Patient with Diabetes Avoids Amputation through Wound Care

Michael Brandes (54) recently “graduated” from receiving treatment at the Trinity Health Wound Care Clinic in Grand Rapids. Typically, patients are thrilled to celebrate their last day in long-term treatment, but when it came time to ring that bell on his last day, Michael was joyful and sorrowful.

That’s because, during his inpatient and outpatient care, he came to know the staff so well that he began to think of them as “family.”

A Simple Callus?

Michael’s journey began with what he thought was a callus on his left foot that turned into a blister. As a patient with diabetes, it is not uncommon for calluses to form that then blister and turn into ulcers. Michael’s primary care physician (PCP) treated him for a foot ulcer with antibiotics, but in a follow-up visit two weeks later, his foot was much worse.

That’s when Michael’s PCP ordered imaging that showed a pocket of infection inside his foot. Because the infection was acute, Michael was referred to Trinity Health Medical Group Podiatrist Brad Christiansen, DPM.

A Rare Condition Leads to Surgery

Even though Michael’s diabetes was well-managed, he developed a rare condition.

“Less than one percent of diabetics develop the condition called Charot Arthropathy. Patients with this condition have structural changes to their foot from diabetes, and they walk on parts of their foot that weren’t made to be walked on. Michael’s first surgery was emergent; we had to address his serious infection and remove some of the bone in his foot,” said Dr. Christiansen.

“My first surgery was in April 2023,” said Michael. “I had never had surgery before. Dr. Brad [Christiansen] cleaned out the infection, and I was hospitalized for three nights. The surgery left a large hole in my foot.”

Follow-up Care

Michaell’s follow-up care occurred weekly at the Trinity Health Wound Care Clinic - Grand Rapids Campus. The clinic staff constantly encouraged Michael to be positive and maintain a good attitude. They acknowledged that it would be a tough road, but they were upbeat about their ability to heal his foot.

“Michael was a great patient because he was receptive to everything that we tried,” said Dr. Christiansen. “With wound care, we are constantly changing our treatment plan based on how the wound responds. Each situation is unique. Patients have to partner with us because a lot of the care falls on the patients — they are the ones doing dressing changes every day.”

To promote healing, Michael was not allowed to put any pressure on his foot. During the following months, he used crutches, a knee scooter, and ultimately two different-sized boots, each containing a customized insert with a cutout that allowed Michael to walk without putting pressure on the site of the surgery. That way, he could still work and care for himself.

Planned Surgery

“Dr. Brad saw me regularly to check my progress. My healing started off good and then it stalled, even with more antibiotics,” Michael said.

Dr. Christiansen ordered an MRI, which revealed the infection had spread to the bone behind Michael’s pinky toe. Michael would need another surgery.

“From a wound care standpoint, the first surgery was unplanned due to infection, and the second surgery was planned in order to repair the deformity in Michael’s foot,” said Dr. Christiansen. “If bony prominences from diabetes persist and form wounds, I often have to restructure the foot to heal the wound and prevent it from returning.”

“My second surgery was seven months after the first, in November 2023. I was confident that Dr. Brad knew what he was doing. He is fantastic. When he is caring for you, you learn what a great person he is,” Michael said.

Michael stayed five nights in the hospital following surgery and went home with oral antibiotics.

“To me, it mattered that I was at a faith-based hospital. It was super evident. That is what kept me going. My hope lies in my faith that God is working for my good, and He graciously put the fantastic people at Trinity Health in my path. They’re friendly and caring. They understood what my faith means to me, and they didn’t discount it.”

The Wound Care Clinic

Again, Michaell’s follow-up care took place at the Trinity Health Grand Rapids Wound Care Clinic.

“The people in the wound clinic are superheroes! They worked tirelessly. They always made sure I knew we were on a good road. They never cut corners or spared words. Praise the Lord, that hole was about 4 inches long and ¾ of an inch deep, but it finally healed!”

Success

Today, Michael participates in activities with his wife and children. He no longer needs to keep pressure off his foot.

“Michael’s prognosis is great because he is faithful with his diabetic management, which is vitally important. He took an active role in his wound healing. I have seen this wound before — and I have seen it end up in below-the-knee amputation. Because Michael partnered with us in his care, this very challenging wound healed,” said Dr. Christiansen.

Michael will continue to see Dr. Christiansen routinely in his office for diabetic foot examinations to ensure he is not developing any foot problems.

Farewell

When his foot was pronounced totally healed at his last visit to the clinic, Michael was emotional. It had been a long road.

“When I rang that bell, everyone was there! In the beginning, they were all there, and they were all there in the end. Over time, we became family.”

Michael enthusiastically endorses Trinity Health: "I’d recommend Dr. Brad, the Wound Care Clinic, and the hospital without hesitation. If you want to get better, these are the people you want to see.”

Learn more about Podiatry and Wound Care Services at Trinity Health.