When Kim Foster describes his ordeal battling two serious wounds at the same time, one on his coccyx, and another on his foot that was so severe the threat of amputation was a daily reality, sometimes tears come to his eyes. He’s been through more than any person should have to deal with, but he knows how lucky he is to be here, and how close his story was to having a very different ending.
Multiple Conditions Led to a Host of Problems
Dr. Brian Heimer, a family medicine physician and wound care specialist, explained the underlying causes of Kim’s wounds. “Kim has what we refer to as ‘multiple comorbidities,’ meaning he suffers from multiple conditions that compound each other and spur new conditions, making treatment scenarios very complex and challenging. His particular conditions include type 2 diabetes, kidney failure, high blood pressure, diabetic neuropathy, poor circulation and valvular heart disease. All of this, together with an extended hospitalization after open heart surgery and vascular surgery on his legs, led to a deep coccygeal wound and severe foot ulcer that required very involved treatment plans.”
“Through our multidisciplinary team of specialists, we were able to provide all of Kim’s care under one roof, not only making it easier on him, but also ensuring optimal collaboration between the treatment team. The result was that his wounds healed beautifully in a relatively short amount of time, despite the challenges his overall health presented.”
Brian Heimer, MD
Board Certified Family Medicine Physician and Wound Care Specialist
Floyd Memorial Wound Healing Center
“He Utilized Basically Every Treatment Modality We Can Offer”
Dr. Heimer elaborated on the treatment plan for Kim’s coccygeal wound. “Kim utilized basically every treatment modality we can offer at an advanced wound healing center such as our own. The first step was to make the wound bed adequate for healing so that it didn’t deteriorate any further. This involved several aggressive debridements, a minor surgical procedure in which we clear away the dead and infected tissue so that new healthy tissue can grow in its place. Next he was placed on an antibiotic therapy regimen and VAC therapy, which involves attaching a suction device that creates a closed vacuum system to the wound area. This helps wounds heal from the inside out by creating new circulation, drawing away drainage and helping the tissues contract and fill in. He also underwent hyperbaric oxygen therapy (HBOT), which allows patients to breathe 100% pure oxygen in a special pressurized chamber. This improves circulation and blood oxygenation, which speeds up the healing process. In addition, Kim required revascularization surgery to restore proper blood flow to his iliac artery, the main artery that supplies blood to the lower extremities.”
Foot Ulcer Presents Additional Challenges
Syed Ahmed, DPM, a podiatrist and foot and ankle surgeon, explained the origins of Kim’s foot ulcer. “Patients with diabetes, neuropathy and circulation issues such as Kim’s are at increased risk of foot ulcers for several reasons. First off, the neuropathy leads to a lack of feeling in the feet, so they walk differently, putting excess pressure on their feet that typically leads to deformities. In Kim’s case, the deformity turned into a callous, which eventually broke down to a severe ulceration. The increased sugar in the body associated with diabetes also leads to weakened immune systems that allow infection to spread quickly and weak skin tissues that are more prone to breakdown.”
Dr. Ahmed continued, “The result is that many diabetics suffer extreme foot ulcers that often lead to amputation, which we try to avoid at all costs. Studies show that lower extremity amputation shortens life expectancy dramatically because of the increased taxation it puts on the heart. With Dr. Heimer focusing on getting Kim’s diabetes under better control, I focused on healing his foot. My first step after debridement surgery was to perform a test that determines how much oxygen was getting to his feet. As I suspected, his blood oxygenation was very poor, so we ordered more HBOT treatments and administered VAC therapy. Once these treatments started doing their job and the ulcer began to heal, I applied a synthetic skin graft to form a new layer of skin. In the end, we were able to save Kim’s foot and completely heal the ulcer in under two months, which is absolutely amazing.”
“If Kim had sought care of his complex wound through traditional methods, the focus would have solely been on the foot ulcer itself. But the ulcer was due to a complex set of health issues, which needed to be dealt with individually to produce the best outcome. It was a combined symptom of poor health, and a team approach was needed to deal with each issue or the ulcer may have continued to worsen and led to an amputation.”
Syed Ahmed, DPM
Board Certified Podiatrist and Foot & Ankle Surgeon
Floyd Memorial Wound Healing Center
Call 812-949-7964 for more information about Floyd Memorial Wound Healing Center or visit the Wound Healing Center section of our website.
See the calendar of events on page 14 for more information on a free Diabetes and Preventive Foot Care seminar on September 30.