We expect our bodies to heal, because they usually do. When they don’t heal successfully, the Emerson Center for Advanced Wound Care offers a range of treatments, from the most basic to the most high-tech. Joanne Warwick (pictured) found that out when she developed complications from cancer treatment. Over the course of two years, Mrs. Warwick turned to the center for three distinct problems. Today she is doing fine.
Mrs. Warwick understood that her two medical problems — non-Hodgkins lymphoma and advanced gynecological cancer — required aggressive treatment. But radiation therapy, although ultimately successful, left her with internal bleeding. “I lost a lot of blood, and I lost a lot of weight,” says the Shirley resident, who is 64.
The internal damage she suffered — an uncommon complication of cancer treatment — required healing of her internal tissues. “I was told that hyperbaric oxygen therapy would be the best way to accomplish that,” says Mrs. Warwick. “So I went to Emerson.”
“Radiation sometimes destroys the microcirculation, which causes the capillaries to break down,” explains Stephen J. Hoenig, MD, vascular surgeon and the center’s medical director. “Hyperbaric oxygen therapy sends oxygen to places that need it for healing. Mrs. Warwick’s microcirculation wouldn’t heal on its own.” Although she initially had to abandon treatment due to ongoing weakness, she returned to the center and completed the 40 hyperbaric oxygen treatments it took to heal the damage.
The center recently replaced its two hyperbaric oxygen chambers with new, state-of-the-art models. “Hyperbaric oxygen treatment is a potent tool that often allows wounds to heal in half the time,” says Dr. Hoenig. “Patients can get back to their lives sooner.”
More healing challenges lay ahead
Mrs. Warwick needed to put that first problem behind her because, before long, she faced extensive abdominal surgery to divert her urinary tract. “I developed kidney disease as a complication of lymphoma,” she explains. “After the surgery, I had a long stomach incision that had to heal from the inside out.” When the incision didn’t heal, she returned to Emerson for another course of hyperbaric oxygen therapy.
Treatments are about 90 minutes long. “I either watched TV or slept, and I saw Dr. Hoenig or Allison Learned regularly,” she says, in reference to Allison Learned, NP, the center’s nurse practitioner. “The entire group is friendly and professional; they’re the best medical team I’ve ever seen in my life.”
Before long, Mrs. Warwick developed yet another problem: skin breakdown on her buttocks. “We addressed Mrs. Warwick’s ulcers through a combination of off-loading, where we repositioned her to reduce the pressure on her buttocks, and localized wound care,” says Dr. Hoenig. “We have expertise in treating this problem.”
The multidisciplinary team at the Emerson Center for Advanced Wound Care includes two internists, two podiatrists, two plastic surgeons, an infectious disease specialist, a dedicated nurse practitioner and a vascular surgeon. “Each of us approaches wound care with our own perspective,” he notes. “It’s not unusual for multiple specialists to share patients who heal poorly, such as those with diabetes, kidney failure or oxygen-dependent chronic obstructive pulmonary disease.”
One thing is true of wound care, Dr. Hoenig adds. “You can’t skip the basics, including debridement — careful removal of dead tissue — good hygiene and daily dressings. We have hundreds of different dressings, forms of compression and topical skin replacement products.”
Mrs. Warwick is grateful to the center’s staff. “I spent so much time there that they became like a family — a family that always pitched in if something needed to be done,” she says. When she was finally discharged in January 2016, after all the treatment she received there, she realized something. “I really miss them.”
“Mrs. Warwick is an example of how we don’t give up on patients,” says Dr. Hoenig. “Some come to us with complex medical problems that are difficult to manage, but we keep at it. It’s exciting work, because we know how to heal the most challenging wounds. That’s because wounds are our entire focus.”
