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Article Category: Highlights

Preventing & Curing Diabetic Ulcers with Wellstar Wound Care

Published on December 01, 2021

Last updated 02:24 PM December 01, 2021

Illustration of diabetic foot ulcer.

When someone is diabetic, a small wound can escalate into a major health issue and, in many cases, lead to an amputation. However, with proper wound care and accelerated healing with hyperbaric medicine, Wellstar patients are partnering with providers to treat wounds like diabetic foot ulcers.

Diabetic foot ulcers can develop if diabetes is not well-managed, and some causes of ulcers include poor circulation and high blood sugar. Ulcers may go unnoticed at first because many people with diabetes are also affected by neuropathy and do not have feeling in their feet, said Dr. Ricardo Duran, Medical Director of the Wound Care and Hyperbaric Medicine Department at Wellstar North Fulton Hospital.

Also, if a diabetic person gets a wound, it may not heal as quickly, as people with diabetes are more likely to also experience poor circulation, immune system deficiencies and elevated blood sugar levels.

“When you combine the lack of sensation in the foot with the lack of healing, that leads to even more damage,” Dr. Duran said.

Foot ulcers should be taken seriously — when a diabetic person has an open wound, their five-year mortality rate increases by about 32%, according to Dr. Duran.


Hyperbaric therapy aids healing

When Venson Rolle developed a foot ulcer, he knew he needed to seek care. In Dr. Duran, he found a healthcare partner dedicated to preventing amputation and keeping him healthy. “Dr. Duran was very patient, and he was ready and willing to do anything possible for me to get the correct treatment to heal all the way,” Venson said.

Dr. Duran helped Venson’s ulcer heal by off-loading the foot with orthotics to prevent further injury, treating him with antibiotics and using hyperbaric oxygen therapy.

A hyperbaric oxygen chamber allows the lungs to get more oxygen. That oxygen then flows through the body, promoting wound healing. It helps repair tissues and treat infections.

“It provides oxygen at high pressure and keeps the tissues alive while the antibiotics work to guarantee that we have a better outcome,” Dr. Duran said about the procedure.

Venson, whose ulcer has healed, said he is grateful that the treatment has improved his quality of life.

“I can’t thank him enough,” Venson said about Dr. Duran.


Preventing diabetic ulcers

Dr. Duran recommends that people with diabetes work with their primary care provider to manage diabetes and monitor their A1C.

People with diabetes should also check their feet every day, looking on the bottoms of the feet and in between the toes for any signs of wounds or ulcers, Dr. Duran said.

“They should not rely on how it feels, because the sensation is abnormal and they might not feel an ulcer,” Dr. Duran said.

Dr. Duran said people with diabetes should also avoid smoking and eat a diet low in carbohydrates and high in protein to help prevent ulcers.

The Wound Care & Hyperbaric Center at Wellstar North Fulton Hospital doesn’t just treat diabetic ulcers — patients can also find treatment for traumatic injuries, burns, pressure ulcers and other wounds. To make an appointment, call (770) 751-2830.

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Ricardo Mauricio Duran North Fulton Hospital Primary Care
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Exterior photo of Wellstar North Fulton Medical Center. Wellstar and Joint Commission logos.

Newsroom

Wellstar North Fulton Medical Center Receives Comprehensive Stroke Center Certification

Wellstar Health System announced today that The Joint Commission recognized Wellstar North Fulton Medical Center as a Comprehensive Stroke Center, the most demanding stroke certification recognizing hospitals that have specific abilities to receive and treat the most complex stroke cases. With two of the eight Comprehensive Stroke Centers in Georgia, Wellstar Health System now offers stroke patients greater access to the highest level of stroke and aneurysm care. Wellstar Kennestone Regional Medical Center is also Joint Commission certified as a Comprehensive Stroke Center.

“For years, we have provided world-class stroke care for each and every patient when they need it most. This designation represents how hard we have worked to provide the very best quality care for patients in North Fulton County and across Georgia. We’re proud that our work and subsequent positive patient outcomes are being recognized,” said Dr. Michael Mendoza, medical director of the Stroke Program at Wellstar North Fulton.

Wellstar North Fulton’s certification allows more Georgians to have access to the most advance diagnostics and treatments for cerebrovascular disease such as stroke. This is important because Georgia is located in the Stroke Belt, which is comprised of 11 states in the Southeast where the associated mortality rate for stroke patients is 10 percent above the national average.

