A Second Opinion Saves Football Coach’s Foot

THE LONGITUDINAL, MULTIDISCIPLINARY APPROACH BY CHRISTIAN HOSPITAL’S VASCULAR CARE TEAM

Lafayette Gatewood III, 56, of St. Louis, Mo., has been a high school teacher and football coach for 28 years. In July of 2019, Lafayette was on the football field at practice, like he is most days, when he developed a blister on his foot. With a history of diabetes and kidney failure, he became particularly worried when his foot swelled up.

Referred to a local podiatrist by his primary care physician, Lafayette was informed he would need immediate surgery to regain blood flow, although they were uncertain they would be able to save his foot. Unfortunately, the surgery was unsuccessful, and after 10 days of inpatient care, a second surgery was scheduled to amputate his foot. Lafayette told them he would need a second opinion.

With a recommendation from his kidney doctor, Lafayette scheduled an appointment with Vipul Khetarpaul, MD, a Washington University vascular surgeon at Christian Hospital whose practice performs the full spectrum of vascular surgery services. Lafayette met with Dr. Khetarpaul and his team the same day he was released from the hospital. “The first thing he told me was that he didn’t believe in cutting the limb off. That made me feel really good,” says Lafayette. “It was a true blessing.”

“We are very passionate about helping people preserve their limbs, even when a lot of physicians turn them down or tell them amputation is the only option left for them,” says Dr. Khetarpaul.

Lafayette’s medical history put him at a high risk of developing peripheral vascular disease, a disorder that causes blood vessels to narrow or block, reducing or completely cutting off blood flow. Dr. Khetarpaul performed an outpatient angiogram procedure in which a tiny instrument was run through an artery in the top of Lafayette’s foot that allowed him to remove plaque and balloon the blood vessel open to restore blood flow. The minimally invasive procedure was a success, and Lafayette was discharged home after only two hours of bed rest.

Unfortunately, peripheral vascular disease is a progressive disease requiring longitudinal care with routine follow-ups. “Intervention is just a small part of the equation,” says Dr. Khetarpaul. “A long-term care plan in a multidisciplinary fashion is really key in addressing the needs of this patient population to sustain the benefits they have received from an intervention, such as good function and circulation.”

This multidisciplinary approach isn’t limited to just Dr. Khetarpaul and nurse practitioner Katie Strope, AGPCNP-BC, who plays a vital role in the medical management of these patients. Instead, the vascular care team engages other specialties, ranging from podiatry and wound care to primary care and endocrinology, to work simultaneously together to give patients the most optimal result and the greatest chance to save their limbs. Soon, Christian Hospital and Washington University will be announcing a Limb Preservation Center to formalize the ongoing, coordinated efforts of these teams.

In Lafayette’s case, he is fully recovered and continues with his follow-up appointments. He couldn’t be more pleased with his care and his outcome. “It was tremendous. The entire staff has been really, really good and very professional. My experience has been great.” He continues, “I’m back coaching, which has me on my feet most of the time. I walk pretty well, I have no pain, and most importantly, I have my foot.”

He is grateful he sought a second opinion and feels fortunate he came across the vascular care team at Christian Hospital.

To learn more about Christian Hospital’s vascular care, please call 314.747.WELL (9355) or visit ChristianHospital.org.