Newsletter: Apr 20, 2022

Delray's "How Foundation", On a Mission To Heal Our Veterans

In every issue of our monthly newsletter, Friends Of Delray highlights one local Delray Beach based non-profit organization that is making a difference in the lives of our citizens.

Their mission “Improve the quality of life for individuals, families, and communities by advocating for and providing access to hyperbaric oxygen therapy” isn’t just mission, it’s a way of life for the staff, board & volunteers of “HOW”.

Today we sit down and talk with Sarah Crane, Executive Director of How Foundation.

FOD: Sarah, thanks so much for joining us today.

Sarah Crane: Thanks for having us! We are thankful for the opportunity to share our work with the greater Delray Beach community.

FOD: Who founded “HOW”, and what was the catalyst for its creation?

Sarah Crane: The Help Our Wounded Foundation (HOW Foundation) was founded in 2014 by my grandmother, Magalen Ohrstrom Bryant. Her brother served in the South Pacific and, though outwardly gregarious, was internally tortured and suffered extreme survivor’s guilt. The duality she witnessed in him gave her an uncanny ability to identify younger veterans’ suffering, even when they appeared emotionally stable. She felt compelled to help. She was also a bit of a visionary who saw solutions before the rest of society caught up. The solution she saw to help our veterans was hyperbaric oxygen therapy. She had personally used this therapy for her own healing and felt its benefits. She wanted her veterans to be able to experience the same relief. So, she charged our family with establishing a Foundation to help veterans get access to this non-pharmaceutically-based, safe and effective therapy because she didn’t want financial restrictions to be a reason veterans did not have access to this treatment.

FOD: Hyperbaric Oxygen Therapy isn’t exactly a commonly known treatment. Can you give us a cursory explanation of what exactly “HBOT” is?

Sarah Crane: Absolutely! HBOT is an acronym for hyperbaric oxygen therapy. The pressurized aspect of hyperbaric oxygen therapy feels more akin to being in an airplane. When someone experiences hyperbaric oxygen therapy, they are breathing in 100% oxygen in a pressurized environment. The air we breathe every day is only about 18% oxygen, so when you immersed in an environment of 100% oxygen, it’s a very different experience already. The pressurized environment where the oxygen is administered is what makes this therapy really special. The pressure compresses the oxygen molecules to a size where they no longer are reliant on just binding to hemoglobin for transportation around your body. They are small enough to now be carried through the body by any fluid: cerebrospinal, lymphatic – any fluid can now transport oxygen through your body. Not only does it increase the presence of oxygen in your body, but it also activates and bolsters numerous physiological support systems in your body: decreasing inflammation, boosting neurotrophic growth factors, and exponentially increasing stem cell mobilization, to name a few. As a foundation on a mission, we set out with a mission to provide HBOT, observe, and document the results. 8 years in we have a 95% success rate!

FOD: What is Hyperbaric Oxygen Therapy used to treat?

Sarah Crane: HBOT is used to treat several conditions that center around detoxification, decreasing inflammation, and accelerating healing. These conditions range from crush injuries to failed skin grafts and flaps, radiation damage, cyanide poisoning. At HOW Foundation, we focus on traumatic brain injuries and post-traumatic stress.

FOD: What is the prevalence of TBI / PTSD in the community

Sarah Crane: We have 83,400 veterans in Palm Beach County. Of these, the West Palm Beach VA Medical Center has identified 21% (17,514) as under the age of 54, having served in the Gulf War and post-9/11 conflicts. Applying the Wounded Warrior Project statistics (from a 2020 survey that found 93% of veterans are living with a mental health condition such as traumatic brain injuries or post-traumatic stress), we can conservatively estimate at least 37% of these veterans suffer from invisible, yet profound wounds of war. This means we have at least 6,480 young veterans in Palm Beach County who are struggling and need our help. We also help concussed student athletes. While we don’t have specific numbers for Palm Beach County, 1.7-3 million sports-related concussions are reported annually in the US, with every 5 to 10 going unreported or unrecognized.

FOD: How does HBOT help those suffering with a traumatic brain injury?  

Sarah Crane: There are two different categories of traumatic brain injury. If the amount of time is short (within the first month of sustaining a concussion), the injury is considered to be an acute traumatic brain injury. If more than a month has lapsed, the brain injury is considered chronic. HBOT helps the brain recover from both of these conditions in different ways. Let’s explore the acute phase first. Though a concussion is considered a “mild” traumatic brain injury, there sometimes is nothing mild about the symptoms or the underlying physiology that causes this type of injury. Often, a concussion occurs because the cells supporting brain functioning get damaged by either a disruption of blood flow, tearing of axons as the brain moves and shifts within the skull, or inflammation from bruising that occurs on and within the brain when the brain hits the inside of the skull. The body has a natural healing response that is triggered by trauma. Think of a cut on your hand. What happens when the skin is cut? It swells. That swelling is your body’s way of highlighting the injury to draw white blood cells in to help restore the damaged tissue. Swelling also happens inside the skull when your head is jolted and brain hits the inside of the skull. In closed-head injuries, you just can’t see the swelling because it is still enclosed within the skull. But, since our skulls don’t have the ability to expand, the inflammation is redirected inward, destroying tissue as the swelling increases. This type of damage is called reperfusion injury. HBOT acts like an icepack for your brain. In other words, when it is applied shortly after an injury is sustained, limits the amount of reperfusion injury the brain can inflict upon itself. It does this while simultaneously boosting neurotrophic growth factors and stem cell mobilization (both of which aid the brain in recovery). When it comes to acute traumatic brain injuries, the more time that goes by, the more swelling can occur within the brain. As the swelling (and damaged brain tissue area) increases, concussion symptoms may become more and more apparent. Therefore, the sooner someone can receive HBOT after sustaining a concussion, the better. While 70% of the time the brain can heal itself, in 30% of cases the symptoms continue for months or years, which is why HBOT is a critically needed treatment option.