At Wellstar North Fulton and Wellstar Kennestone, patients have access to advanced diagnostics and therapies to care for even the most complicated strokes faster and more effectively. These include:

  • Neuro Intensive Care Units –  A multidisciplinary team of physicians and nurses who specialize in neurocritical care.
  • Minimally-invasive treatment – Wellstar is one of only four programs in the state that offer neuroendovascular treatment, such as minimally-invasive clot retrieval, patients can be provided with a much less invasive treatment technique.
  • Cutting-edge imaging – Neurointerventional biplane imaging shows detailed, 3D views of blood vessels in the brain. This allows neurosurgeons to flip neuroendovascular cases to an open neurosurgical case when needed.
  • Pioneering technology – Wellstar North Fulton was among the first hospitals in the country to use the groundbreaking Artemis Neuro Evacuation device to treat brain bleeds, a condition that was nearly impossible to treat in the past.
  • Around-the-clock care – Artificial intelligence such as VizAi allows quicker identification of patients who are candidates for thrombectomy and organizes care in a connected system by quicker response to identify and provide care as quickly as possible.

“Our team of neurosurgeons, neurocritical care physicians, neuroradiologists, advanced practice practitioners and nurses work together to perform world-class thrombectomies, aneurysm treatments, carotid surgeries and cerebral bypass procedures so that patients can regain their best quality of life. Additionally, our dedicated hybrid neurovascular suite is equipped with innovative bi-plane technology. This allows neurosurgeons to view highly detailed images of brain vessels, so we as a team can customize treatments in real time,” said Dr. Arthur Grigorian, neurosurgeon, Wellstar North Fulton.

“When you have a stroke, every second counts. Getting fast, expert stroke care can mean the difference between life, death, or lasting brain damage. We are proud to receive this prestigious certification at Wellstar North Fulton, informing the surrounding community that they don’t have to go far to receive the best treatment possible. We will continue to work hard to provide an interdisciplinary, innovative, and compassionate approach to safe and quality comprehensive stroke care to all the communities we serve,” said Jon-Paul Croom, president, Wellstar North Fulton and senior vice president, Wellstar Health System.

Wellstar is a leading provider of stroke and aneurysm services in Georgia and performs one of the highest numbers of thrombectomy and aneurysm treatments in the country. The Joint Commission is a United States-based nonprofit organization that accredits more than 22,000 healthcare organizations and programs.

Keep reading
Doing good CPR is critical to save someone from cardiac arrest.

PeopleCare

KevinCare

There aren’t many people out there who can say they survived cardiac arrest at 30. Kevin Miskewicz can.

According to the American Heart Association, more than 90% of people who experience an out-of-hospital cardiac arrest die. Those who survive often have permanent neurological disabilities. But Kevin’s story has an incredibly fortunate ending, thanks to the highly coordinated work of his medical experts at Wellstar.

Recovering from cardiac arrest is something Kevin will never forget. It lives forever as a piece of his health history — one that includes a dedicated healthcare team — and his wife, who was the first to save his life.

There aren’t many people out there who can say they survived cardiac arrest at 30. Kevin can.

CPR to the rescue

Kevin woke up on Labor Day 2017 at 5:30 a.m. to take the dog out. Pausing to adjust the thermostat as he came in, he fell, knocking over a lamp.

He was in cardiac arrest.

With no symptoms and no known pre-existing condition, this was unexpected, but that didn’t stop his wife, Andrea, from jumping into action.

“If it weren’t for me knocking over a lamp when I passed out,” said Kevin, “she would have never woken up and saved my life.”

In addition to calling 911 and unlocking the door for the paramedics, Andrea performed CPR for 10 minutes.

“Kevin’s wife doing good CPR was critical,” said Dr. Arthur Reitman, the interventional cardiologist who was a vital part of Kevin’s treatment team at Wellstar Kennestone Regional Medical Center. “More than five minutes of poor blood flow to the brain can result in permanent irreparable injury from which a patient is unable to recover.”

Coordinating multidisciplinary care to save a life

When paramedics arrived at Kevin’s home, he had no pulse and was not breathing. As the paramedics performed their lifesaving work, he technically died two times.

The ambulance took him to Wellstar North Fulton Medical Center, where he was initially assessed and treated by Dr. David Jacoboff. The interventional cardiologist implanted an intra-aortic balloon pump to stabilize him. Then, he transferred Kevin to Wellstar Kennestone Regional Medical Center for highly specialized heart care.

When Kevin arrived at Kennestone by helicopter, his heart function wasn’t strong enough to support his body. Dr. Reitman and a team of doctors including a cardiologist, a pulmonologist and critical care doctors worked in tandem to put Kevin on an advanced life support system called veno-arterial extracorporeal membrane oxygenation. Better known as VA-ECMO, it took the heart “offline” so it could heal. The technology removed unoxygenated blood from his body, oxygenated it and pumped it back in for the next three days.

