Type 1 diabetic facing amputation

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Old 06-02-2009, 05:05 PM
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Question Type 1 diabetic facing amputation



Hello,
I am a 54 year old male that has had Type 1 diabetes for just over 45 years now. Approximately 4 months ago, I developed swelling in my left leg below the knee and woke up one morning and was unable to put pressure on my left foot. I limped around for about a week before I went to the Emergency room at a local hospital here in Montreal, Canada. After ten days in hospital, I was finally told that I may have osteomilitis in my foot because of a charcot joint in the metatarsil bones. the scans ansd x-rays To make a long story short, I am now facing a possible amputation and would like to know what my chances of survival are if the leg is amputated above the knee, and no blood is used for the surgery. I have severe calcification in my arteries below the knee, and I am assuming it is pretty much the same above the knee, or maybe slightly better above the knee since there is plenty of feeling there. Oh yes...did I mention I also have severe neuropathy in my feet? And I have an ulcer in the bottom of my foot which was caused by the charcot joint piecing the bottom of my foot and have been on two different antibiotics in the past 4 omths. I am still presently on Cipro. so, do I or don't I follow the suggestion of my vascular surgeon, and think about removing the leg, or do I just try to endure the pain with pain killers and antibiotics until the ulcer possibly closes?
Help! I need to make an informed decision!
Ted
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Old 06-02-2009, 06:34 PM
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You and your doctor have to decide together what is the best course of action regarding whether or not to amputate your leg. It seems one of your biggest concerns is surviving such a surgery without blood transfusion. People who refuse blood transfusions can usually very successfully survive an amputation. In my experience, most people who have an amputation for medical reasons such as yours (as opposed to having one for an acute injury) rarely get a blood transfusion even if they accept blood. If you decide to have the surgery, ask your doctor to make sure in advance that your hemoglobin level and coagulation studies are sufficient, and to optimize your health as much as possible to help assure you will be stable through the surgery and recovery period. These things are usually done automatically. I wish you well.
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Old 06-02-2009, 06:57 PM
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Quote:
Originally Posted by cossack View Post
Hello,
I am a 54 year old male.... so, do I or don't I follow the suggestion of my vascular surgeon, and think about removing the leg, or do I just try to endure the pain with pain killers and antibiotics until the ulcer possibly closes?
Help! I need to make an informed decision!
Ted

Ouch! Have you tried hyperbaric oxygen? It should be available there in Montreal. Looked into chelation?
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Old 06-04-2009, 12:25 PM
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Liz,
Thanks ever so much for your input. I need as much data as possible for my own education!
Best regards,
Ted
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Old 06-04-2009, 12:29 PM
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Hello Joseph,
Thank you for your suggestions. I will bring them up during my discussion with my vascular surgeon this Monday. I will post his response here once I have his answers.
Best regards!
Ted
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Old 06-25-2009, 01:37 PM
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Diamond Back and Silver Hawk for PVD & PAD

HAve a look at these videos to see if we can be of assistance: Under the tab you will find info:

Good Samaritan Hospital Los Angeles - Podcasts


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Transfusion-Free Medicine & Surgery
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Old 06-26-2009, 12:30 PM
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Thanks! It's greatly appreciated...

Thank you for the PODCASTS. I will review them and give you some feedback.
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Old 06-26-2009, 08:03 PM
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re: amputation

Ted...you obviously are dealing with the full gamut of issues that can result from your diabetes. First of all, the osteomylitis usually only requires amputation in its advanced stages. if it is possible to deal with (debride) the affected area directly, there are usually good long term results. the blood flow concerns in your lower leg are another issue usually resultant from your diabetes, called "Medial Calcification." This is a hardening of the middle layer of the arterial wall and usually independant of atherosclerosis. There are medications that can assist your body to deal with this problem. SilverHawk/Fox Hollow/Diamondback atherectomies are usually only useful in the event of atherosclerosis and have limited long term success, usually requiring re-intervention within the year. However, if it is indeed a matter of limb salvage, then it is a viable option. Also, ensure that the have done perfusion tests (TCPO2 or TCOMS) to determine the quality of blood perfusion at various levels of your leg. If amputation is in fact required, this will enable them to do so at the level of the limb with the best chance of healing. If there are more specific questions, please let me know. sorry I missed this earlier.

t.
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Old 06-30-2009, 12:20 PM
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Type 1 Diabetic looking for answers

Hello wetpeds!
THANKS FOR YOUR INFORMATION....i AM DEFINITELY GOING TO LOOK INTO ALL YOU HAVE RECOMMENDED. I will try to keep everyone informed as to how things go....at present I am schedule for Hperbaric Chamber treatment in early August. I know it may not be successful, but I am willing to go through it all as long as I pass the preliminary evaluation.
I am also eating greens aplenty trying to augment my vitamin K intake right now.
Thanks again!
Ted
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amputation, charcot joint, diabetic, neuropathy, osteomilitis


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