Perspectives in Circulation Today
Where can patients seek help when the local University can not help them?
The End-Stage Foot?
Gangrenous Feet Salvaged by Circulator Boot and Drs. Calhoun and Lieberman
Gangrenous Foot Saved by Dr Calhoun
The foot of this elderly lady had deteriorated in spite of the care offered by a University Medical Center in her state. Her daughter, a lawyer, refused to allow the leg amputation offered to her and sought another opinion. She found her way to Dr. Calhoun, a podiatrist in Ocean Springs Mississippi which was more convenient to the nursing home than the University Medical Center. The baseline photographs were of poor quality, but her subsequent pictures give her story.
 August 30th, 2000: The remaining three toes were at risk. The big toe had a dry necrotic spot. There was blistering and maceration between the toes. The third toe was undermined. |
 August 30th, 2000: The plantar surface was largely necrotic. Some red granulations were beginning to develop at the margin of the wound. |
Her daily treatment program included oral Bactrim-DS twice daily; a ten minute initial cleansing soak with Sea Soaks and hydrogen peroxide; a 40 mg injection of gentamicin into the necrotic tissue; a 45-minute Circulator Boot treatment with the foot immersed in Sea Soaks, 40 mg gentamicin and amphotericin B; and a gauze dressing with wound gel applied over the pink tissue.
 September 24th, 2000: Dr. Calhoun writes that this picture was taken after 4 weeks of booting. The foot was improved, the smell was gone and there was less necrotic tissue. |
 August 9, 2001: Dr. Calhoun writes the wound is clean and significantly smaller with the edges trying to approximate together. |
The daughter became unhappy with the nursing facility and took her mother home. With the help of The Home Health Agency, the foot went on to heal. At the time of her death a few years later her legs were intact.
Comments: The daughter of this
patient is a lawyer and was quite concerned that her outpatient boot care was not covered by
insurance. Another difference between the opportunities of the rich and those
of the poor, she noted. On the other hand, her previous unsuccessful hospitalization was covered and was considerably more expensive. Dr. Calhoun hopes to be back in business soon as her area continues to recover from Hurricane Katrina..
Gangrenous Foot Saved by Circulator Boot and Dr. Lieberman
This patient has sent Circulator Boot the following photographs.... saying that photographs speak a thousand words.
 February 2, 2001:"... this is when Dr. ____ wanted to amputate below the knee. |
 February 2, 2001 |
When sending the last of his photographs (below). he comments..."I truly feel blessed. It saddens" us " how few people know about the combined efforts of current technology and Circulator Boot. I am so grateful to the doctor that invented this system and to the internet being available and God letting" .. us.. " find it. I will do everything in my power to get the word out." His wife comments, "I want you to know I was in our hospital system just one day, looking at records from three hospitals that my doctor is a provider for, I can't tell you how many of these thousands of patients were diabetics and in for amputations, it appalled me. I really wanted to call them and let know they had an alternative, but I could not. Bless all of you and your efforts from" ... us... "and all the others Circulator Boot has helped.
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Comments: Early booting likely would have prevented the deterioration of this foot and shortened his pain and the cost and duration of his treatment. Dr Lieberman reports that the patient was doing well when last seen a few years ago. Hopefully, no new news is good news.
Where does one go when your surgical consultant cannot help you? Most centers do not have vascular medical specialists. Those that do have cardiologist who are skilled in angioplasty procedures. Few can tell one pneumatic boot from another and the programs offered at the national vascular meetings will never teach them the difference. As one of our patients observed, "If you walk into a specialty butcher shop, you should not expect to buy strawberries." .