Dr. Joe Dituri  00:00

Right? So I'm trying to bring awareness to the fact that you can pressurize for a long period of time, and what the mechanisms of action of hyperbaric medicine are. So we knew a whole bunch of them. So we knew, like, decreased inflammatory markers, decreased neuroinflammation, you know, increased activity, increased cognitive function, decreased phase lag, that kind of stuff. Those were all known mechanism of action that we knew were going to come out of this, but we wanted to kind of highlight them for the world so that the on the world stage we can show them. Hey, look, this does work.

 

Dr. Ayla Wolf  00:36

Welcome to Life after impact the Concussion Recovery Podcast. I'm Dr Ayla Wolf, and I will be hosting today's episode where we help you navigate the often confusing, frustrating and overwhelming journey of concussion and brain injury recovery. This podcast is your go to resource for actionable information, whether you're dealing with a recent concussion, struggling with post concussion syndrome, or just feeling stuck in your healing process. In each episode, we dive deep into the symptoms, testing treatments and neurological insights that can help you move forward with clarity and confidence. We bring you leading experts in the world of brain health, functional neurology and rehabilitation to share their wisdom and strategies. So if you're feeling lost, hopeless or like no one understands what you're going through, know that you are not alone. This podcast can be your guide and partner in recovery, helping you build a better life after impact.

 

Today's guest on life after impact the concussion recovery podcast is someone who quite literally pushes the boundaries of human potential underwater in the lab and in the classroom. Dr Joe Dituri is a retired US Navy Commander with over 28 years of service in Special Operations deep submergence and undersea systems engineering. He's a PhD in Biomedical Engineering, a decorated officer and a pioneer in hyperbaric medicine and life support technologies. He also holds a Guinness World Record as the man who lived underwater for 100 days during Project Neptune 100 this was a world record breaking mission aimed at studying human physiology under prolonged hyperbaric conditions, raising ocean awareness and inspiring 1000s of students to pursue science and engineering with three decades of elite military diving experience, Dr Dituri has helped develop rescue systems for Submariners, designed dry submersibles for Navy SEALs, and co authored the Navy diving manual and the art and science of hyperbaric medicine, a go to resource for clinicians in this emerging field. Currently, he serves as assistant vice president of veterans Clinical Research at the University of South Florida, where he leads clinical trials focused on treating traumatic brain injury, teaches medical engineering and continues to advance the science of hyperbaric oxygen therapy from the depths of the ocean to the frontiers of neuroscience. Dr Dituri brings a rare blend of operational grit, scientific rigor and humanitarian purpose, and we are honored to have him on the show today. Dr Joe Dituri, you are one of the most well accomplished people I know. Your background, your bio, your your experience is incredible. And the reason I wanted to have you on the show today is because as an expert deep sea diver and somebody who holds a world record for spending 100 days in pressure under the sea, you're the you're the best person to talk to about the effects of oxygen on the brain, and so thank you so much for coming on the show sharing your expertise. You're currently leading the biggest hyperbaric oxygen therapy research study for veterans in the world right now. Welcome to the show.

 

Dr. Joe Dituri  04:04

Thank you so much. I really appreciate it. Thank you for having me on, and I'm excited.

 

Dr. Ayla Wolf  04:10

Wonderful. Well, why don't we start out? Give me your background. You have spent so much time under the ocean doing some probably pretty cool top secret work.

 

Dr. Joe Dituri  04:21

All right, real quick. So I spent 28 years in the United States Navy. I got to hang out with really cool people and do great things. When I finished that, my boss at the time, Bill McRaven, asked me what I wanted to do. I what I wanted to do when I grew up, basically. And I says, Look, I don't want to come work for you, that's for sure. So he asked me a favor, would I sit on the preservation of the Forson family? And I said, Yeah, sure, I will. I did that for a little bit. And I came back to him. I said, Bill, we're talking to our veterans with TBI, but we're not doing anything. Psychology and psychiatry has a limit. And he looked me dead in the eye, and goes, permission, granted Aquanot. Fix the problem. And I went, right now? I'm like, What am I gonna do now? So I went back to school. I got a PhD in Biomedical Engineering, and I said, I'm gonna fix brains because I'm smartical, right? No, right. Then I started fixing them this way. And then when I did, you know the good Lord basically said, Joe, take a right. And I said, No, no, I got it. I'm fixing him with just this. And then he said, No, no, take a right. I told you to take a right. And then finally, he threw a 6000 pound SUV at my head and gave me a traumatic brain injury. And now I'm like, best thing that ever happened to me, and now I'm trying to fix them the right way.

