From frostbite to diabetes ulcers
Peter Fenelon of Sugar Land traveled more than 8,000 miles for the adventure of a lifetime. But when his trip was cut short due to a medical emergency, he found the specialized care he needed right in his home town, thanks to Dr. Nicholas Desai and the Advanced Wound Care Clinic at Methodist Sugar Land Hospital.
In December 2012, Fenelon celebrated his graduation from the University of Texas by heading to Nepal with three college buddies for a 15-day hike around the Annapurna Mountains near Kathmandu. Though the first few days of the once-in-a-lifetime trip went well, blizzard conditions eventually forced the quartet to make a slow, difficult leg of the hike through thick snow at high altitudes. What was supposed to be an eight-hour trek took 15 hours in freezing temperatures.
After crossing the Throng La mountain pass, the group rested for the evening. But when Fenelon removed his boots and socks, he realized he was in trouble. His feet were severely swollen, and a guide immediately recognized signs of frostbite.
“I honestly thought that the main issue was that my feet were very swollen from all the walking,” Fenelon says. The guide, however, convinced him that he needed medical care, and called for a medivac helicopter to take Fenelon and another hiker with a milder case of frostbite to the hospital.
Fenelon spent four days in a nearby hospital receiving treatment when a doctor told him he had to go home to receive additional treatment because he could not continue traveling. But, he warned, it was possible that he would eventually have to have all of his toes amputated.
After a painful, 30-hour flight home, Fenelon began seeing Dr. Desai at Methodist Sugar Land Hospital’s Advanced Wound Care Clinic. Dr. Desai put the young patient on a rigorous treatment plan that included twice-a-day hyperbaric oxygen therapy sessions of two hours each.
In hyperbaric oxygen therapy, patients are enclosed in a specially designed, pressurized chamber where they breathe 100 percent oxygen. “Breathing pure oxygen under pressure increases the amount of oxygen in the bloodstream, where it is delivered to damaged tissues,” says Dr. Desai. “The increased oxygen flow speeds up the growth of new blood vessels and collagen, both of which are necessary for healing. The therapy can actually preserve tissue that otherwise would die.”
The hyperbaric oxygen therapy led by Dr. Desai and the Advanced Wound Care Clinic’s team of physicians saved Fenelon’s feet. “Over four weeks, I watched my toes progress slowly from a dark blue, very scary color to pink and red and even flesh colors,” Fenelon says. “I have been absolutely thrilled with my progress.”
Fenelon’s injuries still required the amputation of his big toe and a portion of the little toe on his left foot. But the alternative was far worse.
“There are tremendous social and psychological costs to losing a limb,” says Dr. Desai. “And there is a financial cost, as well. The typical diabetic amputation requires 24 months of ongoing treatment and costs approximately $60,000. We can treat a patient in two weeks and save the limb if the patient presents to us in time. We have seen some remarkable results occur very quickly and very efficiently.”
Once used solely to help deep water divers recover from the “bends,” or decompression sickness, hyperbaric oxygen therapy is especially useful for treating wounds and injuries in patients who have diabetes, damaged tissue due to radiation treatment or blood clots, traumatic injuries to the extremities and infections of the bone or skin. The key is to seek treatment early, says Dr. Desai.
“Most wounds should heal within four weeks,” he explains. “If you have a wound that is lingering past that date – even if it doesn’t appear to be serious – hyperbaric oxygen therapy can make a difference. And the sooner we start, the more likely it is that we can preserve tissue or save a limb. Early detection leads to better results and improved quality of life.”
One of the keys to the Advanced Wound Care Clinic’s success is its multi-disciplinary approach to treating patients. The clinic’s medical team includes 10 physicians who specialize in a range of medical fields, including vascular care, infectious diseases, neurology, plastic surgery, podiatry and more. “One patient, one chart and 10 physicians,” says Dr. Desai. “Because a slow-healing wound is often a sign of an underlying medical condition, each of us is involved with every patient, and we work together to ensure that we are developing the best treatment plan for each patient’s unique situation. Our communication with one another and with our patients is critical to achieving success.”
The Advanced Wound Care Clinic is onsite at Methodist Sugar Land Hospital, which allows for easy access to imaging and lab services if needed. “We can use all the available technological resources and medical expertise here at Methodist Sugar Land Hospital to help our patients, which is something offsite clinics can’t match,” says Dr. Desai.
Most importantly, he says, it is critical for the community to understand the value that the Advanced Wound Care Clinic at Methodist Sugar Land Hospital can provide.
“We have the ability to prevent many of the amputations that are taking place these days … but only if we see the patient in time,” he says. “The average diabetes patient, for example, waits 16 months before seeing a doctor for wound or ulcer treatment, because there is a real lack of public awareness about hyperbaric oxygen therapy and how it can prevent tissue and limb loss. If a person has a cut, scrape or other wound that is not healing properly after 28 days, that is an emergency and the individual should seek help. The good news is that we can often heal the wound and help the patient return to normal activity in just a short time.”
To make an appointment with Dr. Desai or Methodist Sugar Land Hospital’s Advanced Wound Care Clinic, call 281-275-0770.