Infected toes, getting frustrated at lack of progress

galileo

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Hi all, sorry for the long post I need to get this out of my system as I am really getting frustrated, I have an infection in my right big toe it started early December 2020. The GP surgery has been busy, I had to wait two weeks for an appointment with the diabetic nurse she brought the GP in during the appointment, and they took a swab.

When the swab identified a bacterial infection I was put onto antibiotics (been on three different types so far) this carried on until late February 2021 when I was finally sent to a podiatrist, she said the infection was the result of an ingrowing toe nail. The podiatrists said the toe was no longer infected and cleaned the wound area and packed it, two days later my toe turned a lovely dark purple colour swelled up and split open. I had yet another swab again positive for infection, so obviously the podiatrist was wrong, this time I asked what type of the bacteria it was, I was told Proteus which is rare bacteria infection for this area. My right foot is swollen and sometimes looks an odd colour they told me that is because the body is trying to heal itself.

I have now had at least five GP telephone consultations, two GP appointments in person, two nurses appointments and three podiatrists visits. My GP referred me for surgery I booked an appointment through e-referral which was a seven-week wait, ten days later the consultant cancels the appointment and weirdly refers me to Orthotics? I tried to book an appointment with a clinic which I had been referred to the podiatrist did not seem to want to know, said she would get back to me not heard from her at all.

HCP's keep telling me the infection will not go away unless I have surgery, Not only do I have T2 I am also immunocompromised with Crohn's and many other conditions, including two forms of Arthritis. At present, they have put me on 100 mg antibiotics I expect to keep the infection under control. However, the infection is now in another toe on the same foot and looks like a third is becoming infected, what are they going to do now? Antibiotics have not worked. It is so frustrating I keep calling the GP surgery and every time have to explain I need a doctor to call me, every time I am told there are no appointments and round and round we go.

On top of all this my poor youngest sister has been diagnosed with malignant breast cancer and will be having treatment, my sister does not drive and nor does her husband. I cannot even get a shoe on so my wife has been giving my sister lifts this will intensify after my sister's operation, I am so worried my stupid toes will need further appointments and interfere with my sister's treatment. When I told the senior podiatrist how I felt about my condition interfering with my sister's treatment "she said how would your sister feel if something happens to you".
I just want to scream it is so annoying it does not feel like any progress has been made since this infection started. I know how quickly this situation can become extremely serious the same surgery treating me failed to handle my dad's condition also T2, and he died of cardiac arrest brought on by septicemia.
 

Pipp

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Dr Snoddy

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Can you ask if they have tested to see if you have an antibiotic resistant form of Proteus? Also, there is one species of Proteus that does not respond to common antibiotics and which colonises immunocompromised individuals. Therefore I hope that your clinics have identified to species level. I hope you have been given the appropriate advice about reducing blood glucose levels, exposing your bare foot to fresh air and sunlight as much as possible etc.
Life must be really challenging at the moment and I sympathesise. Is seeing a different podiatrist an option even if privately? It really doesn't sound as though your treatment is being prioritised and I can appreciate your need to left off steam!
 

galileo

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Any idea what your blood sugars have been recently?

High levels can prolong infections..


Thanks for the reply I don't have a meter was told by GP I don't need one? My last blood test a month ago was 53, and my liver count was elevated. I have a blood test coming up in the next couple of weeks to check liver, Diabetes and Crohn's had a flare now for six weeks oh what fun.


So sorry you are having such a tough time @galileo . Do check your blood glucose levels and try to keep good control.

If you have been told by HCPs that surgery is the only way to heal your infection and your surgery has been cancelled by the surgeon, then you need to persue that. Urgently. In NHS hospitals there are patient advocacy services. https://www.nhs.uk/nhs-services/hospitals/what-is-pals-patient-advice-and-liaison-service/

I suggest you contact them.

Best wishes with it all.


Thanks for the reply, and the link. I don't have a meter was told by GP I don't need one? I am on a low-carb diet Crohn's is not good at the moment it seems all food is making me ill even ones I can normally tolerate.


Can you ask if they have tested to see if you have an antibiotic resistant form of Proteus? Also, there is one species of Proteus that does not respond to common antibiotics and which colonises immunocompromised individuals. Therefore I hope that your clinics have identified to species level. I hope you have been given the appropriate advice about reducing blood glucose levels, exposing your bare foot to fresh air and sunlight as much as possible etc.

Life must be really challenging at the moment and I sympathesise. Is seeing a different podiatrist an option even if privately? It really doesn't sound as though your treatment is being prioritised and I can appreciate your need to left off steam!


Thanks for the reply. I don't know which Proteus I suspect maybe mirabilis they did mention it is antibiotic resistant that's all I know. I have not been given any advice at all I am dressing the toe myself which is not easy when you have limited movement in legs and arms good old arthritis lol. Unfortunately I would not be able to see a podiatrist privately Crohn's and diminishing mobility ended my career many years ago have to survive on benefits now. I do leave my feet sometimes bare, but that's because I
have varicose eczema they get so itchy, after a short time my feet get very cold and painful, so I have to cover them up again.
 

