Leeches make a medical comeback, help Alaska boy

Posted: Sunday, December 30, 2001

ANCHORAGE (AP) -- Most patients count on drugs to get them well. But what if the cure depended instead on a living, bloodsucking animal that many people look at with disgust?

Wormlike invertebrates called leeches have been used for thousands of years, and in Anchorage last year they helped a young boy keep blood circulating in his limbs.

Long ago, leeches were a tool for bloodletting, considered a good thing by the medical profession of the day. So many people turned to leeches in the 1800s that they became an endangered species, medical journals say.

As medical science advanced, bloodletting was seen as medically harmful, not helpful, and physicians stopped using leeches.

But toward the end of the 20th century, leeches made a surprising medical rebound. Today, it's not unusual to hear leeches mentioned in medical circles.

This fall, The Lancet and other journals included reports of a small study that showed leeches can reduce pain for patients with osteoarthritis in the knee. Other medical articles say plastic surgeons can use leeches to improve impaired circulation in severed body parts that have been reattached.

Leeches use three tooth-filled jaws to suck a patient's blood. In exchange, they give the patient medically useful substances.

A leech's saliva has an anticoagulant called hirudin that prevents blood clots, according to an article in the journal American Surgeon. It also has a compound to dilate blood vessels and an anesthetic to dull the pain.

A leech's benefit extends beyond the blood it initially extracts; after a leech detaches, the wound will continue to bleed slowly for hours.

Around Thanksgiving last year, Providence Alaska Medical Center pharmacist Karen Thompson heard that an Alaska doctor wanted leeches for treating a patient. She found the phone number for Leeches USA and ordered some.

The patient in need was Twana Moore's 8-year-old son. He had felt fine Thanksgiving Day, but the next morning he wouldn't get up, she said. That wasn't like him at all. He liked to watch morning cartoons.

''We'd try to call his name and he would not answer,'' she said. ''We picked him up and he fell to the floor.'' Moore's son was also covered with red splotches.

She took the boy to Providence, where pediatric cardiologist Scott Wellmann was on duty. Wellmann's staff diagnosed the boy with a bacterial infection that was quickly progressing to septic shock.

Doctors were concerned that his internal organs weren't getting the blood flow they needed. And blood wasn't reaching his hands and feet, which were turning black and cold.

''Even though he had a fever of 102-103, his hands were like ice,'' Wellmann said.

Wellmann was worried about tissue damage. If he didn't start treatment, the boy risked amputation. One option was medicating him, but drugs that increase blood flow can cause serious side effects. In this case, doctors preferred a local therapy that would affect only his hands and feet.

Wellmann had seen other doctors use leeches. When he was finishing his training in Ohio, Wellmann watched plastic surgeons apply leeches to a baby's finger after reattaching it. During reconstructive surgery, blood vessels may not reconnect, causing the blood to accumulate in an area. Blood that accumulates can cause tissue death. Leeches are used to remove some of that blood and encourage circulation.

Wellmann knew this boy's problem was similar. Leeches, he thought, might improve blood flow in the boy's hands and feet.

Wellmann talked to Moore about his idea. She'd never heard of using leeches, but she agreed to it. Her son didn't know the leeches were being used because he was sedated, Moore said.

Wellmann got the leeches ordered, and when they arrived he started attaching them to the boy's hands and feet. Wellmann's hope was that the anticoagulant substances would promote blood flow.

The effect was immediate, Wellmann said. The boy's skin color began improving, and blood started flowing.

Wellmann continued the leech therapy for seven days, requiring dozens of leeches. After more than a month in the hospital, the boy recovered from his illness.

Some of his fingers and toes had to be amputated, but Wellmann still considered the leeches a success, and he says he'd use them again.

Without the leeches, ''I think we would have lost most of his hands and a big chunk of his feet,'' Wellmann said.

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