The Limbstitute steps up operations this July

Save a limb. Save a life. It is a prescription written every day at the Limbstitute, the new specialized treatment center at 10435 S.E. 170th Place in Summerfield. And every day, for some lucky patient, miracle is the only description that seems worthy.

It starts out as something much less dramatic, perhaps a slight discoloration of the foot or leg. Maybe a little tingling or numbness occurs every now and again, even pain. Or, the symptom may be something much more insidious than any of those — nothing at all.

It is called critical limb ischemia — medical jargon for a severe obstruction of blood flow in one or more arteries in a limb. If left untreated, the lack of adequate blood flow can lead to amputation of the affected toe, foot, or leg. (Critical limb ischemia usually occurs first in a lower limb.) Examination by a trained cardiovascular specialist is the only way to detect the condition and reach a definitive diagnosis.

Until now, the diagnosis has been a grim one. Studies show that almost one of every 200 Americans has had an amputation — 97 percent of those in a lower limb. To pile tragedy on top of tragedy, many of those amputations could have been averted with adequate treatment.

Enter world-renowned cardiologist Dr. Asad Qamar and the Limbstitute.

In a perfect fit of expertise meeting critical need, Dr. Qamar, founder and visionary behind the area’s Institute of Cardiovascular Excellence, focused his energies on creating a solution to the growing epidemic of limb loss.

According to Dr. Qamar, he says, “There is almost always something that can be done before resorting to amputation.” He should know. His team at ICE has intervened in hundreds of cases, restoring circulation and averting disaster. “We are able to restore blood flow in almost all patients,” he adds.

Even patients with multiple arterial blockages — up to now prime candidates for amputation — have reason for hope. “We can restore vascular anatomy from the aorta down to the feet,” Dr. Qamar says. However, he quickly adds, “Not all blockages present with symptoms. Sometimes the ischemia is completely asymptomatic. And because prevention and early detection are key to the best outcomes, it’s important to see your family physician and podiatrist regularly.”

Dr. Qamar’s newest venture, the Limbstitute, gathers all of the specialized testing and treatment procedures for at-risk patients under one roof. It is a resource many doctors and their patients are glad to see come to the region.

Assessment is the first step at the Limbstitute, with a comprehensive medical history and non-invasive physical examination to determine the likelihood of the existence of a blockage.

There are many potential causes for an arterial blockage: heredity, injury, smoking, and diabetes. If a physical exam determines that a blocked artery is probable, the gold standard for ultimate diagnosis is angiography. Dye is injected into the femoral artery and a computer program follows the dye’s progress through the arterial map to pinpoint a location.

Once a diagnosis is confirmed, the next step is removal of the blockage. A catheter is inserted into the artery to deliver a stent, a balloon, or sometimes, both to the affected area. When the blockage is removed and blood flow is restored, the result is often immediate and dramatic.

Recovery is the most time-consuming part of the treatment. The procedure itself usually only takes minutes to perform, but recovery will require about two hours. After that, a home health nurse will be assigned to keep a close eye on a patient’s progress. Follow-up care is important to monitor healing and be sure clots don’t return to the injured area.

The entire process, from detection of a problem to its ultimate resolution, should serve as one, huge warning sign to the potential presence of something far more sinister than the loss of a limb. In the great majority of cases, the presence of occluded arteries in a lower limb is indicative of developing blockages in the arteries of the heart.

of all peripheral artery disease (PAD) cases involve the SFA and popliteal artery.

Loss of life through a heart attack or pulmonary embolism is often the first and only warning a person may get that his or her arteries were in trouble. At least some good can come from the early warning trouble in a foot or leg. What a person does next can be a life or death decision.

“Regular cardiovascular checkups should become a part of every patient’s life after resolving a critical limb ischemia,” Dr. Qamar says. “Even when the outcome is 100 percent successful.”

Outcomes, of course, are what the Limbstitute is all about. After investing a mere afternoon with the doctors and specialists there, a patient’s foot or leg could be saved and an entire lifetime of healthy, happy activity could be restored. That is quite a bargain.

Save a limb. Save a life. Some may go so far as to describe the process as miraculous. But then, to Dr. Qamar and the other medical professionals at the Limbstitute, miracles are all in a day’s work.

For more information about the Limbstitute, watch for the grand opening details in July’s issue of The Villages edition of Lake & Sumter Style.

MMyrlene’s inherited attitude

What matters most to me as a phlebology sonographer at ICE is that all my patients feel like VIPs. I know how many kids and grandchildren they have, and I connect with them during their visit. This is important because I want to do more than just perform a job; I want to make patients feel comfortable, valued, and understood and listening inevitably leads to learning. One patient, Steven Dandreano, taught me a valuable lesson about attitude. We talked at length about homelessness and his passion for providing people with clothing and medications. Meanwhile, I learned that he has been dealing with many personal health issues, but he never complains. His attitude is remarkable, and he is a role model in that way.

Amanda’s gift of demeanor

Clearly, many medical procedures are not fun. But I do my best to create a calm and relaxing atmosphere for my patients. While my job is to manage the often-hectic patient schedules for the radiofrequency ablations, I take the time, greet my patients when they come in. I can tell right away if they need some reassurance, so when I assist Myrlene with the procedures, I take on other roles. I am a hand-holder, a back-rubber, and will get a wet cloth if I see my patient are distressed — just as I would for my mother, father, or grandparents. Also, I am determined to stay upbeat and positive like my favorite patient Betty Jo Jacobs. No matter how hectic things get in the office, she is friendly and calm. Her demeanor rubs off on me!

— Amanda Gavin Patient Coordinator in the Vein Clinic

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