a hiker on a hiking trail

The Doctor Gamble: How Vicki Avoided Amputation

By Kirstin Rizk

For four years, Vicki Sievers dealt with so much pain in her legs that she could hardly walk. Aside from the pain, her legs were heavy and numb. She recalled, “I felt like I was walking on two stumps.” This kept her from grocery shopping, doing chores, and going out with her kids or grandkids. Then, an ulcer on her big toe lead to osteomyelitis: extremely painful swelling in the bone from an infection.

But Vicki did not sit idly by while peripheral artery disease kept her from living. For a year, her specialists disagreed on how to treat her. Her podiatrist insisted that the toe needed to be amputated to keep the infection from spreading. At the same time, her cardiovascular surgeon insisted that her foot didn’t have enough blood supply to heal after a toe amputation, meaning she’d likely end up needing a more major amputation of part of her foot, below the ankle, or below the knee. Instead, he wanted to try to clear out the arteries to get blood flowing once again.

The cardiovascular specialist tried 5 or 6 endovascular procedures, but could not get through the hardened plaque in Vicki’s arteries. She also underwent 50 hyperbaric oxygen chamber treatments. Nothing eased her symptoms.

Still, the pain in her feet, and especially her infected toe, kept her up at night. With both a non-healing ulcer and rest pain, this indicated that Vicki’s PAD had progressed to chronic limb-threatening ischemia.

Between her impaired mobility and the number of failed attempts at fixing the issue, she began to feel hopeless.

Finally, her wound care specialist recommended a new podiatrist, and this podiatrist had a new idea. He did not want to amputate the toe. Instead, he wanted her to try a new, highly specialized vascular specialist: Modern Vascular. The clinic was not nearby, but Vicki was ready to sit through the drive for a new chance at hope.

Dr. Wande Pratt at Modern Vascular in St. Louis, Missouri, started with Vicki’s right leg. Due to the extent and hardening of the plaque in this leg, the procedure had to be done in two sittings. After the second procedure on the leg, Vicki was astonished. She states, “And I loved the fact that I could move it and I could walk. But I still was kind of debilitated a little bit because my left leg was really hurting still… So I looked at him and I said, ‘now can we do my left leg?’”  

After the procedure on her left leg, Vicki was pain-free and walking. She listed off all the things she was able to do again: walk, dust, go out with her kids and grandkids. She recounts, “that really had me depressed for a very long time. And boy, not now. It’s like everything is just opened up to me.”

Vicki is thankful that she saw a new podiatrist who wanted to pursue other options before amputation. Dr. Pratt always supports this move. He says, “I believe that when patients are told they need to have an amputation, they should undoubtedly seek a second opinion. An amputation is final, and once it occurs there is no turning back.”

In a field where each doctor and each clinic vary in terms of training, experience, skill, technology, and resources, relying on a single doctor is akin to taking a gamble.  Because she sought a second opinion, Vicki avoided an amputation with the potential to lead to more major amputations. She adds, “It’s been a miracle. It’s been a godsend. I can’t thank Dr. Pratt enough.”

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.

Dr. Jean-Baptiste's patient from Modern Vascular in San Antonio shares his PAD story.

Patient Stories: “No Longer Bedridden at 27”

Written By Kirstin Rizk

Christian Schott is a patient of Dr. Jean-Baptiste.

At 27, Christian stands apart from Modern Vascular’s usual demographic: patients typically middle age or older. Yet Christian’s symptoms were among the most severe, resulting in three or four emergency room visits over the last few years before finally receiving treatment for his excruciating foot pain.

As a custodian, Christian spends a lot of time on his feet. So, when he began to experience bouts of terrible foot pain about three years ago, his life and work were both majorly disrupted. With seemingly no cause, he would wake up, try to stand, and immediately fall to the ground from the pain. He added, “Usually, I would just wake up with it and I’m like, ‘Okay, I’m going to be bedridden, I can’t move or walk at all today.’”

