CentraState - Healthy Directions

Healthy artery Artery with arterial disease 9 UNEXPECTED DISCOVERIES Cecilia was referred to Aaron VanHise, DO, board-certified interventional cardiologist and vascular medicine specialist with Garden State Heart Care and on staff at CentraState, for further treatment. In assessing Cecilia's readiness for an angiogram, a minimally invasive procedure to relieve the poor circulation and the resulting pain in her leg, Dr. VanHise uncovered a few surprises. Cecilia had both an extremely low blood count and a leaky heart valve, meaning that the pumping action was not as efficient as it should be. Although the leaky heart valve could be addressed later, the low blood count could not. "Cecilia was severely anemic, and the low blood count was actually decreasing the blood flow to the leg," Dr. VanHise explains. So, what started as a toe injury that resisted healing was, in actuality, a symptom of much larger underlying health concerns. Cecilia was admitted to CentraState Medical Center in March 2014. Cecilia's primary care physician, Leonard Schindel, MD, board-certified in internal medicine and on staff at CentraState, conferred with a hematologist and a gastroenterologist on staff to get to the root of Cecilia's low blood count. After tests eliminated the possibility of internal bleeding, Dr. Schindel treated her iron-deficient anemia with medication and, in time, her blood count returned to normal. Meanwhile, in CentraState's Cardiac Catheterization Lab, Dr. VanHise performed an angioplasty, a minimally invasive procedure to reopen the blocked artery in Cecilia's upper right leg, allowing a return of blood flow to her foot. He placed two stents in the artery to keep it open. According to Cecilia, the procedure made a big difference. "I went home the next day, and haven't had a day of pain since then," Cecilia says. To ensure that Cecilia had no additional heart disease beyond what the original tests showed, Jatinchandra Patel, DO, board-certified interventional cardiologist with Garden State Heart Care and director of the Cardiac Catheterization Lab at CentraState, performed a heart catheterization to better view Cecilia's heart arteries, threading the catheter through her wrist rather than the groin. According to Dr. Patel, the radial approach through the wrist increases patient comfort and lessens the time until discharge. The procedure confirmed the severity of Cecilia's valve problem but, fortunately, didn't find any blockages in her arteries. Once Cecilia's other health issues stabilized, the leaky valve would have to be addressed. In a follow-up visit to Dr. Brandeisky in August, it was discovered that Cecilia's John Brandeisky, DPM, FACFAS, board-certified surgeon foot was becoming gangrenous, an indication that the blood flow to her foot was still insufficient. Dr. VanHise immediately hospitalized Cecilia to open further blockages in her lower leg through catheterization. The procedure was a success. "Her gangrene is completely gone now," Dr. VanHise reports. "By coordinating the care of six doctors at CentraState, we were able to avoid surgery, save her leg, and get the wound healed. Within nine months, using both inpatient and outpatient settings, she was able to fully recover." A BRIGHT OUTLOOK Cecilia is now a former smoker, who credits Dr. Brandeisky with helping her decide to quit. He told her that with peripheral arterial disease, one cigarette is too many. As a result, she walks farther now than she has in years. Cecilia also refers to the day she first met Dr. VanHise as "the best day of my life. I have never felt so comfortable with a doctor and his staff." Although Cecilia claims to be Dr. VanHise's biggest fan, she credits everyone at CentraState with her return to health. "I appreciate that they haven't had to cut me open," remarks Cecilia. "This is the new wave of medicine; you're not afraid to go when something is wrong." Cecilia is now in optimal condition to face her next hurdle: open-heart surgery to repair the leaky heart valve. Dr. Patel relates that "if we had not intervened on that leg properly during that time, Cecilia may have had an amputation. We have given her a chance to live again, to tackle the next battle." To learn more about CentraState's cardiology and endovascular services, visit www.centrastate.com or call 866-CENTRA7 (866-236-8727). CentraState is hosting a PAD screening on February 24. For more information and to register, visit www.centrastate.com/events or call 732-308-0570. HD PAD Symptoms • Peripheral vascular/arterial disease is caused by the buildup of fatty deposits in the arteries, restricting blood flow to the kidneys, stomach, arms, legs and feet. Symptoms: • Cramping, fatigue, heaviness, pain or discomfort in the hip, thigh or calf muscles during activity • Numbness in feet or legs when at rest • Sores on toes, feet or legs that won't heal • Change in color of legs, leg skin that shines • Coldness in lower leg or foot • Impotence Aaron VanHise, DO, board-certified interventional cardiologist Jatinchandra Patel, DO board-certified interventional cardiologist www.centrastate.com Winter 2015

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