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Geoffrey Potts Patient Story

Patient Stories: “I Would Drive Anywhere To Have Dr. Correa Treat My PAD”

“He asked me what I wanted out of my treatment and then he surpassed it.”

Geoffrey Potts is a retired mason and a patient of Dr. Juan Carlos Correa, Vascular Surgeon and managing physician at Modern Vascular of Kansas City in Overland Park. 

Geoff said he was originally referred to Dr. Correa by his cardiologist, Dr. Tim Blackburn, a referral he said has made all the difference. But his story begins even before that. Geoff had been suffering from leg pain for many years that he assesses came as a result of undiagnosed and thus unmanaged type 2 diabetes.  He said he first heard the term Peripheral Artery Disease in 2014 while he was in his mid-50s. However, it would take several more years of pain before he would cross paths with Dr. Correa.

As Geoff explains his journey, he told us about his neuropathy and severe leg pain that not only kept him from walking for more than a few minutes but also affected his ability to stand or bend over for extended periods of time. Explained Geoff, “I could not even walk short distances without having to think through where would be my next place to stop and rest until the pain stopped.”

Geoff was a little skeptical when he first met Dr. Correa.  After all, he had experienced this pain for a long time and wasn’t sure what could be done. He wanted to keep his expectations realistic.  Five minutes later, Geoff felt at ease. Dr. Correa looked him in the eye and asked him what he wanted out of his treatment. Geoff responded that he wanted to be able to do things he loved like woodworking, hunting, fishing, biking, and walking. Dr. Correa never lost his gaze and said “Then that is what we will work toward.”

Geoff has had two procedures at Modern Vascular in the last year, one on each leg. His last procedure was completed in mid-November 2021. Geoff and his wife, Rhonda, call the results a complete transformation. Now in his mid-60s, Geoff is walking 2-3 miles and biking 20 miles on a regular basis. His improved activity has helped him lose 60 pounds, which is transforming his health and quality of life in other ways. 

Geoff says he is a success story and that he would recommend Dr. Correa to anyone, and he adds that he has. Geoff and his wife live 2 ½ hours from the Overland Park clinic but they say that they would drive anywhere to see Dr. Correa. Geoff summarized his experience by saying “We both consider him a friend. He knows my wife as well as he knows me and asks about her when she is not there. He delivered everything we discussed and more. There is so much I can do now that seemed impossible just a year ago.”

5 Symptoms You Should Refer to a PAD Specialist - PAD Answers Blog

5 Symptoms That You Should Refer Your Patient to a PAD Specialist

The technological advances in Peripheral Artery Disease treatment that save limbs and lives every day are truly a culmination of science and art where highly trained vascular specialists apply knowledge, a caring heart, and skillful hands. Unfortunately, PAD is still very much so a silent killer making Modern Vascular’s endeavors to drive awareness, education, and tailored treatment options that much more important.  Early detection is integral for intervention and amputation prevention. 

How to know when to refer?

As clinicians, the focus is on our responsibility to heal our patients, through observation, analysis, and care plans. Knowing when it is time to refer a patient to other providers who specialize in PAD treatment can be a judgment call.  Many patients have high-risk factors but there are no showing symptoms. Risk factors include diabetes, hypertension, age, and early detection is vital for treatment.   It is customary for patients with diabetes to get their feet checked every time they see their doctor, but more patients should be checked for discoloration on the foot, and also take a pulse of the foot.  By carefully examining the foot, PCPs, Podiatrists, Endocrinologists and others can more definitely know which patients would benefit from consulting with a PAD specialist.

Here are 5 Symptoms that should be referred immediately:

PAD with Neuropathic Pain

Neuropathy, otherwise known as peripheral neuropathy, is a result of damage to the peripheral nerves located outside of the brain and spinal cord.  This damage causes weakness, numbness and pain, usually in the hands and feet, also affecting other areas and body functions including digestion, urination and circulation.

Both Neuropathy and PAD affect the lower extremities, which sometimes results in mistaking one for the other. They can both be present at the time there are a few outlying symptoms that set them apart; they include1:

Cramps in the thigh, calf, ankle, buttocks, or foot

  • Difficulty climbing stairs
  • Fatigue in the legs or achiness
  • Slow or non-healing wounds on the leg, angle, or foot
  • Temperature of one leg is cooler than the other
  • Leg hair loss or poor toenail growth
  • Numbness or weakness in the legs
  • Pain that stops at rest
  • Paleness or blueness in one or both legs

Neuropathy can occur when there are vascular disorders, in other words, when blood flow to the arms and legs is decreased or slowed by inflammation, blood clots, or other blood vessel disorders. Decreased blood flow deprives the nerve cells of oxygen, causing nerve damage or nerve cell death. Vascular problems can be caused by vasculitis, smoking and diabetes.

PAD with Claudication

Claudication is pain in the thigh, calf, or buttocks that happens when you walk may be a symptom of peripheral artery disease (PAD).2

At first, claudication pain occurs when you walk a certain distance and goes away when you rest. But as PAD gets worse, the pain can occur when you walk shorter distances. Over time, you may no longer be able to walk because the pain is so severe.

