By the time of his 15th surgery in 10 years, Don Lofton had had enough.
Enough pain. Enough frustration. Enough depression.
Then he saw the figure outside his sixth-floor hospital window—porcelain white, sort of Greco-Roman, kind of like (Michelangelo’s) David, “sort of, but not,” Lofton said.
He watched the figure enter his room, from the outside in. He was headed into surgery at the Spectrum Health Fred & Lena Meijer Heart Center.
Afterward, as the anesthesia lifted, Lofton saw the figure again, much smaller now, out of the corner of his eye. And he made a decision.
His next surgery, the 16th, would remove his left leg below the knee.
“I thought, OK, God just sent me an angel. … God is trying to give me what I’ve been praying for,” said Lofton, 42. His hands knead and fold a white tissue.
“I was at peace,” he said, sharing how he told his wife and mother, “‘I’m OK.’”
A genetic time bomb
Peripheral artery disease is a vascular condition that most commonly affects people who have high blood pressure, high cholesterol, diabetes or those who smoke. Arteries clog, often in the legs. Blood flow is reduced. Severe cases require amputation. It affects an estimated 10 million people in the United States.
Lofton’s disease is due to a different factor—his genetics.
“It’s not really something that he’s done to himself,” said Britt Barnett, a clinical registered nurse for vascular surgery at Fred and Lena Meijer Heart Center. “It’s hereditary. He doesn’t have a ton of other risk factors.”
Basically, Lofton’s body creates too many triglycerides, a form of fat necessary to store excess energy from food. High levels can create plaque and clog arteries.
Chris Chambers, MD, PhD, has been caring for Lofton since the vascular surgeon arrived at Spectrum Health in 2008.
“I have never seen anyone in his 30s with the degree of disease he had. Not if he smoked four packs a day. Not in his 30s,” Dr. Chambers said.
Perhaps 5 percent of those older than 50 have PAD, Dr. Chambers said. In some respects, the doctor added, Lofton appeared “in his 30s like someone in their 80s.”
The National Cholesterol Education Program sets guidelines for triglyceride levels. Normal is considered to be less than 150 milligrams per deciliter. Lofton’s level exceeded 900, records show.
“I was told an 80-year-old man who ate at McDonald’s everyday could not be that high,” Lofton said.
Angioplasty—or balloon surgery—can open clogged arteries. Often, a stent is placed to sustain the opening. A surgeon may also bypass the clogged area, grafting another vein from the patient, or using an artificial one.
Both treatments are meant to restore blood flow to the lower leg and foot.
Run the future
Lofton, 42, and his wife, high-school sweetheart Aisha, have three sons: Dorian, 15, Diontae, 17, and Don Jr., 21.
This day, Lofton wears a T-shirt that says, “Run the Future.” He laughs. No, it was not planned, he tells a reporter. He is also wearing blue sweatpants, a lower-leg prosthesis (“like a cyborg”) and bright-white Air Jordans. His mother, Mary, is with him, correcting him, loving him.
Lofton was a crew leader of 25 to 30 workers at Kentwood-based Corium International, maker of transdermal pharmaceutical patches, when he first noticed symptoms in 2008.
One day, his left foot was in pain. “I couldn’t walk for more than 20 feet at a time,” Lofton said. “It took me five breaks to get to the timecard.”
He was taken to the emergency room and eventually landed on the sixth floor at the Meijer Heart Center. Lofton was diagnosed with PAD in both legs, more severe in his left leg than his right.
Doctors told him not just his left lower leg needed to be removed, but his right one, too.
“They wanted to amputate right away. They wanted both legs gone that first time. … ‘There is nothing you did to cause this, and there is nothing you can do to stop it,'” he was told.
He remembers saying, “Man, is there any other option? Are you saying this is the only option?”
‘Every trick out of the hat’
Lofton chose to fight.
For 10 years, he would be in and out of the hospital—18 surgeries in all now. One particularly brutal stretch extended for about three weeks. Pain varied—burning, throbbing, shooting or electric. Small arteries were “Roto-Rooted” to improve blood flow.
Medical staff anguished with him.
Diane Prickett, a nurse who helped care for Lofton, remembers his “composure and calmness,” that he was compliant, and that he required “two or three pain meds, at least,”
“To see frustration like Don was experiencing, you knew. He’d had it,” Prickett said.
“We were frustrated for you,” added Kristin Dykstra, PA, in a recent visit to Lofton. “We pulled every trick out of the hat to save your leg.”
“They tried to keep me walking,” Lofton said.
At first, doctors considered extreme measures. “He presented acutely. … He was at risk of losing both legs,” Dr. Chambers said.
More than a dozen surgeries followed, as arteries collapsed and complications progressed. Vascular surgeon Robert Cuff, MD, and many others were involved. Stents, bypasses, ultrasound, surveillance and other methods proved helpful.
“It is a disease we cannot cure,” Dr. Chambers said. “We can provide solutions, but with ongoing disease, they don’t always last.”
In early January, Lofton underwent his 15th surgery. A bypass in the left leg.
“I knew it didn’t work, just from looking at them. I already knew,” he said.
Lofton’s 16th surgery, the amputation, was on Jan. 30, a Monday.
Since the amputation, Lofton has had two more surgeries—Nos. 17 and 18—on his lower right leg. Small arteries so far are compensating for slower blood flow.
“Through all this he has been remarkably understanding and appreciative,” Dr. Chambers said. “I was always aware of the impact of his faith in his ability to cope with these challenges.”
Since his amputation, Lofton has been fitted with prosthetics. He gets around with the help of a black and silver cane.
For now, doctors say the limb is holding up. Poor blood flow in his right leg is partly being assumed by small collateral arteries.
Lofton believes more people need to know about PAD. His main goal is to help other patients through his experiences.
I was meant to go through it for a reason, he said.
“Maybe I was meant to be an example.”