How My Houston Patients are Affected by the Iceland Volcano

Since the volcano erupted in Iceland last week, there have been major disruptions. Most of them, of course, were directly involving Europe and the everyday effects of having a cloud of ash on top of you. Others were vacationing in Europe, or visiting on business, and can't catch a flight back home. The airports are opening and the delays are lifting.

I have a patient in my Houston, TX wound clinic who encountered a more substantial effect. I treat many patients with open sores, known as ulcerations, on their feet and legs. Ulcers are commonly found in people with diabetes, but can occur in others as well. In the case of this patient, he is a young, otherwise healthy, man who inherited a rare form of neuropathy, nerve damage affecting the feet which leads to numbness and an increased predisposition to developing ulcers. He has had these wounds for over nine years and has already had one of his toes amputated.

I have become concerned about one particular area of his wound, which is deeper than the rest and very close to bone. To ensure the bone is not infected, I wanted to send him for a specialized bone scan. In this test, blood is drawn from the patient, tagged with a radioactive isotope, and returned to him. This isotope is drawn to high concentrations of white blood cells, indicating infection, and is sensitive to areas of bone that are infected.

Here's the problem: The isotope comes from Europe and all the hospitals in the area are out of it. Is there another test? Well, we could do an MRI ordinarily, but he has implanted metal pins near that area and interference is likely, which will give a poor result. Other types of bone scans are possible, but not specific for infection. We're stuck waiting for new product to arrive.

Without minimizing the impact of someone stuck in Europe, my patient is effected in a much more severe way. Without this test, it will be difficult to determine if the bone is infected and the extent of the infection. This will delay surgery, if necessary, and delay full healing of the wound. I will continue to follow up with him regularly to ensure his condition doesn't worsen and will eagerly await the arrival of the much needed isotope from Europe
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