Charcot Ankle Reconstruction
From a Patient's Daughter Addressed to Naples Community Hospital

Hi, my name is C.G. my mother J.P. is currently in your hospital. I'd like to share my story with you. My mother is a diabetic. She broke her foot about a year and a half ago. She walked on that same broken foot for a year. Being a diabetic she doesn't feel pain, that much. One day she noticed a small cut on her ankle. Which turned into an enormous sore. She decided to go to a physician named Dr. ... There she found out that her foot was broken (really bad). He started treating the sore by giving her a cream to put on week after week after week. The sore never healed. The doctor told my mother that she would need to get the foot amputated, before poisons spread through the body. We were not happy with this so we decided to get a second opinion. This time we went to a Dr. -----. He also told her that amputation would be the best thing. My mom is in your hospital at least twice this year. Well, about six - seven months ago. She ended up in your hospital again. Because of high blood pressure etc. She asked the doctors to look at her foot. They sent in a Podiatrist named Dr. Petrocelli He looked at her grotesque foot, and told her that he could help her. From that point on he started treating her. He mentioned to her that himself, along with Dr. Lam would be able to do a reconstructive surgery on her foot. Well this was the best news ever. They told her she would have a 50/50 chance (but what did she have to lose).

She recently got sick again Trouble Breathing, etc.... When the nurses saw her foot you could see the look on their faces, they looked scared or even grossed out. That's how bad my mother's foot was. I'm writing to tell you that, while in your hospital Dr. Petrocelli and Dr. Lam did that Reconstructive Surgery. It is a miracle what they do for my mom's foot. She now has a nice straight foot. The she can now walk on. They had her walking on that foot 24 hours after the surgery (amazing isn't it?) It was unbelievable what these two gentlemen did for my mom. I write to you as president of the hospital, to please not let work like this go unnoticed. These two professionals took the time to care and really look into my mom's case, and did a miraculous surgery. Thanks to Dr. Lam and Dr. Petrocelli.

From Dr. Lam:

Picking a physician for Foot and Ankle reconstructive surgery is a big decision. You depend on your legs to go about your daily activities. The above patient had Charcot Foot and Ankle Disease, a neurological disease that is clinically manifested with a collapsed / distorted foot and ankle due to the lack of sensation in the lower extremity. Seeing a podiatric surgeion early for this deformity, may help to avoid major reconstruction or limb loss in the near future. Braces, casts, special boots are used as conservative therapy with good outcomes. Before you have any foot and ankle surgery, always check the physician's references with past patients as well as other health professionals. Physical therapists and nurses will have unbiased opinions about surgeons due their exposure.

Bunionectomy

In late October I had a phone call from my daughter, who is a nurse in Naples, telling me that she had discovered a new Doctor in town, a foot surgeon whose work she greatly admired. She thought it was time for me to have my feet taken care of. For about 40 years I've been developing a dorsal bunion on my right foot, and similar problem on left foot but not as progressed. She said I should talk it over with Dad and decide. We did talk and I decided it was time to have it at least looked at, and meet this new doctor. We met, both Frank and I liked and trusted him, and I was scheduled for surgery on November 16th. This was a BIG decision for me as I had been procrastinating for all those years, did have legitimate excuses (a job and 4 kids to rise), but still an excuse I guess.

I was fearful and apprehensive on the day of surgery, I told Dr. Lam I didn't want to hear saws or drills, but all went well (at least on my side), I'm told the surgery was more extensive than originally thought, but I was out of surgery and on my new walker all within 3 hours. The pain, which was my big fear, wasn't nearly as bad as I had thought. Pain pills these days are wonderful! I had a good caregiver, my husband who did it all, drove me places as needed, cooked, cleaned, did laundry, and even helped me shower for the first two weeks (I needed to cover the foot with a bag so I didn't get it wet). I spend the first two weeks on my fanny, with my feet elevated, taking pain pills as needed, watching TV and reading. After two weeks things improved (and I began to like Dr. Lam again!!!). Once the pins were removed from my foot I was able to be up and moving a bit more, and day by day I could see the foot improving and healing, with special care given by my husband, and also I had a therapist. Due to bone grafts that were necessary, I had a fixator attached to my foot, which took some mental and physical adjustment, it's not painful, but just "there" all the time and you have to watch your sheets and blankets so they don't get torn, and of course you couldn't get any kind of slipper for shoe on your foot. I was also to walk around the house without my walker, although I did take it with me if I went out in public, but it was more to protect my foot from someone stepping on it, something I DID not want to happen.

For me the hardest part of this was the fact that it is so limiting for the first 3 weeks, your social life becomes non-existent, and you get bored. BUT finally somewhere around 4-5 weeks I found myself walking normally, able to get out and about more, and I decided that to live the rest of my life without that horrible bump on my foot is a blessing and one worth going for. I’ll finally be able to buy shoes I like rather than shoes that fit around my bunion.

I recommend this surgery, although it’s not always a pleasant experience, it is well worth it in the final analysis. I also highly recommend Dr. Kevin Lam, a great surgeon, and a kind and patient man.

I would also like to mention as an afterthought, that the therapist I had each time he looked at my foot said “what a great surgeon I had, he’d not seen as good a surgery” which reinforced my decision to go with Dr. Lam. When I look at my foot today I see a normal foot, I’m thrilled, and can’t wait to hit the shoe store!!!

From Dr. Lam:

The greatest compliment for me, is a fellow health care provider recommending me not only to her patients but her parents for lower extremity care. Despite horror stories of a painful experience with bunionectomies, new pain medications and delicate surgical techniques allows for a more tolerable experience. Advances in fixation methods has allowed progressive surgeon to provide early weight bearing during recovery for most bunionectomies. Remember to check references of your surgeon.