Amputation due to diabetic foot

[KevinJenkins]

My grandad is suffering from diabetes and a stroke, and he is 80 and has been in hospital bed for 20 years. My concern now is recently starting from this year his toes wounds just would not heal, and eventually he has been diagonised with a diabetic foot, and now his toes became completely red and black in color and has spread to the lower surface of his foot. The doctors said amputation is the option however they do not recommend it as of medical co morbidity, and were afraid he might pass away while being on anesthesia.

My genuine concern is how do we actually treat a patient whose toes and foot is slowly rotting away and cannot undergo surgery? I am very worried and extremely sad and I do not have anywhere else to ask, as I am abroad and not with my grandad at the moment. I just had to seek help and what would be the consequences and outcome if we leave him like that without surgery. I really would appreciate anyone in this forum who had this similar experience or is experiencing a similar experience where amputation is required but is not an option because of age, which is caused from diabetes and other health related problems.

 

[PenguinMum]

Kevin
I am so very sorry to hear about your grandad’s health and you are obviously a wonderful grandson. I cant offer you any light on his options but can only suggest you arrange a conversation with the doctors treating him (by phone if necessary) so you can ask them what his options are. Are you the only relative or do you have family who could physically arrange such a meeting, eg. Who is his next of kin? Dont be afraid to ask the questions you want answers to.
I can only wish you and your grandad all the very best.

 

[KevinJenkins]

Thank you for the reply, there are family back home to take care of him but thats what I heard from my family regarding my grandads condition. I am very worried because I do not entirely know what can be done if the surgery cannot be done, and the rotting will proceed, he will eventually pass away from sepsis and other complications. But then if surgery is done it is also risky and limb amputation may even lead to secondary amputation, so I am very worried.

 

[PenguinMum]

You are clearly very upset about this so I again can only suggest a family member gets a proper review asap with the medical team treating him to find out what their plans are and they could keep you informed. My experience of hospitals treating 80+ yo patients with life limiting conditions is you have to make all the effort to be kept informed.
I wish you all the best.

 

[JohnEGreen]

While in hospital a couple of years ago there was an elderly gentleman on the ward with a serious ulcerated diabetic foot infection to try and avoid surgery the doctors where treating him by way of maggot therapy I know it does not sound very nice and am not sure how effective it can be but the maggots clean away necrosed and infected tissue. This may or may not be an option for your grand dad I do hope things turn out well for you lots of well wishes and luck to you and yours.

 

[DCUKMod]

@KevinJenkins - It sounds like you and your family are in a very difficult place at the moment.

Thankfully, not from personal experience, but do know that in UK, where an otherwise unwell person needs an amputation, they medics sometimes consider doing it under local anaesthetic, plus sedation, rather then a full general anesthetic, as that can be easier on the body. Of course, that does change the magnitude of the underlying procedure at all.

As has already been suggested, it would be good to have a family meeting with the medics, where they can be asked to explain the options, and why some may not be suitable for your grandad.

In the meantime, I imagine your graddad is on some fairly heavy duty antibiotics and having his foot dressed regularly?

I wish you all, all the best.

 

[KK123]

Hi @KevinJenkins, so sorry to hear of your present situation. I do have experience of this, my Mum was 82 years old and was what you might call a chronic type 1 diabetic, in and out of hospitals her whole life despite the efforts of my sisters and me. Her last hospital admission was due to a mini stroke but she came round from that and was mentally ok (but had been suffering from a touch of dementia for a few years previously). Anyway, we noticed her foot was a funny colour and seemed colder than the other one. We pointed it out to the medical staff and to cut a long story short, they said there was nothing that could be done to save the foot and the only option was for an amputation. This came as a massive blow and we spent days and days in despair, hoping that somehow the foot would get better. We knew it wouldn't and were then faced with the task of 'deciding' whether to give the go ahead for an amputation, on reflection I think if we had said go ahead they wouldn't have done it anyway given my Mum's age and general condition. There was no way my Mum would have coped with a leg amputation (up to the knee) and even if she survived this massive operation she would have lived for another year or so probably in great pain and not having a clue what was going on. It was the hardest decision we have ever made and it upsets me even now as I am writing this, BUT we took the decision to let it be and enjoyed a month more of my lovely Mum. Sadly, her time came and she died naturally in the end (before the sepsis set in on her foot) and most likely because of the strong painkillers they gave her. Nobody can tell you what to do of course but all I can say is that you must discuss it fully with the Consultants, they will speak about quality of life, the dangers of an operation, how strong your Grandad might be, how much does he understand about it all and many other things. I'm afraid there is no solution as to how to treat this without amputation other than strong pain relief and making your Grandad comfortable. I wish I could say something else and of course this is only MY own experience so would never tell you what to do. I wish you all the best love. x