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Perseverance by Patient and Providers Has a Happy Ending

February 20, 2024

It was during the COVID pandemic that Claire and Ed Peckham started walking. The Uncasville couple would drive down to Harkness Memorial State Park in Waterford and do a two-mile loop, taking a break on a bench overlooking Long Island Sound. They thought of that bench as “theirs.”

Ed had been living with neuropathy in his feet for a while, and had asbestosis and COPD from his days working construction. Now 79, he otherwise felt pretty good, and he and Claire enjoyed the time outdoors during the lockdown. They continued the habit after life went back to normal.

But in January 2023, Ed’s left leg and foot began to swell and hurt, and he developed painful calluses from what he thought was the miles he was putting in. One day the foot was so swollen and painful that Claire took him to the Backus Hospital emergency room. The doctor there immediately called Elizabeth Aitcheson, MD, a vascular surgeon, for a consult. This was Feb. 14, 2023.

“Can you be at Hartford Hospital tomorrow?” Dr. Aitcheson asked Ed.

“He had critical limb ischemia,” Dr. Aitcheson explains. CLI is a severe blockage in the arteries of the lower extremities, which can drastically reduce blood flow. “He had no pulse in his left foot.”

At Hartford Hospital, Dr. Aitcheson put a stent in Ed’s left leg and performed balloon angioplasty to open the narrowed/blocked arteries in his calf. She also cleared plaque from his groin artery.

“His flow now looks good,” she says. But two toes on the foot – the big toe and the pinky toe – were in bad shape. She referred him to Backus Hospital’s Limb Preservation Program, where he met podiatrist Darren Courtright, DPM.

Dr. Courtright found severe eschar on the toes and foot, and dry gangrene. Ed would come to the office once a week to have the eschar debrided – meaning it was scraped off layer by layer in an effort to reach viable, living tissue.

After a month, it was decided to utilize the hyperbaric chamber at Backus Hospital to try and save the toes. For the next 40 weeks, Monday through Friday, Ed and Claire would drive to Norwich and Ed would spend two hours in the chamber.

Dr. Courtright explains that the chamber engulfs the person in 100% pure oxygen, at an atmospheric pressure of 1.5. It’s like being 45 feet underwater. The goal was to “hyper-oxygenate the tissue,” he says. “And the blood flow to his foot was improved, but the vessels were so small that we couldn’t seem to improve the flow to those two toes.”

Finally, the big toe fully healed, but the fifth toe remained problematic. Both doctor and patient didn’t want to give up, although there were times Ed felt like saying enough was enough.

“Dr. Courtright said he was there to save limbs, not take them,” Ed says. “There were times I couldn’t take the pain anymore, but they kept me going. I don’t know what I would’ve done without Dr. Aitcheson or him. They were amazing.”

Dr. Courtright performed surgery on the little toe.

“I felt we should try this,” he says. “We had a good chance of healing it.”

He did a procedure similar to what he does for a hammer toe diagnosis, removing the ulcerated area and using a bovine-based skin substitute to close the wound. This was reapplied weekly.

“It worked,” Dr. Courtright says. “It healed. He kept all his toes and he’s back in regular shoes.”

These days Claire and Ed are back to their routine at Harkness, walking the two-mile loop, resting on “their” bench, greeting the dog walkers and bird watchers.

“Everyone we worked with was so positive and so encouraging,” Claire says. “That’s how they got him through this. They made us believe.”

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