Claudication is linked to health conditions that also increase your risk for heart attack or stroke, PAD with claudication should be checked for and then treated for by a vascular specialist who can address the artery disease in other parts of the body.

PAD with Rest Pain

More serious than Claudication is a symptom of PAD known as rest pain. When the arterial blockages are so severe that muscles aren’t getting enough oxygen while at rest. Foot pain is the most common signal. At first, it’s most troublesome when the leg is elevated, particularly in bed at night.

The earliest and most common symptom is called intermittent claudication followed by Rest Pain.  Patients usually experience it as a cramp-like muscular discomfort, but PAD can also produce numbness, tingling, weakness, or fatigue.3

People with mild blockages can walk substantial distances before the symptoms set in, but patients with severe PAD may experience distress in just a few yards. Whether mild or severe it is recommended to refer to a vascular specialist to for a guided walking program or a endovascular intervention.

PAD with Gangrene

Gangrene happens when blood supply to certain tissues is stopped. This can happen due to4:

  • Infection
  • Injury (burns, infected dog bite, or combat wound)
  • Frostbite

Diabetes, PAD, or other chronic diseases that harm the circulatory system such as Raynaud disease, can lead to gangrene if they are severe and not under control.

If the patient’s gangrene is caused by poor blood flow, it may time to recommend your patient for vascular surgery to improve circulation. For instance, when gangrene is a result of a blocked artery, the patient may have bypass surgery or an angioplasty to address the condition.

Wounds that Won’t Heal

Chronic or nonhealing wounds and ulcers are caused by blockages in the arteries (arterial ulcers) and the result of a loss of sensation, often seen in patients with diabetes (neuropathic foot ulcers). Patients with underlying PAD and chronic wounds are at a higher rate of amputation. Referring to a PAD Specialist will help prevent serious complications in the early stages, helping to identify and treat both the PAD as well as other factors which may be impacting wound healing. Patients with underlying PAD are at increased risk of developing non-healing wounds and ulcers and have a higher rate of amputation. Therefore, it is important for people that have PAD to seek out wound care. Here are some common wounds that occur in patients with Peripheral Artery Disease.

Modern Vascular is not only diligent in early detection and treatment of PAD, but focused on amputation prevention. Consider referring your patients to us for minimally invasive vascular solutions.

We return your patients ready to heal.

To learn more about Modern Vascular to answer your PAD-related problems, or to find a clinic near you to refer to a refer a patient you can call (888) 853-1278 or use the online form at modernvascular.com/referring-doctors to request a consultation with a Patient Advocate.

Sources:

Is it peripheral neuropathy or pad? Is it Peripheral Neuropathy or PAD?: Vein and Vascular Solutions NYC: Board Certified Vascular and Interventional Radiologists. (n.d.). Retrieved April 19, 2022, from https://www.vascularsolutionsnyc.com/blog/is-it-peripheral-neuropathy-or-pad

Mayo Foundation for Medical Education and Research. (2022, March 2). Claudication. Mayo Clinic. Retrieved March 24, 2022, from https://www.mayoclinic.org/diseases-conditions/claudication/symptoms-causes/syc-20370952

Rest pain. Coastal Vascular Center. (2022, January 31). Retrieved March 24, 2022, from https://coastalvascular.net/peripheral-arterial-disease-pad/rest-pain/

Gangrene is a symptom of pad – stand against amputation. Take a Stand Against Amputation. (2021, December 30). Retrieved April 19, 2022, from https://standagainstamputation.com/symptoms-of-pad/gangrene/

Pad awareness month: Take off your socks at your next doctor’s appointment! PAD Awareness Month: Take Off Your Socks at Your Next Doctor’s Appointment! | Iredell Health System – Statesville, NC. (2021, September 27). Retrieved March 24, 2022, from https://www.iredellhealth.org/news/releases/pad-awareness-month-take-off-your-socks-at-your-next-doctor-s-appointment/

Treatment strategies for patients with peripheral artery disease (PAD). Treatment Strategies for Patients With Peripheral Artery Disease (PAD) | Effective Health Care (EHC) Program. (n.d.). Retrieved April 15, 2022, from https://effectivehealthcare.ahrq.gov/products/peripheral-artery-disease-treatment/research-protocol

John Scallions Modern Vascular APP

The Importance of APPs in Amputation Prevention

A Conversation with John Scallions, NP, Modern Vascular in Southaven

Modern Vascular’s mission is focused on Amputation Prevention year-round, we work towards the eradication of lower leg and foot amputation in the general public and specifically among under-resourced and underserved communities. In observance of Limb Loss and Amputation Awareness Month, this April we’re celebrating the Advanced Practice Providers (APPs), otherwise known as Nurse Practitioners and Physician Assistants, who are integral to saving the limbs and lives of patients every day.

John Scallions, MSN, FNP-BC, Nurse Practitioner at one of our busiest clinics in the Mississippi Delta Area, Modern Vascular in Southaven, discusses his role in amputation prevention.

What is the role of the APP at Modern Vascular?

John: “We touch every soul that walks through the doors of Modern Vascular. We perform the initial assessments, gathering medical history on these patients and performing our examinations on the patients in order to see if they have any significant PAD that could lead to amputations in the future.

