Press Releases: Northwest

December 15, 2004

Woman Saved from Double Amputation

The pictures are enough to make even a room full of nurses wince. Open, bloody ulcers on the legs and feet so deep that the tendons are visible. When Delores Hoch came to KSMC's emergency room last February, the wounds on her lower legs and feet were so bad that plans were made to amputate both her legs above the knee. Then Donna Harris, RN, a care coordinator at KSMC, had an idea. And that idea saved Delores's legs.

How had Delores reached such a pass? Delores didn't know it, but she had diabetes. Over time, elevated blood sugar can damage a person's nerves and decrease circulation, especially to the lower legs and feet. Many people with diabetes can no longer feel if they have injured their feet, and calluses and even ulcers can form without their knowledge.

When Delores went to the doctor for treatment of an earlier wound, she became frustrated with how he was caring for it. She says, "Every time the wound seemed to be getting smaller and better, the doctor would cut away the edges and I would have increased pain and a bigger wound. After a discussion with the doctor, I decided to stop seeing him for treatments. My wound healed after that."

Later, when she was working outside, she dropped a chisel on her leg and cut it. She treated it herself. But with her poor circulation, not only did the wound not heal, it got worse. Even minor scratches turned into ulcers. Although to an outside observer, the resulting wounds looked horrific, Delores felt very little pain. She went to the emergency room only when they would not stop oozing blood. The damage was so extensive that her tendons were clearly visible through the wounds.

Then Delores was told about the need for amputation. Her mind was foggy from the medication she had been given. Otherwise, she says "I'm sure I would have had a heart attack if I had been more alert. Not much was real for the next few days."

It was then that Donna had her idea. VAC, Vacuum-Assisted Closure, is sometimes used in hospitals to treat patients who have recently undergone skin grafts. Thin dressings are applied to the wounds, and each is hooked up to a tiny tube that exerts negative pressure. The dressings must be worn non-stop, except for when the wound is cleaned three times a week. To heal, Delores was going to have to spend a long time in bed. But the alternative was losing both her legs above the knee.

Everyone involved—Delores, Donna and her doctors—decided to give it a try. Specialists did everything they could to support the experiment. A nutritionist made sure that Delores was getting exactly the nutrients she needed to aid her healing. A vascular surgeon installed a stent in her left leg to increase circulation. A plastic surgeon followed her care.

Delores says, "I remember the care coordinator, Donna Harris, talking to me about a wound therapy that gave me hope. The representative for the company was consulted and therapy started. Plans for amputation were put on hold for a trial period of seven weeks. I was moved to Friendship Care Center. Dressing changes were done three times a week. These were very painful, but I could bear it knowing that my legs were still attached.

"Judy Markas, RN, at Friendship, and Cyndy Pendleton, from the company that makes the VAC, were so excited with each dressing change. They shared with my family and most importantly, me, what was going on. I was very involved with my care and learned so much that has benefited me. With the help of weekly photos and optimism, excitement was shared by all the staff. Dr. Arthur Hayward and Beth Patterson, ANP, followed my progress in the facility and I had regular visits to see Dr. Hajari in the medical office. After six weeks of therapy, they decided to do a skin graft. The road to recovery was in sight.

"I truly believe my guardian angel sent Donna Harris and Cyndy Pendleton, among others, to me. They have been there since the beginning and even during my grafting surgery. I returned to Friendship Care Center after my graft, where my wounds continued to heal. Finally, I was discharged. I am walking again and now can think about walking on the beach this summer. I can not tell you how thankful I am for my legs and feet. If I had not had the VAC therapy, I would be spending my retirement in a wheelchair. So many people cared for me, gave me hope, shared tears of joy with me, and wished me the best. To all of you who where there, thank you!"

Thanks to Linda Jardin, RN, for alerting us to this story.