Caring for a diabetic parent

[Helen25]

Hi my name is Helen I’m 25yrs old and I care for my mother who has type 2 diabetes, neuropathy and bilateral Charcot foot. She has recently had infection in her foot which resulted in a 67 day stay in hospital and when discharged several open surgical wounds that required regular bandage changes which was done between our hospital and myself. After 6months we have been told she has another infection of the right foot and she will most likely have to have an operation to amputate the foot. This is a very scary prospect for her and me. Is there anyone out there that have any tips on the transition period after amputation? And or any help whatsoever in terms of help with mental health aspect. Mum is clearly distress and I feel like I can’t help her anymore than what I am due to my own mental health.
Please help. Thanks
Helen

 

[Jaylee]

Hi my name is Helen I’m 25yrs old and I care for my mother who has type 2 diabetes, neuropathy and bilateral Charcot foot. She has recently had infection in her foot which resulted in a 67 day stay in hospital and when discharged several open surgical wounds that required regular bandage changes which was done between our hospital and myself. After 6months we have been told she has another infection of the right foot and she will most likely have to have an operation to amputate the foot. This is a very scary prospect for her and me. Is there anyone out there that have any tips on the transition period after amputation? And or any help whatsoever in terms of help with mental health aspect. Mum is clearly distress and I feel like I can’t help her anymore than what I am due to my own mental health.
Please help. Thanks
Helen

Hi Helen,

Welcome to the forum.

I'm sorry to read about your mum's health issues.
My dad was T2. So I sort of appreciate getting the balance right with someone else's condition is difficult.

blood sugar if not managed can worsen the issue with infection. & slow the healing process too.
What medication is your mum prescribed for her diabetes?

 

[JoKalsbeek]

Hi my name is Helen I’m 25yrs old and I care for my mother who has type 2 diabetes, neuropathy and bilateral Charcot foot. She has recently had infection in her foot which resulted in a 67 day stay in hospital and when discharged several open surgical wounds that required regular bandage changes which was done between our hospital and myself. After 6months we have been told she has another infection of the right foot and she will most likely have to have an operation to amputate the foot. This is a very scary prospect for her and me. Is there anyone out there that have any tips on the transition period after amputation? And or any help whatsoever in terms of help with mental health aspect. Mum is clearly distress and I feel like I can’t help her anymore than what I am due to my own mental health.
Please help. Thanks
Helen

Hey Helen,

I'm so sorry about all this. For both you and your mum. Wound healing goes a lot quicker if blood sugars are under proper control, which can be done through a rather rigorous change in diet. Mind you, I think your mum may be on either gliclazide(-like) medication or insulin, so that would complicate matters some. You see, practically all carbs we eat turn to glucose. It's not just sugar, but starches too... All in all what she can't process are spuds, cereals, bread, pasta, corn, rice, fruit etc. But if she is on heavy blood glucose lowering medication, changing her diet would result in hypo's. So if you guys decide to change anything, do so with the aid of her diabetic team. The nurse, a dietician who's up-to-date with the latest low carb stuff.... And adjust medication accordingly. https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html <-- have a read here, have her read it too, and see whether there is something workable in there for the both of you. Maybe dive into Dr. jason Fung's The Diabetes Code? Getting on top of this thing could well make both you and your mum feel rather empowered. i know it did that for me. She's already noticed wound healing is not going the way it should, and neuropathy is a special kind of hell if you ask me, so... Might be a good idea to try and tackle the T2 before it takes even more away from both of your quality of life's.
Hugs,
Jo

 

[Helen25]

Blood sugars are under control, it’s more the fact that we have exhausted antibiotics to treat the infection in her foot. We find out tomorrow if the foot needs to be amputated. We are beyond the point of prevention. I really need help with understand what life will be like following the amputation.

 

[Jaylee]

Blood sugars are under control, it’s more the fact that we have exhausted antibiotics to treat the infection in her foot. We find out tomorrow if the foot needs to be amputated. We are beyond the point of prevention. I really need help with understand what life will be like following the amputation.

Hi,

I'll tag in @Ushthetaff , who I believe has undergone a similar procedure.. & may just help with his own perspective.

Hope this helps.

 

[JoKalsbeek]

Blood sugars are under control, it’s more the fact that we have exhausted antibiotics to treat the infection in her foot. We find out tomorrow if the foot needs to be amputated. We are beyond the point of prevention. I really need help with understand what life will be like following the amputation.