 

Dr. Ayla Wolf  05:44

That's amazing how life throws us curveballs. And, you know, crazy that you were on the track to studying TBI one way, then you get your own TBI, and all of a sudden it's like, oh, I need to go this direction now.

 

Dr. Joe Dituri  05:59

Yeah, it's, it's, it's one of these, like, Holy mackerel, the universe has got a plan. He's got a plan for you. There is a plan. I don't know what it is, but it unfolds before you. You can worry about it all day long, or you can just ride this freaking wave.

 

Dr. Ayla Wolf  06:15

Yeah. So tell me about your recovery. What are some of the things that you did to help recover.

 

Dr. Joe Dituri  06:22

It was this easy. And I'll go back and tell your listeners real quick. That the quick story, you know, I came to the point where I was despondent, right? And I felt that okay. Now I am hopeless, right? Here. I am a clinical researcher for traumatic brain injury, and I have a traumatic brain injury. I can't read, I can't write, I can't think. I'm crying all the time when you say unburdened anger, like I want to rip the steering wheel off the car. All that happened to me. So I was like, Okay, I can't do the one thing that I'm here on this planet for is to help people, and I can't do that anymore. I set a date for suicide.

​

So here I am setting the date. It was on my birthday, December 8. And September 7 is when the car hit me. So I went through this real deep lull, and then I was like, okay, but before I do that, I'm Catholic, and I have three daughters. I says, I have to, I have to do everything, because when I get to the pearly gates, I have to be able to tell them, Look, man, I did freaking everything, and when I did everything. So you asked me what I did when I did everything in combination, in a short period of time, Holy mackerel. I started getting better, and then better, and then more better, and then more better, and then all of a sudden, I'm better than I was before I started. And I said, there's something to this, and I'm steeped in science, right? Science wins over bullshit. So I'm like, hold on, which thing works best, right? Which? Okay, I have to get rid of all the confounding variables and do that one thing. No, that is the wrong way to approach science, and we need to change scientists mindset. It's not just one thing. If you ask somebody, Hey, this this plant, what does it need? You know, water, sunlight, food. Well, we intuitively know it needs water, sunlight and food. So the human body, the human brain, needs to be fixed physically, physiologically and psychologically simultaneously. If you leave one of those out, you're gonna miss the boat on fixing the person, and you're not going to do them justice absolutely everything. Red Light Therapy, beaver mat therapy, I faced east and watched the sunrise and got the red light in my eyes. I grounded every morning. I hopped up and down on a peg. I did ice bath, I did saunas. I did, when I say everything if I didn't think it was gonna hurt me. And I applied a little bit of, you know, science to it, like, Hey, that's not gonna work, or there's nothing to that, you know, that, and no drugs. 

 

Dr. Ayla Wolf  09:04

So talk a little bit. So you didn't just spend 100 days underwater for funsies and to break world records. You actually did this to prove that it is safe to be under pressure in that sense. So talk a little bit about, you know, when people think about diving, obviously they envision scuba divers. And you're talking about something completely different. So describe the difference between the type of situation you're in versus what people might envision when they think diving.

 

Dr. Joe Dituri  09:33

Sure. So when you when you go scuba diving, you're under what we call hyperbaric pressure. Hyper means more than Baric means pressure. So if you're in a hyperbaric pressure environment, you're at an elevated pressure. While I was underneath the water for 100 days. I did it for three basic reasons. The first was to do science, technology, engineering and mathematics to kids, to let them know that you can you. You know, science is not just about white lab coats and beakers and microscopes and they're on board already, right? It's more than that, and you can do science in a cool environment. The second thing was, I'm a biomedical engineer, so I wanted to do blood, urine, saliva, electrocardiograms, electroencephalograms, pulmonary function tests, all that sciencey stuff. And the third thing that I wanted to do was talk to all of the people about reaching out to all the experts in the industry about saving our marine environment. So those are the three main things that we did. But the fourth thing, on a side tangential note, was I stayed underwater at the exact pressure hyperbaric medicine that we treat traumatic brain injury right now, 1.7 po two, 1.7 ata, 1.7 po two, if you're using 100% pure oxygen, right? So I'm trying to bring awareness to the fact that you can pressurize for a long period of time and what the mechanisms of action of hyperbaric medicine are so we knew a whole bunch of them. So we knew, like, decreased inflammatory markers, decreased neuroinflammation, you know, increased activity, increased cognitive function, decreased phase, like that kind of stuff. Those were all known mechanism of action that we knew were going to come out of this, but we wanted to kind of highlight them for the world, so that the on the world stage, we could show them, hey, look, this does work. And they're like, oh, that newfangled thing called hyperbarics. I'm like, okay, hyperbarics has been around since the 1600s almost 400 years. Yeah.

