Before you agree to the leg amputation, please review this information and give us a call. Leg amputations are on an increase in spite of significant progress in medicine.
Latest statistics from the Center of Disease Control indicate that in year 2001 surgeons performed over 80.000 leg amputations. This number is increasing every year. Why this happens?
On one hand there is an increase of incidence of diabetes mellitus. At this time there are approximately 18.4 million individuals in US have diabetes. The population is aging, more Baby Boomers becomes older. There is also progressive increase in obesity. These are some factors leading to the increase of number of patients having diabetes. Another reason is lack of familiarity of family physicians and surgeons with a new development in the area of the therapy available for the impaired leg circulation. Unfortunately, physicians are not aware of the advances. The Circulator Boot has been around for over 15 years. It helped to save thousands of legs from amputations. Your physician may be one who never heard about it, since we did not market it on a large-scale and most often information is spread through the word of mouth. Physicians can learn about the treatment on website, review publish materials and of course contact us for more information. We hear of so many situations when the patient mentions to his physician about the Circulator Boot treatment, his doctor will say that it "does not work", "that they never heard about it" or that it is ''unproven and dangerous". They also insist that the patient needs to have leg removed right away, because the "infection may spread to the heart and they will die". Some patients become frightened and agree to the amputation. Others contact us, review what is available on the Internet, read about it and start treatments, which can save their legs and their life. To clear the myths and false rumors this website will answer questions you may have and show you where and how you can obtain the right help. What is the Circulator Boot? It is device made to treat the non-healing leg ulcers, especially when the patient is not a candidate for surgery, or when surgery has failed. The equipment consists of an adjustable boot, valve assembly, compressor and heart monitor. The affected leg is placed in the mini-bag (leg) or a long- bag (leg-thigh), depending on the location and size of the wound, and then placed in the boot. The boot is a metal box-like shaped structure which allows for the chosen portion of the leg to be compressed. The 3 electrodes are placed on the patient's chest and connected to the heart monitor. The compressions are gentle, painless and compress the leg with the tension similar to the handshake. The compressions are synchronized with the contractions of the heart and are timed to occur during the relaxation phase of the heart cycle. The treatment lasts 40 minutes and typically the patient my need about 35 treatments for his condition to be improved.

Who are the patients that can benefit from the treatments?
Any patient with the symptoms or signs of circulation problems. The typical symptoms are:
1. Leg pain when the patient is walking. It is called claudicating.
2. Leg pain at rest (this happens when the condition is more advanced). This frequently happens at night.
3. Leg cramps.
4. Sensation of the leg fatigue or heaviness.
5. Numbness, tingling or sensation that "something is crawling under the skin".
The typical signs are:
1. Leg swelling.
2. Change of the skin color -- pale, bluish-purple, red or black. Sometimes there is a brown discoloration in the lower portion of the legs (veins disease).
3. Swelling, sometimes quite significant.
4. Increase skin thickness, perception of skin tightness.
5. Tenderness to touch.
6. Leg ulcers, gangrene, and other signs of advanced infection.

The above symptoms usually represent circulation problems in the arteries, veins or lymphatic vessels. We can help in all of these conditions, but our greatest advantage over all other treatments is the ability to heal the most advanced and difficult to treat conditions.
Many of the examples of this type of patients you can found on this website: www.circulatorboot.com.

How much does the treatment cost?
Medicare and many of the insurance companies are paying for the treatments. Some will require pre-approval. You can check with your own insurance company or call our office for the updated list of the insurance companies covering the treatments. The frequency and length of the treatments depends on the condition of your circulation, other problems affecting circulation, your age and many other circumstances. After evaluation the physician will be able to tell if you qualify for the therapy and approximately how long the treatments will last.

