Vascular Procedures Relieve Peripheral Artery Disease Pain in Former Deputy Sheriff, Educator

To say Raymond Johnson is an appreciative man is an understatement.

“I’m the luckiest guy in the world,” said the West Bend, Wisconsin, native and former middle school teacher and team leader, assistant principal, basketball coach, athletic director and deputy sheriff.

Raymond knows he had a wonderful career, and he worked hard for and at each job he held. He also leaned on many colleagues throughout the years — who also leaned on him — for help.

“I worked hard, but I was always surrounded by people who were better than I was, and I was given a lot of the credit.”

But during retirement, when Raymond needed to lean on physicians at the Froedtert & the Medical College of Wisconsin health network for his peripheral artery disease (PAD), he gained a whole new level of appreciation.

“At the Froedtert & the Medical College of Wisconsin health network, I felt the same way as I did throughout my career — surrounded by great people.”

Early Blockage

Raymond’s care began after he experienced a transient ischemic attack, or ministroke, that left him unable to see out of his right eye. His primary care provider referred him to Froedtert West Bend Hospital where Kaizad Machhi, MD, FACS, a Froedtert & MCW surgeon, determined Raymond had blockage in his right carotid artery. He underwent carotid endarterectomy, a surgical procedure to clean out plaque and repair the artery to prevent further strokes. Dr. Machhi also suspected some blockage issues in other parts of Raymond’s body, which were partly confirmed when Raymond said that he commonly had claudication, or pain, in his calves during his routine neighborhood walks with his wife of 50 years.

“The pain kicked in after about two or three city blocks,” Raymond said. “I thought I had maybe pulled some muscles, but in reality, the blood cells in my legs, particularly my right one, weren’t getting any oxygen. That’s what was causing the pain.”

Realizing that Raymond had potential blocked leg arteries that could be possibly opened with stents, Dr. Machhi decided to refer Raymond to see Peter Rossi, MD, FACS, FSVS, vascular surgeon and chief of vascular surgery at the Medical College of Wisconsin, at Pleasant Valley Health Center. Dr. Rossi performed an angiogram on Raymond’s legs to determine the severity of the blockages and if they could be treated simultaneously.

“With this procedure, we place a catheter down the leg artery and use contrast dye to see the blockages and where the blood vessels are going,” Dr. Rossi said. “A lot of times, at the time of angiogram, we can go through the blockages and treat them using balloons, stents or a combination to relieve them. If we can’t do that, then we move onto bypass surgery.”

Raymond’s blockages were heavily calcified, making it impossible for Dr. Rossi to treat during the angiogram. Raymond needed bypass surgery.

Leg Bypass Surgery

During the 2017 surgical procedure at Froedtert Hospital, Dr. Rossi placed an artificial graft inside Raymond’s right leg that allowed blood to bypass the main blockage in his femoral artery. This procedure increases blood circulation throughout the leg, which relieves claudication and reduces the risk of gangrene and potentially, leg loss. The surgery was successful, and Raymond felt better almost immediately.

“I had a stubborn blood blister on my toe from some new walking shoes that wouldn’t heal,” Raymond said. “The day after my surgery, since my blood flow was normal, my toe started throbbing and started healing immediately.”

Raymond spent five nights at Froedtert Hospital recovering but did not need the care of ICU. He also found that he only needed the help of prescription painkillers for a day and a half after surgery. Following discharge, he’s had numerous follow-up appointments to check the status of the graft and also check up on other arteries. All tests have been coming back just fine, and Raymond has been living relatively pain-free. He has also avoided a major stroke thanks to the initial carotid endarterectomy by Dr. Machhi. Raymond credits Dr. Machhi, Dr. Rossi and their colleagues for making him feel better and allowing him to continue his neighborhood walks with his wife, two adult children, son-in-law and “grand-dogs.”

“My leg is as good as gold,” Raymond said. “Dr. Rossi has great bedside manner and has amazing knowledge. I brag about him to people! If you need vascular work, he’d be your first round draft pick.”

Treating Peripheral Artery Disease with an Academic Medicine Approach

According to Dr. Rossi, one of the first signs of potential PAD is cramping in leg muscles when walking that worsens over time. The cramping then graduates to constant pain that starts in the toes and moves up to the foot and leg. Smoking, high blood pressure, high cholesterol and diabetes are the four main risk factors that increase the likelihood of an individual developing PAD. The team of providers within the Froedtert & MCW academic health network is qualified to treat this condition.

“We have a uniformly coordinated, multidisciplinary approach to treating PAD,” Dr. Rossi said. “Our patients get reviewed by specialists from interventional radiology, vascular surgery and any other staff who needs to see them depending on their condition. They get the advantage of a truly integrated and systematic approach to care, which most other health systems don’t have.”