Many of our patients actually come into the clinic and aren’t aware that the symptoms they’re having are actual PAD symptoms. I find that patients feel it is their norm to be having the pains they’re having in their lower extremities.

How are you involved in patient education?

John: “When we start teaching them about the symptoms of PAD and critical limb ischemia. This light bulb goes off in their head and they’re like, gosh, I’ve been having this for so long, and it’s been ignored. They’ve been told that it’s just normal aging or that it is arthritis. And then when we actually get in and investigate, we find issues that need to be taken care of immediately and can intervene and hopefully set these people on a path that veers them away from amputation.

We work closely with the patient’s primary care providers, we give suggestions and examinations on medication needs, exercise needs, and diet changes. So the APP role is multifaceted. We have to help guide them in the right direction from dietary, smoking cessation, or taking their medications as prescribed.”

Why is amputation prevention important to you?

John: “Amputation prevention is the number one goal I have. Once you start to see the first amputation, it seems that will snowball into future amputations. And these patients usually do not do well. I want them to keep both legs and their toes. As we know, one amputation usually leads to several and this increases their morbidity. It would be a disservice for me not to do everything that I could and perform every diagnostic tool assessment that I can. Our APPS all have the integrity and the compassion to truly be advocates for our patients.”

Modern Vascular in Southaven is top-rated for their consults and general patient experiences in the company in part due to how thorough John is with his patient education and advocacy.

To learn more about the non-invasive vascular solutions that Modern Vascular offers or to find answers to your PAD-related problems, you can call (888) 853-1278 or use the online form at ModernVascular.com to request a consultation with a Modern Vascular Patient Advocate.

Mike Ludwig Patient Story

Patient Stories: “Modern Vascular Gave Me the Answers I Needed”

It wasn’t Peripheral Artery Disease (PAD), but it was something.

Mike Ludwig is a retired business owner and long-time resident of San Antonio. 

In January of this year, Mike saw a Modern Vascular ad on Facebook that spoke to him. The ad explained that night-time leg cramps could be a sign of Peripheral Artery Disease (PAD) and he wanted to learn more. He called the number on the Modern Vascular website and spoke to Licensed Vocational Nurse and Patient Advocate, Julie Miller. Mike told Julie about his leg pain, describing his legs as feeling like “a chunk of concrete”, “in a vice”, “electrically charged” and “on fire.” Julie explained to Mike that much of what he was feeling were classic symptoms of PAD but he should have a complete consultation to know for sure. 

Mike was in a great deal of pain and instead went to the ER that night, where he said they provided a quick exam and an initial diagnosis of sciatica.  But something about this just did not sit well with Mike and he soon gave Julie another call and asked if he could please see a medical professional at Modern Vascular’s Lexington location. 

Upon entering the clinic Mike was immediately thrilled with the attention he received, starting with Christine at the front desk. “Everyone was so professional,” said Mike.  “They kept telling me, we are going to get to the bottom of this. I really felt like they cared about my well-being.”  Mike said the ultrasound tech, Michael Johnson, was extremely thorough, reviewing his entire vascular system from head to toe. 

The Advanced Practice Provider, Karen Summy, took the time to explain all of the findings in detail and answered his questions. The news was not good. They found a 100% blocked aorta and an 80% blocked carotid artery. Mike would need major surgery, and they referred him to a Vascular Surgeon at a local hospital who specialized in his condition. 

Even though Mike was not a candidate for Modern Vascular’s services, Mike is appreciative to everyone on the Modern Vascular team for their help.  “Julie was a Godsend.” He said.  “She got me on the right path and then the clinic team took it from there. At the hospital, they did not even take my sock off. So many people are eager to tell a bad story when things don’t go their way.  I wanted to take the time to talk about Modern Vascular’s gold standard care. I am just so thankful.”

can you reverse pad

Can You Reverse Peripheral Artery Disease Naturally?

How to Slow the Progression of PAD Symptoms

Living with Peripheral Artery Disease (PAD) can be challenging, as this condition develops when plaque, made up of fats and other substances in your bloodstream build up in your arteries, making it harder for your arms, legs, head, and organs to get enough blood.1 If blood can’t get to these areas, tissue damage and eventually tissue death can occur. Left untreated, there is a chance of stroke, heart attack, kidney disease, amputation, and can be life-threatening.

Many people ask our doctors how they can reverse PAD naturally. There isn’t a cure, but you can manage, and possibly even reverse, the symptoms. It is preferred to manage PAD with lifestyle modifications, but there are also minimally-invasive endovascular procedures available if it cannot be managed by those changes.

What Lifestyle Changes Can You Make to Treat PAD?

There is no cure for PAD, but you can manage your PAD symptoms and stop the progression of the disease through the following lifestyle changes:

how to reverse pad naturally

Exercise

A key component to PAD symptom reversal is exercise. Studies show that patients who engage in regular physical activity may lead to fewer and less severe symptoms.1 The distance a patient can walk without pain is often the indicator of a successful PAD treatment.  Routine workouts can also aid in improving your mood, self-esteem, energy, and sleep. Exercise can also reduce your risk of other cardiovascular diseases such as heart disease, stroke, or heart attack.

