AboutLauri Ordway Expertise I can answer your questions related to peripheral vacular disorders. This includes all arteries and veins except those inside the head and inside the heart. IE: neck (carotid), arms (carotid subclavian bypases to Thoracic Outlet) belly (aortic aneurysm & occlusive disorders, renal artery stenosis), legs (iliac, femoral, popliteal, peroneal, dorasalis pedis, posterior and anterior tibial) arteries. Aneurysm & occlusive disease, atherosclerosis, leg pain, arterial wounds and gangrene, amputation prevention. Vein disorders: Blood Clots (DVT), post-phlebetic syndrome, varicose veins, venous stasis ulcers. I can help with vascular wound treatments. Also, Raynauds, Buerger`s disease, Thoracic Outlet and other miscellaneous vascular disorders.
I CANNOT answer questions about your heart disease, blood pressure, brain aneurysm, although I can help with questions about the arteries that go to and from those organs.
Experience I am a nurse, I have worked for 14 years with two terrific peripheral vascular surgeons, one of them is also the inventor of very innovative wound care products and surgical instruments to make vascular surgery procedures better and faster. I wrote and manage our clinic website and field questions from patients all over the world.
Expert: Lauri Ordway Date: 5/27/2008 Subject: leg amputation
Question QUESTION: Hi,my dad is 64 years old, he's been diabetic for 15 years now, however he never really dieted and unfortunately he loves his beer! and he drinks a few everyday inspite the constant warnings from me and mum! Anyway 4 years ago we took him to hospital and he was prescribed asperine, which he refused to take... Now things got out of hand and my worse nightmare seems to be coming true! Now he is terrified and is willing to do anything! I hope it is not too late! He had the following procedures done respectively on his left leg and we were told that leg amputation seems to be the only way now.. Is there something else that we can do? he did 1. Arterio Gram, 2.Fem Pop By-Pass,3.Heparinisation & warfarin,4.ultra sound Doppler,5.CT Angio, Chemical Sympathectomy... Now he developed Ischaemia... He takes Metformin tablets to control his diabetis.. From the CT Angio it seems that the 3 small arteries in the leg are all blocked! apparently 2 were already blocked prior to the Fem Pop By-Pass, but after this the last artery in the leg that was circulating blood got blocked too! We were told that the small arteries are extremly difficult to reach and nothing else can be done! I would like your opinion, whether something else can be done or not.
Thank you for your time, looking forward to your reply
Maruska Mallia
ANSWER: well, a 2nd opinion is first on your list, make sure that the doc is a peripheral vascular specialist (only does arteries and veins) there is a list by state or if you want to tell me where you are I can tell you if I know anyone in that area. I would need to know nearest large town or medical teaching university.
there are vascular surgeons who can bypass very small arteries. what matters is if there is an open area BEYOND the blockage, kinda like a pipe blecked in your house, if the pipe is blocked all the way to the end there is nowhere to bypass TO. the angiogram or CT Angio should reveal that.
is he still walking? does he smoke? how well controlled is his bblood sugar?lauri
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QUESTION: Thanks for your prmpt reply! Well the vascular surgeon told me that he shall try to by pass the small arteries, but after viewing the CT Angio he decided that there is no point in even trying! That is when he was given the injection in his spine (Chemical Sympathectomy)now we were told to simply wait a few days to see if it worked or not. I spoke to the family doctor as well who knows all my dad's history and he seems to think there is not much hope in avoiding the amputation. We are from Malta(Europe)and all the medical staff at our general hospital Mater Dei are very helpful and from the explanations we were given about the matter it seems that they are doing everything humanly possible!But I thought maybe there might be something new that we don't yet know about in Malta?!My dad's vascular surgeon is Denis Gatt...Yes he is still walking, he quit smoking about 10 years ago and his blood sugar is now controlled it varies between 6 - 7.5
ANSWER: it sounds like you are in good hands, I am sorry that I do not have better news for you. I have seen many people face amputation with great trepidation and then. once it is over, wonder why they did not do it sooner as the pain relief is so great. Lauri
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QUESTION: i am trying to figure out how this happened! dad is convinced that the blockage in the small arteries was caused by the fem pop by-pass! can this be true? and would he have been better of if he did not do it? there is not much point in analysing now, but i'm terrified that the same thing will happen on his other leg, infact the vascular surgeon told us that an angiogram is needed on his right leg after viewing the ct angio result, but what if another blockage takes place and he ends up loosing both legs?? thank you so much for your time. Regards Maruska
Answer unfortunately diabetes reeks havoc on the small arteries in the lower legs, ankles, feet, calves.
highly unlikely that a bypass caused any blockage- more likely age, diabetes, especially if he smoked.
if the doc thinks that he needs a bypass in that leg, he probably does. best of luck, it sounds like you are in the middle of a tough problem. lauri
