The body needs glucose. It is the cells’ primary source of energy. Without it, the tissues and muscles of the body won’t be able to carry out regular functions well.

What causes Diabetes?

The underlying cause of diabetes depends on the type.

Type 1 diabetes is usually linked to dysfunctional immune system. Instead of just attacking harmful bacteria and viruses, some of those with dysfunctional immune system attacks and destroys the insulin-producing hormones and cells.

Insulin is the hormone that carries the glucose into the cells. With little or no insulin, glucose can build up in the bloodstream.

Type 2 diabetes is usually a result of genetic and environmental factors. Having a family history of the condition and being obese puts you at greater risk of developing type 2 diabetes.

As with gestational diabetes, it’s usually a result of hormonal changes during pregnancy (the placenta makes hormones that can lead to buildup of glucose in the bloodstream.

Regardless of the type, diabetes can lead to excess sugar in the blood. And having too much sugar in the blood can lead to serious health implications.

Symptoms

The most common symptoms of diabetes include:

• Increased thirst
• Frequent urination
• Extreme hunger
• Unexplained weight loss
• Fatigue
• Irritability
• Blurred vision
• Slow-healing sores
• Frequent infections

Health Consequences

When left unmanaged, diabetes can lead to a myriad of health problems including cardiovascular disease, nerve damage, eye problems, Alzheimer’s disease, kidney failure, and limb amputation.

Kidney failure develops when kidney damage is left untreated. Dialysis is an option for diabetic patients with kidney failure. By removing excess salt, water, and wastes from the body, dialysis can help in keeping the body in balance.

Vascular access is an important passageway to the bloodstream created by a minor surgery to be used for dialysis. Premier Surgical Vascular Access Center in Knoxville provides exceptional care for Access patients and their families. Our highly trained vascular physicians and staff use state-of-the-art equipment and the latest in minimally invasive vascular access surgery techniques. We offer comprehensive on-site vascular diagnostic expertise and educational services to patients who are living with kidney disease.

For more information about Premier Vascular Access Center, please visit our Access webpage.

The post Diabetes Month first appeared on Premier Surgical.

Peripheral Artery Disease affects both men and women. Although, there is a higher risk for the disease among those suffering from certain medical conditions like diabetes, kidney disease, high blood pressure, and heart disease. When left unmanaged, PAD can result in a total loss of circulation in the legs and feet. This can lead to gangrene and eventually may result in loss of the limb.

Premier Surgical Limb Preservation Center in Knoxville has a team of experts who are dedicated to treating patients with vascular problems, including those with injuries that place them at higher risk for losing their limb. Our team works closely with patients in order to preserve their limb. We do this through:

• Immediate Evaluation
  Early diagnosis and treatment is one of the best ways to prevent limb loss. At Premier Surgical Limb Preservation Center, we offer same-day evaluation from our team of vascular specialists. In order to properly diagnose your condition, our Vascular Center is equipped with state-of-the-art facilities which provide same-day diagnostic testing like arteriogram and ultrasound. Results of these tests will be used to provide patients with a comprehensive treatment plan.
• Advanced Therapies
  The earlier the vascular disease is treated, the better is the chance of preserving the limb. We have a team of vascular surgeons who will work on your condition, ensure speedy wound healing, and better blood flow in the affected areas. This may be done through medication therapy and minimally invasive procedures like balloon angioplasty and atherectomy.
• Follow-Up Care
  Premier Surgical Limb Preservation Center team works with other specialists to provide patients with the follow-up care they need and ensure full recovery from their condition. From patient education to post procedure assessments, we make sure that the patient’s condition is resolved and that there’s reduced risk of limb loss in the future.

Those living with PAD do not have to reach this point. At Premier Surgical Limb Preservation Center in Knoxville, our team is dedicated to your care and treatment. If you are experiencing symptoms that lead you to believe that you have a vascular disease, contact us to schedule an appointment for a consultation.

