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Charcot's Arthropathy

Discussion in 'Diabetes Discussions' started by martinbuchan, Nov 8, 2007.

  1. martinbuchan

    martinbuchan · Well-Known Member

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    Going for a MRI scan on my problem right foot (abscess last year led to DKA and 2nd toe amputation). In a removeable splint today for the next 6-12 months probably. Anybody gone through this mullarkey?

    Marty B
     
  2. martinbuchan

    martinbuchan · Well-Known Member

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    Had MRI scan 2 hours ago. My radiologist thinks it probably is charcot neuropathic arthropathy. My diabetologist will make me strict non weight bearing for the next 6 weeks. Looks like i am off Christmas again.

    Will post my results.

    Marty B
     
  3. martinbuchan

    martinbuchan · Well-Known Member

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    MRI scan showed abnormal bone marrow of all my midfoot bones consistent with Charcot's. Also, there was alt of soft tissue increased signal and some fluid around the cut end of my 2nd metatarsal meaning there maybe some residual infection.

    So in my aircast boot (Like david beckhams) and as non weight bearing as I can. Also on anitbiotics for the next few weeks. On Fosamaz for the soft bones and Calcium tablets. Due for another MRI scan in a month I believe. Let you know my progress. Due to get my foot temperature measureed next week.

    Marty B
     
  4. martinbuchan

    martinbuchan · Well-Known Member

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    2nd week in boot and crutches. Skin temp feels better to me but the time it felt very hot was when it got measured by the podiatrist (the only time it was hot in week). Swelling is right down as well- the smallest since my abscess last year. Coping well with antibiotic and fosamax.

    Bores- awfully bored. Stressed due to reduced pay. But much more positive this week.

    Looking into hyperbaric oyxgen- 2 chambers with 1-2 hours drive from the house. Going to see diabetologist in Edinburgh with a UK wide diabetic foot interest. Let you know again next week.

    MB

    Marty B
     
  5. martinbuchan

    martinbuchan · Well-Known Member

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    Saw one the the UK's top dabetic foot physicians today. I do not have Charcots arthropathy- i have osteomyelitis (bone infections). On different antibiotics for 3-4 months. 80% chance of success. If not then looking at amputation ofpart of the foot (big toe ray).

    I have been referred for hyperbaric oxygen therapy on the NHS. This can help fight the infection and is reported to be beneficial for neuropathy.

    Marty B
     
  6. junieliz

    junieliz · Well-Known Member

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    Hi Martin, hope everything is ok, get well soon and have a good Christmas.;)
     
  7. martinbuchan

    martinbuchan · Well-Known Member

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    thanks folks.

    Marty B
     
  8. martinbuchan

    martinbuchan · Well-Known Member

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    Chocfish- I don't have MRSA- mind you it would not make any difference. I probably have a normal SA- not the multiresistant one. MRSA is often less virulent than the more common and more serious methicillin sensitive Staph Aureus. (Methicillin is the US name for the antibiotic Flucloxacillin). There is a lot of media and governmental hype about MRSA. Blame is given to doctors, long sleeves, not enough infectional control nurses (god, we don't need more of them interfering) and not washing hands etc etc. Really, the only proven association is % bed occupancy and proximity of beds. Lets guess who is responsible for the closure of wards and causing the bed occupancy to get to as near 100% as possible?


    The link was interesting. I never believe private hospitals' claims (especially european and north american)- their responsibilty is to their shareholders. The NHS , if anything, is probably one of the most honest healthcare systems in the world.

    I face losing my foot- is that my doctor's fault or bad luck due to my disease? No-one achieves 100% success with 0% complications. Some patients need to vent their frustration and anxiety in derogatory ways. If Austria is so good, why have they got such vast experience in bone and joint infections (where many will have had a surgical cause)?

    Anyway, my foot is better. On intravenous daptomycin (£88 per day and does cover MRSA) and having another MRI scan next week. Here's hoping.


