Best Foot Forward

March 9th, 2009 - By Steven Longenecker

Jeff Fulton

(Photograph courtesy of St. Mary Medical Center)

Jeff Fulton is a simple man. He’s friendly, a dedicated worker. He owns a Christmas tree farm and brings his wife with him on business trips to exotic destinations. He is also a diabetic.


His ordeal began simply in February of 2006. A callus on the bottom of his left foot, two inches behind his left toe.

A year ago, Fulton wasn’t expecting to see this Christmas. If he did, he was resigned to the fact that it would be his last. Instead, he celebrated Christmas with the doctor who saved his life and his leg from amputation.

After noticing the callus in 2006, Fulton mentioned it to his podiatrist, who did a routine callus removal. “I didn’t think anything about it,” says 56-year-old Fulton. “But it caused a hole in my foot.” He gives a tense chuckle. “The hole never healed.”

Instead the ulcer worsened—a 1.5-inch wide and 1-inch deep gaping hole. Time-consuming and expensive treatments failed and he saw still more doctors. Then, the infection spread to the bone. “My wife and I both decided that amputation wasn’t an option. With diabetes, it doesn’t have a good five-year history. Usually when they cut off one thing they just have to keep cutting.”

Fulton had been a diabetes educator in the 1980s for a well-known medical device supplier until being diagnosed with Type 1 diabetes and forced by the company to resign. “I’m familiar enough with diabetes that I updated my will and made a living will,” Fulton relates. “They can only control a bone infection so long.” But Fulton refused to give up. Nine doctors later, his regular diabetes doctor suggested someone who might help.

Dr. Ahmad El-Samad, director of the diabetic limb salvage program at St. Mary Medical Center in Hobart, specializes in exactly what Fulton needed. A different approach.

“Jeff was a very desperate man, asking me ‘I hope you’re going to do something different,’” El-Samad says. “He tells me he’s been getting this treated for two years and the ulcer was getting bigger. It was draining, it was smelling and you could see the bone poking out of the wound. And this is when I told him we’re going to put a whole team together,” El-Samad remembers.

At this time, Fulton was on long-term disability. He had to give up his job at a sewer cleaning manufacturing company due to the care his foot required. He sold equipment, then traveled to the buyer for training. He names a few of the places he traveled to—Iraq, Kuwait, China, South Korea.

He was rehired by the same company and returned to work just days before sharing his story with Get Healthy, thanks to his successful treatment.

“Dr. El-Samad was able to completely heal my foot. There’s just a little scar at the top,” Fulton says.

Focused on addressing the whole picture, El-Samad traced the infection back to the initial cause and decided Fulton needed a foot reconstruction—cutting bones, routing tendons and reshaping the foot in such a way to take off the pressure that caused the original, simple callus. “We addressed the deformity of the foot, the infection was cleaned and the skin loss was substituted with a GraftJacket.”

GraftJacket acts as a replacement skin graft and is especially useful to diabetics, since using their own skin could cause another area to become infected. “It’s readily available, and you’re not creating a whole new wound,” El-Samad says.

“Dr. El-Samad did his first surgery on June 28, 2008, then another surgery and skin graft on August 20, 2008,” Fulton says. “And I was completely healed by Christmas. In fact, I found out that [Dr. El-Samad’s] family was going to be out of the country, so I invited him to join us for Christmas dinner.”

El-Samad laughs. “It was a beautiful result—the doctor and patient having a Christmas party together. Driving down [to Rochester, Indiana] I realized how far it was that Jeff drove every time he saw me—and never once complained, never once missed an appointment or was late. I have a lot of respect for his dedication. This is someone who is so eager to continue to do what he has a passion for.”

He warns about the problems associated with diabetes and foot ulcers. “They’re absolutely very common. If you’re diabetic and you develop a problem with your foot it’s an emergency. Jeff started with such a simple wound that literally changed his whole life around. If I could have seen him two years ago when he only had a callus, we could have prevented his ulcer from becoming an ulcer.”

Fulton laughs, “I’ve got about a $125,000 foot now. ’Course, if I’d seen Dr. El-Samad first it’d be a lot less.” He trails off. “If I was to give anybody advice, if they see their doctor twice and they’re not any better—go find somebody else.”

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