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Thursday, August 20, 2015

Audrey Berzow never imagined her foot pain was potentially limb- and life-threatening. A vascular surgeon at WMC told her otherwise

Posted By: Advancing Care

It was Thanksgiving of 2013. Audrey Berzow was celebrating the holiday with her family, including her husband, son and daughter, in her Croton-on-Hudson home. A retired school administrative assistant, Berzow had made all of her favorite traditional dishes, including her special sweet potato casserole. But something was bothering her—specifically, the big toe—referred to in medical parlance as the “great toe”—on her right foot. Severe discomfort had started prior to the holiday, but by the time the meal was over, “It was killing me,” she recalls, prompting a visit to a local urgent care facility that weekend.

Because she didn’t remember injuring her toe, Berzow thought perhaps she had an infected or in-grown toenail. But the urgent care staff, spotting a black wound on the toe, advised her to seek the attention of a vascular doctor or podiatrist as soon as possible. Her podiatrist—whose first diagnosis was tendonitis—referred her to an orthopedist who admitted her to a local hospital; there she underwent further testing and received antibiotics intravenously.

Testing revealed that Berzow had severe vascular disease. She was referred to vascular surgeon Igor Laskowski, MD, at Westchester Medical Center (WMC).  According to Dr. Laskowski, severe vascular disease is a blockage in the arteries that limits blood flow to an area. Berzow’s blockage in her leg limited the amount of blood reaching her foot and resulted in the beginning of tissue loss—gangrene had begun to set in. “If not treated promptly and appropriately,” he explains, “this could lead to an infection that could be limb- or even life-threatening. If patients develop this type of problem,” he adds, “it is of utmost importance to be evaluated promptly by a vascular surgeon.”

A diabetic for about 25 years, Berzow was never told to routinely check her feet and had never experienced a wound that wouldn’t heal. Such wounds, though, are not uncommon for diabetics and can be severe. “If treatment is successful and if the amount of damage is not significant into vital parts of the limb, salvage of the limb is possible,” says Dr. Laskowski. “But there will be no significant chance of healing without seeking prompt professional intervention.”

On Monday, December 9, Dr. Laskowski admitted Berzow to WMC, where, that Friday, he performed an angiogram, a diagnostic procedure in which dye is injected into an artery of the leg, and an angioplasty, where the artery is opened up and repaired. These were the first of several minimally invasive procedures over the next year and a half. Explains Berzow, “I was told that I had only one good artery out of three,” she added. Once the procedure was completed, she says, the blood started to flow and she was discharged with a special boot on her right foot. 

“If things had gone a different way, I could have lost my toe or leg. Dr. Laskowski saved my limb.” – Audrey Berzow.

Between December of 2013 and the summer of 2014, Berzow  had her wound checked regularly and the dead, damaged, and infected tissue was removed. During that time, Dr. Laskowski performed a number of different procedures to promote healing and save her leg, including a stenting, or inserting a tiny mesh, drug-eluting tube that slowly releases medication. Scar tissue developed around the stent, which Berzow explains “is not a good sign for blood flow; it happens to a small percentage of people.” She was admitted back to the hospital, and that September, she received the first of three TheraSkin procedures that use skin from a cadaver to help heal a wound.

Dr. Laskowski performed several more procedures on Berzow in 2015. The most recent, an angiogram and angioplasty on April 10, was positive: Blood was flowing well to her leg, and the original wound was healed, much to Dr. Laskowski’s pleasure. Today, Berzow goes for vascular testing every three months; if scar tissue hadn’t grown around her stent, she would be able to go for the testing less frequently. “They put cuffs around both my legs, and then pump something and it inflates. It registers on the computer, and you can tell how the blood flow is.”

Berzow will have to go for this type of testing the rest of her life, as she is prone to a reoccurring blockage, says Dr. Laskowski. Fortunately, tests can detect a silent reoccurrence or impending failure.

Audrey Berzow's severe vascular disease put her at risk of losing the ability to walk and drive.

Audrey Berzow’s severe vascular disease put her at risk of losing the ability to walk and drive.

“If things had gone a different way, I could have lost my toe or leg. Dr. Laskowski saved my limb,” says Berzow. She chalks it up to the care she received from him. “I’ve had a wonderful experience,” she says. “Dr. Laskowski is amazing—a brilliant doctor and excellent surgeon who is always so very caring, concerned and humble. I am so grateful I was referred to him.”

Berzow is similarly grateful for the excellent care she received at WMC. “Before my first procedure, when I was wheeled into holding room, the nurses were fantastic—so warm and friendly, they made me feel very comfortable.” Her second and all subsequent procedures were performed in WMC’s new high-tech state-of-the-art hybrid operating room,  specifically designed for catheter-based treatments and one of most advanced of its kind in the country. Before wheeling her in, the nurses told her what to expect in the new facility. “They didn’t want me to get scared because it looked different from where we were previously. I just remember admiring how up-to-date everything was,” she recalls. Through every procedure, the hospital staff, she adds, “was very attentive and the care excellent.”

Today Berzow enjoys walking around a mall and just doing everyday activities, like making holiday meals for her family. This Thanksgiving will mark two years from her first symptoms, and she and those around her holiday table will surely be giving thanks for the outstanding treatment she received from Dr. Laskowski and Westchester Medical Center.