Wellness Wednesday with Dr. Carl Williams from The Valley Health System

Joanna Baumann from Sunny 106.5 talks with Dr. Carl Williams about wound care.  Dr. Williams has pioneered several wound care programs throughout the valley. He is currently the director of The Valley Hospital Wound Center and he has elevated it to a center of excellence.

Episode Transcript

(00:00):
It's Wellness Wednesday right here on Sunnyone and six point five, sponsored by
the Valley Health System. This weekwe have two guests on with us.
We'll be talking to Jordan Aldrich anddoctor Carl Williams. And this week we're
talking about wound care. Please introduceyourself. Welcome, thank you, thank
you for having us. Absolutely.I'm Jordan Aldridge. I am the Woundcare

(00:23):
Liaison at the Valley Woundcare and HyperbarrickCenter at Valley Hospital. Awesome, well,
welcome, thank you. And I'mdoctor Carl Williams. I'm a plastic
surgeon and I am the medical directorof the Valley Woundcare and Hyperbaric Center.
All right, well, this weekwe're going to get right into it.
We're talking about woundcare. I'd liketo know you know what defines an advanced

(00:44):
wound care clinic, right, Imean, because I think a lot of
people may not know those even exist. And then how does it differ from
other wound care facilities. That's agreat question, Thank you. We have
advanced modalities such as medical debris mints, offloating, negative pressure wound therapies,
tishue growing therapies, and hyperbaric oxygenchambers. We really customized to the wound

(01:10):
care patient. We have a multidisciplinaryphysician lead clinic full of plastic surgery,
cardiology, family medicine, internal medicine, infectious disease, and a pediatrist.
So we're a true head to toewound care clinic. Oh. Wow,
that definitely sounds much more advanced.So I'd love to hear that. Now,
over the past decade, what notableadvancements or changes have occurred in the

(01:34):
field of wound care. Initially weuse very very primitive techniques. We used
betadine and would put it into thewound and change it three or four times
a day. But after a whilewe found out this is about thirty years
ago, we found out betadine wasactually toxic to the wound. Wow.

(01:55):
So we have evolved as time goeson, and we've developed There's been certain
biologic agents that have been developed fromplacenta, there have been some from cows,
there have been some actually from pigsthat have developed that we use to
stimulate the stem cells to cause ourwounds to heal. Wow. And we've
also developed diagnostic tools we probably havenot had over the last thirty years prior,

(02:23):
where we have MRIs where we candiagnose if there is an infection in
the bone or in the soft tissue. We can make those diagnosies. And
then also we have ultrasound which wecan do to see the importance of blood
flow. We can detect if there'sgood arterial inflow as well as good venus

(02:44):
outflow, because that allows us toreally get in there and try and heal
these wounds. And then with thatwe're able to go in in stint the
smaller vessels to increase the blood flowto those areas which we weren't able to
do in the pasture. And thenwe just add this to better antibiotics and
HBO therapy. Wow. I mean, that's a lot of really great information,

(03:05):
lots of advances I can tell,which is great. So I'm curious
because I have a history of diabetesin my family, and I always hear
that you know, people who battlediabetes, they face harder challenges in many
areas. Now, why do diabeticpatients make up most of your clientele?

(03:27):
And then how does their condition impacttheir healing, specifically wound healing. Okay,
one of the things that diabetes isan epidemic now Okay, believe it
or not, there is one pointtwo million diabetics diagnosed sheerly. Wow.
Twelve percent of our population in theUnited States is diabetic, so we see

(03:47):
it. It's increasing, especially thediet that we use nowadays. You are
all going, So what happens isthat we see a preponderance of diabetic patients
and in turn turn it over toJordan to kind of talk about how they
develop. These wounds develop from diabeticactions. So for them, they when

