Therapeutic Hypothermia

Not just your average cold plunge

Quick update on Benjamin (if you don't know what I'm talking about, here's the background).

Benjamin is now off of all oxygen. However, the lack of oxygen has impaired the reflexes that he developed in utero, and so he is having to learn how to nurse and move. Sadly, this means that he isn't nursing yet. He still has a nasogastric tube that he's being fed through. Fortunately, he's got the most stem cells and vitality possible, and so he's recovering his motor function and reflexes quickly.

The first thing we did upon hospitalization to preserve his brain function was something called therapeutic hypothermia.

For those of you who think this post will be about cold plunging, guess again.

This is about something much more serious than cold plunging.

Not long ago, a Scandinavian doctor was skiing with her friends when she fell into an icy stream. Her head wound up in a bubble of air under the ice, but her body was completely submerged. She quickly became hypothermic. She then became pulseless. They brought in a helicopter to help extract her from the river and resuscitate her. After hours of CPR, they finally regained a pulse.

She went on to, miraculously, make a full recovery.

This story is told in the book “Extreme Medicine,” which is a great read.

How is it possible for someone to die of cold exposure for hours, and then come back to life? (Other than the obvious answer for a Christian, which would be the power of God.)

Cold slows down time, in a biological sense. However, cold below a certain threshold destroys the body, because the body's cell membranes are not optimized for cold temperatures. Cells can rupture and break, which is why you can't just freeze food and expect it to taste the same when you thaw it.

Doctors extrapolated this to the ICU, where they started to cool patients who had presented with a prolonged period of pulselessness or lack of oxygen.

Benjamin spent the first three days of his life in a therapeutic hypothermia protocol. There are no feedings during this time. The patient is placed on some kind of sedation.

The difference between this and a cold plunge? With therapeutic hypothermia, we cool the patient by placing them on a cooling pad and running cold IV fluids into them.

We drop their core body temperature to levels that require monitoring in the ICU (32-36 degrees C). I used to do this as part of the ICU team in my internal medicine training. I didn't realize that they did this for neonates until they offered it for Benjamin.

Why am I telling you all of this?

There's a time and a place for cold therapy. One of those times and places if if you're looking at a prolonged period without oxygen, such as Benjamin suffered.

The data on therapeutic hypothermia is actually quite encouraging. It's one of the only interventions for lack of oxygen to the brain that has proven itself time and again in the literature.

If you or a loved one is offered therapeutic hypothermia, I do recommend it. Doctors are generally well-trained in its use and don't offer it frivolously. It's one of the better interventions in the hospital. I recognize that for many people in the natural and holistic world, there's an ingrained skepticism of everything that happens in a hospital. I specifically had Benjamin transferred to our local children's hospital for this treatment.

However, I must add that it is not therapeutic hypothermia that determines the outcomes of these cases. What is arguably more important is what you do when the patient comes home.

There are many more great therapies that still haven't made it into the standard of care, for various reasons.

Here's a sneak peak some of the things we are excited to use to help Benjamin reach his full potential when he comes home:

• Hyperbaric oxygen

• Pulsed electromagnetic fields (PEMF)

• Plasmalogens

• LifeWave patches

• Phototherapy with red and infrared light panels (see this post)

There are a few more things we will be adding to this list, but I'm not prepared to share them yet.

Stay cool. Stay frosty. Puns intended.

Until next time, be well,

Dr. Stillman