The post How Premier Limb Preservation Center Helps Prevent Limb Loss first appeared on Premier Surgical.

According to the Centers for Disease Control and Prevention, more than 500 Americans lose a limb each day. While trauma or cancer are sometimes the cause of limb loss, most patients at the Premier Surgical Limb Preservation Center in Knoxville are typically at risk of losing a limb due to chronic health issues such as diabetes, peripheral arterial disease (PAD), or critical limb ischemia (CLI), which is a severe complication of PAD that may lead to limb loss if left untreated.

It’s estimated that 65% of amputations are preventable through early detection and treatment. The Vascular Intervention Team at the Premier Surgical Limb Preservation Clinic in Knoxville believes successful limb preservation is best achieved through a combination of early detection, quick restoration of blood flow, and attentive ongoing care.

For early detection, it’s helpful to know the signs and symptoms of PAD or CLI. These include:

• Sores on the toes, feet, or legs that won’t heal
• A change in the color of the legs
• Severe pain in the feet or toes
• Leg numbness or weakness

1 — Early Detection and Referral

If you’re experiencing any of the above symptoms, talk to your physician and request a referral to Premier Surgical Limb Preservation Center. Our vascular experts will work to secure immediate, same-day evaluation to properly diagnose your condition.

2 — Restoration of Blood Flow

The most critical aspect to preserving a limb is to restore blood flow as soon as possible. This may require opening blockages and removing plaque in the vascular system, which can be accomplished through procedures such as balloon angioplasty, stents, atherectomy, and bypasses.

3 — Treatment and Prevention

Once the immediate concern of restoring blood flow is resolved, the goal is to ensure that blood flow doesn’t become restricted again. Your Premier vascular physician will instruct you on the best treatment practices for continuous care, such as how to prevent the development of chronic wounds.

In coordination with you referring physician and other specialists, your Premier vascular surgeon will remain involved in your post-procedure assessments to ensure healing and avoid recurrences.

The physicians and staff of Premier Surgical Limb Preservation Clinic, conveniently located on Papermill Drive in Knoxville, are dedicated to earning your trust through our demonstrated vascular expertise. We are committed to saving limbs and saving lives. Learn more about Premier Surgical on our website.

The post 3 Steps To Prevent Limb Loss first appeared on Premier Surgical.

There was no pain, nor was there any pulse in her feet. Except for feeling as if each of her legs weighed 200 pounds, Cathy Robinson felt just fine. but the lack of pulses in her ankles told her doctor something was wrong.

In January Cathy Robinson underwent an aortobifemoral bypass. The procedure performed by Dr. Richard Young at Fort Sanders Regional has given Robinson the ability to enjoy life and play with her grandson again.

“I have gone to the same primary doctor for almost 20 years, and she knows my whole family history,” said Robinson, whose mother died at 62 of heart disease. “She said, ‘Cathy, I’m not getting a good pulse in your ankles. We need to get this checked out.’”

Testing revealed that Robinson had severe aortoiliac occlusive disease, or more simply, plaque blockage of her lower aorta and proximal leg arteries. With peripheral artery disease (or PAD), the plaque builds up in the arteries, causing them to harden and narrow and restricting the flow of oxygen-rich blood from the heart to the legs. If that blockage is severe enough it can lead to limb threat if not treated.

“I could’ve lost my legs!” said the 63-year-old Louisville woman. “I don’t have very long legs and I wanted to keep ’em so I had the surgery.”

Robinson underwent an operation called an aortobifemoral bypass. The surgery was performed by Premier Surgical vascular surgeon Dr. Richard Young at Fort Sanders Regional this past January. Since surgery Robinson is once again enjoying shopping and playing with her grandson.

“Yesterday was my first trip to the grocery story on Senior Day,” she said, seven weeks out from the surgery. “I used to have to stop in an aisle and rest a minute. I didn’t get short of breath but I had to let my legs settle down before I could do the rest of my grocery shopping. But yesterday, I was just going through the store and I thought, ‘Oh, I’m not hurting.’ This is great!’”

