Never Too Old to Heal



Aileen Busche leaned over, carefully wrapping a bandage around her right ankle. The painful wound had become the size of a silver dollar. She’d done all she could -- stayed off her feet, elevated her legs, wrapped her ankle -- but the venous skin ulcer persisted.

“I’d had ulcers like this before and I knew I was in for a long siege,” recalls the 92-year-old. “But that summer, it got so bad I had to have help.”

In September 2009, her Sanford doctor referred her to Sanford Wound Care Center in Fargo.

“Years ago I tried to get help for these wounds, but back then there wasn’t much that could be done,” says Aileen. “Times sure changed! I couldn’t believe everything Dr. (Warren) Albrecht and his nurses did to get me better. I had a lot of faith in them. Whatever they suggested, I did.”

Healing came, but not in weeks or months. It took two years!

Why so long? What led to healing? How did Aileen get through it? The stakes were high because chronic wounds can lead to extended hospitalizations, even amputations.

Says Dr. Albrecht, vascular surgeon with wound expertise: “Aileen is an inspiration to anyone dealing with chronic wounds. If she could do it, you can, too!”

“I never missed a week”

Every week Aileen went to her wound-care appointment. No longer driving, she arranged for a ride with her son or with Fargo’s senior bus service.

Even in the most brutal winter snowstorms, she didn’t miss an appointment. “I had good drivers,” she says. “They always knew which streets were open.”

And when she arrived at Sanford? Warmth! “I got well-acquainted with so many people -- the nurses, the receptionists, the greeters. I was there so often we became like family.”

With compassion and knowledge, her Sanford family took one step after the next to bring healing. It was particularly challenging not because of Aileen’s age, but because of the wound age.

Explains Dr. Albrecht: “Ulcers that have been present for years have typically gone through a cycle of healing, breaking down, healing breaking down, and so on. The result is extensive buildup of scar tissue -- and scar tissue is not a healthy foundation for the growth of new skin.”

For that reason, Dr. Albrecht urges people with slow-healing wounds to come in sooner rather than later. “If we can address the wound when there’s still normal tissue around it, the chances of healing in less than six months are far greater,” he says.

The path toward healing

Several strategies contributed to Aileen’s healing:

    * Weekly wound cleaning and bandaging by specially trained Wound Center nurses.
    * A minimally invasive laser ablation procedure to address venous insufficiency and improve circulation.
    * Placement of “Apligraf” -- a thin layer of skin cells grown in a lab, then applied to the wound. This sets the stage for the patient’s own skin cells to grow.
    * The use of medical maggots to allow for the precise removal of dead tissue, leaving healthy tissue in place, Aileen took in stride. “I wouldn’t let myself think about it,” she says. “I just wanted to get better.”
    * A brief hospital stay followed by several weeks in a nursing home. “This was necessary because we’d finally gotten to the point of healthy tissue. Next we needed to let the healthy skin grow across the entire wound,” says Dr. Albrecht. The nursing-home stay ensured daily wound care by a nurse and the use of compression to improve leg circulation. With relaxation, good nutrition and daily physical therapy, Aileen significantly improved her strength and stamina. All contributed to healing.

Aileen’s attitude played big, too. “Throughout this long process, she was very compliant and had a great amount of patience, both with us and herself,” says Dr. Albrecht. “Not once did she give up -- and neither did we.”

Advice from a 92-year-old

Today Aileen relaxes in the living room of her assisted living apartment in Fargo. “I love it here,” she says. “ We play cards, eat good meals, get daily exercise, visit. Now that the ulcer has healed, I can really enjoy myself. It’s wonderful!”

And her tips for reaching 92? “That’s a hard question. I’m just living a normal life,” she says. “I like doing things. I’m not one to sit and do nothing.”

She smiles a lot, too. “I’m always laughing,” she says. “I don’t let things bother me.”

But there is one exception: “I’m just sorry my hair isn’t fixed,” she says, playfully patting her head. “Oh well, maybe when you get to be my age it doesn’t matter.” Then she laughs even more.

Posted Date: February 2012

Never Too Old to Heal

Aileen Busche knew she was in for a siege when the sore on her ankle refused to heal. In her 90+ years, she’d traveled this path before. But never had she visited Sanford Wound Care Center!