(04:10):
you have diabetes, unfortunately, whathappens to the blow circulation, So correct
me if I'm wrong, but thereis basically when the blood flows, it
kind of crystallizes, correct, Sothen that's where they cannot get the repair.
So also what happens with a lotof patients who are diabetic, they
develop and neuroopathy. Neuropathy, Yeah, that's very nepathy, and that's where

(04:36):
they can't feel anything on their feet, so they necessarily will not notice that
they have a wound developing like acallus. Wow. And then that's when
that's why you always want to checkyour feet when you see a wound,
you want to come in and makesure you get checked out. Absolutely,
and due to their diabetes, theyhave diminished blood flow, so in turn,

(04:56):
those wounds do not heal. Infact, they can spread very quickly,
and if they don't go to thewound center to get the diagnostic part
of it done and with standing oreither ablation, these can spread very quickly
and in turn they can lose alife or a limbah. Yeah, that's

(05:17):
scary, and the statistics are scarytoo. To know that twelve percent of
the US population now are diabetic.Yeah, scary number is probably only,
unfortunately going to continue to climb.So to understand and to recognize signs and
be able to go get that careright away, so important to keep top
of mind. Now, when shouldindividuals consider seeking treatment at a wound care

(05:41):
clinic and what steps can they taketo initiate that process. Okay, we
accept patients from any PCP or patientfrom any of the tri state areas.
In fact, right now we're treatingpatients from a Mesquite as well as from
the Laftlin area. Yeah, ifa patient does not live in Vegas,

(06:04):
we can coordinate their treatments with certaincenters within their community as long as they
come see us once a week.And that's a very common thing that we
have. What we try to dois for immediate care, we try to
establish a treatment plan, go aheadand follow that treatment plan, and then

(06:26):
if we have to have accessory peoplelike home health or some type of visiting
home nurse, we can coordinate thatwith them. That's very helpful. Now
I want to kind of get intothis fancy term here a little bit.
Can you explain the purpose of hyperbaricoxygen chambers in wound treatment, because when
you hear that term, I thinkinitially, just like most medical terms,

(06:49):
sounds intimidating, right, You're like, oh, well, what's that all
about? Can you dive into thata little bit more? Yes, I
can. In fact, it iskind of intimidating that we get residents in
medical students and the first thing wedo is take them back to the hyperbarier
chamber and you can just see theirmouth open and their chin drop because it's
a very unique environment. So whathappens is during the treatments, the patients

(07:14):
breathe hundre percent O two oxygen withinthe pressure rise chamber. Okay, we
usually always get some type of preauthorization. We also get medical clearances because some
of the patients they have multiple colemorbidities. You know that might have heart
disease, might have kidney disease,so we have to make sure they can
tolerate. That s what it does, it increases the oxygenation within the bloodstream,

(07:43):
which stimulates the wound site the hillfaster, and it helps the wound
heal from the inside out. Now, there are certain indications that were most
commonly see one is patients with chronicrefractory ostemolitis where there's an infection in the
bone okay, and that usually hasto be treated with the hyperbaric with long

(08:03):
term antibiotics. Okay. Also anothersometimes what happens is we have patients that
have had cancers and things like that, breast cancer or cancer lower extremity,
and they get osteoman excuse me,they get soft tissue radio necrosis. What
happens, the radiation destroys some ofthe blood vessels around the wound that they're

(08:26):
treating or or the cancer that they'retreating. So in turn, we use
the hyperbaric to try and increase theoxygen blood flow into those areas, which
normally it was very difficult to doabsolutely okay. Also, we treat a
lot of patients with diabetic footallcers becauseno matter what we do as far as

(08:48):
standing our ablation, we still wantto increase that oxygen level. And usually
they're in there for about two hours, okay, And usually what happens they
actually have a little TV in there, oh okay, and if they have
a movie that they want to see, they can bring the CDD and we
do have CDs for them, okay, the dvdsds. You have the DVDs

