My name is Suzanne Lewis. I’m 54 years old, and in 2017, I was diagnosed with squamous cell cancer of the tongue. After my December 3, 2017 surgery, I began a six week course of daily radiation and treatment with the chemotherapy drug Cetuximab (also known as Erbitux). I received this combination of radiation and Cetuximab during the early months of 2018, as part of a study; I am full of gratitude for the opportunity I had to participate in this study because it helped to guarantee that my cancer has not resurfaced thus far.

“When my radiologist, Dr. Shlomo Koyfman of the Taussig Cancer Center at Cleveland Clinic, told me about hyperbaric oxygen treatment (HBOT), I had never before heard of it, but it sounded to me like a possible lifeline.”

My reaction to radiation was atypically severe, a problem that was likely intensified by the Cetuximab. Despite the passage of time, the inside of my mouth did not heal fully; the insides of my cheeks were so friable that chewing food caused open wounds, and a lingering nerve pain in my tongue severely limited my quality of life both because the pain was oppressive (a 7 or 8) and because talking intensified the pain to such an extent that my speech was seriously inhibited. I had tried various narcotics, gabapentin, neurontin, and multiple NSAIDs; in addition, I had explored “alternative” therapies such as CBD oil and acupuncture. All of these approaches were either completely ineffective or came with intolerable side effects. At the end of two years of seeking a solution, it seemed as if I had run out of options. When my radiologist, Dr. Shlomo Koyfman of the Taussig Cancer Center at Cleveland Clinic, told me about hyperbaric oxygen treatment (HBOT), I had never before heard of it, but it sounded to me like a possible lifeline.

I began HBOT on May 29, 2020 at Cleveland Clinic – Medina Hospital. I chose Medina Hospital because I had received such excellent cancer care at Cleveland Clinic and wanted to stay within that system. So, even though there were reputable HBOT treatment centers closer to my home in Steubenville, Ohio, I opted to drive 2.25 hours each way in order to receive HBOT in Medina. As the days and weeks of daily HBOT treatments accumulated, I became more and more certain that I had made the correct decision.

Many people don’t understand that while it is essential to find medical practitioners who remain abreast of cutting edge research and the most effective therapies in their field, it is equally crucial to find doctors and staff who can remain attentive to hundreds, even thousands, of small details and who possess a heightened capacity for humanity: these are the qualities that set the physicians and staff at the Wound Center of Medina Hospital apart from other mere experts. I would like to highlight some important details concerning my care at Medina that illustrate this point:

    1. *Consistent sincere, ongoing, and enduring attention to my personal comfort and well-being, as well as to that of all my fellow patients*:

Beginning with Dr. Eric Lockhart and Dr. Vincent Ferrini, and including the entire staff (Donna, Shannon, Chris, Tony, and Sam), every member of personnel would ask me and each of the patients how we were doing. If I or any of the other patients said, “fine” or “good,” they would ask for details or otherwise make certain that this was true. Some of my fellow patients suffered from agonizing pain or cognitive/social disabilities, but each doctor and staff member rose to every challenge, going above and beyond to try to solve medical issues and to overcome obstacles to communication – often in thoughtful and creative ways. This factor goes way beyond “etiquette” or simply creating a pleasant environment; without this attention to patients’ well-being, many important medical signs could be missed. How medical practitioners read these signs can make the difference between healing or continued suffering. Much of the success of the HBOT team at Medina Hospital can be attributed to the entire staff’s ability to discern these signs and then respond well to them.

“Beginning with Dr. Eric Lockhart and Dr. Vincent Ferrini, and including the entire staff (Donna, Shannon, Chris, Tony, and Sam), every member of personnel would ask me and each of the patients how we were doing. If I or any of the other patients said, “fine” or “good,” they would ask for details or otherwise make certain that this was true. “

2. *Attention to details*:

Despite the fact that many of the medical  tasks that technicians must perform are routine and repetitive, I observed that during each and every treatment, with each patient, the techs would attach our hoods with great care to be thorough. My hood always had a comforting smell of strong alcohol when the oxygen first began to flow into it, such that I knew that one of the staff had carefully sterilized it. The entire staff’s consistency with the wearing of masks was an enduring source of confidence. They never failed to use gloves, when necessary. No matter which of the techs was scheduled to be in the hyperbaric chamber with us on any given day, they each followed the same pattern of checks and steps according to an unvarying schedule, always with the utmost care. Sometimes there were several patients in the chamber, and some of them had extraordinary needs; despite these “complications,” the technicians rose to every occasion: from holding a bag for a patient who had to vomit, to soothing an agitated and nonverbal patient suffering from dementia, to
responding with great patience to anxious patients who asked for repeated fine-tuning to their oxygen flow 😉 I never once, in 109 different HBOT dives, encountered or witnessed exasperation or even weariness in any staff member. The way that staff handled the details that I could observe and assess gave me great confidence that they also discharged all of the technical tasks to do with pressure and oxygen flow with the same professionalism, eye to detail, and vigilance. Truly, these “little things” could become matters of life or death, and so I want to underline the fact that these tasks were all accomplished with the greatest skill and
attention.

3. *Each staff member (doctors, management, technicians) was a great source of knowledge concerning HBOT*:

I had many questions, and whomever I asked had really useful details and experience to share. Clearly, each person working at Medina HBOT has studied much more about it than is, strictly speaking, necessary for doing their jobs. Rather than simply imposing rules (for example: don’t wear wool; or no ceramic mugs in the chamber), they could explain the reasons behind every protocol we followed. They all helped me understand what to expect in my treatments, and they also helped me to understand why and how I experienced the effects of HBOT. The staff’s knowledge base was an essential component of the great care I received: their explanations helped ensure patient compliance with protocols, a factor that has a direct impact on outcomes.

