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Healing touch

Blood clot leads to painful, slow-healing wounds
Ray Kuntz is healing from slow-to-heal wounds thanks to innovative treatment at Medcenter One.
Ray Kuntz endured slow-to-heal wounds on his calf muscle. Healing the wounds was expedited using an innovative treatment available at Sanford Health.
  Ray Kuntz isn’t letting two surgeries, which probably saved his leg, and 42 treatments of radiation slow him down.

The 69-year-old Drake farmer has two hefty calf scars marking his battle with circulation problems and then serious post-surgical wounds, but is he back to full-time farming.

Kuntz’s story unfurled November 2009 when he was preparing for a biopsy to test for prostate cancer. He had been taken off Coumadin— a blood-thinning medication used to prevent heart attacks and blood clots—to prepare for the procedure when he began experiencing pain in his calf muscle.

“I just figured it was a cramp and ignored it,” Kuntz said. “But then it came back a few days later with a vengeance. It was so painful that I had to crawl to the house to get help.”

He was taken by ambulance to a local hospital where it was determined he may need surgery. He was then rushed to Sanford Health where doctors diagnosed a large blood clot that required immediate surgery. The clot was cutting off the circulation to his lower leg, causing extreme pain and putting the leg at risk for serious complications, including amputation.

The clot was successfully removed just in time to save his leg.

The doctors told me I was dangerously close to losing the leg,” Kuntz said. “I was very thankful for their help.”

Unfortunately, the day after surgery, Kuntz developed compartment syndrome, a serious condition that can lead to permanent muscle and nerve damage.

“Compartment syndrome, which is the compression of nerves and blood vessels can sometimes be the result of conditions like the one Ray had,” said Renee Small, a Sanford Health nurse practitioner.

The remedy for compartment syndrome is often surgery to release the compression. In Kuntz’s case, incisions were made on the inside and outside of his left calf. Kuntz also began radiation therapy at the Bismarck Cancer Center for what the biopsy confirmed—prostate cancer.

Special care for especially difficult wounds

As if radiation therapy was not enough after enduring two surgeries, Kuntz’s wounds were especially slow to heal and required specialized care. But he was in good hands. Kuntz received wound care for two months, mostly administered by Small, who specializes in caring for hard-to-heal wounds in Sanford Health’s wound care department.

Renee Small, NP

Because Kuntz’s wounds were large and causing a great deal of pain, Small used an innovative wound therapy available at Sanford Health called vacuum-assisted wound closure. The therapy uses negative pressure (a vacuum) at the wound site to help draw the edges of the wound into its center while simultaneously removing fluids that are potentially infectious.

A silicone dressing called Mepitel was placed between the foam and wound to ease the pain, especially for dressing changes, which occurred three times weekly via home health treatment.

Although Small downplays her involvement in this successful treatment, the patient applauds her efforts, especially in easing the pain.

“It was quite painful the first week,” he said. “After that, the pain slowly went away.”

The radiation treatments and wound care, which continued through mid-February, prevented more surgery, much to the delight of the Kuntz family. Testing in June confirmed there was no cancer in Kuntz’s prostate, and his wounds have completely healed, except for the scarring. What’s more, the lifelong farmer is back to work.

“I feel very good today. My legs get a little numb when I do a lot of walking or climbing in and around machinery,” he said. “Overall, though, I’m in a much better frame of mind and feel much healthier than I have in a long time.”

He doesn’t even mind the return trips to Bismarck for follow-up visits.

“I was so happy there, and I was just astounded with the care I received at the hospital and the cancer center and from the home health staff. They were all so caring.”

Click here for more information on Sanford Wound Care Center or call (701) 323-6035.


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