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How a foot sore led to healing a clogged artery

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Andy Gall thought he was doing his best to take care of his health. His diabetes was a part of life, but he wasn’t about to let it slow him down.
 
“I’m a farm boy,” he said. “I’ve always been a busy person.”
 
Heart troubles ran in Andy’s family. Doctors told him he had high blood pressure and a slow heart rate, known as bradycardia. Other family members had A-Fib, or atrial fibrillation, so Andy’s heart rhythm troubles didn’t surprise him.
 
Andy, age 64, went about his day like everything was OK. Now that he was retired, Andy and his wife Cheryl moved through life at their own pace.
 
Chores kept Andy busy most days. He took care of livestock on his 20-acre farm near New Paris. Seven grandchildren living just a few miles down the road brought plenty of energy to family gatherings.

Slow-healing wound points to serious problems

A simple callous on the bottom of his foot stopped the normal rhythm of Andy’s life in November 2022.
 
“It started out as nothing, just a blister,” Andy said. “Then it developed into a sore and got an infection.”
 
Foot problems were nothing new to Andy. He had no feeling in either foot, due to neuropathy caused by diabetes. Each morning, Andy would make sure to rub his feet to check that everything was OK.
 
Ulcers and sores popped up every now and then. He had sores treated at Goshen Wound & Hyperbaric Center in 2017 and was quickly back on his feet again. A bone infection in 2021 cleared up after a round of antibiotics.
 
This time however, Andy couldn’t seem to get the sore to heal no matter what he did. By January 2023, his foot was at its worst and looking nasty. That’s when Andy started to hear the word amputation in his doctor visits.
 
“I was very depressed, just feeling pretty glum,” said Andy.

Poor blood flow at the heart of the problem

Andy wasn’t ready to give up on his leg when he met with Vascular Surgeon, Thomas Etter, MD, who specializes in general and vascular surgery and wound care at Goshen Wound Center.
 
“I asked him if there was any hope this will heal, and he said, ‘yes, absolutely,’” Andy said. “My mindset was 180 degrees different at that point.”
 
Andy didn’t realize his troubles weren’t just in his foot. An artery by his hip socket was blocked and cutting off blood flow in his right leg.
 
Lab tests showed Andy had peripheral arterial disease – or PAD. Foot sores that don’t heal or chronic muscle pain in the legs are classic signs of poor circulation that causes PAD.
 
Nearly half the people with PAD are unaware they have the disease. That was the case with Andy, even though plaque buildup blocked 90 percent of his blood vessel.
 
“Nothing hurt. It didn’t bother me,” he said. “But I had very weak blood flow down to my ankle.”

Angioplasty opens blocked arteries, restores blood flow

With renewed hope of healing, Andy agreed to a minimally invasive procedure called balloon angioplasty. A cardiovascular team led by Blair MacPhail, MD, Interventional Cardiologist at Goshen Heart & Vascular Center, inserted a small balloon filled with air to open the blood vessel.
 
The result – instant improvement.
 
“Right after they finished, I could see the difference in my leg on the ultrasound,” Andy said. “It sounded just like my left leg with the blood flowing again.”

Back on his feet, thanks to a team effort

Andy sees improvement in his sores nearly every day. Cheryl – his number one advocate – has become an expert at wound care. She takes pictures of Andy’s foot each time she dresses the wound so he can see the progress.
 
The hardest thing for Andy to do is stay off his feet, particularly as the weather warms up and the land calls him outside. But he knows the sores won’t heal right if he walks around too much.
 
Andy faithfully goes into the Wound Center for debridement to help the wound heal. He also keeps track of his appointments with Dr. MacPhail to check up on his cholesterol and blood pressure.
 
Even his diabetes is showing signs of improvement, now that he’s under the care of Tamara Kermani, DO, at Goshen Physicians Family Medicine Milford.
 
“I finally did what the doctors told me to do,” he said.
 
Looking back, Andy knows he should’ve taken better care of himself long ago.
 
“Don’t ignore the signs if something isn’t right,” he said. “Do the simple things to make it better.”

Is your health in good shape?

If you have diabetes, you are at greater risk of developing PAD and other cardiovascular diseases. Talk with your healthcare provider about steps you can take to control your condition and avoid health complications.
 
Specialists at Goshen Heart & Vascular Center and Goshen Wound & Hyperbaric Center work together to treat circulatory diseases like PAD and get you back on your feet again.



 
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