The boots to save Grethe’s legs

The doctors would amputate the leg of Grethe Valskaar Hetland. Then she got hold of the FlowOx boots. It looks almost like a transparent slalom boot, or an oversized snow jog from the 1980s.

The boot alternates between vacuum and non-vacuum. This should improve blood circulation micro level in the tissue of the foot. The medical community describes the invention as promising, and awaits more documentation.

Diseases in line

But let’s start with the story of the Sandnes woman Grethe Valskaar Hetland (43). Her life has been tough, with an increasingly complex picture of illness.

I got diabetes at the age of five. My childhood was about two daily syringes insulin, and in my teens I had metabolic problems. Later more implications occurred.

She had hemophagocytic lymphohistocytosis, a serious disease that attacks healthy organs because it produces too many white blood cells.

“I was treated with chemotherapy and high doses of cortisone. This made my condition much worse.” As if this was not enough, Grethe was also affected by the bone infection osteomyelia. “I had wounds on my toes, my legs swelled up and I had to amputate four toes and one finger.”

“Then I sat in a wheelchair for three years.” For the soul artist Grethe, the diseases made her life much more difficult. – “I’m not whole as a human until I get to sing”, she says.

The doctors was ready to give up

Senior physician Andreas Reite at the Vascular Surgery Department at Stavanger University Hospital says that complications from Grete’s diabetes have caused her atherosclerosis. She has no blood in her leg, and there are wounds and complications.

“The first time we examined her, she had a small wound. We then did a treatment with a blockage in the arteries and opened up a little. Then things just got worse. Eventually there were no open veins left in her legs. We were no longer able to do surgery.”

– What were you thinking then?

“Common in such cases is amputation, especially in cases like Grethe, where there are infections and resting pain.”

After a working life as a health care worker in home nursing, psychiatry and at an elderly care center, Grethe Valskaar Hetland was disabled as a 35-year-old. Of course it was a hard blow. I like to laugh, but the seriousness took me, says the Sandnes woman. At that time, the blood circulation in the legs was so poor that they were barely able to measure the blood pressure in my foot.

“I had a fantastic specialist, Bodo Günther, who helped me a lot and operated me several times. But then I got to a point where there wasn’t much more doctors could do for me”, says Grethe.

This image has an empty alt attribute; its file name is Grethe_portait-1024x568.jpg

Grethe Valskaar Hetland’s disease picture is complex and complicated.

New evaluation

She was told that there was no way out of amputation. Initially one leg, below the knee. “I could live with losing a few toes, but not a whole leg. I asked for a second opinion.”

For years, Grethe has lived relatively isolated from the outside world. Full up by being a good spouse of Ragnar, and a good and loving mother of Carl Grant of 11 years.

“I can’t do too much in one day.” But two years ago, something happened that sparked a new spark of life at Grethe. Since Grethe is only in her 40’ies  and “a special case,”  according to Andres Reite, SUS asked for a second opinion with colleagues at Oslo University Hospital.

Nor did the Oslo doctors think there was more to be gained by opening up the leg. Instead, they suggested trying the FlowOx boot Aker Hospital had come to know about.

Want to help more

“When you are as far down as I was, you cling to everything that might work. Even though I was skeptical skeptical to this boot, I thought that no stone should be unturned.” Today, Grethe is happy to be given a second chance. The last two years have been an uplifting experience.

“After using the boots, I have had steady progress. The legs are pain free and blood circulation much better. My legs have improved so far that I can walk and use exercise bike. If I am not up for exercising for a period of time, I am usually using  the boots more often.”

She describes the feeling from the boots as if someone was massaging her legs. “Now I’m just sorry that I didn’t know about this sooner. It’s a bit uncomfortable to share my story, but I do it because I want others  to have the opportunity to experience the same progress as I have.”

Andreas Mollatt is Managing Director of Otivio.

The company has produced 400 boots so far. Half are used for clinical trials.

“We have tested the boot on 200 patients in collaboration with 30 leading hospitals in Norway, Great Britain and Germany. The result has exceeded all expectations. Half of the most severe patients have benefited from FlowOx in the form of wound healing and pain relief. Healthcare professionals at these hospitals increasingly want to use our technology.”

What does this cost to the Norwegian healthcare system?

“We think the opposite, and rather think about what society can save. Both in the form of improved quality of life and lower costs. An amputation costs one million NOK on top of the treatment of chronic wounds that quickly amount to NOK 100,000-150,000 per year per patient.”

Andreas Mollatt says that the boot costs NOK 200 a day to rent.

“There are no side effects, it is cheap and the boot can be used at home. If it doesn’t work, we just end the treatment. There are no downsides to this”, he claims.

Want more documentation

Andreas Reite at Stavanger University Hospital answers the following whether he thinks it is the boot that has made the difference to Grethe the last two years:

It is difficult to say 100 percent that this is why, since she has many complications. “What we can say is, that without the boot we would have amputated, and with the boot Grethe has kept her foot,” he adds.

At SUS (Stavanger University Hospital), the boot has so far only been tried on Grethe.

What is the chance that the improved condition will stay on Grethe?

“It’s hard to say, but for now it looks fine. She goes and works better than before.”

Are you surprised she has gotten so much better?

“Yes, in a positive sense. But this did not happen overnight. It has been a long process where she has gradually improved, but with much pain along the way.”

Have a dream

For Grethe Valskaar Hetland, the song is important, perhaps the greatest impetus in life. “I was on the scene for the last time four or five years ago. If I should be able to perform again, I need to be able to stand on my feet. Now I dream of being able to perform a concert again soon.”

“But I know that I would always have to live a life with my conditions. I just have to accept that fact, she concludes.”