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Teamwork Saves Woman's Life

An infected toe caused Cindy Henn, 62, to have a stroke, cardiac bypass surgery, and the toe amputated  ­­— all within about a week.

Your Local Health | Written by BJ Towe

amputee patient Cindy Henn of Forest City had problems with her great toe — the big one — for years. But the real trouble began a little more than two years ago when Henn's Podiatrist in Mason City replaced parts of an earlier joint replacement. A screw broke off and remained lodged in the bone.

Unable to remove the screw, Henn's Podiatrist managed the occasional inflammations with high doses of antibiotics. What Henn's doctor didn't know was that the infection remained, continuing to damage the bone and gain strength in her body.

Henn Delays Decision to Amputate 

On Friday, May 23, Henn was in Des Moines to watch her granddaughter participate in the Special Olympics. Her toe ballooned and she became very ill. Henn ended up in the emergency room, which called in David Groen, D.P.M., a Podiatrist with The Iowa Clinic.

“Cindy had a very inflamed, infected great toe joint,” says Dr. Groen. X-rays showed that it was osteomyelitis, a serious infection that causes the affected part of the bone to die. Usually, treatment requires removing the affected bone. For Henn, this meant her big toe would have to be amputated.

Henn wasn't emotionally prepared to have a part of her body removed. She insisted on being discharged and going home.

Henn says that, deep down, she knew the toe had to come off. With her local Podiatrist still believing it could be saved, she scheduled the procedure with Dr. Groen for Friday, May 30, and was cleared for surgery by her local Family Medicine physician.

Infection Attacks Other Parts of the Body – Fast

On the car ride to Des Moines, Henn developed a fever, began vomiting, and became delirious. “I was really crazy. That's the only way I can put it,” she says.

Dr. Groen recalls, “When I saw her she looked terrible.” Groen canceled surgery, ordered antibiotics, and had her admitted to the hospital for additional tests.

“She went from bad to worse within hours,” he says.

Henn's first memory after that was waking up days later in the hospital. “I couldn't move my right side at all,” she says. Henn had endured a bilateral stroke, which stemmed from bacterial growth on a heart valve and distributed blood clots to Henn's brain.

More tests showed blockage in three coronary arteries and that the infection had attacked her mitral valve, resulting in a heart murmur. She had cardiac bypass surgery on June 6.

Groen says, “The infection brought Cindy's other heart problems to light. That was incredibly fortunate; she could have easily had a heart attack and died before the procedure.”

After a month in the hospital, Henn was able to return home, but not without help.

“The Iowa Clinic arranged for everything — Physical Therapy, Occupational Therapy, even the nurse who came to check up on me,” she says.

The Power of Teamwork

Henn's lifesaving care involved many providers, including Podiatrists, Internists, Cardiologists, Infectious Disease physicians, lab technicians, nurses, and more.

Groen says, “The Iowa Clinic's team approach to care is so nice. It's very easy for us to call other physicians, bounce things off of them, and get a quick response. That definitely enhances care for patients.”

It certainly benefited Henn. “I went in on death's door, but The Iowa Clinic saved my life,” Henn says.

Groen is quick to add, “We all just did our job the way we are supposed to. Everyone involved played a part in saving Cindy's life, from the nurses who first saw Cindy at the surgery center to the specialists who were part of her care.”

It All Started with an Infected Toe

An undiagnosed infection in Cindy Henn's big toe spurred this chain of events:

MAY 24:  While visiting Des Moines, Henn goes to ER for swollen toe. She learns she has osteomyelitis and that amputation is needed, but declines. She changes her mind after returning to her home in Forest City.

MAY 30: Henn returns to Des Moines for scheduled surgery, but arrives ill. Surgery is canceled and Henn is admitted to Iowa Methodist Medical Center.

MAY 31: Blood clots in Henn's heart, caused by the infection, deliver clots to Henn's brain and result in a bilateral stroke.

JUNE 2: Henn's right great toe is amputated.

JUNE 6: Henn has heart bypass surgery.

JUNE 30: Henn is released from the hospital with a home health care plan that included routine nurse visits, Physical Therapy, and Occupational Therapy.

“Had I been ready to do the amputation when it was first advised, I probably would have avoided all of this. I just know I wouldn't have made it without The Iowa Clinic and those doctors. I was in the right place at the right time,” - Cindy Henn

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