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Hello from wife of T2D/PVD amputee .

penelopa024

penelopa024

Member
Messages
6
Type of diabetes
Carer
Treatment type
Insulin
Hello All.
Wife and a carer here.
My husband was diagnosed with T2 diabetes before the age of 40 .
After accident at work he suddenly displayed symptoms of diabetes( not overweight, active - ex army) .
While first 3 years have been seemingly uneventful everything changed in 2010 when he developed ischemic foot and it had to be amputated. Since then almost every year he was losing a finger . Turned out the aggressiveness with which his extremities were deteriorating is attributed to PVD . Despite his sugar levels being in control .
So here we are today : both his legs missing (BK) and 8 digits. One of his stumps healed initially only to become gangrenous and we just cant shift it.
I joined here to seek advice from other people on what to expect and just to really talk to people that go through the same hurdle.

Sorry for such a long post
 
I'm so sorry about your husband. You must be at your wits end, and what dreadful things to happen to him.

Has the doctor made any suggestions as to what has caused all this, and what can be done to help stop any more problems?

You say his blood sugars are under control, but what do you mean by that? What was his last HbA1c, and what sort of levels does he see on a daily basis? (assuming he tests regularly) What diabetes medications is he on?

I wish I had some proper advice, but I am at a loss to know what to say..
 
Hello Bluetit1802 . Thank you for your reply.
When he hasn't got any infection in his body his sugars are between 6-9 .
His recent HbA1C was 6.1 ( his doctor was really happy) .
Doctors are perplexed by the speed with which he's deteriorating. Every time he has a smallest cut on his hand it ends with amputation - every one seems to think its PVD that causes this.
First 5 years he was on metmorfin but last 5 years hes on insulin .

As for me - I just get on with whatever comes - trying to educate myself as much as I can and prepare for next steps .
I am well aware that DM/PVD combo presents him with a very bleak outlook.
It is getting harder and harder to achieve the knowledge i need as he started to be very cagey about his visits and the results - while in the past he would write everything down and tell me or even take me with him to doctors office , now he insists on going on his own and after his reply is usually very generic ( " yeah - it's ok - in norm") which gives me no indication.
 
penelopa024 said:
Hello Bluetit1802 . Thank you for your reply.
When he hasn't got any infection in his body his sugars are between 6-9 .
His recent HbA1C was 6.1 ( his doctor was really happy) .
Doctors are perplexed by the speed with which he's deteriorating. Every time he has a smallest cut on his hand it ends with amputation - every one seems to think its PVD that causes this.
First 5 years he was on metmorfin but last 5 years hes on insulin .

As for me - I just get on with whatever comes - trying to educate myself as much as I can and prepare for next steps .
I am well aware that DM/PVD combo presents him with a very bleak outlook.
It is getting harder and harder to achieve the knowledge i need as he started to be very cagey about his visits and the results - while in the past he would write everything down and tell me or even take me with him to doctors office , now he insists on going on his own and after his reply is usually very generic ( " yeah - it's ok - in norm") which gives me no indication.
Click to expand...

Penelopa - Your situation seems utterly unimaginable.

Is or was your husband ever a smoker? What sorts of insulin doses does your husband take, and is he following any particular way of eating?

Sorry to be asking so many questions, but all the context helps.
 
@AndBreathe
yes, he is an ex smoker . That was definitely a high risk factor, even though he quit the damaged has been done.

Insulin he uses is HumulinM3 .
He does not follow any specific diet apart for limiting the amount of carbs.
Because he's in pain most of the time for the best part of the last year he's on a lot of pain management medications ( cocodamol, tramadol, ibuprofen, oral morfine )
That caused him to lose appetite . On top of it he's on antibiotics due to wet gangrene in his stump which is 10cm in diameter .

I'm not sure what else can be done apart for managing the pain and getting the gangrene dealt with which is what doctors try to do at the moment.
He isn't overweight( he's slightly underweight) , he doesn't smoke anymore, his cholesterol is in check (although I don't know exactly what the reading is) , he's sugar levels seems ok.
I keep trying to get him to check his eyes but we're so busy with all other appointments that he keeps putting it off( I personally think he knows there is a developing problem but is not ready to face yet another problem).
 
penelopa024 said:
@AndBreathe
yes, he is an ex smoker . That was definitely a high risk factor, even though he quit the damaged has been done.

Insulin he uses is HumulinM3 .
He does not follow any specific diet apart for limiting the amount of carbs.
Because he's in pain most of the time for the best part of the last year he's on a lot of pain management medications ( cocodamol, tramadol, ibuprofen, oral morfine )
That caused him to lose appetite . On top of it he's on antibiotics due to wet gangrene in his stump which is 10cm in diameter .

I'm not sure what else can be done apart for managing the pain and getting the gangrene dealt with which is what doctors try to do at the moment.
He isn't overweight( he's slightly underweight) , he doesn't smoke anymore, his cholesterol is in check (although I don't know exactly what the reading is) , he's sugar levels seems ok.
I keep trying to get him to check his eyes but we're so busy with all other appointments that he keeps putting it off( I personally think he knows there is a developing problem but is not ready to face yet another problem).
Click to expand...

Thanks for responding Penelopa. As you say, unfortunately smoking is so very bad for everyone, but worse for diabetics due to the addition risks the condition bring with it, in it's package, but on the upside continuing not to smoke will have an impact on his potential future well-being.

To be honest, you're both in a tricky place, balancing the gangrene, pain relief drugs, diet and insulin, never mind any other factors that just come along with life.

One thing I will say is though, is that the better his blood sugars are then better things will be for him, because any infection thrives on excess blood sugar. That said, if your husband is on fixed doses of insulin, he would need to be quite careful if he was going to change how and what he eats too much.

Should he want to change anything about his way of eating, unless he is confident altering his own insulin doses, the support from his medical team would be critical. What sort of doses of the Humulin does your husband take?

I wouldn't necessarily call your husband's outlook bleak, but I would wholeheartedly agree he has some tough hurdles to get over, to change direction to a more comfortable life.
 
I am so sorry to hear about your situation. It must be so hard for both of you.

Afraid i can't offer any suggestions and advice, because i have no experience of most of your husband's issues, except to say that the pain and infections and drugs must be playing havoc with his blood glucose and mood. I really feel for you.
 
I'm sorry for not replying sooner @AndBreathe .
We are in the midst of house improvement , wound management and childcare during half term.

Yes, the antibiotics are whacking his sugar levels off - infection raises his blood sugar for which he uses more insulin but then he hypos at night .

To answer your question about insulin doses:
When he eats a usual food he administers insulin 3 times a day of 30,30 and 20 units , but if there is a change in diet or a meal that is a bit more naughty then he adjusts accordingly .
His glucose levels are not a problem , he manages that very well.
I believe the problem lays somewhere else .

Just to update on the wound :
Stump is not healing , gangrene still here . Part of the top scab came off though and a lot of puss came out which is a good news . Another part (size of about 5cm x 3cm ) is still covered by dried scab with lots of puss trapped underneath.
I continue to change the dressing using non stick dressing , inadine mesh ( for area without a scab) , honey mesh ( for part with scab), then charcoal ( which suppose to limit the odour- but failing miserably) and soft pads on top.

2 days ago he noticed a small ulcer on one of his finger stumps which by today gotten hard and painful .
Doctor prescribed an ointment ( I forgot the name ) which I will pick up tomorrow.
 
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