His primary care doctor and the doctors at the emergency room suspected Christian’s pain was being caused by gout, a type of inflammatory arthritis, and said that the pain would go away in a few days. Perhaps because Christian doesn’t fit the typical demographic for peripheral artery disease, this potential cause of his pain was ruled about before being considered.

Finally, orthopedic surgeon Dr. Reyes referred Christian to Modern Vascular. Christian explained, “I was very blessed. Everyone was super nice and understanding and for the first time I didn’t get ‘it’s gout, we don’t know what to do,’ it was ‘let’s order a few tests, let’s try this, are you okay if we try this?’ Before they would even touch my foot or anything else they would be like, ‘Do I have permission to try to move this around?’… I felt really loved and taken care of when I was there.”

During his evaluation, Modern Vascular’s specialists checked the capillary refill in Christian’s feet. This test is easy and painless: a squeeze on the foot or toe, and count the seconds until the color returns. It should not take more than 2 seconds.[1] For Christian, it was 7 seconds.

This showed that Christian’s foot was not receiving enough blood flow, due to narrowing or blocking of the arteries in his legs. This could explain why, as Christian described, his foot could “turn any color from purple, blue, sometimes even a little green or black.” It could also explain why sometimes his pain was so bad he had to crawl to the bathroom to avoid putting pressure on his foot.

Christian was recommended for procedure at Modern Vascular. Of his experience during the procedure, he said, “they told me what they would do before they did it, like what to expect, just all the things that you want to hear when you have a procedure or go to a doctor’s office.”

A few days after his procedure, Christian’s foot already felt lighter. He has not experienced the debilitating pain that used to occur every month or month and a half since his procedure. Christian is on schedule to see a rheumatologist soon to ensure that he is not additionally having joint-related issues, but there is no doubt that his severe peripheral artery disease was complicating, if not outright causing, his debilitating pain. Thankfully, he is now on track to live the pain-free and healthy life that a 27-year-old should be.


[1] Sansone CM, Prendin F, Giordano G, Casati P, Destrebecq A, Terzoni S. Relationship between Capillary Refill Time at Triage and Abnormal Clinical Condition: A Prospective Study. Open Nurs J. 2017 Jul 26;11:84-90. doi: 10.2174/1874434601711010084. PMID: 28839512; PMCID: PMC5543682.

Patient Stories: Leonard Whitworth Modern Vascular in Southaven Dr. Leschak

Patient Stories: “I feel like a brand new man.”

By Kirstin Rizk

Leonard Whitworth, 63, had been experiencing terrible, unpredictable cramping in his legs and feet for 20 years. When asked about what brought on the pain, Leonard said, “it could be sitting in my chair watching tv, it could be driving down the road, it could be walking through a grocery store or at my job, it would just come on.”

The pain would even wake Leonard up in the middle of the night. He recounts, “I would have to get up and walk the cramp out of the bottom of my feet a couple times a night, about 3-4 times a week. It would hurt so bad it would bring tears to my eyes.”

For 20 years, Leonard attributed his leg and foot pain to getting older and working on his feet for much of his life. He described these terrible cramps recently when he visited a podiatrist. He also explained another symptom he was having: His feet were so cold that he wore battery-operated heated socks. He recalls, “I had to wear one on my right foot even if it were 90 degrees out.” Because of these symptoms and a heart attack and stroke, Leonard experienced two years before, his podiatrist knew that he was at risk for peripheral artery disease and referred him to Modern Vascular.

After evaluating Leonard, it was clear to Dr. Stephen Leschak and his team that Leonard had significant blockage of the blood flow in his legs. What made Leonard’s case even more tricky was an injury he had as a child. At 12, Leonard’s dad was doing construction on a house while Leonard helped on the roof. Young Leonard made a mistake that caused him to jump off, where he landed on a glass beer bottle. The injury was so severe that he nearly lost his foot. 51 years later, this made it more complicated to clear blockages in the arteries of that same foot.

