Dina Altschul was days away from having her left leg amputated.
And losing her leg was going to break her heart.
Altschul is barely 5 feet tall and 81 now, but back in the day, she was a basketball star for a Belarusian semi-pro team. Energetic and full of smiles, she’s a devoted grandmother who loves walking and tending her large garden in Centennial.
For the past few years, Altschul has been suffering from a severe case of peripheral arterial disease, also known as PAD, which clogs arteries in the arms and legs and can lead to poor blood flow. That, in turn, can cause severe pain, difficulty walking and lead to amputation.
The arteries in Altschul’s left leg became so blocked that she compared her left foot to a piece of white marble. With little blood flowing to the foot, it lost color and was cold to the touch, like a piece of stone.
At night, the pain was so overwhelming that Altschul often couldn’t sleep and would get up every 15 minutes to try to keep blood moving in her leg. She had endured multiple painful surgeries at a Denver hospital, but within days of each surgery, her arteries quickly became clogged again. Over the holidays in 2016, as Altschul lay in a hospital bed after a failed surgery that left her with a gaping wound in her leg, her doctors told her they had no choice but to amputate. They asked her to sign papers, giving permission for the surgery.
“I said ‘no.’ I did not sign them. I said, ‘I will go home first.’’’
She and her husband feared they would have to consent to an amputation within days. They saw other people fresh from limb losses limping around the hospital. They felt frightened and trapped.
“We were lost,” said Leon Altschul, Dina’s husband of 58 years. “She’s a very brave woman. But in the advanced stages of this disease, we thought we had very few choices.”
‘It was a miracle’
Then a remarkable thing happened.
“It was a miracle,” said Leon. “It was amazing. We looked for a doctor for many, many months and we couldn’t find a doctor. We went through many, many clinics and no one could help us.”
Then, thanks to a chance connection through their daughter, who is a professor at the University of Denver, they found Dr. Kevin Rogers, an interventional cardiologist at UCHealth’s University of Colorado Hospital.
Rogers’ nurse arranged for get Dina in for an exam within days of their first call in January.
“They were amazing. The whole office was completely different in their response. (Dr. Rogers’) nurse understood our pain and our situation. They were very busy, but she did everything possible to speed it up,” Leon said.
Dina’s leg was infected and in terrible shape. But Rogers gave the Altschuls an unexpected ray of hope.
“He did an ultrasound and after he looked at my marble leg, he said he would try to save it,” Dina Altschul said.
And amazingly, he did.
The Altschuls now worship Dr. Rogers.
“He is a savior,” Leon said.
“Without him, we wouldn’t be laughing today,” Dina said on a recent sunny afternoon as she showed off purple asters, bright red and pink geraniums and cucumbers growing on the deck at their home.
She went from hopelessness and round-the-clock painkillers to feeling like her old self again.
“I love to garden. I love to walk. I was a sport girl all my life,” Dina said with a twinkle in her eye. “I started as a runner. Then I became a basketball player. I was not tall, 5’2’’ back then, but I played guard.”
Dina and Leon met in college in Minsk in Belarus. After college, Dina was the captain for a Belarusian semi-pro basketball team. They later had to move to Siberia since they were Jewish and couldn’t find work in their native Belarus. Their son and daughter also would have few opportunities.
In 1980, when Dina and Leon were in their 40s, they won the right to come to the U.S. as religious refugees. They had to leave everything behind.
“Because we left, we were considered enemies of the state,” Leon said. “They took away our citizenship.”
Leon, who was a physicist in Siberia, never got to go back to his homeland. Dina made one trip home to see her family. They settled first in New Hampshire, where Leon was an electrical and computer engineer and Dina taught, then they moved to Colorado in 2011.
Dedicated to preventing amputation
Looking back, Leon and Dina think she may have been suffering from lower-extremity peripheral arterial disease as long as 12 years ago.
Dina’s foot was sore back then. She went to podiatrists and physical therapists. Finally one of them figured out that he couldn’t detect her pulse in her foot. That was a sign that she was having vascular problems.
Dr. Rogers said it’s common for people with PAD to suffer without a proper diagnosis.
“PAD is common but under-recognized,” he said of the disease.
Most people know that clogged arteries can cause heart problems. Fewer know that similar clogs in arteries throughout the body can cause the kind of problems Dina was suffering.
Rogers credits the team approach in UCHealth’s Limb Restoration Program for helping him save Dina’s leg.
“You need multiple specialists working together: orthopedics, podiatry, vascular surgery, rehab, diabetes management, and infectious disease among others,” Rogers said. “We strive to provide these services in our unique program.”
Amputations can also be common for patients with diabetes and some patients deal with wounds that won’t heal, so bringing in experts on those conditions is vital too.
“We use an interdisciplinary approach,” Rogers said.
UCHealth’s program is one of the only Limb Restoration programs in the Rocky Mountain region and one of fewer than a dozen similar centers of excellence for limb restoration across the country, Rogers said.
“We are trying to change the paradigm and reduce amputations by improving blood flow. The technology is improving and we now have people who are dedicated and passionate about preventing amputation,” he said.
In Dina’s case, she had already had several previous surgeries. One was a bypass graft that was supposed to reroute blood from a clogged artery. But the incision from that graft had become infected.
“The leg looked bad. It didn’t have enough blood flow and her foot was discolored and in a lot of pain,” Rogers said. “We had the skill set to open up the blockages and thoughtfully treat her infection.”
To fix Dina’s leg, Rogers placed a tube about the size of a pencil in her femoral artery through which he placed stents to reconstruct the occluded bypass graft. It’s like clearing a tunnel that has become blocked.
Rogers was able to use ultrasound to keep checking the flow frequently after the surgery and the arteries have continued to stay clear.
“It looks really good. I’ve been very happy,” he said. “We’ve become increasingly better at preventing amputation.”
That results in multiple benefits.
“Saving a leg improves quality of life and may extend life. It saves costs for health care systems and for society,” Rogers said.
Saving limbs also makes families like the Altschuls very happy.
Inna Altschul is Dina and Leon’s daughter. When she learned that her mother would probably need an amputation, she was concerned that her mom wouldn’t have the necessary psychological support afterwards.
Inna teaches in the University of Denver’s Graduate School of Social Work and reached out to her colleagues who work in health care. One suggested she contact a former student who happened to be working at the University of Colorado Anschutz Medical Campus.
He said Dina needed to see Dr. Rogers.
Inna thought the amputation was inevitable; still, she called Rogers’ nurse.
“She was able to get us in right away. They really took a personal interest in my mom. We were feeling pretty desperate. If we hadn’t gone to see Dr. Rogers, mom was going to lose her leg,” Inna said.
Now, Inna is overjoyed to see her mom doing so well. On weekdays, Dina gets up early and comes to Inna’s home to watch her 2-month-old daughter while Inna takes her 3-year-old to daycare and gets ready to go to work.
“She’s been an amazing grandma. She’s done such a great job of helping me with the kids,” Inna said.
Inna also has gotten a kick out of seeing how dedicated her dad has been at nursing Dina back to health.
As for Dina, she’s thrilled to feel well again and loves watering her plants and taking walks on the Dry Creek Canal near her home.
“I’m on two legs. I do my gardening. I take care of the little one. I’m on no painkillers and I have no infections,” Dina said. “Life is good.”
Her advice to anyone suffering similar problems to those she faced: “Find Dr. Rogers right away.”