At the HOW Foundation, we believe everyone should have the right to not suffer from the debilitative symptoms of brain injuries. This includes chronic brain injuries, which are injuries that occurred over 6 months prior. Because of the nature of their occupation, this is the type of brain injury we address within our veterans program. In chronic traumatic brain injuries, the physiological underpinnings are slightly different, and so is the mechanism of how hyperbaric oxygen therapy can help support the brain in recovering from past trauma. In response to unhealed trauma to the brain tissue, areas of the brain can go dormant. They aren’t dead; just sleeping. Let’s call them Sleeping Beauty cells. They stop consuming glucose and oxygen and are therefore unable to continue functioning. These sleeping cells can cause disruption in the brain’s normal functioning as the brain tries to compensate for these underactive areas. This adjusting may result in overactivation of other areas. Together, dysfunction in the brain can result in debilitating concussion symptoms. HBOT allows oxygen to activate the mitochondria powerhouses in these cells, acting as Prince Charming’s kiss and bringing those Sleeping Beauty cells back to normal brain activity. Once awaken, the brain is able to perform its natural maintenance on these cells and work toward restoring normal brain functioning.

FOD:  In that same vein, how does hyperbaric oxygen therapy aid those with PTSD.

Sarah Crane: We are learning the term “PTSD” refers to more of a spectrum of dysfunction than a specific definition. Along that spectrum is blast-induced post-traumatic stress. Research from the Department of Defense has revealed a significant pattern of post-mortem brain scarring in veterans who had been diagnosed with severe post-traumatic stress. In other words, we have learned there is a subtype of post-traumatic stress that may be more of a type of brain injury than a chemical or electrical imbalance. There is a lot we are still learning about post-traumatic stress, but, for whatever reason, we have noticed consistent improvement in veterans who have come to us seeking relief from PTSD. HBOT has anti-anxiety benefits and often improves sleep quality. Since insomnia is an extremely common symptom of post-traumatic stress, HBOT seems to allow the brain this rare opportunity to rest and restore.

FOD: What are the costs associated with HBOT and does insurance cover the cost of treatment.

Sarah Crane: No, insurance does not yet cover hyperbaric oxygen therapy for any neurologically-based conditions. Our goal is to help enough people to be able to amass a robust dataset. We plan to present our results to insurance companies and be the catalyst to creating systemic, sustainable change where insurance companies feel comfortable covering the upfront cost of hyperbaric oxygen therapy because they could understand the long-term benefits people experience. Currently, there are no costs for our veterans who are seeking hyperbaric oxygen therapy for their brain injuries or post-traumatic stress. Student Athletes are asked to cover the $150 medical clearance examination, but the therapy itself is fully covered by the HOW Foundation. A treatment protocol can range from $1,100 (for acute injuries) to $10,000 (for chronic cases).

FOD: How does the foundation assist those who can’t afford treatment?

Sarah Crane: Through the generosity of our supporters like Impact 100 Palm Beach County, Quantum Foundation, the Charles and Elsie Gols Foundation, the Batchelor Foundation, the Frank L. Weyenberg Charitable Trust, the Major League Baseball Players’ Trust, as well as the many event sponsors and community donors, we are able to provide therapy free of charge for those who require financial assistance.

FOD: Without breaking HIPPA, can you share with us a success story?

Sarah Crane: Absolutely. We met Josiah (whose name has also been changed) a few years ago. He was very accomplished – a professional speaker, married to a wonderful lady, and two beautiful children. Despite this seemingly perfect façade, Josiah struggled. He felt constant anxiety, anger, and depression. He had insomnia. Further, he couldn’t focus. He would start projects but could not complete them. After completing his treatment protocol of 40 hyperbaric oxygen therapy sessions, Josiah returned home. A few weeks went by. He started running, daily. He started working out and taking classes. This time, though, he was able to adhere to these new routines. He was feeling better. His wife commented how she was thrilled (and relieved) they were able to go to bed at the same time. For her, they were feeling more cohesive as a couple. One night, as Josiah was tucking his son into bed, his son turned to him and said, “Dad, you’re not as angry as you used to be.” Admittedly, we both teared up when Josiah shared that story with me. He said the fact that his son actually noticed and felt comfortable enough to share that with him really meant the world to him. It was clear his son had been affected by his temper prior to HBOT therapy. At HOW, we acknowledge by helping one person, we are often improving the lives of those who are around that person as well. HOW though HBOT therapy positively affect the lives of not just individuals, but families and communities as well.

FOD: Are there opportunities to volunteer with HOW?

Sarah Crane: Always! It may be cliché to say, but it takes a village. If you have something you enjoy doing (anything, really) and want to do that thing and do good for our community, please reach out to us through our website at or email me at If you enjoy gathering people, let us come say “hey” and let others know what we are doing for our community. If you know someone who could benefit from HOW’s services, please send them our way. If you enjoy graphic design, planning events, working with spreadsheets, writing press releases, photography – anything – please reach out and drop us a line. Together, we will find a place and positive way you can help make a difference in the lives of those here in Delray Beach.

Best Regards,

The Friends Of Delray Board

Judy Mollica - President

Steve English - Treasurer

Gregg Weiss - Secretary

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