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.
Truly a miracle – the intersection of two lives orchestrated by God.
Sharing your story may well save others from amputation and restore their lives.
We agree, Karin. Truly amazing! Thank you for your note of encouragement. 🙂
I had a similar problem and Dr. Simmons did a 4 hour procedure and the severe pain was better the next day. I ended up losing one toe and not the foot. Dr Simmons was my last chance and I am so grateful. I see him twice a year for a
Checkup. He is a special man!
Wow, so glad you’re doing well, Lyle. Thank you for your kind story and testimony. 🙂 Cheers, Cheryl
Thank you for those kind words Mr. Monette. People such as Mr. Vanderlaan and yourself are what makes this kind of work so rewarding. I am thankful to have the ability to even be in a position to offer something to people that find themselves in situations like the two of you … to have an opportunity to give back some of that functional quality of life that many have lost by the time they see my partners or myself. I hear stories on a regular basis similar what you have mentioned above and what Ms. Clayton so eloquently described when she talked with Mr. Vanderlaan and I. My only hope is that this story and your testimony brings awareness to the kind of comprehensive limb salvage work that my team is able to offer at Spectrum Health. My goal for patients such as yourself and Mr. Vanderlaan is always to restore faith in the healthcare system when many feel as though they have been cast aside with no hope for improvement or told that there only option is a major amputation and to improve functional quality of life. At the end of the day it all centers on quality of life and what that means for each individual person whether it is going on walks with their dogs or loved ones, doing their own grocery shopping, getting back in the garden, being able to do normal household activities again, or any number of other wishes that patients have told me throughout my career. Again I want to thank you for those kind words and I am happy that I was able to help you and Mr. Vanderlaan out when you needed someone the most.
You are a superhero to many, Dr. Simmons. Thank you for participating in this Health Beat story, and for all the work you do each day caring for our community! You definitely exemplify the “care” in “health care” and are so appreciated.
I know the Vanderlaan family very well. Bob’s father was my boss for a time and their family attend the same church as my sister and her family. I had no idea about Bob until reading this article. Wow! Nice to know that he is on a gentle road to recovery. Thank you Dr. Simmons and your staff. Sincerely, Paula J Snyder.
When you think of the lifelong ramifications of losing a leg/foot, this story is nothing short of amazing. Thanks for sharing.
You are blessed which is no surprise—I have always thought of you to be a special friend ever since “working” with you at SYTSEMA’S
God bless you and family!
jo