When a sore won’t heal: Multi-specialty approach at Beacon saved patient’s leg
Terry Wolfinger
It started with a small sore on Terry Wolfinger’s little toe — a small annoyance that refused to go away. “I didn’t think much of it at first,” Terry says. “But then it got worse.”
Pain in his foot put a cramp in Terry and his wife’s plans to enjoy their summer sanctuary. The couple enjoys RV camping at a permanent campsite during the warmer months.
Now in his 70s, Terry has managed diabetes since he was 30. People with diabetes are often at risk of other conditions — and in Terry’s case, he developed peripheral artery disease (PAD). PAD slows blood flow to the legs as plaque clogs the arteries. Without enough blood and oxygen, wounds struggle to heal, and that’s exactly what happened to Terry. Pair that with nerve damage, another diabetes sidekick, and even a minor sore can turn serious.
When the sore on his toe didn’t heal, Terry’s primary care doctor sent him to a podiatrist. Terry also checked in with his Beacon Medical Group cardiologist, Dr. M. Shakil Aslam, to get the bigger picture.
Dr. M. Shakil Aslam
The news wasn’t great: The sore was a red flag that Terry’s PAD had worsened. The tissue in his toe, starved of oxygen, was dying. Left unchecked, he risked losing not just a toe, but his foot or even his leg.
Dr. Aslam called in Dr. Michael Ginsburg, Beacon Medical Group vascular and interventional radiologist, to improve blood flow to Terry’s leg.
“For diabetic patients with PAD, the blockages are often more severe, hitting both big and small arteries,” Dr. Ginsburg explains. Terry’s condition—critical limb-threatening ischemia, or CLTI—is a severe form of PAD with a high risk of amputation. The team sprang into action.
Coordinated planning
Dr. Michael Ginsburg
Dr. Ginsburg walked Terry through everything—how PAD starts, what could happen if they didn’t act, and how they planned to save the leg. “It’s a team effort,” Dr. Ginsburg says. “Podiatry, wound care, vascular experts, and cardiologists all pitching in. When patients and families join the fight, we see better results.” Terry and his wife were all in.
The first step was endovascular revascularization—a fancy term for a minimally invasive fix. Dr. Ginsburg threaded a thin tube, called a catheter, through an artery in Terry’s groin to reach the clogged spots in his leg. “We aimed to create a clear path for blood from the groin to the foot,” says Dr. Ginsburg. “It’s like unclogging a pipe so oxygen can reach the wound.”
But Terry’s arteries were a challenge—calcified and blocked over long stretches, especially below his knee and ankle. In the first procedure, they used a tool to grind away plaque and tiny balloons to pry the arteries open. Still, the sore healed slowly, so they went back, targeting even smaller arteries near his foot to get oxygen right where it was needed.
At the same time, Terry’s podiatrist was treating his foot sores. One toe was already too far gone and had to be amputated. Dr. Ginsburg recommended Terry try hyperbaric oxygen therapy (HBOT) at Beacon’s wound center to prevent future limb loss, but Terry was hesitant. Lying in a pressurized chamber sounded daunting. But after losing a second toe, Terry reconsidered.
Advanced therapies
Hyperbaric oxygen therapy supercharges healing by delivering pure oxygen in a pressurized environment. When under pressure similar to scuba diving, the lungs gather 2 to 3 times more oxygen, which helps oxygen-deprived wounds heal.
Terry was nervous about getting inside the HBOT chamber at first. But the clear glass walls and the Beacon staff help to put him at ease. The wound care team also used negative pressure wound therapy, which removes fluid and bacteria with suction.
Terry now goes for HBOT treatments five days a week and has gotten to know the staff well. “I’m like one of the family there now,” Terry says. “I hear about their families, and they hear about mine.”
After three procedures with Dr. Ginsburg and steady wound care, the results are showing. His blood flow is better, the first sore has healed, and the others are catching up. “I get leg pain in new places, but it’s a sign that the blood flow is creating new arteries in those areas,” Terry says.
The improvement in his condition brings more than just physical relief. Each sign of healing carries the promise of returned freedom — of summer weekends at the campsite, enjoying his favorite activities.
Road to recovery
Terry feels the cardiovascular and wound teams work together well to make his care feel as seamless as possible. “They do a great job talking to each other so one knows what the other is doing,” he says. As Terry makes progress in the wound center, they update Dr. Ginsburg, who occasionally pops in to check on Terry during his wound treatments.
“Dr. Ginsburg truly cares about his patients,” Terry says. “He goes above and beyond.”
Terry and his wife continue to make frequent visits for treatment and are hopeful they’ll enjoy more camping this upcoming summer, enjoying every weekend they can at their campsite.
Learn more about Beacon’s personalized care
Vascular interventional radiologists diagnose and treat diseases by using a variety of nonsurgical treatments and tests and rely on image-guided tools. If necessary, your primary care provider will refer you to our team.
Beacon’s Vascular Interventional Radiology program offers streamlined access to innovative care personalized to patient’s needs. We deliver safe, effective and compassionate care through minimally invasive, targeted treatments using the latest imaging technology. Beacon providers are board certified, and fellowship trained, meaning you don’t have to leave town for excellent care.
