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Vascular Surgery/after artery bypass surgeries problems with toes

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Question
My mother has had problems with the circulation in her left leg. She had a bypass surgery about 10 years ago. The replacement "vein" closed and they had to re-enter and do the surgery again. 10 years later on her same leg they had to go back in and do another surgery. They used the material made for this operation, they could not use any of her veins or arteries. it has been 5 months and her leg is still very swollen and stays red. it is hot to touch and just found out today that anytime anything touches the toe nails on the "bad" leg, the nails crumble like old concrete. I researched online for possible answers and everything I have found says toe fungus, however, all the web pages only talk about one toe not all of them. She doesn't have feeling in her toes so she does not know if they are hurting. She is 71 years old, weighs about 150#. she has high blood pressure and has been smoking all her life. her vascular doctor told her before this last surgery that if she would not have went to see him when she did, they would have had to take her leg. with the pain in her leg, she is not active in any way. she may be up out of her bed for a total of 4 hours throughout the day. I'm very concerned with this and do not know if I need to take her to her family doctor for a referral or if I need to make her an appointment for her vascular surgeon. He is only in his office once a week because of being at the hospital the rest of the time. also he stays booked for months in advanced. any help in this matter would be greatly appreciated! Thank you!

Answer
hi, so sorry for this scary situation yo guys are in, i am amazed frankly that the vascular surgeons is willing to re-bypass with the gortex or any vessel when she is still smoking, you are lucky to have him, most vascular surgeons i know would not do another bypass if she continues to smoke as it WILL fail and she will face amputation. i do think your best bet is to see the vasc doc again to see if there is any chance to help heal her toe / toenails, if there is not enough bloodflow to the foot, it will be a real challenge to heal them and with a bad bypass, there will not be enough bloodflow to  the foot, you guys are in a trsl jam. i think tho, to see the vasc doc is your first, best bet. best of luck lauri

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Lauri Ordway

Expertise

I can answer your questions related to your circulation, your peripheral vascular system. This includes all arteries and veins except those inside the head and inside the heart. For example, neck (carotid), arms (carotid subclavian bypasses 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. Arterial Bypass, Reynaud’s, Buerger's disease (thromboangiitis obliterans), Thoracic Outlet and other circulation disorders. Vein disorders: Blood Clots (DVT), post-phlebetic syndrome, varicose veins, venous stasis ulcers. I can help with vascular wounds from diagnosis to treatments. I have worked extensively with VNUS Closure and EVLT (Laser) for varicose veins and can describe pre and post procedure expectations and describe the procedures themselves. I can't help with spider veins or cosmetic vein treatment, we don't do it. I have 15 years of wound care experience, arterial, venous, trauma and diabetic wounds for example. **I CANNOT answer questions about STENTS or STENTING, 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 worked for 15 years with two terrific peripheral vascular surgeons, and 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 the clinic website and field questions from patients all over the world. I am now working with another vascular surgeon and wound care expert, which has given me an opportunity to widen my horizons as I learn another excellent physician's preferences and benefit from his experiences in this amazing specialty.

Education/Credentials
I am an LPN, licensed in Minnesota

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