 

Dr. Joe Dituri  11:42

But it fell off because we weren't able to describe the mechanisms of action, right? Every single drug that comes out has a mechanism of action, a non steroidal, anti inflammatory and NSAID, it decreases inflammation. That's its mechanism of action, right? Cardiac drugs, everything you know, vasoconstriction, vasodilation, all that stuff is stuff that we're looking for is a mechanism of action for the drug. So this is where I go to med school, and I'm teaching med school, and I'm telling the kids, look, you have to focus on the mechanism of action. If you want a powerful anti inflammatory, you can either A, do hyperbarics, or B, do a non steroidal anti inflammatory, or C, do like a metro dose pack or something like that, steroid type thing that can reduce inflammation. All three of those will do the same job. However, comma, one is two or pill and one is a lifestyle change. Do you want to change your patient's lifestyle? That's the difference

 

Dr. Ayla Wolf  12:45

well, and there are side effects to taking non steroidal anti inflammatories. And I mean, I've had a number of patients develop diabetes as a result of being put on prednisone for long periods of time.

 

Dr. Joe Dituri  13:00

And 15 pounds right on the waistline. I'm sorry.

 

Dr. Ayla Wolf  13:04

Yeah, that too.

 

Dr. Joe Dituri  13:05

That too, yeah. So when it comes to chronic situations, it's like, okay, maybe we need to look at this a little bit

 

Dr. Joe Dituri  13:12

differently. That's exactly it. And to go back to the veteran side of the house, here we are busting these people up. And, you know, okay, so it's not even just veterans. So veterans get exposed to TBI, but as you see, I was in a motor vehicle accident. I spent 28 years in the Navy. Didn't have a knockout you know? I got hurt, but never got knocked out. I got knocked unconscious in my 47 Chevy, right? Holy mackerel, MVAs can do it, domestic abuse, third leading cause of traumatic brain injury. I was shocked at that. Shocked.

 

Dr. Joe Dituri  13:49

right? So we have to start thinking that TBI can come from a lot of different places, not just the military kids, but when you approach this, the blast and the radius and all that stuff that seems like it's a compelling factor, but I don't want to leave anybody out of this discussion, because there are millions of traumatic brain injuries. Incidentally, you probably already know this. I don't know if your listeners do, but traumatic brain injury has been on the books since 1600 BC. Yeah, 1600 BC. For millennia, we have been differentiating this and kind of figuring, you got hit in the head, you're bad off, right? Only in about 1000 ad did we first make our determination the difference between concussion and traumatic brain injury. I think that was actually 1300 right? So, FDA, medicine, regular medicine, Big Pharma, you've had this problem for 1000s of years. How you doing? How's it going? Oh, there. Is no endpoint. I'm running the largest clinical trial. I'm helping with the largest clinical trial in hyperbaric medicine history ever, ever done in the whole world, right? And here this thing is doesn't have a satisfactory endpoint, because the FDA has no satisfactory endpoint for a cured traumatic brain injury after 1000s of years,

and I said, Well, I suggest maybe we're doing it wrong. If you don't have an answer yet, doing it wrong,

 

Dr. Ayla Wolf  15:31

yeah, well, and you know, within medicine, we have standardized protocols, or standard of care for various disorders, diseases, events. We have a, you know, an emergency standard of care when somebody gets a concussion, but when somebody is a year out and they're still struggling, there's no standard of care for what you do, you do with the person who didn't recover in the standard window. And so that's part of the problem as well. Now I'm curious. So your study has over 460 participants. It's a huge

 

Dr. Joe Dituri  16:03

420 Yeah.

 

Dr. Ayla Wolf  16:04

Okay, and what are your objective markers? What are you measuring before and after the H bot sessions?

 

Dr. Joe Dituri  16:11

So interestingly enough, the same stuff or similar stuff to what I did while I was underwater, blood, urine, saliva, electrocardiograms, electroencephalograms, pulmonary function tests, theses, sampling, diffuse tensor imaging, MRIs, like the whole gamut of everything, and like we cast a really wide net, because there are zero approved biomarkers for Long Term traumatic brain injury, zero approved biomarker changes, none. So we're just testing everything, every kind of blood we're doing, interleukin testing, you know, all these myokans, like crazy amount of blood testing that you would never even suspect. And the diffuse tensor imaging is second to none. And we're using all the great places to analyze this like our blood is going to do to be analyzed because their blood experts are diffuse tensor imaging MRI that's being shipped out to Australia because they have an AI component that is reading them and trending the imaging right. So we took all the greatest things in the world, and I'm not the leader of that study by any mile, wild strats. I'm just one of the cats that's helping on it so, but we did get a grade, a team together.