(09:09):
for them where they can watch yourfavorite TV channel. Wow. So kind
of make it a less intimidating environmentfor somebody to be in exactly because the
tubes they are clear, so youdon't feel so claus phobic in there.
Oh that's good, right, becauseI think anytime you hear the word chamber,
right, people are like, oh, I don't know if I can
do this or you know you likeyou said doctor, most important keep the

(09:31):
oxygen flowing and the blood flowing.So we want to make sure they're relaxing
that type of environment. And usuallythey have to have it's a continual thing.
They have to have between thirty andsixty treatments. Wow, five times
a week. Oh wow. Allright, So definitely people want to try
to avoid the hat obviously and stayhealthy and safe out there. Now,
patients, can they be referred toan outpatient wound care facility and what's the

(09:54):
criteria for referrals? Yeah, theyabsolutely can so by primary care physicians or
any type of physician. But alsopatients can self refer. So if they
are seeing any wound, especially ifyour wound is not healing within ten days,
you can just give us a call. We'll be able to help guide
through any insurance and luckily at Valuewe take all insurances. That's great to

(10:20):
help as me patients as possible.As soon as you see your wound,
we refer the wound in. That'sgood. It takes a little bit of
the less headaches on the back endfor somebody, and it makes somebody want
to then go and get that care. Yeah, and if they are feeling
intimidated and they do not want togo their primary care, we also have
ways where we can communicate with theirprimary care provider to get that authorization because

(10:41):
we want them to seek the treatment. Absolutely. Yeah, very very important.
Now, what are those primary factorsthat contribute to a patient's successful wound
healing process? Right, because justlike all recovery there's a process to everything.
Yeah, so for the process isdefinitely compliance. So listening to the
doctors and the nurses at the woundcare clinic, they're coming to their appointments

(11:03):
because for wound care, for thesenon healing wounds, it is a commitment
to come into us once a week. But you start becoming we really get
to know you. Sure you knowour team, and we customize it to
you, and our nurses really goabove and beyond. We even have we
go through nutrition and we educate becauseonce again, we're medicine. We're not
miracle, so we do need alot of compliance and just education with patients

(11:28):
is once they understand they had thisnon healing wound for a year or six
months, next thing they know,they're healing it within twelve weeks, so
they can go and enjoy and goon with their life and just enjoy and
help prevent. Yeah, see thetreatment out fully. Yes, I don't
you know, just say okay,looks like I'm getting better. I'm done
with this. No, keep thetreatments and listen to your doctor. What

(11:50):
was that point that you said Itsaid it's medicine mirrors. I like that
it's going to keep top of mind. I love that very very important.
Now, what advantages does having aphysician led clinic offer in terms of patient
care and then outcomes, Well,it allows us as physicians and care providers
to have a personal relationship with thepatient, you know, because I think

(12:13):
that's the key, because as longas we have that personal relationship with them,
they feel that they're taken care ofand we want to provide that care
for them. We also want tobe able to do the best treatment for
the patient and not just strictly fora company. Sure, and we want
to do it as a physician anda provider to give them the best care
possible. How we feel as providerswe need to give that care. The

(12:37):
medicine nowadays is so much insurance driven. Everybody trying to tell us what We're
very lucky because we don't have thatproblem. Also, it allows for easiy
or referrals to other physicians within ourgroup without all the delays that have been
occurred other As Jordan talked about,we're probably the only multidisciplinary clinic in the

(13:03):
state. Okay, yeah, becausewhere we have the infections disease. If
I want to get a patient toan infects disease doctor for antibiotics. All
I have to do is so sayyou come in on Tuesday and you'll be
able to see that doctor. IfI want to see a patient has a
problem with their feet and then weneed to see a p dietriss, all
I have to say you make anappointment instead of seeing me on Thursday,

(13:24):
you go see that provider on Friday. So it gives us a lot more
leeway flexibility, and that's why Ireally feel our wound center is more of
a wound care center as far ashealing, not a wound care center as
far as maintenance of the wounds.Okay, that's great. Yeah, also