Prior to the surgery, however, Robinson said, “It’s strange – it’s not pain. They don’t hurt. They don’t ache. They just feel like each of my legs weighed 200 pounds if I walked any distance.”

That was particularly true of Robinsons’ driveway, which is pitched at a 45-degree incline. “I was fine going down to the mailbox for the newspaper. Coming up? I had to stop halfway up. I didn’t really think much about it. I just thought, ‘Well, you’re an old woman and you’re out of shape.’ But then you realize it wasn’t the kind of feeling where you’ve exercised and your muscles get all sore.’ For me, it was just a heaviness.”

That “heaviness” or claudication, is one of the symptoms of PAD. Other symptoms might include weak or undetectable pulse in the leg, muscle atrophy, discolored or smooth shiny skin that is cool to the touch, non-healing ulcers or sores in the legs or feet, and cold or numb toes. As much as 40 percent of patients have no leg pain.

“PAD is very common,” said Dr. Young, noting it is believed that anywhere from 8 to 12 million people in the United States currently have it. “The majority of cases can be treated with angioplasty and stents, but Mrs. Robinson had an extensive amount of advanced disease that was better treated with a bypass. Her aorta and common iliac arteries were nearly occluded, reducing blood flow to her lower extremities.”

“Dr. Young told me that it wasn’t an ‘emergency situation by any stretch,’” said Robinson. “But when I got to the point where I couldn’t play baseball with my grandson, I couldn’t run with him, and that’s just heartbreaking … I said, ‘Let’s just get it done. If I’m going to have to have it, I don’t want to wait until I’m 73 instead of 63.’”

Aortobifemoral bypass has been around for at least four decades and is the preferred therapy for severe blockages of the aorta. With this bypass, a polyester tube (graft) is used to go around the blocked arteries connecting the aorta to the femoral arteries.

The aorta is the body’s major artery out of the heart. Near the belly button level, the aorta branches to form the two iliac arteries. At groin level, the iliac arteries become the femoral arteries.

Despite the extensiveness of the surgery, it took only about 90 minutes before Robinson was wheeled back into intensive care. She was back home five days later.

“I don’t think I had an idea in mind about what it would be like. I knew it was serious surgery, but I didn’t realize truly how serious it was and what all he would have to do. But you get through it, you get over it. There was a time, I will admit, when I was all drugged up that I would cry and tell me husband I really wish I hadn’t had this done, but I don’t feel that way now.

“The Fort Sanders hospital was very good to me, they were all really good,” she added. “Dr. Young was a blessing because he was so good and explains things in a way that a non-medical person can understand. He’s very positive with you even though it’s bad news.

“You don’t want to go in and hear that you’re going to have to have a bypass! Who wants to hear that? But he’s still very positive when he’s talking about it, even though he tells you everything that could go wrong. He’s still very positive about it, and I really did like that. I can’t say enough good things about him. I would recommend him to anybody. Anybody.”

The post Leg Work: Bypass Gives Louisville Woman Legs to Stand On first appeared on Premier Surgical.

It’s estimated that 65% of amputations are preventable through early detection and rapid treatment. The Vascular Intervention Team at the Premier Surgical Limb Preservation Clinic in Knoxville believes successful prevention lies in early referral, rapid restoration of blood flow, and proper ongoing care.

Symptoms of PAD or CLI may include:

• sores on the toes, feet, or legs that won’t heal
• severe pain in the feet or toes
• leg numbness or weakness
• a change in the color of the legs

If you’re experiencing any of the above symptoms, talk to your physician and request a referral to Premier Surgical Limb Preservation Center. Our vascular experts will work to secure immediate, same-day evaluation to properly diagnose your condition.

The most critical aspect to preserving a limb is to restore blood flow as soon as possible. This may require opening blockages and removing plaque in the vascular system, which can be achieved through procedures such as balloon angioplasty, stents, atherectomy, and bypasses.