 

Dr. Ayla Wolf  17:30

It really sounds like it. And I will say I don't think I have ever seen a study with 420 people in it where they're doing DTI on every single person before and after the intervention, that's going to be astounding, and I'm so excited to see the outcome of that information.

 

Dr. Joe Dituri  17:46

You and me both, right? But this is the thing science takes a long time. I got three more years of data collection, and then probably a year to write it up. Yeah, four more years. Everybody's like, I need, we need a cure now. And I'm like, Look, I get it. I get it because I wanted a cure instantly. And there is no instant cure, right? What do you have to do everything? How long do you have to do it for as long as it takes, right? Just keep trying, right? Because I guarantee you, if you do nothing, nothing's going to happen, or the same thing is going to happen, but you have to be able to affect change in your body. You have to be able to try and change things.

 

Dr. Ayla Wolf  18:26

Yeah, yeah. So a couple of questions I want to ask you. I have heard of people talking about pulsing the oxygen when somebody is in the H bot, because when you're when you're in a high pressure oxygen situation, some you know different physiological changes happen. Then when you come out of that high oxygen situation, your body has a reflexive response to the change in oxygen. And some people are saying that that reflexive response is also part of the healing that occurs. And so some people are now kind of pulsing the oxygen throughout an H bot session. So talk to me a little bit about, have you looked into that? Or, you know, what are your thoughts on that?

 

Dr. Joe Dituri  19:07

Yeah, that's that's preclinical research at this point, right? So we're doing a clinical trial. We are staying here at one pressure, right? But in preclinical research, we have found that when you decrease the oxygen concentration and then give the oxygen concentration back, and then decrease it again, and then give it back again, and decreases again. What you do is you up regulate something called HIF one Alpha, or hypoxic inducing factor. They won the Nobel Prize in 2019 for this. So it's not like it's old, right? This is brand new stuff. Nobody's ever had it before, right? So when you up regulate HIF one Alpha, you up regulate brain derived neurotrophic factor, okay? And if you up regulate BDNF, that's similar to the lawn seed for the brain. And then if I give you more oxygen, oxygen is like watering the lawn seed on the brain. Right? So it's like, you give it, you give it water, you give it, you give it water, right? So, you know, sunlight, water, food, right? You're trying to do this all together, but that's pre clinical research. It's not there yet. I know that those things happen, but that doesn't mean this, right? Causation, not correlation, correlation, not causation, you know,

 

Dr. Ayla Wolf  20:20

yeah, yeah. Still, a lot of research that needs to be done. Okay, next question, some people have soft shell HBot machines in their office. Other people have hard shell. Talk to me about the difference in terms of the devices that currently exist clinically,

​

Dr. Joe Dituri  20:35

yeah. So most of the current research that has been done has been done at 2.0 or higher. So there's a small window range from 2.0 to 3.0 but remember, hyper means more than Barrett means pressure. So we have found, and we have done research on this at the lower pressures, and we have found that if you just go to 1.3 ATA, it's all about the pressure that you go to. What do you need? Different pressures affect different mechanisms of action. One mechanism of action for hyperbaric medicine is toxin inhibition. Toxin inhibition needs to be up here. Needs to be up at the 2.8 3.0 level. That's where we see the toxin inhibition working its best. Does it work down here? Sure it does. It works down here to lower pressure. It just works less right. Inflammation, decrease in inflammation like a decrease in interleukin six, increase in interleukin 23, pro inflammatory, anti inflammatory, cytokines. That works best at about 1.3 1.4 that's the lower pressure. When you go higher. Does it still decrease inflammation? Yes, just not as well, right? But the range is from about 1.0 100% oxygen to 3.0 effectively, 300% oxygen. So somewhere in there. So what my question to the people that asked me that question is, what is the malady that you're trying to treat doctors? You need to know all these mechanisms of action and where they're best portrayed in the figure, and match the person with that, and then practice medicine while you're doing it by evaluating your patient and looking for objective quality measure changes, just like we were talking about before we started.

 

Dr. Ayla Wolf  22:30

Okay, so when you're talking about toxin inhibition, then you're immediately thinking, what somebody that has say, like Lyme disease or somebody that has these infections that their body is trying to combat.