Don’t know where to start? Well, walking is an excellent option. Your doctor might recommend supervised exercise therapy or a walking program to help manage your PAD. Regardless of the exercise regimen chosen, consistency is the key. The goal is to get some kind of activity as often as you can.

Note: Before making any lifestyle changes to help with your symptoms it is important to discuss with your Primary Care Physician (PCP) or Vascular Specialist.

smoking cessation

Quit Smoking

Tobacco use and smoking constricts and damage your arteries and is a significant risk factor for PAD. Smoking cessation reduces the risk of your symptoms developing further and lowers your odds of Cardiovascular Disease (CVD).

Studies show that people who keep smoking after their diagnosis have a higher risk of death from complications of heart disease than those who quit after their diagnosis.2

If you’re having trouble quitting on your own, ask your doctor about smoking cessation programs that might include the following, behavior modification programs, nicotine replacement therapy, and stop-smoking support group.

Maintain a healthy weight

Healthy Diet & Weight

In living with PAD, a heart-healthy diet can help you control your blood pressure, cholesterol levels, and diabetes, which may lower your risk Many people with PAD also have underlying health issues that benefit from healthy ways of eating. In general, it is important to eat a diet low in sugar and avoid processed food, focusing on meals that highlight vegetables, fruits, and whole grains. Include low-fat dairy products, fish, poultry, legumes, nuts, seeds, and non-tropical vegetable oils like olive oil. Reduce salt, added sugars, and red meat. It is also important to maintain a healthy weight.

Avoid Certain Over-the-Counter Medications

Some over-the-counter cold medicines that contain pseudoephedrine including Advil Cold & Sinus, Aleve-D Sinus & Cold, and others, constrict your blood vessels and could make symptoms worse.1

Stop or Reduce Alcohol Intake

Long-term, heavy drinking can lead to alcoholic cardiomyopathy3, a condition where consuming too much alcohol damages your heart. Ultimately, it can cause your heart to enlarge irreversibly. This weakens the heart muscle, keeping it from pumping as well as it should, which may increase your risk of worsening your PAD symptoms. Limiting alcohol intake may be able to keep it from getting worse.

Foot care

Take Care of Your Feet

Careful foot care is especially important for people with PAD as they may also have diabetes, wounds, and/or injuries on the lower legs and feet that don’t heal. If wounds are not healing properly, it is due to poor blood flow, which puts you at a higher risk for infection. Taking care of your feet in the following manner will also improve your

Quick tips for Foot Care:

  • Wash feet daily and dry thoroughly.
  • Moisturize feet often.
  • Wear thick, dry socks.
  • Make sure shoes fit properly.
  • Treat any fungal infections immediately.
  • Be careful while cutting nails.
  • Look over your feet every day to see if you have any injuries.
  • Have a foot doctor treat bunions, corns, or calluses.
  • If you have a foot injury, see your doctor right away.

Final Thoughts

When you have PAD, your doctor will want to control your symptoms and stop further buildup of plaque in your arteries. Sometimes, lifestyle changes are enough to meet these goals. If not, your doctor might suggest medication or a procedure.

To learn more about the non-invasive vascular solutions that Modern Vascular offers or to find answers to your PAD-related problems, you can call (888) 853-1278 or use the online form at ModernVascular.com to request a consultation with a Modern Vascular Patient Advocate.

Sources:

  1. Benisek, A. (n.d.). Can I reverse peripheral artery disease (pad)? WebMD. Retrieved March 8, 2022, from https://www.webmd.com/heart-disease/reverse-peripheral-artery-disease.
  2. Mayo Foundation for Medical Education and Research. (2021, January 14). Peripheral artery disease (PAD). Mayo Clinic. Retrieved March 16, 2022, from https://www.mayoclinic.org/diseases-conditions/peripheral-artery-disease/diagnosis-treatment/drc-20350563.
  3. Alcoholic cardiomyopathy: Causes, symptoms and treatment. Cleveland Clinic. (n.d.). Retrieved March 16, 2022, from https://my.clevelandclinic.org/health/diseases/21994-alcoholic-cardiomyopathy.
  4. WebMD. (n.d.). Tips for living with peripheral artery disease of the legs (PAD). WebMD. Retrieved March 16, 2022, from https://www.webmd.com/heart-disease/tips-living-with-peripheral-artery-disease.

LaBerge Patient Story

Patient Stories: “I Thought I Was Experiencing Knee Pain”

A patient describes how a routine discussion about knee pain with his Primary Care Physician helped diagnose his Peripheral Artery Disease.

David LaBerge is a retired real estate appraiser for the County Tax office from Rio Rancho, New Mexico.  At age 69, David first learned about peripheral artery disease (PAD) from his primary care physician during a regular 6-month check-up.  David had been experiencing what he thought was knee pain, but knowing that David was pre-diabetic, his PCP thought differently and sent him to a local vein specialist for a complete examination.  The vein specialist identified David’s pain as arterial insufficiency and referred David to Modern Vascular for treatment.

Modern Vascular got David in right away and David noted how immediately impressed he was with the clinic’s staff.  “Everyone was cordial, professional, and friendly,” noted David. “They were patient and explained my treatment options to me in a language I could understand.” 

