Not many people keep a photo of their surgeon on their fridge, but Bob and Susan Vanderlaan do.

That’s how much they value the man who saved Bob’s leg from amputation.

“We are just so grateful for him,” Susan said.

Bob, 60, a career funeral director, spends hours a day on his feet. An active father and grandfather, he also loves working in the yard and walking on the beach near his home in Norton Shores, Michigan.

Life’s activities never gave him trouble until last spring, when he developed painful sores on the toes of his right foot.

When the pain intensified and spread across his foot, he visited a local foot and ankle specialist. The doctor’s reaction made no sense to the couple.

“He looked at it and said, ‘I just hope we can save your foot,’—which to us was like, ‘What are you talking about?’” Bob said.

“We really didn’t understand at that point what was going on.”

It turns out Bob’s sores were diabetic foot ulcers. His pain stemmed from a lack of blood flow to the foot.

“The foot was dying,” Susan said. “All the circulation was shutting down.”

Impending amputation

The news came as a heavy blow to Bob, who, though he’d had Type 1 diabetes since he was a boy of 8, had managed it carefully all his life with no concerns.

The foot doctor referred Bob to a local vascular specialist.

By this time, his pain had become almost unbearable. He took time off work and spent most days “writhing on the couch in a fetal position, crying himself to sleep,” Susan said.

Attempting to restore circulation, the vascular surgeon performed one procedure after another on Bob’s foot—four in the space of a month.

First one angioplasty, then another. And when both of those failed, a peripheral artery bypass.

“He pulled a vein out of my thigh and tried to attach that to the top of my foot,” Bob said. “That didn’t work.”

Finally, the doctor attempted a second bypass, an admitted Hail Mary.

Again, the procedure failed.

Before the Vanderlaans left his clinic that day, the surgeon had Bob scheduled for a below-the-knee amputation of his right leg three days later.

Learning of this development, Bob’s primary care provider, who is also a family friend, stepped in.

She told the Vanderlaans about Justin Simmons, DO, a vascular surgeon with Spectrum Health Medical Group, who had saved other patients of hers from looming amputations.

With Bob’s permission, she gave Dr. Simmons a call.

As it happens, he planned to be at the Spectrum Health Medical Group Vascular and Vein Clinic in North Muskegon on the day of Bob’s scheduled amputation.

He agreed to see Bob first thing that morning.

Entering the room, Dr. Simmons recognized Bob’s pain as a symptom of critical limb ischemia, the advanced stage of peripheral arterial disease.

His foot was starving for blood. It was cold to the touch, his big toe nearly black.

“He was visibly uncomfortable, writhing in pain, frustrated, looked a little forlorn,” Dr. Simmons said. “They’d been told that this was their only option. A major amputation below the level of the knee for a sore on his toe.”

Dr. Simmons, who resists amputations, asked the Vanderlaans to give him a chance. Bob’s circumstances fit his specialized niche, he said—endovascular interventions from knee to toe in patients with diabetes.

“I was like, ‘How committed are you to this amputation?’” he said. He offered to perform an intervention the next day, July 3, in Grand Rapids.

“He said, ‘I’m pretty stubborn, I’m pretty determined. … I want to try,’” Bob said. “I remember … feeling very much like, ‘We have hope here.’”

Elated at the prospect of keeping his leg intact, Bob agreed to the operation. It would be a long shot but worth a try. He didn’t feel ready for an amputation. He wanted off that speeding train.

The next day, the Vanderlaans met Dr. Simmons at Spectrum Health Butterworth Hospital.

Though they didn’t know how things would turn out, they took comfort in knowing they had strong prayer support.

“We’ve had thousands of people praying for this whole situation,” Bob said. “All the churches that I help (with funerals)—I was on all their prayer chains.”

This was enough to get the family through the next procedure, Bob’s fifth since early June.

Last-ditch effort

Dr. Simmons worked on Bob’s foot nearly five hours that day. Reopening old incisions, he quickly discovered that the two major arteries leading into the foot were irreparably damaged from prior surgeries.

“I was dead in the water, basically,” Dr. Simmons said. “I didn’t have an option to improve those at all, so then I started looking at trying to improve a lot of the side streets or collateral roads.”

He likened his work—minimally invasive practices using catheters and balloons to restore blood flow—to a snowplow.

“The balloon goes in and gets inflated and it sort of pushes all that plaque to the shoulders of the road to reopen the main interstate lanes,” he said.

It’s a tedious, labor-intensive process, a race to restore circulation so the foot can start healing.

“You’re trying to find these little microchannels to get your wire through, so that you can then get your balloon through (and) open things up,” he said.

As he’s honed his craft over the past few years, Dr. Simmons sometimes creates channels where they didn’t previously exist.

“I will literally do anything that I possibly can to get these blood vessels open so that these people can keep their legs,” Dr. Simmons said.

In Bob’s case, Dr. Simmons finished the procedure discouraged, afraid his efforts hadn’t made a difference. Bob’s pain remained excruciating.

Still, Dr. Simmons said it was too soon to consider amputation. Knowing how overwhelming the past weeks had been for the couple, he sat with them, then sent them home with pain medication and instructions to rest.

He would see them in a week.

A few days later, Bob noticed a change. He felt blood starting to flow.

“He came upstairs to our bedroom and he’s like, ‘Oh my goodness, you’ve got to feel my foot,’ and it was warm,” Susan said. “We turned on the light and the toes were starting to get pink.”

When he saw Dr. Simmons at his one-week post-op visit, Bob told him something was happening.

The doctor listened with his doppler device and detected circulation beyond the disrupted arteries.

“I’m not going to take credit for that, but he had blood flow going down there,” Dr. Simmons said.

They weren’t out of the woods yet, he cautioned—far from it. But it was a move in the right direction. A glimmer of hope.

From that day on, Bob has seen Dr. Simmons for wound care weekly at the North Muskegon vein clinic, as they work together to get his toe ulcer and ankle wound to heal.

“Every week he says, ‘We’re getting closer. … We can see light at the edge of the forest,’” Bob said. “And today he’s like, ‘We’re really close.’”

In September, Bob returned to work part time. By October, he was back full time and wearing a regular shoe.

The only pain medication he takes is an occasional Tylenol.

Second chances

No one can say for sure what caused Bob’s foot to heal. But he has his theories.

“I’m quite convinced it was part of what Dr. Simmons did,” Bob said. “But we believe it’s also a small, big miracle.”

Though Dr. Simmons won’t discount that notion, he also points to the remarkable role that time can play in healing.

“The body has this innate ability to heal itself and it will make new blood vessels. It just sometimes needs time,” he said.

“I’m just glad I was able to help him, honestly.”

The couple sees Bob’s recovery as a second chance, an opportunity to pick up where they left off, to resume life in the community and with their kids and grandkids.

“We’re just very, very thankful to be this far,” Bob said.