Podcast with Dr. Kenneth Walsh, Vascular Surgeon

Carol Gifford:

Okay. Well, hello. This is Carol Gifford. I am the host of the Mason City Clinic podcast series, and we speak to the different providers and surgeons at the Mason City Clinic about all the things they do for the community in North Iowa. So with me today is Dr. Kenneth Walsh, and he is new to the clinic. He is a vascular surgeon, and we’re so excited that he is with us at the Mason City Clinic. And so we’re going to learn more about his background and learn more about not only how he treats vascular disease, but how people might be able to prevent it. So welcome to the program, Dr. Walsh.

Dr. Kenneth Walsh:

Hi. Thank you for having me.

Carol Gifford:

So just give us a little background. I think I was reading that you come from the South or you went to medical school out East and then were down in Georgia somewhere, so tell me a little bit about your background.

Dr. Kenneth Walsh:

So I was born and raised on Long Island in New York. I did medical school and residency and fellowship up in the Northeast, and then I had a job that I was at in Columbus, Georgia for a few years, and then I moved on to come to Mason City.

Carol Gifford:

Wow. So the weather is a little bit different up here in Iowa, right?

Dr. Kenneth Walsh:

Yeah, the snow, it’s a little colder, but I grew up in New York so I’m used to it.

Carol Gifford:

You are used to it, yes. Okay. So let’s start at the beginning. So you went to medical school, where did you say, out East?

Dr. Kenneth Walsh:

Yeah, Temple University in Philadelphia.

Carol Gifford:

And so at what point along the way did you decide that you wanted to specialize in vascular surgery?

Dr. Kenneth Walsh:

Initially, I did a residency in general surgery, which is very common for vascular surgeons, and then you do a fellowship afterwards. So I knew pretty early on once I got to medical school that I wanted to be a surgeon, and I got an opportunity to shadow a plastic surgeon, an orthopedic surgeon, prior to going to medical school. So I knew heading into medical school I wanted to be a surgeon, and then I went into a general surgery residency and then I decided on vascular surgery from there. Basically during general surgery residency, we did a lot of vascular, so I liked the procedures a lot and then decided that that would be the best fit for me.

Carol Gifford:

If you could just define for our audience, what is vascular disease and is it connected to the heart, or can you describe that a little more thoroughly?

Dr. Kenneth Walsh:

Sure. So vascular disease has a lot of different components, but one of the common things that we treat is peripheral arterial disease, and basically it’s the same disease process for patients that have atherosclerotic disease or coronary artery disease. It’s the same process, it’s just in different arteries throughout the body. So while the cardiologist would treat that disease for the heart, peripheral arterial disease is usually of the legs. So we treat arterial disease of the legs, but also of the arteries in the neck, the carotid arteries, as well as some things can happen with the arms and the arteries in your belly also. So basically, outside of the heart, those are the situations that we take care of. But in addition to arterial disease, that’s only part of vascular disease, so patients also can get disease of the veins and we treat those as well. And also there’s a other group of patients that we treat, patients that are on hemodialysis, so there’s a lot of different conditions that can be treated.

Carol Gifford:

So it sounds almost like circulation issues, of blood flowing well through all of these different arteries and veins that are outside of the heart.

Dr. Kenneth Walsh:

Yep, that’s exactly right.

Carol Gifford:

And so just a couple of questions. How do people end up with problems with the circulation in these different arteries and veins? Is this something that affects only older people? Is it genetically connected, or is it a lifestyle issue? Tell me a little bit more about that.

Dr. Kenneth Walsh:

Sure. So in terms of the arteries, the disease process is very similar to the heart, so things that would cause people to get the disease of the arteries in the heart, it’s the same for the legs. So we’re talking about high blood pressure, high cholesterol, smoking, diabetes, kidney failure, and dialysis, and those are primarily the things that can cause you to have disease of the arteries. There’s a hereditary component as well in terms of we treat aneurysms, and that’s an enlargement of the blood vessel. It can be any blood vessel, but most commonly in the big artery in your body, the aorta, so that can be hereditary and is also related to high blood pressure. So those are some of the reasons that you would get diseases of the arteries.

In terms of the veins, venous disease is very common. We’re talking about varicose veins and you can get swelling in the legs, and there’s also situations where we treat blood clots in the legs. So that also has a hereditary component, but things that could cause patients to have venous disease would be if you had a previous blood clot before, obesity puts you at risk, and different lifestyle factors in terms of people that stand on their feet a lot during the day, and pregnancy can put you at a risk factor for that. So there’s a lot of different things, but that’s in terms of the veins.

Carol Gifford:

So how are people getting diagnosed with one of these types of vascular disease? Is it they have symptoms, their legs hurt, or are sometimes the symptoms silent? How do people best assess if they’re either at risk or they have some blockages? Because it sounds like it’s something that really needs to be treated quickly, not over time, unless I’m not understanding.

Dr. Kenneth Walsh:

Well, there’s acute situations that would put you in the emergency room that do need to be treated very quickly, but they are chronic diseases so it depends on the severity of the illness. For example, disease in the arteries in the legs, predominantly patients would first get symptoms of claudication. This means when you’re walking, you get cramping or pain in your calf or buttock that the further you walk, you get the pain and then you’re able to walk less and less distances, and when you stop walking and rest, then the pain goes away. So that’s the first symptom.