On the day of David’s procedure, he first had an opportunity to meet directly with Dr. Hootman who answered all of his questions.  “The next thing I knew I was done.  I was waking up in the recovery room and soon I was on my way home.”  David was told after the procedure that Dr. Hootman had put in a stent that would help keep his arteries open. 

David said the recovery was quick and easy.  “Almost immediately, my leg pain stopped,”  David reported staying quiet for a couple of days after the procedure, but by day 3 he was out shopping, walking, exercising, and doing yard work.  A month later, David returned to Modern Vascular to have his second leg revascularized as well. 

A year later, David has been back to Modern Vascular several times for follow-up appointments and reports that he has not had any leg pain since the procedures and that his activity level remains high.  When asked about the biggest life improvement, David laughed and reported. “I can sleep. The pain in my legs had been waking me up at night.  I was really surprised by how much my sleeping improved after my visits to Modern Vascular.  I really feel more rested, and that helps to keep me active.”

David needs that energy to keep up with his two sons and two grandchildren who live locally.  He likes to dabble as an amateur auto-mechanic and enjoys doing woodwork in the garage.  He is grateful for the PCP who first realized his knee pain was a circulatory issue and set him on the path that ultimately landed him at Modern Vascular.

Treatment options for patients with PAD

Treatment Options for Peripheral Artery Disease

Peripheral Artery Disease (PAD) is not curable, but is treatable, and often without major surgery. The best method of treatment depends on the patient and the severity of the disease. The following treatment options are the most common options for patients that are suffering from PAD.

Lifestyle Modifications

The lifestyle modifications are typically prescribed to all patients with Peripheral Artery Disease. In some cases, making these modifications are all a patient needs to see improvements to their condition. However, some patients may still require a procedure. After a procedure, the patient should also adjust their lifestyle to prevent a recurrence.

All patients with PAD are advised to:

  • Maintain a healthy, low-sodium diet
  • Take aspirin, as directed by your physician
  • Consistently take blood pressure, diabetes, or cholesterol medication(s) as prescribed
  • Stop smoking
  • Begin a structured walking program, if possible

Angiogram & Endovascular Intervention

If your symptoms cannot be managed with these lifestyle changes alone, the next step is to get an angiogram with endovascular interventions. An angiogram is performed by inserting a thin tube, called a catheter, into an artery in your leg. A contrast dye is then added through the catheter to take x-rays of the blood vessels. Then, the doctor will be able to see where the blood is flowing perfectly and where there are blockages disrupting the flow of blood.

What can vary during an angiogram is which minimally-invasive approach the doctor uses to treat blockages. Your provider will make this decision based on the location, size, and the number of blockages found while performing the angiogram. The types of treatments your doctor may perform during an angiogram are the following:

  • Atherectomy: Physician “debulks” or removes plaque from artery walls
  • Angioplasty: A tiny balloon is inflated in the blocked area, flattening the plaque, making space for blood to flow through again, and then the balloon is removed.
  • Stent placement: A small, expandable, mesh-like tube is expanded in the artery, where it remains to keep it open. 
Balloon Angioplasty and Stenting

These minimally-invasive treatment options have been shown to be safer, yet equally as effective as the next, more invasive option, which is open surgery. 1

Peripheral Artery Bypass

Occasionally, the minimally-invasive endovascular options described above must be repeated to keep the artery open for strong circulation. If for any reason these options are not providing long-lasting relief, an open surgery called “peripheral bypass surgery” may be performed. In this procedure, the surgeon will use either a man-made graft to act as a new blood vessel or take a healthy vein from your body to use.

Whereas the options above clear out existing arteries for blood to flow through, in this option, the new blood vessel is attached to direct blood around the blockage. The blocked artery stays in your body, but no longer helps with circulating blood.

Which Treatment Option is Best?

It’s best to leave that decision to the experts. Speak with your doctor to discuss your options. It is most beneficial to get peripheral artery disease diagnosed early to increase the likelihood that the treatment is less invasive. If the less invasive treatment options do not provide relief it may be beneficial to ask your doctor to refer you to a vascular specialist. Specialists have a deep understanding of specific conditions and have helped many people suffering from the same condition.

Surprise Patient Testimonial

Patient Stories: “Only Dr. Pozun was Able to Give Me Relief”

A patient expresses deep gratitude for the doctor who gave him pain relief after almost 5 years of looking for a solution.

Radek Kuczmierowski is a 72-year old big rig truck driver from Surprise, Arizona.  Radek was first diagnosed with Peripheral Artery Disease (PAD) in 2017 when he visited an area specialist for the intense pain he was feeling in his left leg. What followed was a frustrating series of doctors and procedures, 6 to be exact, none of which provided any relief. Radek received his 6th procedure in April of 2021 after which he said the pain was so extreme he could no longer stand it.  He immediately called his physician to let him know how much pain he was in and was told he could not be seen for another 2 weeks.

Desperate for help, Radek called Medicare who suggested he find a new specialist to evaluate him.  In July, Radek went to an endovascular specialist in Glendale hoping for a fresh start but was once again he was disappointed when he was told that there was nothing that could be done using endovascular procedures. He would have to go to the Mayo Clinic in Scottsdale and the wait would be 4 more months. He was told that open surgery was his only option, but Radek still wasn’t sure.

