For One Weymouth Veteran, Healing for a 50-Year-Old Wound is Found Close to Home
Most people would define a chronic wound as one that lingers for a few weeks, maybe a month. A particularly troublesome wound might stick around for a few months.
For Richard Lalond, a few months dealing with a stubborn wound might as well be the blink of an eye. After all, what’s a few months when you’ve been seeking healing for more than 50 years?
Over the course of those 50+ years, Lalond’s efforts to heal that wound took him all over Massachusetts, from VA hospitals in the suburbs north of Boston to the salty waters of Cape Cod.
But it wasn’t until he landed at South Shore Hospital — just a stone’s throw from his home — that the healing of a wound acquired half a world away could truly begin.
A wound, an infection, and the beginning of a long journey
Richard Lalond was just a teenager in 1966. That year, as a member of the Marine Corps, he was deployed to Vietnam during the height of the Vietnam War.
Shortly after arriving, Lalond was wounded in combat, with shrapnel tearing into his right leg. While medics were able to treat the resulting wound, the injury was serious enough to require an extended stay in a field medical facility.
“The shrapnel doesn’t give you an infection, because it’s hot, burning steel that opens you up,” said Lalond, now 73. “But my wound stayed open for months and months in an infectious orthopedic ward. If you have 50 guys in a ward with open wounds, everybody is taking everybody’s diseases.”
It was during his stay in that ward that Lalond’s wound got infected. The infection spread to his bone, beginning his decades-long battle with osteomyelitis.
Healing a serious wound is taxing enough on the human body, and the addition of a bone infection made healing that wound even more difficult.
“Once [the osteomyelitis] set in, it drove everything from there,” said Lalond. “Over the years, I had very brief spots of time where I would actually heal up, but I’m talking two or three weeks. So for almost 50 years, I carried open wounds.”
When Lalond returned home from Vietnam, his wound was far from healed and treatment was lacking.
“Basically, at that time the fix was ‘put a bandage on it and take these pills,” said Lalond. “I was in a ‘woe is me’ stage of my life at the time because they had given me maybe another 10 years to keep my leg.”
In his attempts to find a solution, Lalond even turned to natural healing.
“My old doctor, he was the old-fashioned family doctor,” Lalond said. “I’d go see him and he would say ‘get down to Cape Cod and get in that ocean.’ His mix was cold, salt ocean water. It would work — you still had your wounds, but they were clean wounds.”
However, clean wounds are still wounds, and Lalond’s case of osteomyelitis prevented those wounds from fully healing. Over the years, Lalond underwent countless skin graft procedures, but the lingering bone infection made long-term healing virtually impossible.
“Your body has the natural ability to heal itself, and mine didn’t,” said Lalond. “When the infection got really bad, it travelled through my body and I had to stay in hospitals because the grafts would just start falling off of me and the wounds would be open again.”
A trip to South Shore Hospital, then a breakthrough
Unfortunately, his osteomyelitis had Lalond stuck in a frustrating, decades-long cycle: grafts would be applied, the infection would flare up, and the grafts would deteriorate, leaving him with an open wound.
The process would then begin again from that point, seemingly with no end in sight.
A few years ago, Lalond was admitted to South Shore Hospital with what he thought at the time was an unrelated illness. Instead, his care team was able to see the bigger picture.
“They saw the leg and they started putting two and two together,” said Lalond. “They found out the leg got infected and caused all the problems in my body.”
That stay at South Shore Hospital marked a turning point in Lalond’s search for healing, as it was there that he learned about South Shore Health’s Center for Wound Healing.
“They recommended [the Center for Wound Healing] to me,” said Lalond. “I came and chatted with Dr. Gibbons, and he wanted to give it a whirl.”
“He was in the hospital, hospitalization after hospitalization, but he never really saw a multi-disciplinary wound care team,” said Dr. Gary Gibbons, Medical Director of the Center for Wound Healing at South Shore Health. “He was going here, there, and everywhere, and getting bits and pieces. No one owned it.”
By visiting the Center for Wound Healing, Lalond had found a team that would own his healing from start to finish. The first step, however, wasn’t an innovative procedure or experimental treatment.
Instead, Dr. Gibbons and his team went back to basics.
“When he came here, we started all over again,” said Dr. Gibbons. “Culturing [the wound], understanding it. We took bone out and cultured it. We identified the factors that we thought were keeping him from healing. I think the thing we did initially that people had really underestimated was debridement.”
Debridement involves removing infected or dead tissue from a wound site, essentially “cleaning up” a wound. Once the wound had been debrided, further treatment could begin.
“We started him on a whole different set of dressings that we thought were tailored to him and his wound,” said Dr. Gibbons. “We then started him on non-contact low-frequency ultrasound, which helped with his pain as well as the wound. Then we put him in the hyperbaric chamber, which, along with debridement, helped us get the wound from a chronic, inflamed state to one where there was a healing component.”
“Back then, it was a lot of trips to the hyperbaric chamber…constant wound cleansing,” said Lalond. “There was a lot involved with it. It wasn’t just coming in and getting procedures.”
“Around that time is when I felt the warmth of this clinic,” Lalond continued. “Every time I made a phone call or came in, everybody rushed to me and it just made me feel so good because I am not accustomed to that kind of treatment.”
Still, for Lalond, there was no magic treatment. His healing involved a multi-faceted, methodical approach to treating the underlying cause of the wound, not just the wound itself.