If there's neuropathy present, I'm not entirely sure you and I consider the term "blood sugar control" the same. But yeah, antibiotics can be problematic indeed... It does make it all that much harder, eh. But just to make absolutely sure, not to be mean or try to scare you or anything: Blood sugar control, to me, means blood sugars never over 8.5 mmol/l, and a HbA1c of under 42, 48 tops. I was going to say it's not about prevention, but I suppose in a way it is... My uncle had horrendous blood sugars, and he had multiple amputations; the wounds just never healed because he had syrup in his veins. Cost him both his legs above the knee, 30 years ago. (We know so much more now, though!!!) So while you're awaiting the verdict, to save the foot or not, you really want to look further down the line. It's a wound that will need to heal properly. A bad situation doesn't need to become worse.
I think you will want to read up on phantom pain though, at the least. Other than that I'm quite useless I'm afraid.

 

[TriciaWs]

That is a difficult thing to face, but in the end you are in the right place to get some good advice and support.

I agree with the others that this history indicates her blood sugars aren't well controlled.
Even if we have low HbA1c results that can mask spikes and lows over each day, big enough to do damage. Does she test before and then 2 hours after meals to check for this? Does she aim for 'normal' ranges?

 

[davej1950]

Hi Helen, if blood supply is poor then antibiotics have trouble getting there. If mum has open wounds then topical antibiotics/antiseptics can be used. There are also granules that can be sprinkled on, they soak everything up and can then be washed off I think they are called iodosorb or similar. Or stiff icing sugar paste. Icing sugar is sucrose and doesn't get into the bloodstream and raise blood glucose. It creates very high osmotic pressure and literally rips the bugs apart so there is no induced resistance like with antibiotics. I did a Medical Microbiology Masters in the mid 80's and one of my colleagues did his thesis on treating intractable leg ulcers and lower limb wounds with icing sugar. Before and after pictures were incredible. If amputation is inevitable, bear this in mind if the wound is slow to heal or becomes infected.

 

[Diakat]

Hi Helen,
Have you asked her doctor what the protocol is? What support and rehabilitation is available for both of you?

 

[Honeyend]

If you have not had one you need to make sure they include the tissue viability nurse for a review of the existing wound and the planned surgery.
You probabely know all this but before discharge she should have an OT assesment, and physio on the ward, even if she is not going to make her own meals its for her independance, and assesment for any aids she may need. You also need to see the discharge planning nurse, and socail worker if she needs a care package.Some areas have a reablement team Take what ever they offer because once she is discharged its far harder to get a referal and takes a lot longer. If she is under 65 years, I was 61 when I was discharged from hospital last year, you seem to slip through the net.

 

[Ushthetaff]

Blood sugars are under control, it’s more the fact that we have exhausted antibiotics to treat the infection in her foot. We find out tomorrow if the foot needs to be amputated. We are beyond the point of prevention. I really need help with understand what life will be like following the amputation.[/QUOTE

Hi my name is Helen I’m 25yrs old and I care for my mother who has type 2 diabetes, neuropathy and bilateral Charcot foot. She has recently had infection in her foot which resulted in a 67 day stay in hospital and when discharged several open surgical wounds that required regular bandage changes which was done between our hospital and myself. After 6months we have been told she has another infection of the right foot and she will most likely have to have an operation to amputate the foot. This is a very scary prospect for her and me. Is there anyone out there that have any tips on the transition period after amputation? And or any help whatsoever in terms of help with mental health aspect. Mum is clearly distress and I feel like I can’t help her anymore than what I am due to my own mental health.
Please help. Thanks
Helen

Hi Helen
Firstly sorry to hear about your mum. It’s not a nice prospect to lose your foot. I had similar problems with my toe which after numerous attempts to save it I had removed , my chiropodist had warned me I would lose it a. She also said it was likely I would have my leg removed . I did speak to the surgeon brfre I had my toe removed and told him that I didn’t want him to remove my foot if it was unsuccessful but just to take my leg as I didn’t want to be having too much surgery , so in fairness I did prepare myself for the worse .
I know this sounds like a horror story but to be honest I walk better now than I did before. It takes a while to adjust and itdoes take a positive mental attitude but it is far better than what I was like before . The support I received was excellent and the prosthetic dept at glasgow were fantastic , and having talked to other amputees it seems to be common wherever you are..
it does taking getting use to but it’s like all new things ,
The best advice I can give is don’t give up , think positively and before long you will forget you have a prosthetic, the support system is excellent , plus don’t forget as an amputee you should be eligible for PIP .
Transition involves plenty of physiotherapy , who give plenty of great advice on use of new prosthetic, first time I walked was extremely emotional and a few tears were shed but it made me realise I wouldn’t be confined to a wheel chair . Like in diabetes treatment technology is advancing constantly this is true of prosthetics materials used now make them lighter and more manipulative ,
It takes some getting use to but it’s not the end , it’s just a new beginning , please send your mum my best wishes