Published on August 23, 2019

Special Care at MidMichigan Health’s PAD Program Healed Her Legs

Photo of Virginia Hess, PAD patient with MidMichigan Health.

Thanks to specialized care at MidMichigan Health, Virginia Hess is able to walk normally again.

Virginia Hess of Midland had been having trouble walking for some time. For years she had attributed the pain and tired muscles to her advancing age.

Recently turned 80, Hess has been self-sufficient in retirement. She had long finished raising her son and daughter, and now has two granddaughters and seven great-grandchildren. Difficult mobility is something that she expected at this time in her life. “I had thought for a long time I’d had arthritis,” she said.

However, Hess first felt that something was not normal when she discovered a sore on the back of her leg. “I don’t know how it happened,” she said. A mysterious open wound was cause for concern. “I don’t mess around with sores like that,” she said.

The next morning, Hess scheduled an appointment with Family Medicine Physician Nicole Zimmer, M.D., at MidMichigan Health’s Family Practice Center in Midland. Dr. Zimmer agreed that the wound was indicative of a larger problem. After bandaging it up, Dr. Zimmer referred Hess to MidMichigan’s Wound Treatment Center.

At the Wound Treatment Center, Hess was cared for by Podiatrist Heidi Monaghan, D.P.M. Dr. Monaghan performed a thorough exam on Hess her first day in the Center. In one test, she placed blood pressure cuffs on Hess’s arms and legs to calculate her Ankle Bronchial Index (ABI). This ratio indicates the difference between blood pressure in the arms and legs, and a number close to one is ideal. Hess’s ABI was low, indicating that the blood pressure in her legs was lower than it should have been.

To identify the root of the problem, Hess was referred to MidMichigan’s Peripheral Artery Disease (PAD) Program.

There, Hess was fully examined by Cardiologist Andrzej Boguszewski, M.D. He performed an Arterial Doppler test on Hess’s legs to determine where the circulation problems were stemming from. This test measured the blood pressure in several different areas in her legs.

With the positions narrowed down, Dr. Boguszewski followed up with a peripheral angiogram to confirm. During this procedure, Hess was given a special dye that allowed her blood vessels to be visible by X-ray. Dr. Boguszewski located two blockages in Hess’s major arteries – one in each leg. These blockages were restricting blood flow and keeping her skin and muscles in her lower limbs from getting the oxygen and nutrients they needed to function well and heal themselves.

While she was undergoing diagnostic testing, Hess was simultaneously receiving care at the Wound Treatment Center. She went in every few days to have the bandage on her wound changed and the dead tissue cleaned off. Each time, Dr. Monaghan put a medicinal salve on the injured site. After about three weeks the wound had completely healed.

Shortly after she finished at the Wound Treatment Center, Hess was scheduled to have stents placed in her blocked arteries during her peripheral angiogram. “They told what to expect beforehand,” she said. “Everything was explained thoroughly in terms I could understand.”

During the procedure, Dr. Boguszewski placed a stent in each leg to open up the blockages and allow better circulation. Everything went very smoothly and Hess was well cared for. “I had a very good experience,” she said. “The doctors and nurses have all been great. I have nothing but good things to say about them.”

Afterward, Hess had next to no downtime before she was up and moving around again. “When I first got up to go to the bathroom there was almost no pain,” she said. “The incision sites were so small I didn’t even have to put a Band-Aid on them.” She stayed one night at MidMichigan Medical Center – Midland, only because her care team did not want her staying alone at home right afterward.

The next day, Hess went home without any complications. “When I walked down the hallway, I was almost ready to break down and cry,” she said. “It was such a relief.”

Since her procedure, Hess has been going to physical therapy to regain the strength in her legs and has also started Supervised Exercise Therapy (SET), offered through MidMichigan Health’s Cardiac Rehabilitation Program. The treatment involves supervised exercise that helps decrease symptoms, improve pain-free walking distance and improve overall quality of life. “I’m working my butt off but it’s so therapeutic. I feel so much better after I get done. It’s worth every minute!”

The most reassuring part of her entire treatment plan is that everything was set up for her through MidMichigan. From her initial primary care visit to the Wound Treatment Center, to the PAD Program and rehab – everything was coordinated in a seamless way that made it very easy for Hess to get all the care she needed.

Now, the pain in Hess’s legs is long gone and she can walk further than she has in years. “It was miraculous,” she said. “I could not believe the difference.”

Those who would more information about MidMichigan’s specialized PAD Program may visit www.midmichigan.org/PAD.