 

Dr. Joe Dituri  22:42

Yeah. So toxin inhibition, like mold is a toxin, right? So we use it for gaseous gangrene. Gaseous gangrene, you know? We want to inhibit those toxins. We want to get your body to stop allowing toxins to reproduce, right or to get the toxins out of your body in some way, shape or form. We realize, and we see through lots of objective testing and measurement, that if you get the oxygen concentration right here, right so this is 35 millimeters of mercury. You know, when you put that stupid little light on your finger, that's about 35 millimeters of mercury of oxygen. Well, we're at 760 millimeters of mercury pressure right now, and you're only getting 35 at your finger. What we have found is that toxin production stops at 450 millimeters of mercury, give or take. Stops it cannot reproduce. You know, alpha toxins, you know gaseous gangrene, all of those seed proteins, all of that kind of stuff, stops reproducing at 450 millimeters of mercury. So if you get the oxygen to here to 450 millimeters of mercury, you can stop oxygen production, or you could stop toxin production, right? But that's a slippery slope, because when you get up to 3.0 that's human tolerance. Humans cannot tolerate any higher than 3.0 right? So you really don't have much of a band to work with, right? You get to hear minimum effective dose, and that's the problem. Who funds hyperbaric oxygen research? Well, the drug companies do. Oh, there are no drug companies. Who are the drug companies when it comes to hyperbaric oxygen therapy? In my opinion, it is the hyperbaric chamber manufacturers, right? Because they're kind of peddling the drug, if you will, whatever. But otherwise, nobody's making money off this. There's no like, Oh, we're gonna make a billion dollars off this. Trust me, anybody in the hyperbaric business is not making a million dollars. They're not making a billion dollars. Nobody's getting rich here. But it's basically compressing the oxygen that we have on the planet, naturally produced, by the way. Uh, by trees and, you know, plants and stuff. So, you know, we compress that down, and then we use a hull to hold that pressure in. And we've been doing this for, you know, 42 forevers, you know,

 

Dr. Ayla Wolf  25:13

yeah, yeah. Okay, so different pressures have different mechanistic effects on the body. And so based on kind of what somebody is coming in for that would determine what the best pressure is for that person. Or maybe they need multiple pressures, if there's different things happening at different pressure.

 

Dr. Joe Dituri  25:31

Yep, this is why the doctors need to take a class, right? Like doctors are smart people. I get it, but, but you have to know the mechanism of action and where you want to put them on this number line from, you know, 1.0 to 3.0 when you put them here, it does something different than when you put them here, right? It's, it's wonky, but that's the way it is.

 

Dr. Ayla Wolf  25:52

Yeah, yeah. And so you teach this class. It sounds

 

Dr. Joe Dituri  25:55

well, I teach that class at med school, but find an instructor from, like, the International Board of embassy medicine or something like that, right? This is one of these, like, go find a good instructor near you and get them to teach you. It'll be good.

 

Dr. Ayla Wolf  26:09

Yeah, excellent. And then my next question, some people are combining we talked about, I mean, with research, you have to look at one thing, HBOT, by itself, same pressure, whole time, right? But in clinical practice, in real world, we like to stack different therapies, and so I know some people, when they're using HBOT, they're also encouraging the person to be doing cognitive exercises or different things to stimulate their brain while they're in the HBOT or immediately after. So what are your thoughts on, you know, and even maybe your personal experience on trying to like stack therapies with HBOT clinically?

 

Dr. Joe Dituri  26:47

Stacking therapies is always a better concept, right? Because the whole is better than the sum of its parts, right? I you know, it's, it's, it's not going to work. The onesies twosies are no longer going to work as effectively as multiple therapies. However, caution, Warning, warning, warning, right, please don't stack things that don't go together in the hyperbaric chamber. I'll give you a perfect for instance, red light therapy, wonderful on its own. However, red light therapy requires, in my estimation, of varying wavelength, requiring at least 110 volts, if not 220 right, with a varying intensity and magnification and a heat generating source. And we already know that heat and power do not go well inside a hyperbaric chamber. So please, please, please, please, please, don't stack those modalities, right? Like, don't, you know, I see people wanting to work out in a hyperbaric chamber. You can absolutely exercise in a hyperbaric chamber. Exercise lowers your oxygen toxicity threshold. It used to be 3.0 when you're laying there, doing nothing. But if you're in there working out, do you think 2.0 is safe? We don't know.

