people: pay attention to your feet!!!!

justjoshingu

i have a chart that i have to follow for rotations. so this guy comes into the ER.
he is elderly. not on any current medication, but that is probably due to the fact that he hasnt been to the doctor in years.

1 week ago.
his foot starts to hurt. he didnt hurt it or injure it in any way he knows.
couple days later.
Foot starts to smell. bad.
couple days more.
foot smells unbelievably bad. bad. horrible.
they try to take off the sock, but its stuck to the foot. a few hours of a warm soak later, they can take it off.
they come to the ER because his big toe, 2nd toe, 3rd toe. are black. not just black. OOOOZZZZiiiiing black. oozing black. and smells like satan just shit himself. he has gangrene. apparently this is the first time his sock has been off in almost 5 days.
oh and we find out his blood sugar is 4 times where it should be. he is also diabetic.
so we clean up the foot. (and by we i mean not me) and they amputate it below the knee.
so sad but if he had just come sooner or even better, if he went to the doctor regularly, then he might still have both feet.

the wolf

wow, how amazingly depressing.

illegal pants

ohhhh no how horrible :( so he lived by himself?

(also wear socks at night time rain hail or shine if you live in Australia.. trust me on this one :eek: )

South of Seattle

illegal_pants wrote:

ohhhh no how horrible :( so he lived by himself?

(also wear socks at night time rain hail or shine if you live in Australia.. trust me on this one :eek: )

I hope you didn't tell Helen about your situation :eek:

xscorcho

justjoshingu wrote:

so we clean up the foot. (and by we i mean not me) and they amputate it below the knee.

whyd they clean the foot up to amputate it if its coming off anyway?

Jennytree

was the gangrene caused by the undetected diabetes??

Heineken Helen

illegal_pants wrote:

ohhhh no how horrible :( so he lived by himself?

(also wear socks at night time rain hail or shine if you live in Australia.. trust me on this one :eek: )

I don't wanna hear this do I? Damn you all today anyway all needles and spiders and amputated feet... you're making my neck sore... can't somebody fucking talk about puppies or something?

South of Seattle

Heineken Helen wrote:

I don't wanna hear this do I? Damn you all today anyway all needles and spiders and amputated feet... you're making my neck sore... can't somebody fucking talk about puppies or something?

Yep, you're better off not knowing (since you did make a thread about it )

Gossard_Is_God

This scares me coz im type 1 diabetic, my sugars are often 4 times higher then theys hould be :(. Shit. Im gettin better at susgar control though

JaneNY

xscorcho wrote:

whyd they clean the foot up to amputate it if its coming off anyway?

I would think for the following reasons - for an amputation they're going to need everything to be as clean as possible, and maybe they weren't sure it needed to be amputated until everything was cleaned up. Poor guy.

Heineken Helen

Gossard_Is_God wrote:

This scares me coz im type 1 diabetic, my sugars are often 4 times higher then theys hould be :(. Shit. Im gettin better at susgar control though

change your socks every day and you should be ok

Gossard_Is_God

Heineken Helen wrote:

change your socks every day and you should be ok

Just tried, but cant get it off :O

stargirl69

Goodness diabetes is a terrible condition.My ex boyfriend had type 1 since childhood and he would become ill very quickly.
My mums neighbour was diagnosed with type 2 in her 30's.I understand its rare to be diagnosed before 40's?She had only been diagnosed a few months and was still on trials for what dosage of medication would stabilize her diabetes she fell asleep on her sofa one night with her leg folded under her.When she woke her leg was black,her circulation had been cut of and because of the complications with her diabetes the medical team couldn't save her leg and it had to be amputated.She is now in a wheelchair.

Heineken Helen

Gossard_Is_God wrote:

Just tried, but cant get it off :O

hmm... I think you're gonna have to try cutting your foot off now!

Buru

Poor guy... :(

More than pay attention to your feet I'd say pay attention to your blood!! Do some routine tests... to catch things in time

Urban Hiker

OMG!!!