“We looked at everything,” said Dr. Gibbons. “We really took into account what we thought was keeping him from healing, and then we had the modalities to do it. While a lot of places have hyperbaric, if you still don’t take care of the wound, hyperbaric is hyperbaric. It was doing all of this together that helped him make progress.”
With a wound that had lingered for 50 years, progress was swift by comparison. With regular visits to the Center for Wound Healing, it didn’t take long for Lalond to have a breakthrough that was decades in the making.
“I got done with the chamber, and there was no active osteomyelitis in my body,” said Lalond. “Over 50 years in my body, and it’s gone."
Lalond explained that in the past, he used to get bone deterioration where the osteomyelitis had rotted the bone out. However, x-rays taken after he finished with the hyperbaric chamber showed that the hole caused by that deterioration is completely gone.
“I am one proud peacock,” Lalond said with a laugh.
With an infection gone, healing can begin
With the osteomyelitis finally under control and the wound debrided, Lalond’s care team could focus on healing his wound. Many wounds are treated using skin grafts, which involve taking healthy skin from one area of the body and transplanting it to the affected area.
However, after years and years of skin grafts, Lalond’s body had, by his own estimation, “basically been stripped of graft tissue.”
Fortunately, wound care technology had come a long way since Lalond’s time in the Vietnam field hospital. At the Center for Wound Healing, he underwent cutting-edge grafting treatment.
“When we thought the wound bed was ready, we used a cellular-based tissue product, a cryopreserve,” said Dr. Gibbons. “We had participated in a trial where we found it could be used to cover bone, tendon, and scar. We had a history of using these products appropriately, and when we weighed all of the risks vs. the benefits, it seemed like because it had stem cells in it, using a cryopreserve would be the best for him.”
This cryopreserve contains placenta cells, similar to those collected by South Shore Health’s Placenta Donation Program.
The grafts interact with Lalond’s own skin to create healthy tissue. The results thus far, in Lalond’s words, have been “absolutely phenomenal.”
“The grafting stays like real skin, and doesn’t get dried and brittle,” said Lalond. “You grow it from the bottom up instead of just laying it over the top. Before, it looked like a piece of cardboard that was left out to dry, and now it’s red and rosy.”
His current treatment plan involves weekly visits to the Center for Wound Healing so Dr. Gibbons can check on the progress of the grafts. Compared to prior skin grafts, Lalond sees the process as a simple one — one he has down to a science.
“Come in have a coffee, have your blood pressure taken, doc does some scraping, cleans it up, the nurses prep everything, and boom, you’re out the door that quick and you can go about your normal day,” said Lalond with a smile.
A system-wide approach to healing, from wounds to knees
The progress Lalond made at the Center for Wound Healing offered more than just a chance at healing an old wound – it gave Lalond an opportunity to address another long-term ailment, all within the same health system.
“I had bad knees for 15, 20 years,” said Lalond. “Until he was sure there was no osteo or anything…no doctor in his right mind would try to fix that. That would devastate a knee replacement.”
“They said they’d work on the worst leg [first] in case something went badly,” Lalond explained. “They did the knee replacement and I rebounded perfectly. [Dr. Ayers] is reading the reports, and everything is clean as a whistle. The other [knee] rebounded even faster with no issues.”
Prior to the procedure, Dr. Ayers had known Lalond for a decade, which made it especially gratifying to be able to help his friend get back on his feet.
“Rich is a proud veteran and a successful business owner in the marine industry,” said Dr. Ayers. “After his wound issue was under control, it was time to address his painful knees. Two partial knee replacements later, he’s back in, on, and around boats, doing the work he loves.”
Part of any successful joint replacement procedure is the follow-up rehabilitation, which can be difficult. But for Lalond, his long journey toward finding healing for his wound, combined with his Marine Corps background, gave him a different perspective – one that he tried to share with the people he met during rehab.
“You suffered for how long with those knees, and now you won’t put the effort in? Go jump in a casket somewhere,” he said, laughing. “They were calling me a drill instructor at the therapy place because I was calling out people who were slacking.”
At long last, healing – and close to home
For Richard Lalond, the road that led him to the Center for Wound Healing was winding, and occasionally bumpy. He was wounded some 8,500 miles from home, but found healing just five minutes down the road.
“If I didn’t know about this clinic, which was talked about to me at South Shore Hospital, I probably would have gone [elsewhere],” said Lalond. “But they suggested this, and I was like ‘let me go see what this is about.”
“When I met Dr. Gibbons and told a couple of people he would be my doctor, they said there is nobody around better than Dr. Gibbons,” Lalond continued. “He is a wonderful guy and he knows what he’s doing.”
While Lalond’s wound is getting better with every visit, he knows there may be setbacks ahead, particularly with deterioration of old grafts. Still, the future is bright.
“The beautiful thing about Dr. Gibbons is he will not build your hopes up to then let you down,” said Lalond. “Now, he says everything is looking good and we are on the road to recovery.”
For Dr. Gibbons, it has been rewarding to guide Lalond on his journey toward healing.
“You only get so many chances,” said Dr. Gibbons. “When he got admitted, he was really sick, and you can only do that so many times. I think we really gave him hope again.”
“He just had to find the right people, the right team,” Dr. Gibbons continued. “He had a wound for years that no one could fix, and we got him healed.”