Once the immediate concern of restoring blood flow is resolved, the attention turns to ensure the blood flow does not become restricted again. Your Premier Vascular physician will instruct you on the best treatment practices for on-going care, such as healing chronic wounds, and preventing future occurrences.

“A multi-disciplinary approach is paramount to meeting our goal of limb preservation,” explains Premier vascular surgeon C. Scott Callicutt, MD, FACS. “We have established a network of specialists to assist us in delivering efficient, quality care defined by the ultimate prevention of limb loss in CLI patients.”

The physicians and staff of  Premier Surgical Limb Preservation Clinic, conveniently located on Papermill Drive  in Knoxville, are dedicated to earning your trust through our demonstrated vascular expertise. We are committed to saving limbs and saving lives. Learn more about Premier Surgical on our website.

The post The Numbers Behind Limb Loss & Your Best Tips For Prevention first appeared on Premier Surgical.

Step one: Early intervention

The key to maximizing your odds of limb preservation is in early intervention. From the very minute you recognize any signs and symptoms you may be at risk of limb loss, get in touch with your physician to discuss your situation and request a referral to Premier Surgical Limb Preservation Center of Knoxville.

From there, our vascular experts will work to secure immediate, same-day evaluation to properly diagnose your condition and give you the best possible chance to prevent amputation. In addition, to this evaluation, we will conduct a number of diagnostic procedures including diagnostic imaging and go over a comprehensive treatment plan all on the same day of your referral and evaluation whenever possible.

Step two: Restoring blood flow to the affected area

The earliest steps in the treatment plan consist of the procedures necessary to set the stage for proper healing and increasing the likelihood of preserving your limb. From balloon angioplasty and stents to atherectomy, bypass procedures, and other techniques, Premier Surgical’s vascular surgeons will work to ensure you have the blood flow necessary to support the healing process.

Step three: Boosting the healing process

Once blood flow is restored, we will work to eliminate any infection in the skin or soft tissue through medication, dressing, debridement, incision, compression, vacuum-assisted closure, and other methods. Your individualized care plan will dictate what methods are necessary based upon the specific details of your condition including location of the problem area and the type of bacteria causing the infection.

Step four: Maintain ambulatory status through follow up and therapy

Premier Surgical Limb Preservation Clinic works in conjunction with referring physicians and other supporting specialists to ensure you receive proper follow-up care and rehabilitation support and enhance the healing process and prevent future issues. From simple follow up appointments and exams with your physician or a specialist to physical therapy, our process includes everything necessary to resolve the problem, prevent loss of your limb, and prevent future risk of amputation.

At Premier Surgical Limb Preservation Clinic in Knoxville our staff and physicians are dedicated to earning your trust through our demonstrated vascular expertise. We are committed to saving limbs and saving lives. Learn more about Premier Surgical on our website.

The post The Premier Process for Limb Preservation first appeared on Premier Surgical.

Immediate evaluation on the day you are referred

Limb preservation requires early intervention. If you recognize any signs and symptoms you may be at risk of limb loss, it is vital that you immediately discuss these symptoms with your physician and request a referral to Premier Surgical Limb Preservation Center. Our vascular experts will work to secure immediate, same-day evaluation to properly diagnose your condition and give you the best chance at preventing amputation.

Same-day appointments with multiple specialists

When we created the Premier Surgical Limb Preservation Clinic, one of our goals was to offer more rapid access and treatment to individuals at a disservice in remote areas—areas where transportation to and from medical care is difficult. Knowing faster treatment is key to preventing limb loss and ensuring faster healing, we sought to improve the efficiency and speed of treatment.

To that end, in addition to a same-day evaluation when you are referred to the Premier Surgical Limb Preservation Clinic, our program coordinator will work to enable you to undergo diagnostic imaging and develop a comprehensive treatment plan all on the same day of your referral and evaluation, whenever possible. The coordinator can also manage your treatment plan and coordinate with our network of specialists to set up same day appointments and minimize the amount of travel necessary for your treatment.