Is there any danger or precautions to treatments?
The treatments are safe, painless, provided on the outpatient basis. The treatments are approved by FDA and Medicare. It is non-invasive and non-surgical. It is proven to be effective in healing infection, wounds and helping with many of the symptoms of "poor circulation". The effects of treatment are long lasting. Before the treatment we are screening the patients to establish the cause of the condition and extent. We do approve tests done in your present physician's office and in many situations we do not need to repeat them. If the tests are available at the initial consultation we can begin treatments right away. The patients who can not be treated are the ones who have either blood clots in their leg veins and patients with an active infection in the leg. These patients first will be stabilized with medications and then treated as soon as they are stable.

What happens if I do not have transportation to the treatment center? Some patients can drive the car and come by themselves. Other depend on their family members or friends. In cases when the person is unable to sit in a chair or walk, insurance company may pay for transportation on stretchers. We are always looking for volunteers willing to drive patients for treatment to our Center and you may inquire if there is someone available in your area that will bring you for treatments.

What happens if I live in another state or outside the US? We have a list of the Clinics providing treatment in the US and can refer you to the nearest place close to you. Please call our office for information. Some patients chose to travel to our Center and either stay in a local hotel or sub acute nursing facility (SNF) for the duration of treatments. If the patient needs to be admitted to the hospital we will arrange for this promptly.

What do I do if I am a patient in another hospital? You can be evaluated by your physician and it is up to him to decide to discharge you and allow you to travel to our Center. He has to determine if you are capable of tolerating the trip safely. Otherwise you will need to wait will you are discharged from the hospital and arrange for an appointment at our office.

What do I do if my physician will not approve the treatment? There are many reasons why your physician may be advising you against the treatment. He may not be aware or familiar with it and in this case he can review information on our website. He is also welcome to call our office and ask questions. He may not be aware that some of the conditions previously considered to be untreatable like the bone infections, now can be cured with the Circulator Boot therapy. Since the bone infection in the past was an indication for amputation this is what he will advise you. Other physicians may not want to learn and continue to be non-supportive and skeptical. Then it is your decision what you want to do.

What are the indications for leg amputation?
In the past there were three main indications:
1. Severe, persistent leg pain not responding to any treatment.
2. Infection difficult to control, threatening life.
3. Critical lack of blood supply to the leg, not correctable by any known means. At present the first two indications are less frequent reasons for leg amputation. The Circulator Boot by improving blood flow to the leg and increase oxygen delivery can reduce pain and help to heal infection. We do have number of medications that can reduce or eliminate pain and we do have spectrum of antibiotics that can control or cure infection. Even infections which can temporarily go out of control with adjustment of antibiotics can be stopped. When we consider lack of blood supply, again the Circulator Boot is the best noninvasive treatment that can increase blood flow to the leg. It is superior to surgery in some conditions. Surgery can bring more blood in the larger blood vessels, previously obstructed by a plaque. Surgery will not improve blood flow in small blood vessels of the foot and toes, which are commonly the cause of problems in diabetic patients and frequently in women who have normally smaller arteries.

How much do the treatments cost?
The average cost of the leg amputation is between $ 80-100.000. The patient is left without leg, needs a significant family and society support. Treatments with the Circulator Boot, for the entire course of 35 treatments costs $ 4,000 to 5,000 and the most important patient is spared surgery and keeps his leg permanently cured.

What is the main reason for the reduction of amputation rates? Use of the Circulator Boot is the most important tool in significant reduction frequency of amputations. Recognizing the risk factors and multidisciplinary approach by a team of dedicated specialists can reduce the rate of leg amputations by 85%. We work with a group of endocrinologists, infectious disease specialists, podiatrists, vascular surgeons and cardiologists to provide complete evaluation and care of treated patients.

How can I find out more about the treatment? Please call our office at 610.527-1213 or 610.527.6300 and either ask for Steve or Angel. When is the Center open? We are open daily Monday to Friday from 8 AM to 5 PM. On Saturdays 9 AM to 11:30 AM Center is closed on Sundays and for Official Holidays

(*Please note that: " The Bryn Mawr Wound Care Center" is not to be confused with the Bryn Mawr Hospital or The Wound Healing Center at the Bryn Mawr Hospital. "The Bryn Mawr Wound Care Center" is a different entity and is not part of the Bryn Mawr Hospital.")