Then the other category would be patients that have chronic limb ischemia, which is you develop rest pain, which is a burning pain in your feet at night when your legs are elevated that is relieved by if you dangle your legs, for instance, off the edge of your bed. So that’s a little bit more serious. And then also in that category is patients that get wounds. So patients with diabetes are very prone to wounds in their feet and ulcers in their feet, so you can get wounds or ulcers on your feet and things of that nature.

Carol Gifford:

And so what are some of the surgeries that you do at the clinic?

Dr. Kenneth Walsh:

So we do both open and endovascular or minimally invasive procedures. For the legs, we perform angiograms, which is similar to a heart catheterization but for the legs. So we would go into the blood vessels under fluoroscopy and open up any blockages with balloons and stents if necessary. These are usually same day procedures and are very well tolerated by patients.

Carol Gifford:

Well, that sounds good. So not every surgery is an open procedure. It sounds like you’ve got some minimally invasive options.

Dr. Kenneth Walsh:

Yep, we try to start there and open surgical bypasses for the legs is really reserved for certain situations where you can’t do it with the wires and the catheters. Another common surgery that we perform is carotid endarterectomy, so what that means is when you have that same disease of the arteries but you have it in the arteries going to the brain, once it gets to a certain degree of blockage, it’s recommended that you get surgery. So that is an open surgery that is commonly performed, but again, it’s a very short hospital stay. And a lot of times, that’s discovered in patients that have had a stroke or a mini stroke. Those are the two of the presenting things for symptomatic disease, as well as it can be picked up in asymptomatic patients on ultrasound. So a lot of you might be at your cardiologist, and with different risk factors, there’s an indication to check one time to at least look at the arteries in the neck, so that can be picked up that way as well.

Carol Gifford:

And so what does your day look like? How do you break it up in terms of seeing patients in the office and being in the operating room?

Dr. Kenneth Walsh:

So right now, I’m in the office one and a half days per week, and I’ll be in the cath lab doing the minimally invasive procedures once a week, and then I’m in the operating room once a week. And then in between that, when there’s patients in the hospital that need surgery, then they would get added on in the other times that are available.

Carol Gifford:

And so you are the only vascular surgeon at the clinic, right? Or at Mercy 1?

Dr. Kenneth Walsh:

Yep, that’s correct.

Carol Gifford:

So what is it that you’re excited about being in the middle of the tundra here in Iowa?

Dr. Kenneth Walsh:

Well, I think the weather’s fine, but-

Carol Gifford:

Okay.

Dr. Kenneth Walsh:

Yeah, just that it seemed like there was a very big need here. One of the vascular surgeons retired that was here for a very long time, and there’s a lot of patients that we’ve seen already that have expressed that there’s a very big need for it in this area. The other vascular surgeons in the area could be as much as an hour and a half away, and there’s a large population here that has all these different vascular conditions that need to be treated. And so I saw the opportunity that I could have the ability to help a lot of people and as well as do a lot of surgeries and see a lot of patients.

Carol Gifford:

I love that. So do you have any message about it? Like you said, there’s a population that really struggles with this disease in North Iowa. Do you have another message about prevention and what people can think about as it relates to maybe they have some form of vascular disease or they don’t, but what are some of the key messages you want to get out to the patient population about at least decreasing your risk of vascular disease getting worse?

Dr. Kenneth Walsh:

So the things that you can do to prevent vascular disease or prevent it from getting worse, it starts at the basics. Eating a healthy diet, not eating too many foods that are high in fats, exercising, and those are some of the things that everybody can do. But then when you have these different conditions, then preventing the disease from getting worse is about treating those medical conditions. For instance, high blood pressure. If you have high blood pressure, it’s important to check your blood pressure and to take the medications as prescribed by your medical team, so if you have your blood pressure well controlled, that’s going to help. And it’s similar for diabetes. If you have diabetes, taking your medications as prescribed and making sure that your blood sugars are well controlled, whether that’s with checking your blood sugar multiple times a day or checking lab work when you go to see your medical doctor. But there’s various ways, but it’s important to keep your blood pressure really well controlled and your blood sugar and other factors like that.

Carol Gifford:

Wonderful. Well, this has been very educational. It’s very exciting to have you in Mason City. Besides treating patients, what else are you excited to do in Mason City or in North Iowa now that you’re a new resident here?

Dr. Kenneth Walsh:

Yeah. When I was here visiting, they have a lake nearby and I’m excited in the summer to go to the lake, and I’m sure that they have a few golf courses. And I like ice skating so I’m trying to-

Carol Gifford:

Oh, great.

Dr. Kenneth Walsh:

Yeah, I played ice hockey-

Carol Gifford:

I think it’s called Clear Lake, right? It’s probably about a half an hour drive from Mason City. Yeah. Well, terrific. Well, welcome to the clinic, Dr. Walsh, and thank you for taking the time out of your busy schedule to talk to us.

Dr. Kenneth Walsh:

Yeah, thank you so much for having me.

Carol Gifford:

Yes, and good luck to you.

Dr. Kenneth Walsh:

Thank you.