Unable to fathom waiting 4 months to see another doctor, Radek turned to the internet and found Dr. Anthony Pozun of Modern Vascular practicing in his own neighborhood of Surprise, AZ, just a couple of miles from his home.  Radek knew his luck was changing as he had an opportunity to tell his story to a member of the clinic team. 

“You are my last hope,” he told the clinic scheduler. They got him in to see Dr. Pozun right away. 

Dr. Pozun knew immediately that he could make a real difference in Radek’s life.  “I was really moved by his perseverance. This is a guy who was really fighting for his quality of life. I couldn’t imagine not helping him.” Soon after Dr. Pozun performed a 7th and final endovascular procedure on Radek’s left leg. During the procedure, he inserted a stent to make sure the artery stayed open.

Radek said the pain relief was immediate. “I knew as soon as I woke up, the surgery had been a success. I was home the same day and by the next day, I was walking pain-free. I walk 10,000 steps every day, sometimes 20,000.” says Radek with pride, “I am extremely happy with my outcome.  Imagine after so many years, I am finally pain-free, and the solution was right here in my neighborhood. I would absolutely recommend Dr. Pozun and Modern Vascular to anyone.” 

These days Radek is back on the road in his big rig and has a packed schedule, but he took the time to be interviewed for this article because he wanted to say thanks and share his story with others who may have given up hope.

Watch Radek’s video testimonial:

Deciding between amputation and revascularization

Revascularization or Amputation?

Technology has opened the door for innovation in medicine that has led to great advances in the treatment of many chronic diseases. Over the last 20 years, patients with Peripheral Artery Disease have benefited from life-saving revascularization treatments that are minimally invasive and focused on limb salvage. These changes although remarkable for those with success stories, don’t come without scrutiny and can result in tension within the vascular community.

The History of PAD Treatment

Historically, treatment for peripheral artery disease is based on risk-factor management or surgical interventions that were only done in a hospital setting.

Risk Factor Management

Roughly 30% of Modern Vascular patients receive a recommendation to move forward with a procedure at their initial consultation. Many more are recommended to control their risk factors through:

Interventions & Amputations

If risk factor management approaches are not successful, other treatment options include revascularization therapies to treat blockages. Revascularization techniques can be minimally-invasive using stents and balloons or can include open surgery such as bypass surgery.

Treatments for Severe PAD Include:

  • Balloon Angioplasty/Stenting
  • Bypass Grafting
  • Cryoplasty
  • Percutaneous or Laser Atherectomy

Patients with critical limb ischemia have an advanced form of peripheral arterial disease where patients are getting no blood flow in their foot and are in danger of losing a leg to amputation.

Amputation is a procedure used when tissue destruction, infection, or disease affects a body part so severely that it is impossible to repair or puts the person’s life in danger. For instance, in PAD patients, a foot or leg may be removed by surgical amputation if blood flow cannot be returned to the foot or leg.

Unfortunately, amputation can impact a patient’s life expectancy. According to a study in Vascular Health and Risk Management, the rate of death after major lower extremity amputation in the US is approximately 48% at year 1, and 71% at year 3.4  

This is why it is so important to catch PAD early so that a doctor can intervene before the disease cuts off blood flow to a body part for an extended period of time, leaving the patient with limited options.

About 54% of all surgical amputations result from complications of vascular diseases and other conditions that affect blood flow, such as diabetes and PAD.2

Chronic vascular problems can lead to tissue death in the toes, feet, and legs. Of patients undergoing amputation for complications of these diseases, nearly half will die within five years of the amputation procedure.

Innovation & Tension in the Vascular Community

Over the last decade, there have been great advancements in the treatment or therapy used for Peripheral Artery Disease. PAD affects 8 to 10 million Americans, primarily those with diabetes, over the age of 65, and ethnic groups including Black, Latinx, and Indigenous communities. With technology, we have been able to detect PAD much earlier and treat it without the need for amputation or other invasive procedures.

The innovations have not come without a cost, as there is a bit of tension within the vascular community on the legitimacy and necessity of certain approaches.

With regard to the evolution of medical innovation, not everyone has been this forward-thinking. While some in the vascular community hesitate to deviate from the traditional methods, tension is increased further as many vascular surgeons who are not embracing endovascular treatment are losing patients to those who are. These revascularization procedures can be done more safely and earlier in the disease progression, in outpatient facilities like Modern Vascular with multiple clinics throughout the country.

Patient advocacy has played a huge part in emphasizing the importance of treatment options for patients because the patient’s best interest should ultimately be the focus of care. Patient advocate and Founder of The Way to My Heart, Kym McNicholas shares, “When it comes to treating patients with peripheral artery disease, every single vascular physician needs to respect the fact that different doctors have different tools, techniques, and approaches… Patients should be made aware of, whether one physician or another offers them so that they can make a well-informed decision on what it will take to give them a better quality of life.”

