About three years ago, the calf muscles in his left leg really started to talk. Doing yardwork became unbearable. Last year, Bettosini finally listened to the pain, but it was too late.
It began in his toe, which had turned purple and black with a crusty exterior. His blood was clotting from the calf and after a few months his foot turned white and throbbed with pain. In April 2008, his arteries became so blocked and the pain so excruciating he had to have a leg amputated.
“When the doctor said let’s take it above the knee, I didn’t think twice,” Bettosini said. “I haven’t really felt any limitations until I read on the Internet that you’re not supposed to be able to do something like run or climb stairs.”
Bettosini started paying a little more attention to his body. He began losing weight. He was in the midst of learning to walk again with an artificial limb and things started looking up — until the heart attack. Just nine months after the amputation, Bettosini went into cardiac arrest. From that point forward, he knew he had to do a lot more than just lose weight.
He had to exchange biscuits and gravy, bacon and 1,600-calorie milk shakes for greens and foods with Vitamin K. The smoking habit he picked up as a Marine in the 1980s had to be dropped nearly cold turkey. His 18-hour work days on the computer have been shortened to keep his body a little more in motion.
Bettosini had to change his lifestyle completely in less than one year, sacrificing saturated fats and cigarettes to get himself into better shape after losing his left leg and then suffering a heart attack less than nine months later.
Following his amputation, Bettosini began the long process of adapting to a prosthetic leg and taking better care of himself. It has had its challenges, but it awoke the 46-year-old aerospace engineer to a new way of living. So much so that it’s like his old life never existed.
“It’s almost like nothing ever happened, other than I decided to get healthy,” Bettosini said.
With the help of local medical experts, Bettosini was able to take advantage of Renown Regional Medical Center’s Cardiac Rehabilitation program. Cardiac Rehabilitation is a collaboration of doctors, dietitians, respiratory therapists and other specialists, like hematologists and vascular surgeons. Recently, the program was recognized by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) for meeting the standards for certification.
The cardiac rehab facility at Renown individualizes plans for patients who need to get in shape and participate in prolonged activity. Bettosini has been working with a staff of doctors and registered nurses in the facility, which has four treadmills, three recumbent bicycles and free weights.
“We teach the patients how to use the equipment,” said registered nurse Karen Page, a 22-year employee of Renown. “There are options. We have these heart monitors that monitor their heart rhythm; that’s the main reason they’re here, instead of just going to a gym.”
Page has been working closely with Bettosini since his amputation.
The medical condition that led to his amputation was peripheral arterial disease, or PAD, in which the blood vessels become narrow and constrict proper blood flow through the arteries.
According to Dr. Colin Fuller, cardiologist and co-director of Renown’s vascular institute, an estimated 10 to 12 million people in the United States have PAD, but millions more don’t know what it is. He said symptoms include experiencing an ache in the hip or thighs that may come with walking but gradually subsides after a few minutes of rest.
Fuller said it’s simple to tell if someone has PAD.
“If you take blood pressure in the ankle and blood pressure in the arm simultaneously, they should be the same,” Fuller said. “If you have PAD, the blood pressure in the ankle is lower than in the arm.”
Bettosini found out he had PAD the hard way: first losing his leg and then a heart attack. He said the heart attack wasn’t very painful nor was it the “grab your chest and scream” sort of episode.
“It was just kind of fade-to-black and I literally lost consciousness at some point,” he said. “I woke up in the hospital and they’d done a stint in the lower descending arterial and busted two other clots.”
He took some time in the hospital after the attack.
“I was at a point where I was pretty frustrated with myself,” he said. “Everything seemed it was getting worse and not better.”
His wife, Sue, who said her husband was always stubborn about going in for a physical or seeing a doctor when he wasn’t well, vividly remembers the day in February.
“I remember I was at work and I had called him every day since he lost his leg,” she said. “That morning I forgot to call my husband and it was about 9:15, so I called him and he wasn’t sounding right, not feeling right and he said, ‘Suddenly I can’t breathe.’ So I told him I’m coming home and … I was at a traffic light and he said, ‘Hurry.’ ”
Sue said when she made it to him, his face was white. She took him to Northern Nevada Medical Center, but he couldn’t get out of the car because of his prosthetic. It took a couple of times to get anyone’s attention at the hospital because nobody realized he had an artificial leg. When he finally did make it in, he went to the restroom and went into cardiac arrest.
“The second time I was screaming,” she said. “My thing was, ‘Do not let him die. He’s not ready. I’m not ready to let him go.’ ”
When he was hospitalized, Bettosini was found not only to have PAD but CAD, or coronary artery disease, as well.
Fuller said that is common among PAD patients.
“He was very, very sick,” Fuller said. “There was total blockage and we had to open him up with a stint. We put a balloon in and took care of that.”
Fuller said if one artery is blocked, it is likely that some or most of the other arteries have blockages, as well.
PAD, which is attributed to build-up of plaque in the arteries, can be controlled. Fuller said exercising, keeping body weight down and maintaining one’s cholesterol level below 70 are key to avoiding the disease.
Bettosini also gave up almost 25 years of smoking.
“I was probably smoking the day I went to the hospital to have the leg cut off just because I knew I’d never be able to do it again,” he said with a chuckle. “I joke and say if you ever want to quit smoking, spend 20 days in the hospital with a morphine drip and you get right through the withdrawal symptoms. You leave the hospital and you never feel the craving.”
Since his amputation and heart attack, Bettosini has been going to the gym about five times a week, walking on a treadmill and doing weights on the floor. He also goes to the institute at Renown to have his heart monitored.
He never thought he would enjoy his rehabilitation, but he finds humor in counting the calories on the treadmill.
“Now I can have a root beer float,” he said. “It’s only 45 minutes (to burn off that much).”
Renown staff say it’s Bettosini’s positive attitude that has helped with the healing process.
“There’s no guarantee, but your future is good; you have a great attitude,” Fuller told Bettosini Wednesday. “He has a great attitude. He’s exercising, he’s keeping his weight down and eating right and he stopped smoking so I think his plaque probably will not grow.”
Bettosini still does the same work he did before April 2008 but spends less time in front of a computer. As an engineer for his own company, he helps design jets and serves clientele who ask for special projects in their private jets, such as making sure that large televisions are attached properly to the bulkhead.
Bettosini has two stepdaughters and some grandchildren and they have often been curious about their grandfather’s leg. For the most part, Bettosini said his family has been supportive.
“It was tough, but I needed to get him better,” Sue said. “(The institute) was a good place to start.”
Renown offers PAD screenings for $25 for those who are smokers or have had diabetes.