Diabetes patients find new hope through inventive partners
December 12, 2018
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Diabetic wounds are very dangerous and the most common complications of diabetes. The Legacy Emanuel Medical Center Hyperbaric Medicine and Chronic Wound Care Clinic offer a multidisciplinary approach to heal wounds to reduce the risk of amputation, particularly for those with diabetes.
Legacy Health recognized the opportunity to intervene in these patients’ lives and reduce amputations by giving the team the necessary tools to diagnose and treat these patients” says Dr. Enoch Huang, program medical director for Legacy Emanuel Medical Center’s Hyperbaric Medicine/Wound Healing department and one of Oregon’s two fellowship-trained, board-certified hyperbaric physicians on staff.
One of his adult patients, Robert Downey, was diagnosed with type 1 diabetes at age eight. Type 1 diabetes in children is an autoimmune disorder in which the body’s immune system damages the cells in the pancreas that make insulin. Insulin, a hormone, is needed to help sugar in the blood get into cells of the body to be used as fuel. Without insulin, sugar builds up in the blood which can lead to problems throughout the body.
“I was diagnosed way before a lot of the technology used to treat the disease today was invented,” says Downey. “You had to hand sharpen the needles.” For the most part, he managed his diabetes well, but it was often a challenge to keep his blood sugar at normal levels to prevent foot problems. He developed neuropathy in his feet.
Downey recently suffered a foot wound when he tripped and slid out of his shoe. “It wouldn’t heal, and my primary care physician recommended the Chronic Wound Care Clinic. Hyperbaric oxygen therapy was part of my treatment plan.”
Dr. Huang says diabetes is a complex disease to treat and manage. “One of the risks is a loss of sensation in the feet – called neuropathy – as well as poor circulation and a higher chance of infection. People with neuropathy can miss a small cut or blister or even have a tack or nail stuck in their feet and not know it. If treated too late, infection can set in the wound and reach the bone.”
About 60 percent of people with diabetes can develop neuropathy. Diabetes compromises the immune system and decreases the body’s ability to fight off bacteria and slow circulation hinders the supply of blood needed to support healthy tissue growth to heal wounds. Amputation was once the main option for seriously infected wounds that reached the bone and didn’t respond to antibiotics or other treatment.
Dr. Huang says the good news is that amputations are declining. “We have gotten better at managing patients with chronic wounds at our dedicated wound care clinics and using hyperbaric oxygen therapy to complement the treatment plan. The key is for our patients to not wait but to call us right away if they notice a problem. By going to a wound care clinic, amputation is no longer the first and only choice available to patients.”
Legacy Emanuel has a 12-person hyperbaric therapy chamber that administers oxygen to wounds caused by diabetic foot ulcers, bone and chronic bone infections. The hyperbaric chamber is pressurized to 2.4 atmospheres, or the equivalent of being 45 feet under the sea. “Oxygen under pressure acts like a drug when it dissolves into the blood,” explains Dr. Huang, “The hyperbaric chamber becomes the ‘pill’ or the ‘shot’ to get that medicine into your body.
“This helps speed cell repair and form new blood vessels, which in turn assists in the healing of wounds. Repeated exposure to pressurized oxygen gives a lifeline to ischemic tissue, boosts the effects of some antibiotics, activates white blood cells to fight certain infections, reduces tissue swelling, and promotes the healing process of specific chronic wounds.” Patients usually need a daily 90-minute hyperbaric therapy treatment for 20-30 days.
Downey says hyperbaric oxygen therapy helped his foot. “I have some vessel damage from years of diabetes in my legs and then I had this wound on my foot that wouldn’t heal,” says Downey. “The key is getting to the right doctor right away. The wound care clinic and hyperbaric oxygen therapy helped me, and I gradually saw an improvement of the wound to the point it healed.”
For more information about Legacy Health’s Wound Care Clinics and Hyperbaric Medicine, contact your primary care or internal medicine physician or call 503-413-3311.
For more information about the Chronic Wound Care Clinic and hyperbaric oxygen therapy at Legacy Health https://bit.ly/2EhR0lQ.
For media inquiries: Vicki Guinn, Legacy Emanuel Public Relations, vguinn@lhs.org, 503-413-2939.
Photo credit: Robert Downey
Photo credit: Enoch Huang, MD