Sources:

  1. Logar, C. M., Pappas, L. M., Ramkumar, N., & Beddhu, S. (2005, March 21). Surgical revascularization versus amputation for peripheral vascular disease in dialysis patients: A cohort study. BMC nephrology. Retrieved December 2, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1079864/.
  2. Amputation | Society for Vascular Surgery. Retrieved December 8, 2021, from https://vascular.org/patients/vascular-treatments/amputation.
  3. Torbjörnsson E;Ottosson C;Blomgren L;Boström L;Fagerdahl AM; (n.d.). The patient’s experience of amputation due to peripheral arterial disease. Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing. Retrieved December 21, 2021, from https://pubmed.ncbi.nlm.nih.gov/28527728/
  4. Swaminathan, A., Vemulapalli, S., Patel, M. R., & Jones, W. S. (2014, July 16). Lower extremity amputation in peripheral artery disease: Improving patient outcomes. Vascular health and risk management. Retrieved December 21, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107174/
  5. Innovations in pad therapy: Make sure you’re up-to-date on … (n.d.). Retrieved December 21, 2021, from https://journals.lww.com/nursing/Fulltext/2008/03001/Innovations_in_PAD_therapy__Make_sure_you_re.3.aspx
Modern Vascular - Ultrasound - What to Expect at Your PAD Evaluation

What to Expect at a PAD Evaluation

Patients who are referred to Modern Vascular often wonder exactly what will happen at their consultation. Although every patient is different, we will discuss what you can expect to happen in a standard Modern Vascular evaluation and consultation for Peripheral Artery Disease.

Referrals

Patients with PAD are referred to Modern Vascular in one of few different ways: Primary Care Physician, Podiatrist, Vein Specialists and Endocrinologists (to name a few), or self-referrals. In terms of self-referrals, patients will have a conversation with our Patient Advocates after taking our PAD Assessment, which incorporates recognized risk factors from the American Heart Association.

Vascular & Doppler Ultrasound

On the day of a PAD Evaluation at Modern Vascular patients fill out new paperwork which will include questions related to a list of medications, current medical conditions, and providers (physicians/specialists) that they currently see.

After the paperwork is filled out an ultrasound will be administered by an ultrasound tech.

A vascular ultrasound uses sound waves to evaluate the body’s circulatory system. Doppler ultrasound is a special ultrasound technique that can help detect areas of restricted blood flow through an artery. Ultimately, these ultrasounds are used as a diagnostic tool to garner a clear picture.

Generally, there is a scan of the hip, entire leg, foot, the tip of the toe, slowed blockages, which help identify blockages or narrowing in the arteries, decreased circulation, and disease.

After the ultrasound is complete you will meet the Advanced Practice Provider (Nurse Practitioner or Physician Assistant). They will go over your complete medical history and ultrasound results and do a comprehensive physical exam. Depending upon the findings, you will learn about the appropriate treatment.

Treatment Options

Treatment is unique for every patient and is dependent upon the severity of the blockage. Blockage can be categorized between minor, moderate, or severe. The provider will decipher the appropriate approach for the type of blockage.

Minor Blockage

Not every patient requires a procedure-based intervention. If a patient is found to have minor blockages, their treatment could involve a conservative approach involving changes to diet, temporary medication, and incorporating a Walking Program.

Moderate to Severe Blockage

Patients who have signs of moderate or severe blockage may require additional diagnostic tools and procedures to intervene.

To better visualize the patient’s condition an angiogram or arteriogram is used. An angiogram is an imaging test that uses x-rays and a special dye to see inside the peripheral arteries. This minimally invasive procedure is done in our Modern Vascular clinics in the procedure rooms.

Living with PAD

Peripheral Artery Disease is a chronic disease so early detection is vital and staying on top of it is integral in saving limbs and lives.

Dr. Brannan Talking to a Patient Modern Vascular of Mesa

Patient Stories: “The Care We Received was Extraordinary”

A retired law enforcement officer recounts how Modern Vascular gave his friend hope.

Dr. Dale Tunnell is a psychologist, army veteran, and 41-year law enforcement professional from the Phoenix area. When his Marine buddy of 10 years, Thomas,* was facing extreme medical challenges, Dale stepped up to the plate. “My friend was going through a lot and needed to be driven to many medical appointments and wanted me to be there for moral support.” 

Thomas, age 79, had been going to a local Vascular Surgeon for his peripheral artery disease treatment (PAD), but even after surgery and a stent had been placed, he was still experiencing swollen legs, open sores, wounds, and gangrenous toes. The disease had just been progressing for too long. The Vascular Surgeon suggested bypass surgery and said amputation of the leg would be the most likely result.

Luckily, during a post-surgery follow-up appointment, Thomas’ podiatrist suggested that Thomas visit Dr. Scott Brannan, Modern Vascular’s Chief of Endovascular Surgery, at Modern Vascular’s Mesa clinic. Dale says that the first visit to Modern Vascular was a turning point.  “They moved mountains to get him into the facility quickly.”  The pace of care had changed; there was a sense of urgency now. Three accomplished doctors, Dr. Brannan, Dr. Correa, and Dr. Jean-Baptiste, all collaborated on the case overtime to make sure Thomas had the best possible PAD treatment. The doctors at Modern Vascular were seeing the same feet and legs that the Vascular Surgeon saw, but now through the eyes of hope. They might not be able to save all the toes, but they owed it to the patient to try.

