Frank Diaz's PAD Odyssey
Frank and Maria celebrate on their wedding day
Frank Diaz was introduced to peripheral artery disease while driving. He was commuting home in traffic in November 2014, when his right ankle stopped working. He had to use his left foot to operate the pedals during rush hour in Chicago — “If you’ve ever tried that, it’s quite a trick,” Frank said. Up to that point in his life, despite 30 years of living with diabetes, he had little knowledge of PAD and had even less concern.
A native of the Windy City, Frank is Puerto Rican and spent much of his youth on the island. His family has a history of diabetes, including an uncle who had both legs amputated because of poor circulation. Frank was diagnosed with diabetes at age 26 and started out on Glucophage®, a drug used to treat high blood sugar levels caused by type 2 diabetes, but he did not take insulin. “I switched doctors eight years later and began using insulin under orders from my new endocrinologist,” Frank said. A third doctor added metformin to his treatment in 2006. During these years he worked a variety of jobs at nonprofits, including several years working for the local affiliate of the American Heart Association as a public education specialist teaching CPR.
“I always thought of myself as a pretty good patient; not perfect but aware of the disease and its warning signs,” Frank said. “I didn’t realize that arterial blockages happen slowly, and that certain factors can accelerate them. Although I’d never smoked before, I picked up the habit about 11 months before I was diagnosed with PAD.”
In hindsight, he says he had felt his ankle droop once or twice before. “It didn’t concern me enough to mention it to my doctor,” he said. “So much for detecting a warning sign!”
But after that harrowing drive home on a Tuesday after work, Frank was about to get a crash course in the warning signs of PAD.
Throughout that evening and the next morning, he could not flex his right ankle. He told his fiancé, Maria, that he wanted to go to his doctor, a GP who treated his diabetes. When the doctor checked the pulse in Frank’s feet, he couldn’t find one. “My foot had no pulse and it was turning white very quickly,” Frank recalled. “The doctor said, ‘You’re having some kind of circulation problem, and we’re going across to the hospital and see what we can do in the emergency room.’”
For Maria, this was a big shock: “We had only been together about a year,” she said. “I knew that he was a diabetic, but the PAD was totally unexpected and a big shock.”
Tests at the hospital found a blood clot behind Frank’s right knee, and a vascular surgeon was called in to remove it. Recovery did not go smoothly — there was swelling and more surgery — and he spent most of December in the hospital. Frank and Maria had planned a wedding, but that had to be postponed until he was more medically stable and could walk.
All did not go as planned for Frank. There were more surgeries, as well as several stents and multiple bypass surgeries in his right leg. Other complications involved compartment syndrome — painful swelling of muscle tissue, usually in the lower leg, which is treated by surgically opening the muscle compartment to relieve the pressure and allow blood to reach the muscle. Dead tissue was also removed. In addition, doctors used a wound VAC on each side of his calf to keep his dual incisions clean and help the wound heal, but eventually a skin graft was required. Each procedure produced short-lived relief. During one of those periods of relief, on Labor Day weekend 2015, he and Maria got married. Frank was even able to dance at the wedding. They went on a cruise for their honeymoon, and that was a high point, but by the end of the cruise his leg was worse. “I noticed that it was getting darker,” Maria said.
For the next year and a half, Doppler ultrasounds, angiograms, bypasses, and a swollen right foot dominated the new couple’s daily life. “At times my foot would improve, but after a few weeks, I had trouble walking more than a few yards or around the block without stopping for a break,” Frank said. Much of 2015 and 2016 was spent in and out of hospitals.
Maria’s initial shock at the PAD diagnosis evolved into concern, and ultimately preparing for what was expected as he underwent escalating surgeries. “But I have a strong faith in God, so I did a lot of praying, and that helped me deal with what was coming our way,” she said.
And as it turned out, there was much more coming their way.
To be continued in part two of this series in our Winter 2018 issue. You won’t want to miss the rest of Frank & Maria’s dramatic story.