Since his surgery, Joe Arndt checks his pulse every morning—via the long arm vein that has been re-routed down his left leg.
Arndt hadn't been to the doctor in about nine years when he decided to make an appointment following his 40th birthday. His wife, Ronda, had suggested he get his cholesterol and a lingering cough checked out.
It wasn't until two days before the appointment that he told her about a lump on the inside of his leg that he'd noticed about four months earlier.
"Guys need to pay attention to their health and be more willing to go to the doctor. I probably never would have gone if I'd been single," said Arndt, a farmer and an office manager/purchasing agent for a Fairfield, Iowa, glove manufacturer. "My motto now is plan for the future, live for today. That's the lesson I've learned from all this."
"All this" began to unfold the minute he visited Medical Arts Clinic, P.C., and told his local physician, Michael Greiner, MD (a 1987 University of Iowa Roy J. and Lucille A. Carver College of Medicine graduate), about the lump. An MRI was taken, and when doctors suspected a malignancy, Arndt was referred to Joseph Buckwalter, MD, professor and head of the Department of Orthopaedics and Rehabilitation at UI Hospitals and Clinics.
After Buckwalter removed a slice of the mass—an extremely delicate task, as it surrounded the femoral artery, the main artery in the thigh that provided blood to the lower extremity from the knee down to the foot—pathologists made the diagnosis: Arndt had a malignant vascular tumor.
"It was a shock," Ronda Arndt said. "He's very fit, with a good family history—no cancer."
"Because the tumor surrounded the artery, the only way to save Mr. Arndt's leg was to cut the artery," said Buckwalter, who quickly contacted Jamal Hoballah, MD, professor and chair of the vascular surgery and an expert on re-routing blood flow.
Buckwalter and Hoballah then planned a unique two-stage operation to permanently provide blood supply through an alternate path, maintaining the circulation to the leg and allowing for the wide resection. "The task of the vascular surgery team was to harvest a vein [from Arndt's right arm] from the wrist up the shoulder, connect this vein to the artery in the groin, route it along the outer aspect of the leg, and then connect it to the main (popliteal) artery below the knee," Hoballah said.
A week after this bypass was completed and doctors were satisfied with the new circulation, Buckwalter successfully removed the 3.5-centimeter tumor. Arndt then completed seven weeks of radiation therapy to ensure all remnants of the tumor were gone. He is now considered cancer-free.
"Completing this procedure took a multidisciplinary team effort," Buckwalter said. "It required cooperation among the referring physicians, nurses, pathologists, anesthesiologists, Dr. Hoballah and myself, and the oncologists."
Four months after the procedure, scar tissue developed along a section of the bypass. The team corrected the problem using a small portion of vein from Arndt's left arm. Afterwards, Arndt had a transient foot drop (loss of the ability to raise the foot at the ankle), a problem he has now overcome. Otherwise, complications were minimal.
"I used a walker briefly after the initial procedure, but I love the outdoors and was able to jump pretty quickly back into my usual activities," Arndt said. "I was out in the tractor within three weeks —thank goodness for power shift. The real challenge was getting in and out."
For information about the multidisciplinary patient care provided by Holden Comprehensive Cancer Center at The University of Iowa, patients and families should call UI Health Access. For consultation or referral, physicians should call UI Consult.
-Clancy Champanois |
