YES!!!

Daniel Bryan is cleared to wrestle in WWE again!

YES!!!

The damage in his brain is thought to be less severe than it was!

YES!!!

And it’s all thanks to hyperbaric oxygen therapy!

YE– huh???

Well, at least, that was the latest Hail Mary, “alternative” medical practice Bryan tried before he was given the go-ahead by WWE doctor and perennial naysayer, Joseph Maroon. Could hyperbaric oxygen therapy (HBOT) really have been the key to bringing Bryan’s brain back from the brink?

Before you look for an explanation …

Unlike acupuncture, naturopathy and some of the other practices Bryan’s tried to help turn his various health problems around, HBOT is a legitimate medical treatment, approved by the FDA. It’s done by sealing the patient in a tube or pressurized room, where he breathes pure oxygen (rather than normal air that’s made up mostly of nitrogen), at three times ordinary atmospheric pressure.

This allows the lungs to capture more oxygen than under usual conditions, so the therapy is good for pretty much what you’d expect it to be — things like smoke inhalation, carbon monoxide poisoning and the bends (decompression sickness caused by bubbles of dissolved gas forming in the body when divers come back to the surface too quickly).

Problem is, some people think that if a treatment is good for one thing, it must be good for EVERYTHING. Chiropractic (a kind of spinal manipulation), for example, seems to be good at alleviating some kinds of lower back pain, though it’s not really any better than conventional physical therapy. But some chiropractors claim it can cure anything, from ear infections to menstrual disorders to the colic of babies (yes, BABIES).

Similarly, HBOT is pushed by some practitioners for non-FDA approved uses, like treating autism, Parkinson’s disease and even AIDS. The clinical evidence that HBOT is good for any “off-brand” treatments is very dubious, and often there’s no clear mechanism of how it could be helpful in those situations. While evidence shows that HBOT is useful in cases of brain abscesses, there’s not much saying it does anything for the kind of lesions Bryan is reported to have suffered.

… make sure there’s something to explain

But besides all of that, the very nature and degree of Bryan’s “damage” is in doubt. Maroon isn’t just WWE’s medical director — he’s also the NFL doctor portrayed in the Will Smith movie Concussion as denying the realities of chronic traumatic encephalopathy (CTE) and other long-term effects of multiple concussions. As Dave Meltzer reminds us in the edition of his Wrestling Observer newsletter dated March 26, 2018, Maroon’s recommending of Bryan’s retirement also occurred while a CTE-inspired lawsuit filed by 53 ex-WWE employees was in the headlines, so looking “soft” on concussions may not have been an option, in his mind, at the time.

The whole history of Bryan’s injury, as compiled by Meltzer, is worth checking out. Turns out, despite the early 2016 test that showed a lesion on Bryan’s brain, more than one of the doctors who’d examined him thought it was too soon to rule out a comeback. Several other doctors had already cleared him, at that point. As Bryan mentioned on last week’s Smackdown! opening, he’s since seen SO MANY doctors that have agreed he’s not at any greater risk than anyone else, it may have just gotten to the point that Maroon would’ve seemed pointlessly stubborn to not change his decision.

But did the HBOT actually help in diminishing the lesion? It might have appeared to do so, as Bryan’s said a SPECT scan of his brain following HBOT treatments was “way better” than previous ones. SPECT scans are simply measures of where oxygen is flowing in the brain, though, the implications of which are uncertain, leading to criticisms of a similar technique called fMRI, which claims to be able to determine brain function by tracking blood flow.

And even if the lesion in Bryan’s brain has diminished, that doesn’t necessarily mean the HBOT is responsible, just because it was last thing he tried. In addition to there being poor clinical evidence and no real mechanism for how that would happen, we know that correlation doesn’t always mean causation. Other things might be going on, and the timing could just be coincidental. Sometimes, people just get better on their own and regress to the mean. More particular to this case, as Meltzer points out, the brain is proving to be much more “plastic” than originally thought, as it can sometimes “rewire” itself by building new pathways after traumatic events.

The human body is an incredibly complex system with almost innumerable variables, making it nearly impossible to tease out causes and effects without doing the hard, scientific work. Too many alternative medicine users get tricked by the “It worked for me!” fallacy, despite sound clinical evidence that a treatment doesn’t work. Fortunately, we haven’t seen a rush to praise non-standard uses of HBOT coming out of what’s already the feel-good story of the year, but if it happens, you’ll know that it’s a lot of hot air.

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