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How a second opinion helped one woman walk again

After undergoing a procedure performed by Dr. Ashkan Karimi, Betty Roadcap was able to resume her normal daily activities.

For one patient, getting a second opinion turned into a chance to live without pain

What started as an itch turned into a health emergency. Thankfully, it has a happy ending.

When 84-year-old Betty Roadcap felt a tingle on her left shin, she instinctively reached down for a quick scratch, figuring it was her usual dry-skin problem. The itch went away, but a tiny nick from her fingernail persisted — and then it got bigger. About a week later, that once imperceptible mark had grown into the size of a quarter, she recalls, and it began to hurt.

When she visited her regular doctor, he recommended removing the scab so the wound could heal fresh. The procedure felt like he was stabbing her in the leg, Roadcap says.

“I couldn’t believe the amount of pain from this tiny scratch,” she states. “I was holding onto the nurse, and if there hadn’t been people in the waiting room, I probably would have screamed.”

A Worsening Problem

That was Roadcap’s first indication that this was no ordinary wound. When she got home, and it got worse instead of better, she really started to worry. It just kept growing, winding around the back of her leg until her whole calf felt inflamed.

At that point, it hurt to walk or stand, and although she tried propping up her foot, even the slightest pressure on her calf was excruciating. That limited her mobility to almost nothing, and even sleeping became nearly impossible. She took pain pills, which she hated, and tried to sleep in a chair.

“Everything felt miserable,” she remembers. “I began to wonder if they would have to take part of my leg as the situation kept getting worse.”

Because her condition involved the blood vessels in her leg, Roadcap was referred to Ashkan Karimi, MD, a cardiologist who’d just joined Augusta Health.

“Looking back, I remember being anxious,” she says. “Now, I thank him with all my heart for what he did.”

Second Opinion, Second Chance

By the time she saw Dr. Karimi, Roadcap had been dealing with her non-healing wound for over a year. The problem was so extensive it caused a complete blockage of her leg artery — a condition known as critical
limb ischemia.

The condition caused her foot and ankle to feel cold all the time — a result of insufficient blood flow. The blockage could have eventually resulted in amputation, since the joints, muscles and tissues weren’t getting the amount of blood and oxygen needed to stay healthy. The poor blood flow is what prevented the wound from healing, creating inflammation that kept Roadcap in continual pain and greatly increased her risk of infection.

Without treatment, and given her age, Roadcap was looking at a difficult future if the situation continued, especially if she had to have an amputation. Not only would her general mobility and sleep continue to suffer, but her chances of falling were heightened, which could lead to significant events like fractures.

Dr. Karimi was determined to clear the blockage, and that’s exactly what he did. During a three-hour procedure, he painstakingly worked his way along a completely occluded blood vessel from Roadcap’s knee all the way to her ankle, opening the blockage up so blood could flow back in.

“Healing these types of wounds can be very difficult when you don’t have proper blood flow, so that’s always our goal,” says Dr. Karimi. “Typically, if we are able to open at least one of the three arteries that supply blood to these wounds they heal rather quickly. That is what we did for Betty.”

Roadcap got her life back. Within a few days, her pain was gone, and her leg and foot were no longer cold. She slept easily again and was able to resume all her normal activities without restriction. Just 10 days after the procedure, her leg had healed to the point that it was as if nothing had happened.

“There’s a little tiny mark you can barely see,” says Roadcap. “You would never know it had ever gotten so serious. I thanked Dr. Karimi for coming to Augusta because I don’t know what I would have done without him.”

Roadcap’s story showcases not only the skills of Dr. Karimi and Augusta Health’s cardiology team, but also the value of getting a second opinion.

“If patients have been told nothing can be done, I suggest that they keep asking,” Dr. Karimi notes. “Medical technology and therapies are always improving, and we now have the ability to do so much when it comes to vascular issues. I am very grateful to have joined Augusta Health and work with our incredible team members. My main message is don’t give up.”

Learn more about the Heart & Vascular Center at Augusta Health at augustahealth.com/heart.