​

Nobody knows, right? So here you are working out, maybe 1.3 is safe enough. No, no, it's fine, right? I'm on my rowing machine. It's fine, whether they rowing machines have metal wheels on metal rails, which create friction. Friction rubs together. Friction creates heat, heat and oxygen. Oh, God, we stop, right? So, like, Don't stack the modalities. Or if you're going to get somebody smart to make sure that whatever you're doing is correct, right? Is it good to do breathing exercises while you're in a hyperbaric chamber. I do them all the time, right? I I do a quad, you know, four count four. Count, four count. You know, we've done that in the military for years to reduce our parasympathetic relax, calm down a little bit, right? So that's the kind of thing that's great. Can you do eye exercises? Oh, boy, yes, those are great, like those functioning visual things. Can you, you know, can you listen to meditation? Absolutely, if you have an approved device that's inside that's giving you sound, yeah, sure. Why not do a meditation? Right? Should I do a hallucinogenic inside a hyperbaric oxygen chamber. Oh, my God, I'm a little bit afraid, right? Like, you know, I'm saying so you got it?

 

Dr. Ayla Wolf  29:31

I was thinking more line the lines of, like, eye exercises or cognitive exercises. You just opened a whole nother level of like

 

Dr. Joe Dituri  29:39

Oh no, no, I'm sorry, but like you see all this craziness happening on the internet, I literally saw a video of a girl inside a hyperbaric chamber with her red light mask on and an oxygen mask over the red light mask pushing the oxygen through the red light. Oh, please don't do that. Oh, please stop. Please stop. Right? So this is the kind of thing that we're dealing with, right? You know, people like, I can't get away from my cell phone. I have to have my cell phone on me. 24/7, it needs to be in the chamber. No, first of all, you me, everybody, we need a break from this damn cell phone. Mine sits over here on the charger over there, right? It doesn't sit in my pocket. I try and get away from it. I try, right? I'm addicted, just like everybody else, but we got to try and get away from that. So don't bring the cell phone in there. But yeah, if you have a way to do eye exercises and breathing techniques and you can listen to a meditation, sure, that's great stacking of modalities at this point, but yeah, any of the craziness? Yeah, let's not do that.

 

Dr. Ayla Wolf  30:42

Yeah, yeah. No, I wasn't even thinking of the craziness. But you know, honestly it, you're right. People are doing crazy things, so it probably absolutely needs to be said, like, these are the things that you cannot do when you're in the H like,

 

Dr. Joe Dituri  30:55

just take a class, learn, right? It's like, everything else. Just learn. Go, Oh, that makes sense? Yeah, yeah, uh huh.

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Dr. Ayla Wolf  31:02

I also know, like some people, they'll do their HBOT, and then afterwards, they'll come out and they'll do a bunch of rehab, you know, immediately after too. So people are kind of not maybe stacking at the same time, but stacking right after they're doing

 

Dr. Joe Dituri  31:17

I've done ice bath before and ice bath after. I've done sauna before, I've done sauna after. I can't see much of a measurable difference. I am freezing after I do my ice bath. So it's really uncomfortable, so it's better for me after, and the sauna is better before. But I don't know that kind of stuff. Yeah, I get it, you know, Ewa training stuff like that afterwards is always, you know, it's always beneficial. But, yeah, that kind of, that kind of stuff, we're actually getting to a point where I just ordered a new type of hyperbaric chamber. It's called a Hypo goes to altitude like it goes to the top of Mount Everest, and then pressurizes all the way down to 3.0 Wow. So it's a Hypo hyperbaric chamber. It can do both. And what we're going to do is a study on increasing brain derived neurotrophic factor by going all the way up to altitude and giving you hypoxia and then coming back down and watering it on a severe jump, up down. So we're going to see how that works. Crazy. It's fun. It's science, right? This is what, this is what keeps me awake at night.

 

Dr. Ayla Wolf  32:30

Yeah, absolutely. The other thing that I think is, you know, one of the biggest barriers to HBOT is the amount of sessions people have to do. So talk about minimum effective dose, ideal dose, and how this is structured, for people who may not be

 

Dr. Joe Dituri  32:45

familiar, I'll give you a very sad answer and the truth right up front, we don't know right. Minimum effective dose, we have no idea, right? I can tell you that if you want to decrease inflammatory markers, I have had really good results with 10 to 12 treatments reduces the interleukin six enough in 10 to 12 treatments. However, comma, if you're treating traumatic brain injury, it seems to be more like 25 to 40. Nobody really knows, and that's because there is no drug company funding these studies. The study that I'm doing right now at the University of South Florida, right? USF is doing this study because the governor of the state of Florida and the Speaker of the House said, Listen, we want to help our veterans, and we want to figure out the science behind hyperbaric medicine, so we're going to fund this. So he funded us. That's the only funding that people get in hyperbaric medicine. There is no like $20 million to go do this study, or $50 million or $100 million to go, do, you know, a phase two clinical trial? There's none of that kind of money rolling around. So unfortunately, we don't have those answers of minimum effective dose just yet. But there's people that are funding it out of their own pocket, right? So the International Bank of Joe is looking to do some more research.