TeddyTottie

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Probably akin to spitting in the ocean, given the severity of your infection, but I resolve my minor, occasional in-grown toe-nail infections by liberal swabbing with tea tree oil. Might be worth a try?
 
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Hopeful34

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Really sorry you've got all this happening. As you've already said, it could turn into an extremely serious situation quickly, and as it's spreading to more toes, I think you need to go to A & E today. At least they will look at it, and may put you on different stronger antibiotics, which may even mean you don't need surgery. (I'm not a medic so don't know though).
 

Dr Snoddy

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I second A and E as another point of view can only help. Also, they may have a nurse practitioner who is a specialist in wound dressing. Please let us know how you get on.
 
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Pipp

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If choosing the A&E option it is now advised to call 111 for an appointment. Unless it is an emergency requiring an ambulance.
https://www.rcem.ac.uk/docs/Policy/NHS111_FAQs_October_2020.pdf

From what @galileo has told us, it would appear prompt medical assessment is needed. So if it were me I would call 111, and mention the concern about sepsis. I would also involve the PALS people to ensure the situation is flagged and correct support is provided.
@galileo , please let us know how you get on.
 

elsalisa

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My daughter had 2 ingrown toenails, both toes were swollen, red, puss coming out... our diabetic team referred us to a surgeon but since March we had no information when and what is going to be done. So we made an appointment in April at London Podiatry Centre in Lewisham, nail was removed and toe is fine now. Now we are waiting for the second surgery.

It isn’t easy, but nowadays unfortunately it’s much faster if you can pay to have an appointment or if you have a private insurance. We had no choice, we had to pay. If we waited for hospital surgeon to contact us (and he still hasn’t) we could just lose that toe - it looked that bad.

I wish you and your sister the best of health.
 
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galileo

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I wish you and your sister the best of health.

Thank you.


Thanks everyone for the replies and advice much appreciated.

GP called this morning I have been prescribed mupirocin ointment turns out I have Staphylococcus infection and Proteus infection, mometasone 1% ointment for the Varicose Eczema. My doctor is going to investigate why I have been told I will have an appointment with Orthotics, he agrees completely the wrong clinic.
The GP seems quite concerned and said he does not understand why my operation was cancelled, he is referring me to a diabetic clinic for serious foot infections. I told him I have a problem with my left foot as well, now being investigated for Mortons neuroma.
 

Geordie_P

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Probably akin to spitting in the ocean, given the severity of your infection, but I resolve my minor, occasional in-grown toe-nail infections by liberal swabbing with tea tree oil. Might be worth a try?
Agreed, Tea-tree is worth a go. TCP used to be good too. If it's Staph though, you probably need to get a course of antibiotics
 

EllieM

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My last blood test a month ago was 53, and my liver count was elevated. I have a blood test coming up in the next couple of weeks to check liver, Diabetes and Crohn's had a flare now for six weeks oh what fun.

Just be aware that infections will raise blood sugar, and raised blood sugar leads to slower healing in your feet... I'd recommend self funding your own meter and seeing what your actual levels are.

Lots of virtual hugs.
 

galileo

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Agreed, Tea-tree is worth a go. TCP used to be good too. If it's Staph though, you probably need to get a course of antibiotics

On antibiotics at the moment but very low 100mg dose, have been on antibiotics up to 2000mg a day since 15th December 2020.
 

Dr Snoddy

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Thank you for the update and good luck with your incoming treatment. At least your GP seems more engaged and supportive.
 

Pipp

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The GP seems quite concerned and said he does not understand why my operation was cancelled, he is referring me to a diabetic clinic for serious foot infections

Good that your GP is now being proactive. As there is a bank holiday next Monday, do make sure you get some sort of action from the diabetic clinic before the weekend. Keep on at GP if you don’t hear from the clinic. Hope you can get this sorted out soon. Best wishes, and please keep updating the thread with your progress.
 
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galileo

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Thanks for the replies.

The diabetic clinic for serious foot infections called yesterday, I have an appointment tomorrow, the call was a bit of a surprise as it was so quick literally 6 hours after the referral. They are also going to investigate the left foot for Mortons neuroma.
I really don't know why I was not referred to this clinic earlier when it was just one toe, now the infection is more widespread.

I also have an appointment for a private hospital mid-May I was told not to cancel it as it might be needed, the first appointment available for a NHS hospital on the E-referral was January 2022.

I will keep updating this thread and hopefully this is the start of the road to recovery.
 

Brunneria

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I am very glad things are finally moving along a bit for you.
Hope tomorrow’s appt goes well and they put something into rapid action for you.
 
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Antje77

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The diabetic clinic for serious foot infections called yesterday, I have an appointment tomorrow
Very happy to hear things are happening now!
I'll keep my fingers crossed for an uneventful recovery.
 
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Dr Snoddy

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Pleased to hear that appointments are being made. Good luck for tomorrow.
 
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