• Orthopedics Patient Stories

    Saving Dave Boyett’s Foot With the Help of a Pressure Chamber

After a series of accidents led to increasingly serious foot wounds and infections, Dave Boyett was told he might have to have his right foot amputed. Staff at Mayo Clinic’s Hyperbaric and Altitude Medicine Program in Rochester, however, helped change that.

Dave Boyett was just trying to be helpful when, on Labor Day weekend in 2010, he flew from California to Minnesota to visit his good friend Roxanne (who is now his wife) and her children, and to work on some projects around the house.

As Dave was clearing brush in the yard, one hatchet swing caught the top of his left foot.

"I hit it with the back end of the hatchet," he says. "I had boots on, so it didn't do anything but bruise the big toe on my left foot at the time."

When the pain subsided, Dave kept working. But what seemed like a minor incident at the time turned out to be the first in a string of injuries to his feet — including one that would put his right foot at risk for amputation. Fortunately, Dave's care team at Mayo Clinic was able to provide him with a treatment that spared his foot.

A search for healing

Three weeks after hitting his foot with the hatchet, Dave noticed that bruise on his toe was getting worse instead of better, and it looked infected. Complicating matters, Dave would learn that he has type 2 diabetes.

"I had my toe checked out when I flew back to California," Dave says. "They said, ‘You're a type 2 diabetic, so this kind of thing happens.'"

Over the next 12 months, Dave moved to Minnesota after asking Roxanne to be his wife. As they began their new life together, there was one nagging part of Dave's past that wouldn't go away. His foot refused to heal. So after settling in to his new home, Dave made an appointment at Mayo Clinic Health System in Red Wing, Minnesota.

"They irrigated the wound, and it finally started to heal a little bit," he says. "But the healing was still very, very slow because of my diabetes."

"Hyperbaric is something that's used throughout the United States and around the world precisely for the kind of medical condition Dave has, which is a non-healing diabetic foot wound." — Paul Claus, M.D.

For that reason, Dave's care team at Mayo Clinic Health System referred him to Mayo Clinic's Rochester campus for hyperbaric oxygen therapy — a treatment that includes breathing pure oxygen in a room with air pressure three times higher than normal. The idea, says Paul Claus, M.D., medical director of Mayo Clinic's Hyperbaric and Altitude Medicine Program in Rochester, is that under these controlled conditions, the lungs are allowed to take in more oxygen than would be possible in a normal environment. Your blood carries then carries this oxygen throughout the body, which helps fight bacteria and promotes healing.

"Hyperbaric is something that's used throughout the United States and around the world precisely for the kind of medical condition Dave has, which is a non-healing diabetic foot wound," Dr. Claus says.

The results couldn't have been better for Dave.  "I saw dramatic healing with my foot," he says. "It completely healed up in 24 treatments."

A string of injuries

Just when Dave thought his foot problems were behind him, he broke all of the metatarsals in his right foot while jogging. As part of the injury, Dave noticed an exterior wound that would quickly go from bad to worse.

"The second metatarsal was protruding from the bottom of my foot and became really badly infected," he says. In fact, it was bad enough that his orthopedic surgeon at Mayo, Daniel Ryssman, M.D., removed the second metatarsal and adjoining toe on Dave's right foot. After that, the foot began to heal.

But that wasn't the end. Three weeks later, Dave had another incident involving his right foot.

"I was out in the home gym in our garage … and I felt a ripping sensation on the bottom of my right foot," he says. "I developed another small wound there, but it didn't look too bad at the time."

His care team at Mayo Clinic's Vascular Ulcer and Wound Healing Clinic agreed, telling Dave that as long as the wound didn't become infected, it would likely heal on its own. A week later, though, things had changed.

"It started to swell and really turn red," Dave says. "Before I knew it, the infection had spread all the way up to my knee, and the bottom of my foot had turned black and become gangrenous."

Given the severity of his infection, Dave's care team told him to get to the Emergency Department at Mayo Clinic Hospital — Rochester as quickly as possible.

A best-case outcome

Dave would spend the next four days on antibiotics, all the while thinking back to the positive healing results he'd experienced in Mayo Clinic's hyperbaric oxygen therapy chamber.

"It got to the point where whenever someone would enter or leave my room, I'd say the word ‘hyperbaric' to them," Dave says. "I wanted to go back to hyperbaric."

His care team requested that staff from the hyperbaric program pay Dave a visit. They did, and decided further hyperbaric oxygen therapy might help. Dave had 53 more hyperbaric oxygen therapy treatments.

"Once again I experienced dramatic healing," Dave says. "But despite that, the fifth toe on my right foot was still black, so they sent me back to Dr. Ryssman."

After an evaluation, Dr. Ryssman confirmed that the fifth toe needed to be removed. The question of whether Dave would be able to keep the rest of his foot would hinge on how much flesh would be available to suture the incision. They decided Dave would complete another eight hyperbaric treatments, and then they would do the surgery. When the day of the surgery came, Dave was expecting the worst.

"Those people in hyperbaric … I've come to know them like family. Each one of them poured their hearts and their souls into my healing, and I cannot sing their praises enough." — Dave Boyett

"I went in thinking I was going to lose my right foot," he says. "When I woke up after the surgery, I was like, ‘Do I really want to look down?' When I finally got up the nerve to look, I saw that my right foot was still there, all bandaged and wrapped up."

That unexpected sight was overwhelming. "I'm not a crier, but I started crying right away," he says. "I wasn't expecting to see anything from the knee down, and so to see that my right foot was still there was pretty emotional."

When Dr. Ryssman came to see Dave after surgery, he explained the dramatic change in events.

"He said the bottom line is that hyperbaric saved my foot," Dave says. "Things were a lot cleaner than he thought they were going to be. And he said it was my hyperbaric treatments that made that happen."

For that, Dave could not be more thankful.

"Those people in hyperbaric … I've come to know them like family," he says. "Each one of them poured their hearts and souls into my healing, and I cannot sing their praises enough. The way they take care of their patients and the work that they do is simply amazing to me."