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‘They tested the pulse in my foot for the first time and it was very weak,’ says Rev Stephens.
‘They said it suggested a problem with blood supply to my foot, saying I needed to see a vascular surgeon.’ Until then, he’d had no problems linked to blocked arteries and had been very healthy, running marathons until the age of 63.
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That’s because 70 per cent of leg ulcers are venous, which means they’ve been caused when persistently high blood pressure in leg veins causes fluid to leak out, causing swelling and damage to the skin.
Concerned about his left leg, which by then had three large open wounds just above the ankle, causing excruciating pain from infection, he decided to pay for an appointment with a private specialist that day rather than wait for an NHS appointment.‘He said the lack of blood in the lower part of my leg was causing the ulcer,’ says Rev Stephens.
This is because when blood supply is poor, tissues are starved of oxygen and nutrients and so break down, forming an ulcer.
But over the next three weeks, rather than improving, they got worse.
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Rev Stephens was then referred to the NHS Royal London Hospital, where his consultant, vascular surgeon Constantinos Kyriakides, works (he is also in private practice at London Bridge Hospital).
By this time, Rev Stephens had three large ulcers and half a dozen small ones. The key test was a colour duplex ultrasound scan, which looks at leg arteries and veins using an ultrasound probe.
Gel is spread on the skin and the probe is run along the legs, measuring blood flow.
But if this kind of leg ulcer is treated with compression bandages (the ‘gold standard’ treatment for venous leg ulcers, as the pressure increases blood flow in the veins), it can make the problem worse, as the bandages can reduce blood flow in the artery still further.Rev Stephens’ ulcers were dressed with ordinary bandages.