Everyday, bodies of people who had been shot by communist soldiers trying to escape, floated by on the river. Finally, friends said they had a log for him to float across the river. On a moonless night, he got into the river and hung onto that log. No one told him that the log would roll over from time to time in the current! Dr. Ung did not know how to swim. But he knew how to hang on.
The log finally made it to the other side. Now, in Thailand, Dr. Ung began searching for his father, mother and seven brothers and sisters who had escaped two months earlier. He miraculously saw his little sister playing in the dirt. She led him to the basement of a Thai family where his family was living so they could avoid being put in a refugee camp.
Dr. Ung then convinced the US Embassy staff to allow his whole family to immigrate to America. Following the advice of an American friend, the Ung family chose to move to the Midwest. Centerville, Iowa, became their new home. “When we arrived, the whole town was there to greet us. They brought us clothing, furniture and household supplies. English tutoring was next,” Dr. Ung reports.
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After working as a full-time janitor to help support his family, Dr. Ung decided that it was time for him to further his education. War had prevented him from completing grade school, but he had learned how to speak eight languages. His father told him, “Speaking eight languages won’t put food on the table.”
With the same determination that helped him hang onto the log, Dr. Ung decided that to be successful, he would need to go to college. The first two years at Cornell University were challenging. Studying chemistry, biology and math while learning English required hundreds of hours of study. Things began to get easier in his junior year. “They threatened to kick me out as a freshman, but I was a teacher's assistant in Chemistry by my senior year,” Dr. Ung said. He graduated in 1981 with majors in chemistry and biology and a minor in math. |
Due to improvements in diabetic
patient care over the last 14 years, amputations should no longer be
considered a valid treatment option.
They should now be considered
a failure.
- Kham Vay Ung, DPM.
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So after working as a researcher at the University of Iowa, Dr. Ung decided to study to become a Podiatrist. Because his school was affiliated with a medical school, Dr. Ung was able to work with doctors from other disciplines such as family practice, surgeons, endocrinology, nutrition and diabetic education.
This, plus his understanding of tribal life, suffering and perseverance have led him to work with Native American communities. Beginning as an intern volunteer with the Winnebago Tribe in Nebraska and the Red Lake Band of Chippewa in Minnesota, Dr. Ung was able to turn a passion of searching for better ways to help Native Americans with diabetic related foot problems into procedures that have saved toes, feet and legs of thousands of patients including Crystal Gale, B.B. King and a band member of Willie Nelson. Today, Dr. Ung and his staff at the Sioux City Foot and Ankle Clinic, serve Native people from the USA, Canada, and Central America. He is truly a doctor and leader and friend of the American Indian community.
The purpose of the LaFlesche Elders Amputation Reduction Network (LEARN) is to get the word out to every Native American that help is available. Before you, a family member, or a friend has a diabetic related amputation, contact Dr. Ung’s clinic first.
FOOT & ANKLE CLINIC PC
1502 Pierce St.
Sioux City, IA 51105
(712) 255-0502
By using good prevention techniques such as proper diet, exercise and care of feet, along with the Dr. Ung's amputation prevention techniques, your quality of life can be dramatically improved.
Hope for Diabetics
LAKE TRAVERSE, SD - Dr. Kham Vay Ung, Pediatrist-Foot Surgeon, and Consultant to the United States Public Health, Indian Health Service, presented his message of hope throughtout the Lake Traverse Reservation September 21 & 22, 1999. Dr. Ung was brought in by the Sisseton-Wahpeton Sioux Tribe's Diabetes Prevention Program in its efforts in the prevention of diabetes.
Dr. Ung has worked extensively throughout the United States and Canada with chronic and diabetic foot complications. All of his professional life he has worked with Indian people. Dr. Ung's work with Indian people started when he received a grant from the Department of Health & Human Services to study the incidence of limb amputations on the Winnebago Indian Reservation. He believed the number of amputations was much too high. The Winnebago Tribe was seeing an averagel of 14 amputations per year. Three years after the start of the grant, amputations were reduced by half and after six years there were no amputations at all. Dr. Ung believes that it is important to "never give up." Many diabetics give up thinking that this is part of the disease. Dr. Ung works to show that it doesn't have to be that way.
The average cost for a limb amputation is between $25,000 to $40,000. This does not include follow-up appointments or prosthesis. The cost to heal an ulceraton is about $36,000. Dr. Ung argues it is much more cost effective to save a limb.
According to Dr. Ung there are about 16 million diabetics in the U.S. today, with about 600,000 newly diagnosed diabetics each year. He said that for every person diagnosed there is one who is not. He pointed out that there is no such thing as a boderline diabetic, saying "either you're pregnant or not." Within the Indian people the most common type of Diabetes is Type II. It too is preventable. Before 1940, diabetes was not seen as a problem disease within the Indian population. It was not until after 1960 that diabetes quickly became an epidemic.
It has been reported that close to 90% of all diabetics smoke. Smoking has a detrimental affect on the diabetic's circulation. If you are diabetic and smoke, Dr. Ung strongly recommends you quit. It is one of the most important steps in the prevention of chronic foot problems for diabetics. Dr. Ung believes that amputations are a failure of previous treatment. Too often limbs are being amputated unnecessarily. Indian people have 4-6% more amputations than the general population. A common condition of diabetes is neuropathy. Neuropathy manifests itself when the diabetic has lost sensation or feeling in their feet. Neuropathy is a major factor leading to foot ulcerations.
Prevention is the key
Dr. Ung works to train Community Health Representatives (CHR) and Community Health Nurses (CHN) to be patient advocates. CHRs and CHNs can routinely check peoples feet at the same time they check blood pressures (they are not expected to treat only to monitor the diabetics foot). So, if there is a small cut or blister, it will stay a small cut or blister.
In addition to routine checking of the diabetic's feet, shoes are also important in the prevention of chronic foot problems. Today, shoes are designed to fit the the diabetic's foot, especially those who have foot deformities. Shoes purchased should be made of real leather, which "breathes" and not of plastic or vinyl. In addition, cotton socks with a lot of cushion should be worn. There is no such thing as regular or normal shoes for diabetics. Shoes are as individual as the person. Once you are fit with the proper shoes, remember that walking is the best exercise for a diabetic.
Dr. Ung is known for the development of the Limb Salvage Procedure. This procedure was developed for diabetics with complicated foot ulcerations. Dr. Ung works to save as much of the foot as possible. Ulcerations are cleaned and lost muscle is replaced by muscle grafts. Skin around the ulceration is then stretched gradually. Once the skin is stretched to where ulcer can be covered it is stiched and a cast is put on. The cast, designed by Dr. Ung, allows the patient freedom of movement and serves to protect the foot while healing. Dr. Ung believes it is important to get the patient moving and walking as soon as possible after foot surgery. Walking and movement promotes good blood circulaton and allows the healing to start.
Dr. Ung teaches physicians to "quit blaming the patient." Diabetic patients are often unaware of the serious condition of their feet. One of the first signs of the loss of feeling in the feet is a tingling sensation. Without proper care or prevention ulcerations and/or gangrene can set in. Dr. Ung believes there is a lot of misunderstanding between doctors and patients. When he is training physicians, he feels the physician must have a good understanding of the patient's economic and social environment. "If a doctor doesn't live in the community of his patients, he shouldn't be there."
Diabetes is a silent killer. Prevention is the primary key to living a long and healthy life. Dr. Ung certainly brings a message of hope to the thousands of people at risk of foot ampuations. We applaud and thank Dr. Ung for his extraordinary work in our Indian communities.
From Wicozabum Sept./Oct. 1999 issue and Indian Life Jan/Feb 2000 issue.