    Marty B
     
  9. martinbuchan

    martinbuchan · Well-Known Member

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    <u>Osteomyelitis of foot</u>
    Foot is doing reasonably well. Had a problem with my insole last week and got a blister under my 3rd metatarsal (which has the dislocated joint and a lot of hard skin- callous- forming). Got early podiatric treatment to deroof the blister. Not too deep. Got a forefoot offloader from my orthotist and dressed to raw ulcer with inadine antisepic dressings. Healed in just under a week.

    I have been back to work for 5 weeks and next week I go back to operating (gently at first). Can't wait to try to get back to normality.


    Still on antibiotics (tummy settled on probiotic capsules and brewers yeast tablets). Will be on antibiotics for at least a total of 6 months but hoping for 12 months.

    The hyperbaric oxygen was put on hold but I have been told by public health that it will be funded if needed. Its good to have a plan B that just doesn't involve a below knee amputation. The cost is £6000 per week for 6 weeks. However, the chamber in Millport, Isle of spambrae is one of the largest in the country. It can take 8 'divers' and a life support trained technician. It costs an additional £20 per diver per treatment (just for the extra oxygen involved). If I do have to go for HBOT we shall be scouring the Glasgow area looking for other potential recipients in order to get our money's worth. That is the Aberdonian in me. HBO is great for ulcers, osteomyelitis and neuropathy.

    The cost of HBO is far less in other areas having contacted some diving physicians on a doctors forum. There are NHS guidlines for HBO therapy and can be a useful adjunct for complications of diabetes.

    Marty B
     
  10. martinbuchan

    martinbuchan · Well-Known Member

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    <blockquote id="quote"><font size="1" face="Verdana, Arial, Helvetica" id="quote">quote:<hr height="1" noshade id="quote"><i>Originally posted by martinbuchan</i>
    <br /><u>Osteomyelitis of foot</u>
    Foot is doing reasonably well. Had a problem with my insole last week and got a blister under my 3rd metatarsal (which has the dislocated joint and a lot of hard skin- callous- forming). Got early podiatric treatment to deroof the blister. Not too deep. Got a forefoot offloader from my orthotist and dressed to raw ulcer with inadine antisepic dressings. Healed in just under a week.

    I have been back to work for 5 weeks and next week I go back to operating (gently at first). Can't wait to try to get back to normality.


    Still on antibiotics (tummy settled on probiotic capsules and brewers yeast tablets). Will be on antibiotics for at least a total of 6 months but hoping for 12 months.

    The hyperbaric oxygen was put on hold but I have been told by public health that it will be funded if needed. Its good to have a plan B that just doesn't involve a below knee amputation. The cost is £6000 per week for 6 weeks. However, the chamber in Millport, Isle of c-u-m-brae is one of the largest in the country. It can take 8 'divers' and a life support trained technician. It costs an additional £20 per diver per treatment (just for the extra oxygen involved). If I do have to go for HBOT we shall be scouring the Glasgow area looking for other potential recipients in order to get our money's worth. That is the Aberdonian in me. HBO is great for ulcers, osteomyelitis and neuropathy.

    The cost of HBO is far less in other areas having contacted some diving physicians on a doctors forum. There are NHS guidlines for HBO therapy and can be a useful adjunct for complications of diabetes.

    Marty B
    <hr height="1" noshade id="quote"></font id="quote"></blockquote id="quote">

    Marty B
     
  11. martinbuchan

    martinbuchan · Well-Known Member

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    Hi

    I have been in contact with the diving physician there in Plymouth. Him and many like him are so encouraging about the benefits of HBOT. The main UK centre is Aberdeen for diving and hyperbaric medicine. One even receives travel expenses for going there. The director of that chamber has offered me to go there as well. (Aberdeen is funded differently than the other NHS associated chambers in Scotland). I will have it if I need it - hopefully I wont need it at all. I was sort of wanting it anyway hopefully to reverse some of my neuropathy. But I will be happy if I am cured.

    There is no real hard randomized controlled study evidnence to force the issue. There are 4-5 good studies that make it unethical to refuse HBOT in certain cirspamstances. I will post here if I have to have HBOT.

    Thanks for your support.

    Marty B
     
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