 

Dr. Ayla Wolf  34:05

Excellent, excellent. And how many women are in your study?

 

Dr. Joe Dituri  34:08

Half, one, half, And this is, this is the thing. And female veterans are hard to come by, but I'm like, Girls, get in here. Get in here. I'm done having this, like, it's only guys, so about half, it's a 40 something percent right now, but about half of the people are coming in are female, which is great, right? Because we are, like, like we were talking about earlier, we are woefully inadequate in doing research on females, because, man, you're so different well.

 

Dr. Ayla Wolf  34:40

And I think one of the problems too is that even when females are included in the study, that doesn't necessarily mean that when all the data is being sifted through and all the statistics are being run, that people are even asking the question like, Okay, we now have 420 before and after dt. Is Is there a difference in the female. Brains versus the male brains? Like, that's the question that I would want to know. But do you know is your is that one of the aims of your studies?

 

Dr. Joe Dituri  35:07

It's one of the sub aims, right? Because you have to have a primary and a secondary, and then you have to have subs. So, yeah, it's one of the sub aims. But yes, absolutely, the the stratification of female to male, and how their blood biomarkers differ, how their theses differ, how the urine differs, everything, right? Like how their EEG scores differ. Because y'all, your brains work totally differently than our do. I mean, that's just the way that it is. And if a guy, you don't believe that, trust me, that's the way it is. I do a lot of EEGs on people and women are just wired differently.

 

Dr. Ayla Wolf  35:41

Absolutely. Yeah. Well, that makes me so happy that that is actually part of your study. I mean, this is going to be so exciting when all this data comes out. And like you said, it's probably gonna take you a year to sift through it all.

 

Dr. Joe Dituri  35:53

 For three and a half more years or so, we'll have something,

 

Dr. Ayla Wolf  35:56

yeah, incredible, amazing. So right now, you know, you're also writing a book on your personal journey. So talk a little bit about the book you're writing.

 

Dr. Joe Dituri  36:05

 So it's why my traumatic brain injuries, the best thing that ever happens to me is the working title, right? And I'll give you just a real quick for instance, um, I was engaged to a beautiful, you know, 40 year old Bulgarian fitness model, like she was just fabulous, but when I got hit by the car, she couldn't find her way to the hospital. But two of the seven days that I was in the hospital, I was like, This is not cool, right? So that's just one of the things that happened to me where it was like, okay. That made me realize that that support system wasn't there, that person wasn't the right person for me. And after a couple of months, we were like, Okay, we're done, right? And the changes that I had also here, I am a person from the military, 28 years of active duty service, and then I didn't really have a lot of empathy. Now, being a traumatic brain injury survivor, I have more empathy. So when that kid was in my chamber with a traumatic brain injury and reached up and ripped the speakers off the wall because he had to go to the bathroom so badly, he's like, I have the shed at the shed. And that was literally the tone that he took and he ripped the speakers off the wall, I was totally empathetic to him and his mom. When his mom was pulling him out and trying to clean him up and then get him to the bathroom, and then she looks at me and goes, What's that going to cost me to repair? And I said, come here. You said, Mom, you're doing a great job. I didn't have that empathy before God gave that empathy to me through my traumatic brain injury, right? So I needed this to be able to help people. This is, I mean, that among you know, a hopeful cure for traumatic brain injury and many, many, many other modalities, and just giving people hope when it comes to fixing traumatic brain injury, it's going to be great, like I said, that's the working title. We'll see how it goes.

 

Dr. Ayla Wolf  38:03

Yeah, well, I can't wait to read it, and I'm so excited that you, you know, you share your story with everybody, because people do need to hear and I think especially from doctors, you know, from people that are in positions of power to also say, and I have empathy, and I have lived through this, and I'm now devoting my entire life to researching it, to help you. Mean, that is so powerful.

 

Dr. Joe Dituri  38:26

Yeah, it's, it's, and this is where I kind of talk about you finding your purpose in life, you know, now that I have a purpose, you know, I did the military thing, I did the teaching, I did this, I did that. Now it's like, I want to help right now. I just want to give back. I want, and that's my that's my currency. So when you have that kind of currency, you get to do the things that you want to do, and everything else falls away. It's like all those little things fall away. How are we going to get the money? And we'll figure it out. I don't know. We'll figure it out and keep trying.

