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When Wounds Won’t Heal

Sue and Emilia
With her leg wound finally healed, Sue Albrecht has regained her zest for life, including spending time with granddaughter Emilia.
Sue Albrecht took on the world of competitive diving when she was a lively eight-year-old. She fell in love with the sport and enjoyed six great years of competition until, at age 14, she suffered a diving board accident that crushed both her knees. Her teen years suddenly went from exciting to excruciating.

All told, she underwent six surgeries, but none of them brought the complete healing Sue and her doctors hoped for. Instead, Sue spent the next year getting around with a wheelchair and crutches, waiting for her knees to regain their strength. She was eventually able to walk again and even resume diving, but not at the level she once enjoyed. She entered her adult years with feeble knees and the realization that knee replacement surgery was in her future.

Forty years after her childhood accident, Sue decided it was time. Her ability to walk with confidence was quickly fading, and she was unable to enjoy simple pleasures like gardening and walking her dog. In January 2010, Sue underwent knee replacement surgery for her right knee and sailed through recovery.

But things took a different turn after she had her left knee replaced in September 2010. Though the knee replacement was successful, the incision would not heal. Shortly after her surgeon removed the surgical staples from her wound, he sent her to a plastic surgeon. The plastic surgeon performed a muscle flap – a procedure where part of the calf muscle is transplanted across the knee in an effort to increase blood flow to the damaged area.

The procedure didn’t bring the healing expected. Sue was told her only option was to change the wound’s dressing frequently with assistance from an in-home healthcare service.

But despite the weekly care, Sue’s wound grew worse. Soon weeks turned into months, and Sue felt hopeless, depressed and eventually very scared. “More than anything, I was afraid I was going to lose my leg,” she says.

Hyperbaric Oxygen Therapy:  A Different Kind of “Dive”

Finally, Sue received the lifeline she so desperately needed when a visiting nurse suggested she consult with a wound care physician. Sue had never even heard of such a doctor but followed the nurse’s advice.

Sue and her husband Dan met with Namchi Le, MD, medical director of the Hyperbaric Oxygen Therapy Center at Miami Valley Hospital South. [The center opened in July 2010.] Dr. Le did a complete evaluation and determined that Sue was a perfect candidate for hyperbaric oxygen therapy.

In hyperbaric oxygen therapy, patients are safely enclosed and monitored in a pressurized chamber where they breathe 100 percent oxygen under increased atmospheric pressure. The treatment increases the amount of oxygen the blood delivers to the body’s tissues, thereby fighting infection and supporting tissue growth and healing.

Patients who benefit from the therapy are those like Sue, who have wounds that do not heal over time. Patients undergo the therapy in daily two-hour sessions that take place five days a week for six weeks. While the therapy is time-intensive, it delivers powerful results. On average, patients begin to see visible improvement by their 12th session.

The therapy is often likened to deep-sea diving because, within 15 minutes, patients are surrounded by the same amount of pressure as if they were 45 feet below sea level. Despite that change, patients feel little difference while inside the chamber, aside from some pressure inside their ears. An hour into therapy, patients are required to put on a mask for a couple of minutes to breathe in a normal level of oxygen.

Le HS
Namchi Le, MD
Sue was hesitant at first but soon became confident once she entered the clear chamber. Patients are able to watch a television located just outside the chamber, but in many cases, they find the therapy so peaceful they settle into a nice nap.

Hyperbaric oxygen therapy is just one aspect of the complete wound care given at the center. Complementary treatment is often used. In Sue’s case, a product called Prisma was placed into her wound to provide a grid-like structure on which new healthy skin cells could grow.

“By my seventh session, I was more confident, and my pain sensitivity started to fade,” Sue says. “By my 15th session, I was able to undo my own bandage and get up on the table myself.”

By the last session, Sue was able to drive herself to the hospital – a sure sign of her growing self-reliance.

A Proven Method Gains Acceptance

Sue’s amazing results are not isolated. Nearly all patients who undergo hyperbaric oxygen therapy experience life-altering changes. Unfortunately, the therapy hasn’t always been widely recognized by physicians despite its demonstrable results, but Dr. Le believes that is changing.

“There is a lack of awareness as to what conditions can and cannot be treated with this therapy,” Dr. Le says. “In the past, it was a nebulous type of practice, but now it has been well studied, and we have seen clear indications that it works. It is, therefore, vital that patients with slow-healing wounds, regardless of origin, come to our center for a thorough evaluation.”

HOT
Dr. Namchi Le (left) is an enthusiastic advocate of hyperbaric oxygen therapy for patients who have wounds that will not heal. Brenda Blair, LPN, encourages John Johnson to relax as he enters the pressurized chamber.
Wound therapy has been around since the beginning of medicine while hyperbaric oxygen therapy has been practiced since the 1940s. In the 1980s, wound and hyperbaric oxygen therapy became a dedicated specialty and is now a subspecialty of emergency medicine.

Dr. Le was exposed to wound therapy while in residency and became interested in the specialty. In August 2010, Dr. Le joined the inaugural team of physicians and nurses that would make up MVHS’s new wound center.

The high-tech center became one of only a few in the greater Dayton area. It was initially staffed with two physicians and one full-time nurse. But need for the services grew so rapidly the center soon expanded its operating hours and added another full-time nurse to handle the demand.

A Team Approach

The physicians and nurses at the center work together to develop individualized treatment plans for their patients. At biweekly meetings, they discuss the patients being seen in the wound center, including whether they are candidates for hyperbaric oxygen therapy. The meetings also focus on ways to reach new patients in the community who might be in urgent need of the therapy, but are unaware that it exists.

Heather Brown, MSN, RN, and nursing clinical educator at the center, is responsible for educating the medical community on the benefits of wound and hyperbaric oxygen therapy. Her most powerful tool isn’t stats or studies, but rather before-and-after-photographs of a man who was treated with hyperbaric oxygen therapy. The first photo shows a black foot, devoid of circulation, but the second shows a healthy foot complete with new toenails.

“There may be a lot of skepticism out there,” says Mindy Bowen, RN. “I just wish they [the skeptics] could see the great results our patients have achieved.”  Still, the center’s best form of advertising remains its former patients.

Taking the Plunge Again

Now that her wound has completely healed, Sue can focus on the things in her life she was forced to put on hold.

She is no longer afraid to walk her dog alone and has returned to gardening. A small pink scar is the only trace left of the gaping wound that forced her to cut back on the time she spent at the tool-and-die company she co-owns. And she has more energy for her rapidly growing 21-month-old granddaughter Emilia.

Best of all, Sue can fully enjoy her weekends on the boat she and her husband keep at Lake Cumberland in Kentucky. Recently, she got up on the back of the boat and taught her new knees how to dive.

For more information, visit us online or call the Hyperbaric Oxygen Therapy Center at (937) 438-4977.