April is Limb Loss Awareness Month. The Amputee Coalition of America estimates there are 185,000 new lower extremity amputations each year within the United States. That’s more than 500 amputations every day. It’s a procedure designed to solve certain issues, but can lead to death, disability, and emotional and psychological problems. The main causes of limb loss are diabetes and vascular disease. Nearly half of all patients with vascular disease will die within five years after amputation. This is higher than the five-year mortality rates for breast cancer, colon cancer and prostate cancer. Around 30 percent of amputees experience depression or anxiety. Amputees can have “phantom pain” in the missing limb that causes stabbing, burning or shooting sensations.
When a patient’s doctor suggests amputation, the lucky ones find a second opinion with Dr. Mehdi Shishehbor at University Hospitals. Mehdi Shishehbor, DO, MPH, PhD, President, UH Harrington Heart & Vascular Institute and Angela and James Hambrick Master Clinician in Innovation is an interventional cardiologist who leads UH’s Limb Salvage Program where specialists use minimally invasive approaches to restore blood flow and prevent amputation.
Linda McClain of Lancaster, Ohio enjoys going to the salon, grabbing lunch with her friends and line dancing. But in 2018, a diabetic ulcer appeared on her toe and wouldn’t go away. It caused pain and kept her from being active.
After several failed procedures at another hospital, circulation to her left foot couldn’t be restored.
“It was really hard when the toes started to turn black. There wasn’t any blood flow to my foot. It was cold all the time and I just had a lot of pain,” said Linda.
She was headed toward a below-the-knee amputation, which would sideline her from line dancing and other activities forever.
Instead, in April of 2020 she found Dr. Shishehbor. Linda was approved to participate in the LimFlow clinical trial and underwent the procedure in June. UH Cleveland Medical Center is the only site in Ohio offering this procedure through the clinical trial. LimFlow is a minimally invasive treatment which uses a unique device to disable valves in the vein, reversing flow in the vein so that blood can flow down to the foot. Dr. Shishehbor, the national principal investigator for the trial, successfully restored circulation. Her foot warmed and eventually healed. Her pain dissipated.
Unfortunately, Linda’s toes were too badly damaged and needed amputated. But with an orthotic she can now walk on her own with no pain. For Linda, the three-hour drive to Cleveland for appointments has been well worth it. She credits Dr. Shishehbor and the LimFlow procedure for saving her left foot and leg.
“I finally have hope. I’m going back to line dancing and going back to lunch with my friends. I get around the house better,” she said. “I’m so thankful to Dr. Shishehbor. My pain is greatly decreased and I have more independence. I would urge anyone to get a second opinion before amputation. I’m so glad I did.”