 

Dr. Ayla Wolf  38:56

Yeah, amazing. Well, and you got the money?

 

Dr. Joe Dituri  39:01

Yeah, they paying me that money. I'm just a researcher and a college professor, so, you know, I don't have a pot to pee in.

 

Dr. Ayla Wolf  39:09

The money's going to the AI Lab in Australia. It sounds like, wow, wow. Well, you know, one time I had somebody on my podcast and I said, you know, if there was future research you would want to see, I go, what kind of what, what type of research would you want? He goes, honestly, it's the kitchen sink studies that I think are the most fabulous, the ones where you can, just like, throw all these different things at people and then see, you know, did they get better? And sadly, those Kitchen Sink studies aren't really what we consider the gold standard, which is why we're left with having to do one thing by itself, in isolation at a time, first to say, here's how this thing works, and then go from there.

 

Dr. Joe Dituri  39:52

But whose model is that? That's the drug company model, yeah, yeah, that's the drug company model, because they want. Just see the red pill, the blue pill, the red pill, the blue pill, and that's it. And they have the ability to do that. All things remain the same. I just give you a pill that's not real life. That is not real life.

 

Dr. Joe Dituri  40:13

Now you and I were talking before we even started. Is it beneficial for you to go to the gym, to spell Jim with a G right to Is it beneficial for you to drink a lot of water? Is it beneficial for you to have breath work and believe in some kind of faith, in some way, shape or form, that this is all going to work out, all those things we know are beneficial now? Is there a double blind, randomized, placebo controlled study that proves that? No, but I'll give you a little piece of information. There is no double blind, randomized, placebo, controlled study that cigarettes cause cancer. It's not ethical to do that kind of a study. So there is no proof. So that bar of randomized, controlled clinical trials.

​

It's a drug company thing. It really is. There are things that are ethical and unethical to do. So when you give somebody advice like, Hey, have a better diet than freaking Cheetos. Hey, drink a lot of water, and it has to be the right kind of water that's going to nourish you, and get out in the sun a little bit and catch that early morning red light, good. None of that's bad. And that's the Hippocratic Oath, right? Do no harm. So that's where I push people. I'm like, Look, come on, this is not going to do you any harm, and it might just help. So, yeah, try that too.

 

Dr. Ayla Wolf  41:40

Yeah, yeah, absolutely. I mean, I've been in practice for 20 years, and I still say on a regular basis, are you drinking enough water? Like, I mean, lots. It's like, it's for 20 years. I still have to come back to, are you drinking enough water here, 100%

 

Dr. Joe Dituri  41:56

See, people think that I drink coffee all day long. This is a cup of refillable water that I take my water bottle and I refill the water up and I drink water all day long. Absolutely need it. 

 

Dr. Ayla Wolf  42:10

yeah, absolutely. Well, thank you so much for coming on the show. And I, like I said, I'm excited about your book. I'm excited about the outcomes of all this research. Thank you for all the hard work you're doing for this community. Thank you for including women in your study.

 

Dr. Joe Dituri  42:26

No, it's important. It really is. You know, it's it look they're over half the people on the planet. For Christ's sake. Can we figure these people out? Please? Plus, I got a personal desire to figure them out too, because I still am not good at it.

 

Dr. Ayla Wolf  42:44

Well, I don't know if you're ever gonna figure us out, but you can try.

 

Dr. Joe Dituri  42:49

That's the plan. That's the plan. So, yeah, no. Really exciting work. And thank you. Thank you for having me. Thank you for the listeners. If you want to get in touch with me or look and follow what we're doing, it's Dr Deepsea. Look up Dr. Deepsea, Google it. That's usually the handle on most of the things. But, you know,

 

Dr. Ayla Wolf  43:06

excellent. I will share all that in the show notes. And then when your book comes out, maybe we'll have you back on the show. That'd be fun.

 

Dr. Joe Dituri  43:12

You can I would love that. I would love that. Yes, please. Thank you. Thank you. I appreciate you having me on. It's, it's great. I love the compatibility of what you're doing too. Look, we got to do this differently. The drug company model is not working. Let's figure out a different way to help people.

 

Dr. Ayla Wolf  43:32

Yeah, yep, absolutely, absolutely. Well, thank you for your service. Thank you for everything you're doing, and we'll definitely have you back on.

 

Dr. Joe Dituri  43:41

 Hoorah. Thanks.

 

Dr. Ayla Wolf  43:46

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