“The Care for the Patient was Extraordinary”

From the moment Dale, Thomas, and Thomas’s wife entered the clinic, they felt the difference. The environment was kind and congenial. Dale even used the word “fun”.  Dale never felt anxiety about being the advocate for his friend; he was included in all conversations. He met all three doctors as well as Denisse Martinez, one of the Modern Vascular staff members who he said, “Took care of my friend, like he was her father… and still does.” Denisse and Dr. Brannan have gone the extra mile to follow up with Thomas, even visiting his home.  Dale said Thomas can’t help but cry when he speaks about Modern Vascular and tells Dale, “I love them all,” as he had never before in his life received that level of care.

Thomas is now recovering slowly. His condition was dire but is now stabilizing. Dale stresses, “If the vascular surgeon had performed an intervention more quickly, we would never have been in this place.” But for now, Thomas and his wife are focusing on the progress they are making: “The swelling is down. Both legs look a lot better.” Thomas still ended up needing to have the toes of his right foot amputated, but both Thomas and his wife know things could have been a lot worse. Dale feels nothing but gratitude for the care Dr. Brannan and his staff in Mesa provided to his friend. “I would recommend Modern Vascular for anyone who has PAD. All the staff at the clinic were empathetic and when Thomas was hurt, they all hurt. It was truly a team effort. They do extraordinary work and show a level of professionalism that you just don’t see anymore. [Thomas], his wife, and I are forever grateful.”

* Thomas is a fictitious name used to protect the patient.

This blog is written and published with the consent, collaboration, and approval of Dr. Dale Tunnell.

Peripheral Artery Disease (PAD) Patient Advocacy & Outcomes Modern Vascular

Patient Advocacy and Outcomes

Managing vascular diseases, like Peripheral Artery Disease (PAD), requires a lot of decision-making. Whether treatment involves a lifestyle change or requires a procedure, patients rely on a great support system to help make the best choices about their care. It is important that patients feel comfortable with the process or they might avoid medical care altogether. Avoidance of medical care can be due to cost, distrust of medical professionals, fear of knowing, or other reasons. This is why patient advocates play a huge role in the patient journey.

What is a Patient Advocate?

Patient Advocates play an incredibly important role because they essentially help patients communicate more effectively so that they get the information they need to make decisions about their own health care. Patient advocates can help provide patients with educational materials and inform the patient about different treatment options that may be available. They may also assist patients set up appointments for doctor visits and medical tests and acquire financial, legal, and social support for various portions of their journey.

Patients may need an advocate throughout the diagnosis and treatment processes, coordinating with medical professionals, reviewing treatment choices, or even finding the right vascular partner, reviewing background in health and medicine, as a doctor, nurse, or other medical professions.  Patient Advocates could be family members, mission-driven organizations, primary care physicians or other medical professionals patients interact along their patient journey.  At Modern Vascular, we have a team of Modern Vascular Patient Advocates that take calls and answer patient questions throughout their journey, all at no cost to the patient.

Actions to Promote Patient Advocacy

In our mission to eradicate lower leg and foot amputation in the general public and specifically underserved communities, patient education and advocacy are at the forefront. Here are 5 key strategies Modern Vascular patient advocates take to make sure every patient feels seen, heard, and understood.

  1. Good Communication and Listening

    One of the best tools of communication is listening. It is very important to let each patient tell their story. We may ask the same medical screening questions when we first meet a patient but behind these questions is a unique story that can only be told by the patient themselves. Listening to their recitals helps us offer customized advice, build positive expectations, and aid in the medical screen process.

  2. Compassion and Empathy

    These qualities are different than sympathy. We let the patient know we understand their pain, concerns, and needs without feeling sorry for them. That is not what they want.  They prefer understanding. When we go over the screening, and touch on the symptoms they are experiencing, this gives them a great sense of acceptance, validation, and understanding. When patients feel understood, they are much more likely to have trust in our recommendations.

  3. Gain Trust

    By listening and providing validation to what they are feeling, we are showing the patient that we care, we understand, and we are here to help. All of these qualities build trust in the relationship. With this trust, we build a bond with each patient and they realize they are not just another number but a very special and important part on Modern Vascular. Trust is very important in every relationship, especially the patient/caregiver affiliation.

  4. Build Value

    We want each Modern Vascular patient to know in detail the services we offer. As we talk about each step of the process we always “check-in” to make sure they understand each stride. As we go over each action we ask them questions such as, “Does this make sense to you?”, “Are we going down the right path?” or “Does this sound beneficial to you?” These questions pose as a platform where the patients can express their concerns or validate their affinities.

  5. Honesty and Accuracy

    If a patient does not have PAD or is not likely to benefit from our services, we tell them.  There is nothing to be gained by bringing the wrong patients into our clinics.  When a consultation is merited, we always include a full report for the clinic.  The more that physicians or nurses know, the better equipped they are to provide accurate and effective care to that patient.

Great patient advocates ask the important questions that impact patient outcomes. This is particularly true with PAD where the stakes are so high.  When the right patient advocacy can result in saving limbs and lives, having a great team in place becomes that much more important.

To learn more about Modern Vascular or to find answers to your PAD-related problems, you can call (888) 853-1278 or use the online form at ModernVascular.com to request a consultation with a Modern Vascular Patient Advocate.

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