“Very few places in the state — only four or five hospitals — have the technology and specialized training to put a patient on ECMO,” Dr. Reitman explained.

Keep reading
If you can’t stop gaining weight or simply aren’t seeing the pounds come off no matter what you do, it’s time to consult a primary care doctor or advanced practice professional (APP).

Highlights

Overcome Obesity with the Help of a Primary Care Provider

You’re considered obese when your body mass index (BMI) reaches 30.0 or higher. Sometimes that means you gain 15 pounds, and nobody notices you’ve gotten much bigger. Sometimes it means you have a visible weight problem.

For U.S. adults aged 20 and over, there’s a 41.9% prevalence of obesity according to the Centers for Disease Control and Prevention. That most likely makes it more common than you suspected. And, even if you don’t feel like you’re severely overweight, being obese — according to the numbers — means opening the door to a long list of potential health risks.

So, if you can’t stop gaining weight or simply aren’t seeing the pounds come off no matter what you do, it’s time to consult a primary care doctor or advanced practice professional (APP).


Understanding what causes chronic weight gain


“Physicians previously thought obesity was only due to overeating and less exercise,” said Dr. Alicia Shelly, a Wellstar primary care provider. “The advice was always to move more and eat less, but it never guaranteed they would lose significant weight.”

In recent years, there’s been a shift in understanding weight gain, where it can stem from and how broad the range of categories really is. You can be obese because of:

  • Medical conditions
  • Depression or anxiety
  • Thyroid issues
  • Genetics
  • Immune conditions
  • Environmental issues


The factors that impact your weight gain drastically affect your options for treatment and what lifestyle changes you need to make to see a difference.


The one constant of obesity

Even with so many factors potentially causing obesity, the one constant is its negative impact on your health.

“There are more than 200 complications that accompany obesity,” Dr. Shelly said. 

These include more serious issues like heart disease, liver disease, hypertension and diabetes, but also other risks like reproductive disorders, sleep apnea, joint pain and mood disorders.

“Losing only 5-10% of your current weight can prove beneficial at reducing the risk of many of these obesity-related complications,” Dr. Shelly shared.

Reducing your weight by just 2.5% percent can help lower your risk of diabetes, and losing just 5% percent of your weight can improve your overall quality of life.


Having the weight conversation with your provider

Being overweight — and talking about it — can sometimes be difficult. You may feel embarrassed or that your weight gain reflects poorly on you. However, seeing that so many factors can cause weight gain that may be out of your control, there’s no reason to fear this type of conversation. What’s important though, is having a doctor or APP you trust and who supports you.

Tips for discussing weight with your doctor

  1. Be ready to talk about your weight. This conversation may include answering questions that feel uncomfortable to you but will help your doctor provide the right level of care.
  2. Listen carefully to the health risks associated with your weight and be open to creating a strategy for even a modest weight loss, like 5-10 pounds.
  3. Participate in the creation of your treatment plan. Consider your doctor's recommendations, and speak up about what will or won’t work for you.
  4. Be open to losing weight at a realistic rate.


Your expectations for what weight loss should look like may be different than your health provider. However, it’s sometimes necessary to put your assumptions about weight loss aside. Use the information your doctor gives you to make an educated choice as to what’s best for your overall health.

There’s no rush to lose weight. What’s important is making positive changes that you can commit to indefinitely that will take weight off and allow you to keep it off.


What a weight loss plan may look like

Many weight loss plans begin with lifestyle changes. These can include changing how you handle stress, keeping a food journal or focusing on portion control. You may even have to add or remove certain foods or beverages from your diet.

With these changes should also come a plan for staying vigilant even when life throws a curveball to your routine.

“It is common for people to get overwhelmed with the challenges during their weight loss journey and quit,” Dr. Shelly said. “This is why a piece of your weight loss plan will include addressing potential challenges and mapping out ways to overcome them.”

Appetite suppressants may also assist with an effective weight loss plan. New weight management options have come on the market in recent years. Your doctor may prescribe an FDA-approved medication, but it’s good to know that most offer an average weight loss of anywhere between 6-15%, and all carry the possibility of side effects that range from insomnia to nausea to constipation.

Work closely with your doctor before taking any medication, and only use what they prescribe.


Beginning your weight loss journey

Once you’re motivated to start losing weight, the first step on your journey is to create a road map with a qualified medical professional as your guide. Schedule an appointment with your primary care physician or search for a primary care provider near you.

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