Clinical

Saving Limbs from Diabetes Drives Ben Taub Hospital Experts


By John F. Martinez | February 2, 2017

Oscar Betancourt has lived with diabetes for years. He knows letting it get out of control can affect all parts of his body, so when he noticed a sore not healing quickly on his foot he knew it was serious.

His doctors at Harris Health System’s Aldine Health Center felt the same way and referred him to a specialty service at the system’s Ben Taub Hospital for follow-up. They knew the sore, if infected and not responding to treatment could require an amputation.

At Ben Taub Hospital, Betancourt saw a team of experts led by Dr. Lee Poythress of the Osteomyelitis Wound Clinic, and T.J. Pelton, physical therapist and manager, Rehabilitation Services. The team specializes in saving diabetes-ravaged lower limbs (leg, feet and toes) and found a significant problem for Betancourt—the sore had gotten infected and spread to the bones in his foot.

“I put it in perspective, if I had to lose a toe to save my foot, that was OK,” Betancourt says. “Of course, keeping my toes and feet was the best thing for me.”

Unfortunately, saving a person’s limbs is not always possible. A person with diabetes has a 25 percent lifetime chance of developing a foot ulcer and 85 percent of all amputations are preceded by an ulcer. Once gangrene or dead tissue sets in, amputation is often the only option, says Poythress.

Based on 2010 data in the U.S., 73,000 lower limb amputations were performed on adults with diabetes, according to the American Diabetes Society. Amputations and associated care for diabetes cost $245 billion annually—$176 billion in direct medical costs and $69 billion in lost productivity.

“It’s about saving a patient’s quality of life and helping them continue to be productive members of society,” says Poythress, also an associate professor at Baylor College of Medicine. “We have an aggressive program to treat and heal foot wounds and infections. Amputation is our last option.”

Betancourt can’t praise the clinic and its staff enough. After 40 days of treatment, staff saved his right foot. Since his near-amputation scare, he checks, washes and dries his feet daily.

“Our physical therapists are certified in advanced wound care and use a hands-on approach to care for patients to promote an optimal wound healing environment,” Pelton says. “Our team educates patients in the care of the wound and how to implement lifestyle changes that will promote healing and prevent reoccurrence.”

The team uses multiple treatment methods to care for patients and has seen excellent results in wound healing and decreased amputation rates, Poythress says.

Since his recovery, Betancourt has made significant healthy lifestyle changes and is able to maintain a job that often keeps him on his feet.

“I eat well and exercise more,” he says. “I’ve always been one to exercise, but now I’ve joined a gym and make it a regular part of my life.”

Poythress warns that patients with diabetes who fail to control their sugar levels risk severe health issues, including death. Diabetes can contribute to kidney disease, blindness, heart attacks and stroke.

Symptoms of diabetic foot disease:
• Fungal infection
• Neuropathy—decreased feeling in toes, feet and legs
• Ulcers
• Dry skin and foot infections
• Developing of bunions, corns and calluses
• Ingrown toenails

For more information on diabetic foot disease, visit www.diabetes.org/living -with-diabetes/




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