(13:45):
allows for a COHESI treatment plan followedfor the patient's benefit, and it allows
us to work better as a teamwith the patient, the providers and everything
else. It's get a better outcomefor the patients. Great information today,
Thank you both very very much.Anything else that either of you want to
add the conversation today. Yeah,I just want to say, just like

(14:07):
some of the stories that we've hadReclichians, Yes, that's been my favorite
aspect of this is the patience.This is actually two stories. So one
of my first ones when I wasabout three months into the job and I
was going over to a MA andspeaking with her about just the services we
have to offer and everything, andI really connected with her and her team,

(14:30):
and I left the next day,she ended up calling me because unfortunately
her daughter had received a burn bya motor bicycle okay, and it was
pretty significant, and even though herteam could treat the burn, she felt
so comfortable with me and with ourclinic she wanted to come in and see
us and have her take care ofher daughter. So it just shows like

(14:52):
just our community alone recognizes that wedo have those healing aspects and that you
know that she could ten not sayingthat every teine couldn't do it, but
she just felt more comfortable coming withour experience, our expertise, with the
wonderful doctors that we have, suchas doctor Carl Williams. Yes. Absolutely,
and that's always I think the biggestcompliment, right is that you know

(15:13):
they could go somewhere else, butthey remember the way that your facility,
your doctor, your care team madethem feel. Yes. And then another
one is I had just also starteda month in and one of my friends
noticed on my LinkedIn that I hadstarted becoming a wound care liaison. So
that's where I kind of go andI just educate doctors and around the valley

(15:37):
and any nurses and really patients aswell about the wound care clinic. And
I updated my LinkedIn and one ofmy friends unfortunately suffered a finger infection okay,
and she needed to go in forsurgery and they wouldn't go in for
her surgery because of her infection.And unfortunately the doctor that she got referred
to they were no longer practicing.And just by luck by seeing on my

(15:58):
LinkedIn with the Value worm Care,she reached out to me. And the
best part was she reached out tome that morning. That afternoon, we
got her in with doctor Carl Williamsand he got to treat her. Wow,
that's amazing. And you know,a lot of things that's kind of
sad about it is we see alot of patients that have had wounds for
two years, sure, five years, We've even had one twenty five years

(16:22):
that they've been living that's become partof their life and they come see us
and we get them healed. So, you know, because patient we just
had, she was in California,got hit by a truck and had a
degloven injury to her entire lower leg. Had a big soft tissue necrotic dead

(16:44):
area on our leg and was seenby other providers who just kind of picked
at it a little bit. Wesaw her and took her to surgery,
were able to clean everything up,put a synthetic one of the biologics on
her temporarily, because you can't puta skin graft over if there's exposed bone,
tendon, or carilage, So youhave to use some of these biologics

(17:07):
to act as kind of a groundworkfor you. Okay, And then we
were able to come back and Ihave come back, put a skin graft,
and she walked out of the clinicjust this last week, you know.
And it's nice because they give youthe hugs and then they ring the
bells, so you know, andwe always try to tell them it's going
to just take a little patience.Just trust us. Just have patience and

(17:29):
we'll get you healed rights. Andthat's what I like about it. We
are definitely womb care healing, notwon care maintenance. I think that's our
kind of our slogan. No,I mean, that's a good point.
And you know, it's it's justinteresting to hear that, you know,
people out there would wait so longto take action for their own health and
what's on their body. But Imean that's just because you know, these

(17:52):
places, these situations can be intimidating. People don't know where to go,
who to trust, you know,and so to just talk with both of
you today, I mean I canhear the care and the compassion that you
both provide, which is joining agreat service to the medical field, specifically
here in southern Nevada. So thankyou very much to both of you for
being on this week's Wellness Wednesday.Big thank you Jordan Aldrich for being on

(18:15):
in Doctor Carl Williams, we appreciateyour time today. You're so welcome.
Thanks for having us, Yes,thank you for helping us spread the word
about wound healing.