When Jim Leonard came to the Brattleboro Memorial Hospital Center for Wound Healing last summer, he was ready to try anything to treat the deep, open wound on his left foot. It had been about two years since he had an operation to remove an infection. His weekly follow-up appointments with his doctor consisted of little more than monitoring and re-dressing the wound and he became frustrated with the progress.
Jim had heard that BMH’s newly opened Center offered Hyperbaric Oxygen Therapy (HBOT) and decided to go there for a second opinion. Greg Gadowski, MD, the center’s Medical Director, said they could try 30 HBOT treatments along with a regimen of other techniques to close the wound, but there were no guarantees. “Dr. Gadowski told me I’ve got to make a commitment,” recalled Jim. “I told him I would.”
Having lived with Type 1 diabetes since the age of five, Jim was already accustomed to making commitments to his health. He admits he did not always pay close attention to the lifestyle do’s and don’ts of his chronic disease as a young man growing up in Stamford, Connecticut. These days, he is grateful for modern technologies like the pump that makes it easier to regulate his insulin. Still, over the course of more than 50 years, he has been afflicted by many of the health complications that result from diabetes, including heart disease, cataracts and Charcot foot syndrome.
The Charcot foot syndrome was directly responsible for Jim’s wound. The condition created deformities in his ankles, and one day while stacking 300 and 400 pound boards at his job with Cersosimo Lumber Company his left heel just blew out. The heel bone could not be re-attached and Jim was fitted with a brace to stabilize his leg. He went to work as a machine operator at VerMed, which prompted his move from Brattleboro to Bellows Falls. Over the years he had grown accustomed to checking his feet daily for wounds and one day he discovered a blister had formed at a pressure point underneath the brace.
“I don’t know if I could have caught the blister any sooner. I went to my doctor the next day and she had me in the operating room within an hour,” said Jim. “She said the infection had tunneled down to the bone, so she had to cut a whole big chunk of meat out of there.”
Jim had the little toe on his right foot amputated due to an ulceration a few years before, and he feared he would lose his whole left foot if this large wound couldn’t be closed. That fear is what gave him the determination to catch the 5:50am Connecticut River Transit bus to Brattleboro every weekday morning for 30 days. Then from there transfer to The Current’s blue line, which stops at BMH, to get treatment for his wound. It also enabled him to overcome the claustrophobic feelings he experienced when first entering the HBOT chamber. Jim is quick to gives a lion’s share of credit to the Center’s nurses and staff for making his whole experience more comfortable.
“Going down there every day on the bus, I’d get there a little after 7:00am. You don’t go into the HBOT chamber until about 8:00am,” said Jim. “The first couple of days I was sitting out in the hallway. One of the nurses, Tracy, came walking through and asked what I was doing sitting there. I told her I get here early so I wait. She said ‘I’m going to open early for you.’ Then she started coming in every day early. She’d make me a cup of coffee and sit and talk to me while doing her work.”
HBOT promotes healing by using pressurized oxygen to move blood into a wounded area. In addition to the two hours Jim spent in the HBOT chamber each day, his wound underwent regular debridement — a process of cutting the edges of a wound and roughing the center to facilitate healthy bleeding. He was also fitted with a total contact cast: a regular brown tubing sock underneath a mesh sock that is then wrapped in fiberglass. A special boot is then placed over the fiberglass and two braces connect to the heel so all the weight is off the wound.
There were no miracles after 30 treatments, but Jim did notice the wound had started to close in certain spots. Dr. Gadowski recommended another 30 treatments and Jim says that’s when he started seeing real progress. “Every week I started seeing it closing in and closing in and closing in,” said Jim. “When the second set of thirty treatments finished, the wound opening had shrunk to about the size of a pencil eraser. The insurance company approved another 10 treatments, and according to the chart they keep at the Center my wound is now 99.9 percent healed.”
Rather than dwell on what might have happened had he not gone to the Center for Wound Healing, Jim chooses to focus on the future. He’s been fitted for diabetic shoes to help his Charcot foot syndrome. His primary care provider, Andrea Galasso, DO of Brattleboro Internal Medicine, has helped him with his diet and he has lost 19 pounds thus far. He is currently investigating job re-training programs that can get him back into the workforce and he hopes to move back to Brattleboro. Most of all, he looks forward to walking over to the Connecticut River and continue the passion for fishing he developed while growing up on Stamford’s side of Long Island Sound. “I can go down there and catch nothing and have a great day. I like sitting by the water, nice and quiet,” said Jim. “I’ll take it easy but I am going to do what I like to do.”
Jim said he’s already written a thank you letter to Healogics, BMH’s partner in providing the Center for Wound Healing’s technology and training. “I can’t boast about those people enough: Jim, Jen, Lynne, the whole crew. They don’t just look at a wound. They knew how I was feeling inside about the whole thing when I first started going there and they didn’t let that just go off to the side. They tackled the whole problem all at once,” said Jim. “They keep saying to me, ‘don’t thank us, you’re the one who made the commitment.’”
For more information about the BMH Center for Wound Healing, visit www.bmhvt.org or call 802-275-3674.