In March 2022, Gloria Ohman and her husband moved into a senior living facility in Des Plaines, Illinois. Their new home had it all: a swimming pool, fitness classes, movie nights, clubs, choirs and excursions.
There was a problem, though. Gloria couldn’t enjoy any of it.
“I was in constant pain,” the 89-year-old remembered.
The cause of Gloria’s pain was a nickel-sized ulcer on the inside of both of her legs. Following her primary care doctor’s advice, she bandaged them with antibiotic ointment and changed her dressings regularly. However, months passed and her wounds never seemed to close or heal.
Gloria is very close to her daughter, Suzanne Grimesand live just ten minutes apart. During her frequent visits, Suzanne noticed her mother becoming more and more depressed as the pain kept her from walking and socializing.
Do you have a wound that’s taking longer than usual to heal? Find out if an Ascension Illinois wound care specialist can help.
Wound care doctor to the rescue
In June, Gloria’s doctor referred her to Poonam Joshi, MD, at Ascension Alexian Brothers - Wound Care. An infectious disease specialist by training, Dr. Joshi took a course in wound care by chance early in her career and has specialized in it ever since.
Wound care is a constantly evolving field of medicine, incorporating evidence-based treatments such as hyperbaric oxygen therapy, debridement, skin substitutes and a wide spectrum of topical dressings and medicines. What’s even more exciting for Dr. Joshi is the technical innovations impacting patients’ lives.
“We’ve learned that there is no one way to treat a wound,” said Dr. Joshi. “No two wounds are the same. Each wound needs its own care plan that considers the patient’s support network, lifestyle and pre-existing health issues.”
Today, Ascension Alexian Brothers - Wound Care treats more than 200 patients each week for wounds related to diabetes, cancer care, surgery, physical trauma and vascular issues.
“We’re seeing primary care doctors refer their patients to us in a more timely fashion,” claimed Dr. Joshi. “I think a lot of that has to do with a growing awareness that there are wound care doctors and centers close by that specialize in taking care of a variety of wounds.”
Venous and arterial insufficiency leads to leg ulcers
Before they could treat Gloria’s leg ulcers, Dr. Joshi and her wound care team had to determine what was causing them. A series of tests, including an angiogram and CT scan, pointed to two likely suspects: venous and arterial insufficiency.
“Venous insufficiency is when the blood vessels in your legs are not able to pump the blood back to your heart,” explained Dr. Joshi. “Instead, the blood pools in your legs, which causes the legs to swell like a balloon. Wounds can develop as a result.”
Arterial insufficiency also contributes to delayed wound healing.
“Wounds need oxygen to heal,” said Dr. Joshi. “Much of that oxygen is delivered by our blood flow. So no blood flow, no oxygen, no healing.”
Gloria visited Ascension Medical Group Illinois - Vein Care Elk Grove for three endovenous laser ablations. This procedure uses a catheter to carry a small laser fiber to the targeted vein. The heat from the laser then seals it off so that the blood has to find an alternate route through healthier veins. Ablation along with compression stockings took care of Gloria’s venous insufficiency.
Gloria’s artery in her right leg, however, was completely obstructed, so ablation would not be enough. Atif Baqai, MD, chief of vascular surgery at Ascension Illinois, restored blood flow through the affected artery via revascularization procedure to treat her arterial insufficiency.
“Many wounds tend to be a mix of arterial and venous, and it is important that both components are addressed,” said Dr. Baqai. “Restoring adequate blood flow is critical in wound healing as patients are at risk of losing a limb without intervention.”
Once blood flow is restored, Dr. Baqai believes that diligent wound care, including debridements with antibiotic therapy, helps give patients the best chance to heal.
"Gloria’s case clearly highlights the importance of having a multidisciplinary team to take care of these complex patients,” he added.
Healing the wound by hurting it
By November, the real healing could begin at last. Suzanne drove Gloria up to Ascension Alexian Brothers - Wound Care once a week for mechanical debridement. During debridement, an ointment is applied to the wound to loosen the dead and infected tissue on its surface. Then a medical device resembling a crochet hook is used to scrape it away. To minimize discomfort, patients often take painkillers beforehand; lidocaine is also applied to the wound.
“Your body gets used to being hurt, which is why chronic wounds don’t heal on their own,” explained Dr. Joshi. “Debridement turns the chronic wound into an acute wound. In other words, it makes the body think that the wound just happened. This kick-starts your natural healing process so that healthy cells grow.”
After debridement, a collagen-based graft known as a wound matrix was applied to Gloria’s leg ulcers along with fresh dressings. In between appointments, a home health aide visited Gloria once a week to change her dressings. Gloria helped herself heal with a protein-rich diet and a treatment of antibiotics.
Ringing the healing bell, twice
Gloria, Suzanne and Dr. Joshi got to know each other very well during these weekly visits.
“You see these people every week, they start to feel like your buddies,” Suzanne and Gloria said during a joint interview. “Dr. Joshi was always positive and upbeat. All the nurses were fantastic.”
As Gloria’s wounds shrank, the wound care center team could see her returning to her normal, bubbly self. Gloria also earned a reputation as the center’s best dressed patient.
“Gloria is very close to my heart,” Dr. Joshi said. “Not many women her age have the zest for life that she does. She has an amazing collection of clothes, scarves and jewelry, and always came to her appointments dressed to impress.”
On May 15, 2023, ten months after her wound care journey began, Gloria was finally considered fully healed. She got to ring the wound care center’s healing bell twice, once for each leg.
“When you ring it, everyone in the waiting room smiles,” said Gloria.
“There were a lot of factors working against Gloria,” noted Dr. Joshi. “Her age, the level of infection and vascular issues. The two months before she’d gotten tested and treated. So it took time, but eventually with all the puzzle pieces in place, Gloria did very nicely and healed very well.”
Back to being a high-spirited mother and friend
Gloria is happy being able to walk again. Every Saturday, she hops aboard the senior living facility’s bus and heads to nearby malls for a little shopping. She also looks forward to participating in more clubs and activities.
“I have no pain where the ulcers were,” reported Gloria, adding with a laugh, “They don’t look very pretty with the scars, but I’m no spring chicken anyway.”
Suzanne is also overjoyed to see mother come back to life.
“She’s back to herself because she’s getting bossy again,” she joked.
For Dr. Joshi, successes like Gloria’s are what keep her going. “As our understanding of wounds improves — especially their relationship to diabetes and other health conditions — we’re helping more and more people live happier lives. Not just wound care patients like Gloria, but people like Suzanne who’ve had to watch a loved one suffer for so long. It’s amazing to see how many lives we’ve changed,” she said.