Follow up and therapy are built into the process

Once we’ve put you on the road to healing, the Limb Preservation Clinic strives to ensure you receive the proper follow up and therapy to maintain your ambulatory status. We work in conjunction with referring physicians and a network of supporting specialists to ensure proper follow-up care and rehabilitation to support the healing process and prevent future issues. From simple follow up appointments and exams with your physician, podiatrist or other specialist, or physical therapist, we include everything in your treatment plan necessary to resolve the problem, prevent loss of your limb, and prevent future risk of amputation.

At Premier Surgical Limb Preservation Clinic in Knoxville our staff and physicians are dedicated to earning your trust through our demonstrated vascular expertise. We are committed to saving limbs and saving lives. Learn more about Premier Surgical on our website.

The post 3 Facts about Premier Surgical Limb Preservation Clinic first appeared on Premier Surgical.

• Early Intervention. Recognizing the signs of CLI is the most vital step in prevention. Severe pain in the feet or toes while resting or wounds that won’t heal on the legs and feet are all common symptoms of CLI. Discuss these symptoms with your physician and request a referral to Premier Surgical Limb Preservation Center. Our vascular experts will work to secure immediate, same-day evaluation to properly diagnose your condition.
• Restore Blood Flow. The sooner blood flow can be restored the better your chances in preserving the limb. With rapid diagnostic testing and evaluation, the Premier staff will prioritize a treatment plan to restore and maintain blood flow long-term. Balloon angioplasty, stents, atherectomy, and bypass procedures are all techniques performed by our vascular surgeons to open blockage and remove plaque.
• Speed the Healing Process. The first step in treating a chronic wound is to eliminate any infection in the skin or soft tissues. Medication, dressing, debridement, incision, compression, and vacuum-assisted closure are all methods used to treat chronic wounds. Your care plan will depend upon factors related to your specific condition including culture results identifying what type of bacteria is causing the infection.
• Maintain Ambulatory Status. Premier Surgical Limb Preservation Clinic works in conjunction with referring physicians and other supporting specialists to ensure proper follow-up care and rehabilitation to support the healing process and prevent future occurrences. Once the immediate concern of restoring blood flow is resolved, the attention turns to ensure the blood flow does not become restricted again.

“A multi-disciplinary approach is paramount to meeting our goal of limb preservation,” explains C. Scott Callicutt, MD, FACS. “We have established a network of specialists to assist us in delivering efficient, quality care defined by the ultimate prevention of limb loss in CLI patients.”

Dr. Callicut says the Center understands many patients must travel long distances and coordinate multiple appointments on the same day. “The benefit of our program coordinator is they manage the treatment plan and work to coordinate same day appointments. At Premier Surgical Limb Preservation Clinic a patient can be evaluated, undergo diagnostic imaging and agree to a comprehensive treatment plan all in the same day.”

At Premier Surgical Limb Preservation Clinic in Knoxville our staff and physicians are dedicated to earning your trust through our demonstrated vascular expertise. We are committed to saving limbs and saving lives. Learn more about Premier Surgical on our website.

The post Critical Steps to Amputation Prevention first appeared on Premier Surgical.

• Severe injury or trauma
• Cancerous tumor
• Infection
• Neuroma or thickening of nerve tissue
• Frostbite

The Premier Surgical Limb Preservation Clinic is committed to the prompt care of patients at risk of limb loss due to peripheral artery disease, diabetes, and ischemia. An estimated 65% of amputations are considered preventable and prevention is our primary goal. With early detection and rapid treatment as critical steps to limb preservation the expert staff of Premier Surgical Limb Preservation Clinic offers the following signs and symptoms to look for if you have a condition putting you at risk for limb loss:

1. Intense pain or numbness in the limb while not moving
2. Sores or wounds unable to heal or heal very slowly
3. Gangrene
4. Shiny, smooth, dry skin on the limb
5. Thickening of toenails or nails
6. Absent or weakened pulse in the limb
7. An infection in the limb unresponsive to antibiotics

If you have peripheral arterial disease or diabetes and begin to experience symptoms listed above, seek treatment immediately. The sooner blood flow can be restored to your limb, the more likely you will be to prevent amputation.

