The strange feeling in Abram*’s legs told him something wasn’t right. “After a couple months of progressive pain, I went to Emergency because I couldn’t take the burning sensation,” he says. “I didn’t get treatment that helped, and it was discouraging. I couldn’t walk, let alone play tennis or dance.”
After a year of living with intense discomfort and visits to various Emergency Departments without success, Abram was finally referred to Sunnybrook vascular surgeon, Dr. Giuseppe Papia and the Vascular Limb Preservation Program.
“We recognized Abram’s condition as a symptom of peripheral arterial disease, a narrowing of the arteries caused by plaque build-up,” says Dr. Papia. “Plaque can exist in multiple areas of the body, not just the heart. In Abram’s case it was in his legs, preventing oxygen from getting to his toes.”
The Vascular Limb Preservation Program (part of the Schulich Heart Program at Sunnybrook) is a novel paradigm for delivering care. It has been gaining increasing recognition for its innovative usage of image-guided angioplasties which enlarge a narrowed artery using a balloon, restoring blood flow. This approach is commonly used for heart patients, but Sunnybrook’s vascular surgeons are using it to save legs. Once blood flow is restored, patients go home the same day without ever having undergone general anesthesia.
“Our goal is to help as many patients as we can,” says Dr. Papia. “Patients that might be slipping through the cracks because doctors are not sure what’s going on. This is why we created a program model with a dedicated nurse practitioner who navigates patients’ needs quickly so they have the best chance of saving their legs.”
Currently, there are no other programs in Ontario like the Vascular Limb Preservation Program. With a nurse practitioner as first point of contact, referrals are followed-up within 24 hours.
“We’re offering coordinated care and we want to change the way the system is managing these patients by intervening early,” says Dr. Papia. “Often arterial disease manifests itself in unique ways, beyond foot ulcers or leg pain, so if family or emergency doctors have any question, they should contact us.”
12 months later, Abram is doing extremely well. He visits Dr. Papia every 3 months and can walk rather than rely on a wheelchair. He gets a Doppler ultrasound to test his blood flow, and has had hyperbaric oxygen chamber treatment to improve wound healing.
Now 76 years old, Abram is enjoying life, “I’m so thankful that my feet have improved so much. I am walking well, maybe a little wobbly, but hey I can even dance a bit again so I am happy.”
For more information about the Vascular Limb Preservation Program or to submit a referral, please visit sunnybrook.ca.
*Only the patient’s first name is being used to maintain patient confidentiality
