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mason330

Amputations

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I have read alot on here about people who have friends and relatives who had had numerous diabetes related amputations. My question is this, Were they a result of a sore or wound going un-noticed for an extended period of time, or was it a traumatic injury, or was it a wound that had been attended to from the start that just would not heal?

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In my mom's case, she had a co-worker accidentally step on her toe. It became infected and just wouldn't heal. She tried treating it herself at home for a long time, instead of going to the doctor and it developed gangrene. When she did go, she was put in the hospital for IV antibiotic coverage and wound care. Her circulation was compromised, causing it not to heal. She went in for surgery, hoping just to lose a toe, but the circulation was so impaired that they removed her foot. That wound didn't heal, so they ended up amputating her leg above the knee, as that was where they found the best blood flow.

 

She was 47 or 48 when she lost her leg, but she'd been a T2 diabetic for 20 years by that time, and was very non-compliant. She was first started on insulin while in the hospital with her toe. My grandfather also lost his leg to a non-healing ulcer, but that was in the 70's.

 

I've mentioned to my internist my concerns about circulation and what happened to mom and grandad. He told me it's very rare anymore for anyone to have to have an amputation if they seek medical attention at the first sign of an infection.

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I do know of a tragic non-diabetic case involving a teenage girl who was perfectly healthy but got a cut to the leg on a camping holiday. It became infected after she was taken to the local hospital for stitches due to sub-standard hygenic practices. Infection set it, becoming an ulcer that never really healed. It was some hospital 'superbug' because all the subsequent anti-infection treatments never really worked. She ended up having her leg amputated above the knee after a few years of absolute **** at the age of 29. This kind of case is however rare.

 

In the case of diabetic amputations, I have always assumed that it was more due to circulatory weaknesses more than any other cause (in the case of normal cuts & wounds & NOT some superbug). With a relatively healthy circulatory & immune system, I think this sort of risk is greatly diminished. Or so I would like to believe anyhow.

 

Immediate medical attention for any minor thing that can lead to infection is a critical priority for any diabetic.

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I only have two friends out of many with diabetes who ever had an amputation. One guy I don't know the details, but the other was a doctor and should have known better. He had a problem with his big toe and rather than seeing someone, he decided to self treat topically. Then he took his son back to university (a 10 hour drive). By the time he got back his toe was black and he finally went to see a colleague. He ended up losing only half his foot, but eventually lost part of the leg. In his case, had it been treated properly and early, he may not have needed the amputation.

 

While sometimes it's a fluke, I suspect (although I have no evidence) that many cases are problems that were neglected and then not seen to until it was too late.

 

 

Cora

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Well in my case I have had 3 surgeries on my left foot so now I'm minus the 5th and 4th toes and most of the bones that go along with them. I have an on going ulcer on my left foot and still have chronic Osteomyelitis. I have been on one form or another of antibiotics since this time last year. Since May 1st I've had 43 doctor/healthcare apointments. The start of my injury was really not very big at all. I rolled a small wheel on a motorcycle trailer into my foot of course with my PN it really didn't hurt so didn't think anything of it, a week or so later I notice small spot of blood in sock still no big deal well in a couple of day calf was working on being size of thigh. So here I am 35 days inpatient 3 foot surgeries and 2 others later still with an open wound and almost a year later.

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I also developed a ulcer on my rt foot neglected it change bandages every day but it got infected. After surgery twice on same foot six weeks at home iv antibiotic treatment s 3 times a day a total of 60 hyperbaric chamber treatments My foot is finally healed after a little more than a year , Daily wound care appointments, home nurses to change dressings and wound vacuum treatments. Definitely do not neglect or ignore any wounds on the feet. They even had to put a stent in my leg to open up the artery to increase the blood flow to my foot so i would not loose it

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My dad (at 89) died right after an amputation, most likely caused at least in part by uncontrolled diabetes. In his case, he also had a lot of blood clots all over the place. As far as I can tell (speaking to him on the phone every day as he lived far away), there were no symptoms, except that he said that his leg felt "tired" all the time. And his balance was off. When he finally was convinced (forced) to go to the doctor, they admitted him to the hospital right away. Turns out that his leg had completely necrotized, due to poor circulation and many, many, many blood clots. They couldn't open up the veins, so had to make a split second decision to cut the leg off above the knee. He survived the amputation part of the operation, but had so many blood clots in other parts of his body (he hadn't been taking any of the medicine he had been prescribed - unbeknownst to us), he never recovered. So, in part, the poor circulation from the diabetes did lead to his amputation, but he had other, long-term issues, not uncommon for an 89 year old man. Sorry to be so detailed, but I think that everyone with diabetes needs to be overly sensitive to any strange feelings or wounds in their feet/legs.

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I feel weird racing to a podiatrist for an ingrown toenail. Does anybody feel my pain?

 

I had a tiny splinter in the bottom of my foot a couple of years ago. I nor my wife could find it. I went to the ER and doc used a magnifying glass to find and yank it. He said it probably wasn't necessary to come in, but he was glad I did. [This is Canada. I don't pay for ER visits.]

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My dad (at 89) died right after an amputation, most likely caused at least in part by uncontrolled diabetes.

 

It's my understanding from reading and from discussions with doctors that generally amputees don't live for very long afterwards. It's an iceberg syndrome. This is just the tip. You don't get this unless you have severe vascular issues. I know your mileage may vary, and I believe these vascular issues can be halted and somewhat reversed. I have a friend who lost some toes but is doing very well now on a pump.

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My friend's step-mother has had multiple amputations (part of one leg, all of another)...starting with just a small part of each one...then the amputation wound wouldn't heal/got infected, necessitating more amputation, etc. I'm not sure how it started (I believe it was with small injuries that didn't heal) but obviously the post-amputation wounds were well-cared for & just wouldn't heal.

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My friend's step-mother has had multiple amputations (part of one leg, all of another)...starting with just a small part of each one...then the amputation wound wouldn't heal/got infected, necessitating more amputation, etc. I'm not sure how it started (I believe it was with small injuries that didn't heal) but obviously the post-amputation wounds were well-cared for & just wouldn't heal.

 

That's how it was with my mom, too. The blood supply/circulation just wasn't good enough to her feet to adequately heal. They had to keep going up the leg until they found an area that they felt would heal.

 

My mom lived 7 years after her amputation, my grandfather lived 6 after his.

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Dad's was a stubbed toe. Turns out it was broken. Within a month it started turning black. That was just the start....

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