possible toe amputation - advice please

TooManyCrisps

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535
Type of diabetes
Type 2
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Hi
My dad is T2, in his late 70s and has had diabetes for almost 40 years and has been on insulin for over 30. He has chronic neuropathy in his feet, and regularly attends a foot clinic.

I phoned him today and he said that the ulcer he has had for several weeks on one of his toes, and which was healing, has suddenly got worse. It's been dressed every other day at his local health centre and the nurse there has referred him back to the foot clinic next week but advised him that it might very well have to be amputated.

If the foot clinic makes a decision to amputate, does anyone know if this is usually a fairly immediate thing? I'm presuming that if it is past saving, there will be a risk of sepsis etc and they will amputate almost immediately rather than putting him on a waiting list, but am I right? Has anyone got any experience of toe amputations?
Thanks in advance
 

DCUKMod

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I reversed my Type 2
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Hi
My dad is T2, in his late 70s and has had diabetes for almost 40 years and has been on insulin for over 30. He has chronic neuropathy in his feet, and regularly attends a foot clinic.

I phoned him today and he said that the ulcer he has had for several weeks on one of his toes, and which was healing, has suddenly got worse. It's been dressed every other day at his local health centre and the nurse there has referred him back to the foot clinic next week but advised him that it might very well have to be amputated.

If the foot clinic makes a decision to amputate, does anyone know if this is usually a fairly immediate thing? I'm presuming that if it is past saving, there will be a risk of sepsis etc and they will amputate almost immediately rather than putting him on a waiting list, but am I right? Has anyone got any experience of toe amputations?
Thanks in advance

Without knowing a little more about your Dad's situation it's really impossible to say, and I'm certainly not going to ask you for more details.

If your Father's ulcer has become infected, and is either verging upon or has already become gangrenous, then it could indeed be pretty pronto, for fear of involving other parts of his foot. As I understand it, they will often try to get any infection under control before surgery, with antibiotics. As those can sometimes be administered intravenously, it can involve an inpatient stay.

It's not at all a pleasant position your find yourselves in, and your Father must be quite afraid. I'm surere you are afraid for him yourself. That's very natural.

Does your Father have any interim plan, should he feel things are taking a turn for the worse with his toe? I'd say that would be, "if in doubt shout!" 111 or A&E.

If his toe is in an unsalvageable place, then he might well feel a lot better without it. Please don't think I'm being flippant in saying that. I'm not, at all.

I wish you both well. The very best of luck.
 
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Jenny15

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Hi
My dad is T2, in his late 70s and has had diabetes for almost 40 years and has been on insulin for over 30. He has chronic neuropathy in his feet, and regularly attends a foot clinic.

I phoned him today and he said that the ulcer he has had for several weeks on one of his toes, and which was healing, has suddenly got worse. It's been dressed every other day at his local health centre and the nurse there has referred him back to the foot clinic next week but advised him that it might very well have to be amputated.

If the foot clinic makes a decision to amputate, does anyone know if this is usually a fairly immediate thing? I'm presuming that if it is past saving, there will be a risk of sepsis etc and they will amputate almost immediately rather than putting him on a waiting list, but am I right? Has anyone got any experience of toe amputations?
Thanks in advance
I have no experience of amputations but I'm sure they would do it on an acute basis, not elective.

As far as I know, you are allowed to attend visits with him as a support person if he wants you to. Most HCPs like it if an elderly patient has someone with them, because they can sometimes get more info about the person's health and rehab situation, and two sets of ears are better than one when it comes to understanding what the patient needs to do in the recovery period.

Good to know the HCPs are onto it.
 
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TooManyCrisps

Well-Known Member
Messages
535
Type of diabetes
Type 2
Treatment type
Diet only
Without knowing a little more about your Dad's situation it's really impossible to say, and I'm certainly not going to ask you for more details.

If your Father's ulcer has become infected, and is either verging upon or has already become gangrenous, then it could indeed be pretty pronto, for fear of involving other parts of his foot. As I understand it, they will often try to get any infection under control before surgery, with antibiotics. As those can sometimes be administered intravenously, it can involve an inpatient stay.

It's not at all a pleasant position your find yourselves in, and your Father must be quite afraid. I'm surere you are afraid for him yourself. That's very natural.

Does your Father have any interim plan, should he feel things are taking a turn for the worse with his toe? I'd say that would be, "if in doubt shout!" 111 or A&E.

If his toe is in an unsalvageable place, then he might well feel a lot better without it. Please don't think I'm being flippant in saying that. I'm not, at all.

I wish you both well. The very best of luck.
Thank you. They did some sort of test on it a few weeks ago and apparently there is still blood flow to the toe. He was given a course of oral antibiotics a couple of weeks ago and the toe was healing. However it got a lot worse early this week and is now down to the bone. He hasn't been given more antibiotics though.

My mum will take him to the foot clinic on Thursday which is when he's been booked in for. I hadn't thought of an interim.plan if things deteriorate but they are both pretty clued up and will call an ambulance if necessary.

Thanks for your concern.
 

TooManyCrisps

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Messages
535
Type of diabetes
Type 2
Treatment type
Diet only
I have no experience of amputations but I'm sure they would do it on an acute basis, not elective.

As far as I know, you are allowed to attend visits with him as a support person if he wants you to. Most HCPs like it if an elderly patient has someone with them, because they can sometimes get more info about the person's health and rehab situation, and two sets of ears are better than one when it comes to understanding what the patient needs to do in the recovery period.

Good to know the HCPs are onto it.
Thank you Jenny15

My mum.will take him to the appointment. Sadly I'm not near them and work full time so would struggle to attend although obviously would if they wanted me to.
 

DCUKMod

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Messages
14,298
Type of diabetes
I reversed my Type 2
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Thank you. They did some sort of test on it a few weeks ago and apparently there is still blood flow to the toe. He was given a course of oral antibiotics a couple of weeks ago and the toe was healing. However it got a lot worse early this week and is now down to the bone. He hasn't been given more antibiotics though.

My mum will take him to the foot clinic on Thursday which is when he's been booked in for. I hadn't thought of an interim.plan if things deteriorate but they are both pretty clued up and will call an ambulance if necessary.

Thanks for your concern.

They may elect to do an MRI to see how the bones are doing, and if necessary, metaphorically hit it hard with IV antibiotics. .

Fingers crossed for you all.
 

Jenny15

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Thank you Jenny15

My mum.will take him to the appointment. Sadly I'm not near them and work full time so would struggle to attend although obviously would if they wanted me to.
That's great that he has your mum who can attend with him. I always like to have someone with me for important things like this. I think your mum and dad should be prepared for him to go to A&E before Thursday if anything gets worse.

I've had a lower leg wound and it can get worse very quickly. I don't know what specific things they should look out for but I'd have thought any fever would be a red flag, showing there is an infection which needs IV antibiotics in hospital to prevent sepsis.

I imagine he may not be able to feel pain in the area due to neuropathy. So that isn't much use as a possible warning sign.

I hope he is keeping the leg elevated as much as possible, as that will promote blood circulation, removing waste products and supplying oxygen and other good things. Leg elevation was key for my recovery.

I'm sure he is in good hands and anything that needs to be done will be done.
 
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NalaS

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Hi there, I can only offfer understanding of your position as I'm in the same place! Elderly father, T2, gangrene on one foot but worse are the ulcers on the other. Podiatrist said one is down to the bone which is crumbling. So he's on antibiotics, off to the hospital this week and I'm expecting some kind of amputation. I'm a long way from them too. It's devastating for those going through it but emotionally and practically very difficult for family too. Sending hugs.