    4. *Kindness:*

patients who come for HBOT are in some state of suffering, and many of us have been suffering for long stretches of time. While kindness may seem unnecessary in medical practice, I’d like to insist that this factor affects medical outcomes in dramatic ways. To make the long drives in order to commute to treatments – and later, to decide to accept the expense of staying in a hotel close to the hospital – required determination and endurance. But I looked forward to seeing everyone at Medina Hospital, and this helped me to overcome the toil, the costs, the exhaustion, and the troublesome eyesight changes I experienced. Even the people who would ask screening questions and take temperatures as I’d arrive at the hospital were unfailingly kind and welcoming. But the HBOT staff were each among the kindest people I’ve ever met. Perhaps I would have completed my first one hundred dives with perfect attendance even if the entire staff were mean to me. I’m pretty hard-headed. But it would have been far more arduous, and I’d have had to overcome much more personal resistance, and maybe even dread. I’m certain that patients are more compliant (and thus more likely to heal, and to heal as well as possible) because of the extraordinarily generous decency, gentleness, and solicitude of every staff member I encountered. I will miss everybody at the Wound Center very much, and I will never forget any of them.

Some notes on individuals:

1. Dr. Lockhart‘s impressive knowledge and passion for HBOT, and his evident desire that I would get better, make him a great practitioner. I
cannot recommend him highly enough.
2. Dr. Ferrini‘s interest in my case, despite the fact that I had not been initially assigned to his care, was extraordinary. During my very
first week of treatments, when he learned that I’d had a bout of nausea while driving to Medina, he took care to ask me for details and to
troubleshoot solutions in order to save me from a repeat attack. When I asked him medical questions, he never handed me off to Dr. Lockhart but
instead responded to me in ways that were unfailingly helpful. I suspect that he is also responsible for the excellence of the staff because many of
the qualities I observed cannot be picked up through training but must be discerned during the hiring process.
3. Donna put me immediately at ease during my first call to make an appointment for HBOT. Her friendliness and care made me certain that I
could call her if I had any questions or needs. Later, my experience was to prove that this impression was correct.
4. Shannon Regal was a tech when I first began HBOT and then she later took Donna’s job. She is one of the warmest, most personable and positive
people I have ever met. With her good humor, and her expansive and generous personality, she was able to break through the crusty exteriors of several
of the more reserved or even crotchety patients who came for HBOT. When I had concerns that felt sensitive, I knew I could go to her for advice and
for help in resolving them. Her approachability and discretion were saving graces.
5. Chris has the most experience out of all the techs, and it shows. He is able to combine efficiency with tremendous care, and does all this with no fuss at all. His           attention to patients’ needs is both discrete and sincere. He also has a wry, deft, and witty sense of humor that creates a atmosphere of ease in the waiting room       and the chamber, which might otherwise be tense places. Though there is nothing flashy about him, his steadiness sets the tone for the unit and ensures the   excellence and competence that permeate everything that happens: before, during, and after HBOT. I also have to give Chris credit for the overall positive experience of patients receiving HBOT. As he goes about his work, he also pays attention to the whole picture, noticing needs that surface and acting as a kind of “glue” to see that those needs are met.
6. The gentleness and solicitude with which Tony attends to the most frail and needy patients inspired me deeply. Putting on and taking off the rings can also be quite tricky, and sometimes hair can get caught in the rubber neck piece, but Tony was by far the best at this task. I told him h  should give the others lessons, and he brushed the suggestion off with a humble, self-deprecating joke. I do think, though, that his skill is a sign that he cares about the patients to an extraordinary degree. Tony’s deadpan sense of humor and his ability to be direct and nonjudgmental contributed to making us patients feel part of a community of care. His greatest strength, though, is his tender-heartedness, which he cannot disguise, no matter how many ironic jokes he deploys.
7. Sam is by far the most outgoing and transparent person at the Wound Center. He has a rare talent for engaging with others and drawing people in. He seems genuinely interested in everything to do with everybody he meets: even people who are much different than he is. He shares his own life and interests in such a way that I feel I’ve known him for far longer than just a few months, and he pays attention to others in such a way that we feel known and seen by him, too. He is an excellent listener and is extraordinarily empathic. His enthusiasm for his work, and the humanity with which he approaches it, provide a balm for patients who are suffering, sometimes in dramatic ways. His sense of humor has the rare quality of establishing connections between himself and those he’s speaking to.

Later today, I will have completed 109 hyperbaric oxygen treatments. My improvement has been dramatic. When I first began, I was on gabapentin and NSAIDs for pain, and even so, my pain was as high as a seven or eight most evenings and my ability to speak was severely limited. I was also taking all of my nutrition in liquid form. Now, with no pain medicine at all, I even have some days with no pain. While some pain lingers (most days the pain level is at 1, 2, or 3 at the very highest), it is so vastly reduced, and manageable by sucking on ice and/or taking NSAIDs, that I can speak as much as I want to, and I am able to chew food. I have also had a remarkable improvement (though not a complete recovery) in saliva production, and my otolaryngologist, Dr. Prendes, confirmed this week that my fibrosis,
swelling, and inflammation are all significantly decreased. While the HBOT treatments themselves are the direct cause of these improvements, please let me repeat that none of this would have been possible without the human element I encountered at Medina Hospital, among the physicians and staff who provide the HBOT treatments in the Wound Center.

I give my permission to use any or all of what I’ve written here, and to include any identifying information necessary, including my name, in any way that might be helpful to Medina Hospital, the practitioners of HBOT, the care of future patients, or anyone who is curious about my experience.

With heartfelt and lasting gratitude,
Suzanne M. Lewis