The first time I spoke with Leonard, it was a few weeks after the procedure on his right leg. When asked about his experience getting a procedure from Dr. Leschak, Leonard says, “I feel like a brand new man… I can’t say enough about how much they’ve done for me. I’ve been in pain for a long time and now my right leg is 100%. I can’t wait to get the other one done.”

A few weeks later, I checked in with Leonard the day after his procedure on the left leg. He said, “my foot’s not cold, the cramping went away, I couldn’t ask for anything better.” In fact, he was returning to work the day after our conversation, where he works on his feet all day as a manager.

Leonard summed up his experience at Modern Vascular in Southaven saying, “Couldn’t ask for a better staff than you have right there. From the moment I went in, in the surgery, all of it.”

Finally, I asked him if he still uses his battery-operated heated socks. “No,” Leonard said, “I put them away and we’re getting rid of them. My feet stay warm.”

I also asked if his sleep has improved, and was happy to hear that now Leonard actually has to use an alarm clock, since his foot pain no longer wakes him up.

Check out Leonard’s Patient Testimonial:

https://modernvascular.com/clinics/southaven/

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.”

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.”

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.

Modern Vascular 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:

Native American Heritage Month

Native American Heritage Month

Written by Kirstin Rizk

November was Native American Heritage Month and we are recognizing and celebrating Modern Vascular’s work with this community in this month’s PAD Answers blog.

Through his work on reservations, Dr. Scott Brannan, Modern Vascular’s Chief of Endovascular Surgery, has learned the value placed on the connection to the earth. The Navajo people have variations of a prayer that begins with “Walk in Beauty,” or “In beauty I walk.” Each line is centered on experiencing the earth’s beauty and most end with “I walk.” As limb salvage experts, Dr. Brannan explains, “We, at Modern Vascular do all that we can to help our patients practice that faith to walk in beauty.”

Dr. Brannan and ultrasound technologist Denisse Martinez go onto reservations regularly to ensure patients have access to much needed health care. This can include late nights after a full day of procedures at their Modern Vascular clinic in Mesa, Arizona, and even weekends, as they travel to the nearby reservations to check in on patients. As many patients have advanced disease, these trips are especially important to prevent amputation and promote overall health. Most difficult to treat are patients that are not referred at all during the course of their disease and find their way to Modern Vascular as a last resort. According to Denisse, “Many Native American patients present to our clinic for a second opinion when they have been signed off to have a major amputation.”

Luckily, some patients are referred by doctors who know a multidisciplinary approach is necessary to save limbs. Denisse recalls one patient referred after having a surgery to remove part of the bone in her heel. The wound had made no progress toward healing after several weeks. After a significant surgery like this, blood flow is vital to the healing process and closing of the surgery site. With advanced PAD, however, arteries of the leg and/or foot are so clogged that blood is barely circulating through the foot. Denisse remembers, “I thought to myself, ‘I can literally see her bone, there is no way we will be able to turn this around and have her back on her feet.’ Well, I was wrong! Dr. Brannan was able to re-canalize the previously occluded and stenotic arteries which provided her with great run-off. Afterward, with good wound care management, this patient healed!” Between Dr. Brannan reestablishing blood flow to the foot and the wound care specialist treating the wound, the patient was able to keep her foot.

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first day after calcanectomy

Day 1

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day fourteen

 

Day 14

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day 142 after calcanectomy

 

Day 142

To Denisse and Dr. Brannan, this patient’s story reaffirmed many lessons they’ve become familiar with. First, this patient highlighted the need for preventative care and early intervention in communities that typically don’t receive treatment for PAD until it is too late to save the limb. Second, it showed the importance of coordinating care, as this patient’s level of disease required each of her specialists’ commitment to save her foot. Finally, it revitalized their commitment to spread awareness of the importance of trying all options to save the limb before amputation. Even at extremely advanced stages of disease where amputation seems inevitable, other options should be given a chance first.

The extended version of this story is available in the case study.

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.

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