Native American Heritage Month

Native American Heritage Month

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.

Peripheral Artery Disease can be effectively treated when diagnosed early and properly.

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