My husband is a type 2 diabetic. He constantly checks his feet, but lately (due to some slipped discs in his back and planter fasciitis) he's been having a lot of numbness in his leg. We really have to rely on visual checks for any slow healing wounds etc.

chadwick

wow that is bizare.
poor guy.

i bet that was a mess
disgusting smelling rotten living tissue
nicely done justjoshing

gabers

But unless you have diabetes, you probably don't have to worry about your foot turning black and melting off, right?

Doesn't diabetes start early in life, or is it common to also contract it later on?

GreenTeaDisease

stargirl69 wrote:

Goodness diabetes is a terrible condition.My ex boyfriend had type 1 since childhood and he would become ill very quickly.
My mums neighbour was diagnosed with type 2 in her 30's.I understand its rare to be diagnosed before 40's?She had only been diagnosed a few months and was still on trials for what dosage of medication would stabilize her diabetes she fell asleep on her sofa one night with her leg folded under her.When she woke her leg was black,her circulation had been cut of and because of the complications with her diabetes the medical team couldn't save her leg and it had to be amputated.She is now in a wheelchair.

a friend of mine wasn't diagnosed with type 1 until she was 21! she didn't even feel sick at all, she just went for a routine physical, and one urine sample later her whole life was changed!

iluvcats

Gossard_Is_God wrote:

This scares me coz im type 1 diabetic, my sugars are often 4 times higher then theys hould be :(. Shit. Im gettin better at susgar control though

you have to take care of your feet. get pedicures and don't get hurt....
don't trip over stuff. my family has diabetes. do you ever go to the foot doctor? here is a good rule for diabetes, do not eat anything white (flour or sugar.) boring, I know :(
but safe...

justjoshingu

well, this patient hadnt checked his sugars in a long time. so his diabetes was way out of control. and diabetes causes loss of sensation and nerve damage. it also will impair any wound healing. typically type I was thought to be in the young and type II in the old, but now they are seeing more type II in the young.
type I means that you were born producing a certain amount and it goes down until eventually you dont make any insulin. type II means that your receptors for insulin get damaged over time, until you body stops recognizing that you have insulin.

and they cleaned it for a couple reasons. one was cause of the smell, but also because it could be infected and it could spread around not only this patient but to others. not only that if the infection from the foot gets into the blood, that would be bad.

now the foot wasnt black because of infection necessarily. it was black because it was dead tissue and the dead tissue was spreading. the dead tissue can get infected though and make it worse.

PJPixie

I am a Type 1 Diabetic and I have been for the past 21 years.

Type 1 and Type 2 Diabetes are two totally different disorders.

Type 1 is completely insulin dependent. The Pancreas completely stops producing insulin therefore the glucose in your blood can not be broken down to normal levels (80-120). This Type of Diabetes requires insulin to be given to keep blood sugar (glucose) levels at a normal range. Diet is also extremey important. Type 1 diabetes has a pretty quick onset (unlike Type 2). You will become symptomatic quickly and require treatment quickly before becoming very very ill.

Type 2 diabetes, usually onsets later in life. Weight, Diet and Family Genetics are huge in this Diagnosis. In Type 2 Diabetes, your pancreas is not secreting enough insulin to keep your blood sugars at a normal level. The pancreas is still working but the insulin it is secreting is not effective (enough). People with Type 2 diabetes can control this disorder very well with diet and exercise, making the insulin that the pancreas DOES secrete work better and more efficiently. If diet and excercise are not effective, they can take oral medications to make the insulin they do have on board work more effectively. This is where a lot of people confuse the two different disorders. Type 2 diabetics can go for quite sometime without diagnosis or treatment because they are "managing to get by".

I'm completely insulin dependent and take my insulin via an insulin pump that is attached to me 24/7. I was on about 5 injections of insulin everyday before I went onto pump therapy about 14 years ago. I have pretty good control of my blood sugars and have never suffered the dreaded complications that go hand in hand with the disease. My feet are in pretty good health as well

brain of c

feet don't fail me now.

mca47

I worked in Dept. of Surgical Pathology as an undergrad. We would get in toes, feet, and in come cases large portions of legs very frequently.
Diabetics really, really need to take care of their extremities and get checked out often!