Surgeons and wound specialists at GVCH team up for a remarkable recovery.
“I was working with a road crew in San Luis Obispo, and I was walking by the machine while it was grinding the asphalt,” he recalled. “I think the machine jumped. It jumped over my foot, and that’s all that I remember.”
Even though Joel was wearing steel-toed shoes, his foot was mangled so badly that some doctors felt an amputation and prosthesis was his only hope to walk again.
But Joel’s family refused to believe that, and they urged emergency medical staff to find specialists who could help save Joel’s leg and foot.
Dr. Salvatore Garofalo, a foot surgeon, said that Joel was transferred from San Luis Obispo to the trauma service at Santa Barbara Cottage Hospital. He recalled the emotional encounter with the family before the surgery.
“Joel’s son took me aside and he told me ‘we have to do everything we can to save my father’s foot.’ I was confident that I could put Joel’s foot back together so that he could walk without a prosthesis. My biggest concern was infection and tissue loss.
“But I knew that I had the option to put him in the hyperbaric chamber (in the Center for Wound Management at Goleta Valley Cottage Hospital) to facilitate the healing of his foot,” Dr. Garofalo added.
The hyperbaric chambers at the Center for Wound Management are used to treat people who have long-standing wounds that will not heal, such as from diabetes, and also for treating wounds resulting from accidents, such as in Joel’s case.
Drs. Salvatore Garofalo and John Deacon
When Joel awoke after his surgery, he received the good news that Dr. Garofalo was able to put his foot back together.
“They said they saved my foot, and we were really glad when we heard that!” Joel said.
The day after surgery, he was transferred to Goleta Valley Cottage Hospital, where the Center for Wound Management is located, to begin hyperbaric oxygen treatment with Dr. John Deacon, a specialist in hyperbaric medicine.
“With a severe crush injury, such as Joel had, that area is not getting the normal amount of oxygen because the capillaries are damaged and that reduces the blood flow,” he said.
Inside a hyperbaric chamber, a patient is breathing 100 percent pure oxygen. In comparison, living at sea level, the normal level of oxygen we breathe is about 21 percent.
The hyperbaric chamber can be pressurized to increase the oxygen level to twelve and a half times the normal amount to help prevent more tissue damage and help the healing process, Dr. Deacon said. Contrary to common belief, the oxygen is not working “topically.” It does not travel in the air to the surface of the wound. Instead, the oxygen is dissolved in the lungs just like it would be when breathing normally. The oxygen is absorbed into the bloodstream and is pumped by the heart throughout the body.
Joel was a bit scared of the chamber when he first saw it.
“When I saw it, it was really, really hard for me,” he said. “But after one time in there, I felt good. And the doctor told me it would help heal my foot.”
Joel’s treatments lasted about two months, which involved spending two to three hours at a time in the chamber, five days a week. He passed the time watching movies and television.
He also spent time in physical therapy, and after three weeks was able to take his first steps without help. He used a wheelchair and crutches for six months, but as each week went by, he was able to walk a little bit longer.
Today Joel walks two miles a day for exercise near his home in Oxnard, and he wears regular shoes, just one size larger than before on the left foot.
“I walk every day. I walk sometimes by myself, sometimes with my wife and family. I want to keep improving,” he said, adding that he hopes to take on more ambitious footwork in the future. “I want to dance,” he smiled. “I can’t do that right now, though.”
Instead of losing his lower leg and foot, Joel ended up losing only one toe and a small bone.
“Joel was an inspiration to all of us who took care of him,” Dr. Deacon said. “And his case shows the real reason that the wound center is here. We do more than heal chronic wounds,” he added. “We help save limbs and lives.”