Conceptual Artist Retains Limb Against Long Odds

In his 33-year career as a conceptual artist at Lawrence Livermore National Laboratory, John Maduell illustrated futuristic technologies few others could imagine. But he never envisioned the toll diabetes and vascular disease would take on his body—or that one day he might lose his legs because of these problems. 

Maduell's troubles started two years ago when he developed a diabetic ulcer on his left foot.

"Before I knew it, I was in the hospital, with three toes amputated," he says. Still, the wound didn't heal, and Maduell, who now lives and paints in Modesto, was told removing the entire leg was his only option. 

Instead, he sought help at UCSF's Center for Limb Preservation, which brings together podiatrists, vascular surgeons and other specialists to provide coordinated care for patients at risk of foot or leg amputation. "Even small wounds progress rapidly in people with diabetes, and like many of our referrals, John came to us when it was almost too late,” says Dr. Michael Conte, who co-directs the center.  “Time is tissue, and we had to move quickly to save his leg.” 

The center specializes in treating complex lower extremity wounds, and Maduell's infection first required an urgent procedure to remove unhealthy, infected tissue from the foot. This was performed by a team of podiatric surgeons led by Alexander Reyzelman, DPM, the center’s other co-director. Then Conte performed surgery to reroute blood around a series of blocked arteries extending from Maduell's knee to his foot. At a final stage the podiatry team completed surgical closure of the foot once infection was cleared and blood flow improved. The multi-stage treatment plan was successful and after additional weeks of wound healing and outpatient treatments, Maduell was walking normally again. But a year later, he developed another ulcer — this time on the other foot. Once again, Conte's team acted quickly and saved his leg. "I’m eternally grateful to Dr. Conte and the entire team," Maduell says. "They’re the best in the world at what they do. Had I not gone there first, I would have lost both legs." 

"We're the first clinic in the Bay Area to focus on amputation prevention and high risk diabetic patients like John”, Conte explains. “We save limbs because we offer efficient, coordinated care with a high level of expertise and because we are aggressive in our goal of preserving a functional foot."