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about internal medicine, and the vascular issues of a human body, I placed “How are you doing today? Is everything well, please let me know.”
trust on my team of expert surgeons. “I am fine Doctor”, was my simple answer. “I am having a good day”.
Few minutes later, a gentleman, wearing a black tie and an immaculate white “Glad to hear that you are so positive,” he answered with a smile, “I like your
uniform, appeared at the door of my VIP hospital room and asked: attitude and positive energy”. He smiled at this point apparently pleased, as he
“May I come in Sir? “ continued, “This inspires us, our whole team, I mean...”.

I said: Yes. Please do come in. “Thanks doctor”, I replied with confidence.
My son-in-law also appeared, swinging the door fully open. He brought a file “You need to undergo an Angiography, in a couple of days,” said the doctor.
with all my medical data and information, which had been collected the other But the procedure was not shocking to me, since I was mentally prepared to
day by another staff nurse. While we discussed issues related to my sickness, I undergo it without fear of unforeseen problems and emergencies, as the doctor
just raised a question: explained further:
“Can you explain what the problem with my vascular system is, and what are “Catheter angiography and intravascular ultrasound, in most cases, should be
its functionalities…? reserved only to document the anatomy before any treatment is being carried
He patiently explained: out to the patient. This procedure should not be used for making the
diagnosis. There are many patients here with noncritical PAD, a term used for
“The word vascular means something relating to, affecting, or consisting of Peripheral Arterial Disease, and coexisting diabetes, vacuities, or degenerative
vessels, especially those which carry blood through the veins of the human arthritis that masquerade as CLTI.”
body. A vascular surgeon treats many conditions that affect the blood vessels in
every part of your body, with the exception of your heart and brain.” The Doctor stopped for a moment, and then asked the staff nurse Jameela to
help him with the handheld scanning device to check whether I was
First, he explained to me about the diagnosis of CLTI, which is being
performed medically; CLTI means Chronic Limb-Threatening Ischemia. developing low blood pressure on both of my limbs.
This rare treatment requires a thorough history and physical examination by “Therefore, because of the initial evaluation, additional tests should be
an experienced vascular physician, as well as combination of tests, including performed in an accredited vascular laboratory equipped with objective
noninvasive physiological studies. The need of a complete diagnosis would hemodynamic tests, in order to establish the diagnosis, using segmental limb
soon follow, either by duplex imaging or cross- sectional imaging using and toe pressures and ankle-brachial indices.
computed tomography angiography or magnetic angiography. “Once the initial assessment is completed based on grading of wound,
The gentleman with the black tie was quite eloquent, and explained in details Ischemia and foot infection (WIFI- Wound, Ischemia, and foot infection);
about my heart-disease and its related symptoms, which would eventually which provides the most accurate results of CLTI. …”
show throughout the body. He talked to me for almost a couple of hours, in He stopped for a moment, and said, “Nothing to worry, we will take care of
order to keep me informed in the best possible way. you and your limbs”. The day ended with a smile and bliss within myself.
As a good patient relation, knowing my desire to be informed on the subject,
Wounds the window of the room. It seemed to be smiling at me, and infusing a positive especially in this rare medical field, the doctor on duty had been given the task
energy in my mind and body. of keeping me informed on the subject.
Soon after my light tea break for the in-patients, I was taken to a separate, and I knew that the hospital was more technically advanced than other ~ Williamsji Maveli ~
It was early afternoon, I was sitting on my bed in a positive mood, feeling very very comfortable air conditioned room, since my surgery date was postponed, Government hospitals, which were less caring of their patients' best interest.
relaxed in those special moments. I could see the bright sky as I looked through pending further investigations of my vascular system. Since I knew very little Soon after, the doctor with his medical team visited me, and said in greeting:

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