“Our team works to develop and implement a timely and aggressive treatment plan to all patients within the Limb Preservation Clinic,” says C. Scott Callicutt, MD, FACS. “Life in general becomes much harder following an amputation in regards to physical exertion and emotional state. In addition the risk of death increases drastically if a lower extremity is amputated.  We are committed to saving limbs and more importantly saving lives by offering immediate, state-of-the-art care from initial evaluation to rehabilitation.”

Learn more about Premier Surgical Limb Preservation Clinic at our website.

The post 8 Signs and Symptoms You May Be at Risk of Limb Loss first appeared on Premier Surgical.

Peripheral arterial disease (PAD), the progressive buildup of plaque in the arteries outside the heart (usually in the legs), is usually caused by atherosclerosis, the same disease process that causes heart attack and stroke. High cholesterol, high blood pressure, obesity, smoking, diabetes, and a sedentary lifestyle all contribute to atherosclerosis. These cardiovascular risk factors are nearly always present in my PAD patients. Not surprisingly, PAD patients have a 1 in 3 chance of having coronary artery disease.

The most common PAD symptom/complaint is claudication, which is often described as a tired ache-like cramp in the legs when walking that is relieved when activity stops. People often dismiss leg cramps as a natural part of aging or arthritis, and may never mention it to their physician. An estimated, one in 20 Americans over age 50 has PAD, but are unaware of the condition. If PAD risk factors are not controlled, this atherosclerosis of the arteries can progress and lead to limb threat and possible amputation.

As PAD progresses, so does the inability to walk even short distances without having to stop frequently. The arteries can eventually become clogged with plaque and the blood flow so restricted, that the foot doesn’t get enough oxygen to meet its basic needs to remain viable. When we see patients in this advanced state of limb threat, there’s a high risk of limb amputation if steps aren’t quickly taken to intervene.

Patients who present with PAD symptoms, especially those with heart disease and other high risk factors, should be encouraged to be screened for peripheral arterial disease. The simple ankle-brachial index (ABI) test, which compares the blood pressure in the ankles to the arms, can show how well blood is flowing to the legs. A Doppler ultrasound test may be used to determine where a specific artery is blocked.

Fortunately, like heart disease, the progression of PAD can be slowed or stopped with lifestyle changes, medication, or a combination of both. Being physically active, especially with a walking program, can increase blood flow to the affected leg. For smokers, the most important intervention is to stop smoking immediately. Strict glucose control in diabetics and eating a low-cholesterol, low-fat diet, can also help reduce the buildup of plaque in the arteries. Medications to lower cholesterol, blood pressure, and diabetes are also a part of PAD treatment.

For patients whose PAD has advanced to the stage that it is disrupting their ability to work, enjoy favorite activities, or threatening a limb, circulation may be restored by opening the blockage with a minimally invasive procedure. This outpatient endovascular procedure is performed through a catheter that opens the blocked artery and restores circulation to the leg and foot. If a long section of an artery is blocked, bypass surgery may be needed.

PAD treatments are not “cures,” but can provide a very durable result, especially in patients who have minimized the risk factors listed above and embraced a more active lifestyle and healthier diet. PAD is often a gateway indicator to one’s overall cardiovascular health. Early detection and treatment of peripheral arterial disease can help improve patients’ quality of life and reduce the risk of amputation.

Richard M. Young, MD, FACS, is a vascular surgeon with Premier Surgical Associates at Fort Sanders Regional in Knoxville, Tennessee. He is board certified in vascular surgery by the American Board of Surgery and a Fellow of the American College of Surgeons.

The post Close Cousins: Screenings Encouraged for both Peripheral Arterial & Coronary Artery Disease first appeared on Premier Surgical.