On March 17, 2010, after having awakened with the cold, numb foot, Charles and I arrived at the Loudoun Hospital Emergency Room and the process started--off to interventional radiology for Doppler studies which showed no pulse or blood flow in his right leg. The decision was made to have the interventional radiologist attempt to open it up and start thrombolytic (clot busting) therapy. We had to move quickly, because a limb without adequate blood flow is in real jeopardy; the tissue will die if the blood flow can not be restored in time. And Charles was in a lot of pain from the blockage that was the presumed source of the lack of blood flow. The pain was most likely being caused by a blood clot, and that had to be remedied soon if his toes and his foot were to be saved.
There was a problem, however. Surgical back up was necessary in case the blood vessel was damaged during the procedure, necessitating surgical intervention, and our friend and my colleague, Dr. McDow, the vascular surgeon, was out of town, and this meant that perhaps he would need to be transferred to a tertiary hospital, 20 miles away. We really didnt want to do that. Charles had been there before for surgeries and procedures; it had not been a great experience and he was simply, more comfortable being home at Loudoun.
Over the years, Charles had endured many medical procedures, most of which had been related to his longstanding cardiovascular disease, and he had experienced heart attacks, heart surgery, carotid artery surgery and repair of an abdominal aneurysm. He had suffered his first heat attack in his early 40s, and he was certainly considered high risk. But we knew and trusted our team at Loudoun and this was where we wanted to be, if at all possible.
Thankfully, another surgeon agreed, very graciously, to cover the procedure and would be available if anything surgical was needed. Although he wasnt officially on call and covering for Dr. McDow, he too was a colleague and agreed to help us out by being available should the need arise. The radiology team was able to place a catheter into the artery that was blocked and start the medication to dissolve the clot. The plan was to leave the catheter in place and to continue the thrombolysis (clot buster) and blood thinners for 24 hours, and then the following day, Thursday, bring him back to the interventional radiology lab to repeat the procedure to see what progress had been made. He