03/30/2017

Back in the Saddle

I’m an outdoors freak,” says Gretchen Vercauteren, who works five days a week at a horse barn in Lebanon, Maine.

When your daily routine includes responsibility for the care and well-being of four-legged creatures – one weighing over 1,500 pounds – it’s hard to let health issues slow you down.

This was the challenge Gretchen faced last year. Not only was she unable to walk comfortably, but vascular disease affected her ability to ride her beloved German Warmblood horses. She could not feel her right leg when she dismounted.

“I was a person who never even caught a cold,” says Gretchen. And then, “I hit a wall. I simply could not do my job at the barn, which involves using a pitchfork and a wheelbarrow when you clean out stalls. And I am very fussy about doing everything right, not only for my own horses, but for others.”

Now that debilitating numbness and weakness are behind her, thanks to the specialized treatment she received at Wentworth-Douglass Hospital’s Cardiovascular Care Center by vascular surgeon Dr. James M. Estes. 

The vascular team at Wentworth-Douglass is “the cream of the crop,” according to Gretchen. “I was spoiled by their outstanding bedside manner and their medical know-how.”

The first step was an ultrasound which showed “severe blockage” in the femoral artery of Gretchen’s right leg.

“I was getting foot sores because of the lack of circulation,” Gretchen says. Gretchen met with Dr. Estes, who explained to her why the blockage was causing pain: “As demand for blood flow increases with exercise, it exceeds the actual delivery of oxygen and results in a build-up of lactic acid,” he says.

According to Dr. Estes, Gretchen “was an unusual case because she is also a cancer patient. So we needed to come up with a way to treat her in a minimally invasive way, since an open surgical approach was not an option. Fortunately, we have a lot of tools in our toolbox, so we can discuss the best options with our patient to make an informed decision about what is both appropriate and safe.”

Her leg responded well with only angioplasty. No stent was needed. In most cases, this is a day surgery procedure, but Gretchen stayed overnight in order to monitor her blood pressure. “Since I was not expecting to stay overnight, I didn’t even pack a toothbrush. But the floor nurses made sure I was given everything I needed. I got a bad headache around midnight, so I buzzed for help and started off by saying ‘I hate to bother you.’ The nurse replied, ‘You’re not bothering me. This is why I’m here.’"

Gretchen was a supervisor at American Airlines working out of Logan Airport for 30 years. “I was the lead agent at the gate overseeing departures, so I know the importance of customer service,” she says. “My care team was so solicitous and fun. The techs helping Dr. Estes, the nurses on the floor, everyone kept me laughing and their level of personal attentiveness was amazing.”

Dr. Estes puts a premium on teamwork: “There is a strong infrastructure and coordination of care here at Wentworth-Douglass. In Gretchen’s case, Dr. Khosro Farhad of Coastal Neurology Services recognized her vascular issues (an Arterial Duplex Study showed blockage), and we were able to coordinate with her cancer treatment here at the Seacoast Cancer Center and with Dr. Syed Naqshbandi of Seacoast Pulmonary Medicine.”

Our vascular care providers – Dr. Estes, Dr. Stephen Gemmett and Dr. Ritoban Sen – manage all aspects of vascular health including carotid disease/stroke prevention, artery blockages, aneurysm disease, and vein problems. “We can offer the full spectrum of endovascular treatment. We were trained in open surgical procedures, and we can couple that with catheter techniques. We treat the whole patient, for example, making sure they are on the right medications for the long term – beyond the immediate medical concerns," says Dr. Estes.

Gretchen agrees. “Right from my very first appointment, I felt like I was in good hands. It was so reassuring to know that I could get exactly what I needed here locally. I’m back at the barn every day, and yesterday I cleaned seven stalls and then rode for an hour. The horses are happy, and so am I.”

For more information about vascular care or to make an appointment, visit the Wentworth Health Partners Cardiovascular Group or call (603) 516-4265.