Dr. Gregory J. Yanish in the News

Des Moines Register

For Winterset man, leeches save the day — and a finger

• By REID FORGRAVE • Des Moines Register • rforgrave@dmreg.com • July 14, 2009

Eric Poore never thought too highly of leeches.

The 39-year-old Winterset painter always considered the slimy bloodsuckers annoyances, things that clamped to his body when he went to a local swimming hole as a boy. He tried using leeches as bait for catfish and bluegill on the Middle River in Madison County but never had much luck.

But that was before the tiny invertebrates saved his marriage - or at least his ring finger.

On June 21 - Father's Day, and the first day of summer - thetemperaturereached 90 degrees. It was a perfect day for Poore and hiswife, Darcy, to go tubing and waterskiing on Saylorville Lake with their two sons, Codie, 17, and Dakota, 12.

Late in the afternoon, they coasted back into the Jester Park boat ramp. Poore, a good ol' boy with close-cropped hair, jumped into the waist-high water to guide the boat in. As he jumped, his gold wedding ring snagged on a boat-cover snap. Poore's arm pulled tight, then let loose.

He hit the water and felt excruciating pain.

Poore looked at his ring finger. It was bare bone, pearly white. Skin, tendons, veins and artery were wadded on top of his finger like an accordion. His wedding ring, which he'd inherited from his wife's  father, was smashed into an oval.

 An ambulance arrived within three minutes. Paramedics sliced the wedding ring off. Poore yelped in  pain.

  The ultimate damage was akin to an amputation; the edges of the torn veins and artery were ragged from being ripped apart.

 At Mercy Medical Center, the on-call surgeon didn't do surgeries under a microscope. Surgeons at three other trauma centers in the Midwest also declined to do the delicate surgery.

The clock ticked. If the finger wasn't reattached soon, it would die.

Poore figured his ring finger was gone forever.

A couple miles away, at Court Avenue Brewing Company in downtown Des Moines, Greg Yanish was on a date when his pager went off.

Mercy doctors told Yanish, a Clive hand surgeon who specializes in microsurgery, that he was

Poore's only hope. Yanish paid the bill, left behind a plate of steaming chicken wings and root beer, and apologized to his date.

Duty called.

"I knew we didn't have much time because he was already hours out from the injury," Yanish said. "We were pushing the envelope at that time. It was equivalent to a full amputation because he lost the full blood supply all around the finger."

At 9 p.m., Yanish tuned the radio in the operating room to a classic rock station. He relaxed his upper shoulders and neck. Peering into a microscope, the surgeon anchored his hands on stacks of towels so only his fingertips manipulated the tiny needle, smaller than a human hair.

The surgery was extraordinarily delicate; he was sewing together veins only a couple cells thick, the size of lead for a mechanical pencil.

"You sew them back together end to end, like putting two tiny little pipes together," Yanish explained. "It's like playing a video game on the hardest level for six hours and trying not to die. It just takes that level of concentration."

By 3 a.m., Yanish had reattached the skin, sutured the tendon, and sewed the veins and artery back together.

Then a problem: The artery was pumping blood into Poore's finger, but the traumatized veins weren't returning blood as quickly. The finger was filling with blood.

"It was like the drain in the bathtub is slow, but the faucet is on full blast," Yanish said.

Yanish had an idea: leeches. He could use them to drain blood from Poore's finger until the veins worked.

Leeches have been used since the days of Hippocrates, the Greek father of medicine, but modern doctors tend to eschew them.

Yanish had never seen leeches used, but he thought they were his only chance.

"It's one of those things in medicine people know is out there, but people are afraid to do it," Yanish said.

The leeches arrived in a sterile saline solution. Yanish placed two on Poore's finger. They pulsed as they sucked his blood, and they secreted an anticoagulant that thinned Poore's blood. After about 45 minutes, the leeches fell off.

For several days, nurses and doctors gathered in Poore's hospital room when it was time for more leeches.

"It was the talk of the hospital," Poore said. "I'd walk through the hallway and people would say, 'You're the leech guy!' "

Nearly a month later, Poore's finger is healing. Yanish believes he'll recover to nearly 100 percent. Poore is in physical therapy and hopes to be back at work within a couple of weeks.

Still, Poore is pretty sure he'll never wear a wedding ring again.

"I've been teased about it a lot," Poore said. "You know, 'All you had to do was ask for a divorce. You didn't have to do that.' "