9/30/16

Reality check pushes patient to make major changes

conrad ruppert and his wife near hyperbaric chamberConrad Ruppert and his wife, JoAnn, were ready to hop in the car and drive to South Carolina for vacation.

Sure, a quick visit to Carle was going to have to happen first, but that wasn’t going to delay their plans; then came a diagnosis from Allan File, MD, in Wound Healing.

“The idea was that we would get right back in the car, which was all packed, and leave,” Conrad said. “That’s when we found out the wound was infected, and Dr. File explained that the healing they had hoped to see to that point wasn’t occurring.”

Conrad had a diabetic ulcer that turned into a bone infection. The pain didn’t affect his life too much, up until that point. And Dr. File—as well as podiatrists Philip Logsdon, DPM, and Sean Grambart, DPM—hoped the treatment would be minimal.

When things turned, though, Conrad considered it a blessing that the physicians didn’t sugarcoat it.

“They told me, bottom line, if the infection goes untreated and doesn’t heal, then I could lose my foot,” he said. “Well, if you put it that way, then I’m motivated.”

Motivation can make a difference, but Conrad also needed a treatment plan. Following Dr. Grambart's minor surgery to clean up the wound, he went back to Wound Healing.

Dr. File then turned to a process he became amazed by in 2004, and has since used since 2005—Hyperbaric Oxygen (HBO) therapy. This treatment places patients in a pressurized chamber to breathe pure oxygen. 

The extra oxygen enters the plasma of the blood, increasing 10 to 15 times the amount of oxygen available to the compromised tissue. This oxygen helps new blood vessels form, which can save the wounded area. 

“The way we treat people with HBO often leaves them wondering, ‘How does this work so quickly?’ Dr. File said. “It can be confusing, but it comes down to this on and off switch that we know provides a boost to the blood flow and produces a lot more blood vessels.

“Then it’s just about the body producing this remarkable response.”

Dr. File recalled that Conrad went through 45 treatments to improve his particular wound.

That meant the patient visited Wound Healing every day, Monday through Friday, for two-hour sessions over the course of nine weeks. Each session lasted about 90 minutes.

“It’s like being in a submarine that’s pressurized, and the chamber can actually go much further than what we use it for,” Dr. File said. “All that we ask is that the patients be reasonably healthy when they come for a session.”

Conrad said the treatment was not physically demanding or at all painful.

Rather, the toughest part was the mental hurdle he had to clear by dedicating himself to this treatment. His life changed. Not only did he have to set aside the time to come in, he also complied with doctors’ orders.

That meant keeping weight off his foot, keeping his blood sugar under control, eating a diet high in protein and remaining diligent with cleaning and bandaging the wound.

The patient credited staff members like LaToria Jake and Kandice Bemount with always being a positive influence.

Just as important as the staff, the doctors and the technology, though, was his wife, JoAnn—who he called his “lead nurse.”

“Conrad and his wife did everything we asked of him. And guess what? That made a huge difference,” Dr. File said. “I could tell his wife was with him every step of the way, and she played a huge role in his improvement.

“In this instance—and so many similar ones—it’s the patient who does the work. We can lead a horse to water, but … .”

During the healing process, Conrad was able to maintain a high quality of life. A scooter helped him get out of the house, and even over to the University of Illinois where he teaches a course on railroad engineering.

And his excitement about the healing process grew as he saw consistent improvement.

“Once I started on HBO, every time I came in I was pretty amazed,” Conrad said. “Dr. File would look at it, and I could tell immediately each time that it was getting better. His measurements confirmed those thoughts.

“It was like, ‘Wow, this is progress. Whatever we’re doing, let’s just keep doing it.’”

And they did, to the point Conrad came in for one more appointment in September. Dr. File doesn’t expect to see him anymore.

The long road marks a successful conclusion.

“Sometimes patients think the HBO or Wound Healing staff saved their foot, but the biggest contributing factor is the patient’s compliance,” said Dr. File. “Outcomes like Conrad’s are gratifying for me, and I’m happy he’s back to feeling well and resuming his normal activities.

"People like Conrad are a major part of why I love this work.”

And for Conrad the happy ending began when the fall semester started a few weeks ago. Nearly healed, he still uses his scooter to zip around campus, but increasingly he walks on his own two feet.

Through all the changes and improvement, Conrad doesn’t anticipate becoming lackadaisical now.

“The treatment worked, and I’m healed, but I don’t want to go through that again,” he said. “Working with the doctors and the nursing staff at Carle was certainly a positive experience. But the first thing this tells me is that I need to alter my lifestyle. I don’t want to have this problem again.”