Just down the hall from the waiting room, a man was in a clear glass tube. Resembling an inflated test tube, the cylinder’s glass casing contained a thin bed, which the man was laying on.
Tom Linn, 68, entertained himself with a movie while the tube provided oxygen therapy to heal a chronic wound on his foot that has left him wheelchair-bound.
Linn and thousands of other patients have gone to Lodi Health’s Wound Treatment Center for help in healing chronic wounds since its opening in 2008. The center’s specialty is hyperbaric oxygen therapy, a medical treatment that increases the amount of oxygen in the patient’s blood.
Although the Wound Treatment Center began small, there has been a steady increase in patients who choose to use this therapy as a way to heal chronic wounds.
Local residents find hope
Linn is a retired teacher from Lodi Unified School District. A Lodi resident, he enjoys gardening, photography and history. He especially enjoys traveling.
He was on a trip to Ireland when some new shoes caused a blister on his foot. Despite the blister, he continued on his journey. Upon returning home, his problems became more severe and the blister ended up turning into a full-scale ulcer.
Wounds often start out simple but turn into complicated problems after they become infected or require surgery.
In Linn’s case, vascular problems caused a decrease in blood flow to the wound, said Dr. Harvey Hashimoto, the medical director at the Wound Treatment Center.
“The blockage was so severe it couldn’t support healing,” he said.
On a daily basis, 20 to 25 patients walk through the center’s door. Some have bone and skin infections; others have radiation injuries.
The majority of patients are people who have vascular disease or uncontrolled diabetes, said Vivian Vanzandt, program director at the center. The most common injuries are complications to wounds in the lower extremities or diabetic foot ulcers.
A person might have a non-healing wound for a slew of reasons, she said.
“There is a reason, if it goes past 30 days, why it’s not healing. We are sort of like investigators and see why it’s not healing,” she said.
When Shannon Jameson was told at a wound treatment center in Stockton that her foot was going to have to be amputated, she went into a panic.
The 53-year-old Lodi resident had been struggling with a staph infection that broke open and caused complications. She was afraid she might have osteomyelitis, an infection of the bone.
“I was concerned. For awhile, I didn’t have a lot of hope,” she said.
Patients who have wounds that don’t heal within two to three weeks at home are usually referred to the center by their doctor, said Hashimoto.
After a variety of testing, the wound is checked for infection. A clinical assessment then seeks to find out why the wound isn’t healing.
“We then try to do battle with controlling that,” he said.
Linn was also facing amputation; he had been given a only 10 percent chance of keeping his leg. When his friends convinced him to get a second opinion, he ended up visiting Hashimoto at the center.
“I felt hopeful this was something they were going to actively pursue. I was very optimistic,” he said.
By that time, everything had pretty much disintegrated, said Linn. He remembers asking the doctor when he would walk again. He was told it would be two to three months.
The length of treatment varies according to each case. Some people heal within one to two weeks; for others, it can take up to three years. The more complications attached to the wound, the longer it can take, explained Hashimoto.
“We have an 80 to 85 percent success (rate) with getting wounds to heal. Our goal is to get them to heal within 12 weeks,” he said.
Lodi embraces wound therapy
Prior to the Lodi Wound Treatment Center’s opening, patients had to go to Stockton, Sacramento or Walnut Creek. In 2011, the first year of recorded data, 2,946 patients visited the center. Last year, the number reached 4,533, Vanzandt said.
Typically, there is an increase of patients in the spring, summer and fall. This past May, the center broke its record with just a little under 500.
“It’s kind of a trend from time to time. It is an all-time record,” Vanzandt said.
It was serendipity that Hashimoto ended up in wound treatment, he said. His background in family medicine, as well as his skill as an assistant surgeon, qualified him to become the medical director of the center from the beginning. He embraced the medical specialty because he feels rewarded by being able to cure ailments rather than just manage them.
“The satisfying aspect of this clinic is taking a problem that some patients have had for three, four, five or six years and actually getting them healed,” Hashimoto said.
The center specializes in hyperbaric oxygen therapy, which increases the amount of oxygen in the patient’s blood. This provides more oxygen to the wound, which helps to increase healing.
Weighing more than a ton, the hyperbaric oxygen chamber is a clear acrylic tube with a reclining bed where patients lay during their two-hour treatment.
Treatments include the time it takes to pressurize and depressurize the chamber, plus 90 minutes at the prescribed treatment depth. The appropriate pressure level is adjusted to each patient’s tolerance level, said Vanzandt.
“The prescribed depth depends on the diagnosis of the patient, and also depends on the sensitivity of the patient,” she said.
After surrounding patients with 100 percent pure oxygen, the chamber is pressurized at a rate that is higher than sea level. The combination of oxygen and pressure saturates the red blood cells, which increases capillary growth and circulation, helping to heal wounds, explained Craig Becker, a certified hyperbaric registered nurse at the center.
The treatment is often called a “dive” because the pressure applied to the patient is similar to pressure caused by diving underwater.
“You feel the pressure in your ears like you are driving through the mountains,” said Jameson. “It’s that feeling, and sometimes you get a little light-headed.”
A time of healing
During Jameson’s visits, the doctor changed her dressings, which included a cast she wore to help her keep the pressure off her foot.
The wound was cleaned and the drainage checked. The healing stage she was at determined the type of dressings used. One type of dressing, Silver Alginate, helps to manage the bacterial burden and prevent infection.
After every 20 days of oxygen therapy, Jameson’s progress was evaluated and more treatment was ordered. In the end, she spent a total of 101 days in the chamber.
Although she lost a few toes on her left foot, she is grateful that it wasn’t completely amputated. She is still able to walk to get the mail, clean her house and prepare meals.
She knows she would have survived without her foot, but she is grateful for the chance to keep her independence.
Jameson said she appreciated the honesty and hard work that was put into her care.
“I’m impressed with the whole thing. They didn’t give me false hope. It was ‘either/or,’ and it just happened to be ‘or,’” she said.
After finding a doctor in Davis who could perform surgery to open up the artery in Linn’s leg, things began to turn around for him, Hashimoto said.
“He was determined to keep his foot, so we were determined to help him do that,” said Hashimoto.
Following his surgery in July, Linn spent over nine months in the hyperbaric chamber on a daily basis.
During his time spent in the office, he was impressed with the dedication of the staff. On a normal visit, bandage changes took 20 minutes, but on busier days, it could take much more than that, he said.
“I’ve been here when people have skipped lunches or when the machines have been down,” he said. “They’ve done everything to speed things up.”
Two hospitalizations during the nine-month period left him unable to get to the center. Instead, the staff provided in-home care.
Hashimoto says Linn’s case has been the most inspiring for him. Faced with a problem wound with very poor circulation, Hashimoto thought at first that there was no cure other than amputation, but Linn’s determination to save his foot led Hashimoto to locate a surgeon who could help restore circulation.
“Once that was done, the wound healing blossomed like a plant with fresh water and fertilizer,” Hashimoto said.
Linn’s treatment ended in December. He sees a difference in himself on a daily basis. Once in a wheelchair and facing amputation, he now walks with a cane.
These days, he often visits the staff at the center and brings them vegetables from his garden. With a smile on his face and gratitude in his eyes, Linn said there’s not a day that goes by that he doesn’t feel thankful.
“I now have the wherewithal to go out to the garden and pull weeds and take the bulldog for a walk,” he said.
Contact reporter Pam Bauserman at firstname.lastname@example.org.