Working: Lewiston surgeon restores pulse and flow

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LEWISTON — To April Nedeau, working as a new surgeon felt like jumping out of an airplane.

“It’s intense,” she said. “It’s an adrenaline rush. It’s amazing.”

And it wears off.

At 39, Nedeau is still relatively young, but she’s no longer inexperienced in the operating room. After medical school at Boston University, she underwent a seven-year residency at the Hospital of the University of Pennsylvania in Philadelphia and spent two years at Beth Israel Deaconess Medical Center in Boston. She’s worked at Central Maine Medical Center for two-and-a-half years.

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She’s learned to find her satisfaction in gentler but no less fulfilling ways. Using state-of-the-art equipment and techniques, the vascular surgeon is helping people. And she’s doing it while leaving fewer scars to heal.

“The real satisfaction you take home every day is when the patients come back and say, ‘You saved me,’” she said.

Humbly, Nedeau compares her job of fixing diseased arteries to being a plumber.

“Honest to God, you have a blocked pipe and there are two ways to fix it,” she said. “You can snake it or you can take out that piece of pipe and replace it with a new one. Or you can bypass it if you want to get really clever.”

Traditional vascular surgery is the same principle, she said.

“We make an incision in the skin, we expose the artery and we either open it up and clean it out (or) we can bypass it with a vein,” she said.

Endovascular surgery, which Nedeau also performs, begins with needle punctures in a healthy artery, often in the groin. She reaches problem areas with wires, tubes and a tiny camera.

“General surgery is hard on the body and (traditional) vascular surgery is very hard on the body,” she said. People have options.

In cases of someone with an abdominal aneurysm, the need can be huge. The abdominal blood vessel is a wide pipe, supplying blood to the abdomen, pelvis and legs.

On a screen in her Lewiston office, Nedeau examined a 3-D image of a vessel with an aneurysm. It was constructed from CT scans of a patient and used as a reference prior to surgery.

She performs this surgery to place a stent — a tiny but expanding metal framework — into the abdominal vessel about once a month. On an average week, she sees four to eight patients with artery blockages in their legs.

In her CMMC operating room — the endovascular suite — she has immediate access to X-ray, ultrasound and CT scan equipment.

“The things we are doing here are as very much cutting edge as they’re doing in Boston,” she said. “We’ve brought Boston to Maine.”

The technology serves her patients. Most are elderly with a variety of chronic health problems, including weakened hearts and lungs. Yet she taxes their bodies surprisingly little.

“I can send someone home in a day with a Band-Aid in each groin, having fixed an aneurysm,” she said.

Helping her patients has replaced the rush that surgery once had.

When she finishes a procedure, she returns to the X-rays and the monitors.

As an example, she pulled up an image of a recent surgery on a man’s foot, in which she was able to remove a blockage. The blockage was pictured with a blank, resembling the map of a highway with a piece missing. The after-surgery image showed a complete artery.

“What feels really good is when you get this picture,” Nedeau said. “I come back here, and I see this. That is a home run.”

At the best times, it continues moments later, without computer screens, scans, stents or wires.

To put your hand on the foot and there’s a pulse where there was none,” she said. “That is just immediate gratification.”

dhartill@sunjournal.com

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