. Pontani said the technology traces its origins to scuba divers in World War II who needed to learn to handle decompression.
"The key is that you're breathing 100 percent oxygen at that pressure, that 2.5 atmospheres of pressure," Pontani said. "And you say, 'Well, why is that important? Why not just give me an oxygen tank to breathe at home?' When you're breathing the oxygen at pressure you're actually getting a significant amount of oxygen dissolved in the plasma, the liquid part of the blood, and that's actually what drives the high-oxygen content into the tissue, which actually helps the healing mechanisms. So by breathing that high oxygen at pressure, you're getting a significant increase in the amount of oxygen that's getting out to the damaged or infected or nonhealing tissue."
The treatments could make a significant difference in the Four-State Area, as several counties in Southwest Missouri, Southeast Kansas and Northeast Oklahoma have a rate of diabetes diagnoses above the national average, according to the Centers for Disease Control and Prevention. Nationwide, 9.3 percent of Americans have diabetes. The number is even higher in the region. Benton and Washington counties in Northwest Arkansas are both near the national average, but they are the only two of the state's 75 counties with a rate of less than 10 percent. Only three of Oklahoma's 82 counties and seven of Missouri's 114 are below 10 percent.
Pontani said a national increase in diabetes levels might be attributable to diet and increasingly sedentary lifestyles, particularly as the U.S. population ages. The CDC data show a trend of heightened diabetes rates in the Midwest and several Southern states such as Louisiana, Mississippi, Alabama, Georgia, Tennessee and Kentucky.
"Diabetes is a terrible disease because it requires 24-7 management," Pontani said. "You can never have a day off. You might go have a big meal, but you better be doing something about it to make sure your sugar doesn't go up because even those few little highs can cause damage to the vessels in your eyes, in your kidneys, in your feet, in your nerves."
Nationwide, 9.3 percent of Americans have diabetes. Rates of diabetes in area counties are as follows:
Ottawa County: 15.6 percent
Barton County: 13.9 percent
Cherokee County: 12.2 percent
Crawford County: 11.5 percent
Jasper County: 10.8 percent
McDonald County: 10.3 percent
Newton County: 9.3 percent
Source: Centers for Disease Control and Prevention