Thursday, December 11, 2008

Diabetic Foot Infection... Emergency Surgery as it Happened Today

Today was one of the days I dread. I was coming out of a treatment room and Sherrie stopped me to ask if we could ad an emergency diabetic patient. A diabetic man man was on the phone. He had called and said his big toe was "black and blue and squirting blood." Never a good sign. I told Sherrie to tell him to either come in immediately or go straight to the Emergency Room.

Twenty minutes later he was in my podiatry office sitting in a treatment room. He was right, it was black and red. But squirting more pus than blood. I started to trim a way some of the thick hard callus to drain the infection. And drain it did, odor and all. Paula, who was assisting me, asked to leave the room.

I explained that he was going to need surgery. I had him sign a consent form and explained what we would need to do. I took some cultures, wrapped up the foot and sent him straight to the hospital to be admitted for powerful antibiotics and to get ready for surgery. I sent over some orders and then saw the rest of the patients.

After I finished seeing all of the post-op bunion patients, heel pain cases, and a guy that almost lost his toe a year ago, I went home to eat with my wife and son Alex. He's going to be a year old next week. We ate dinner and I waited for the hospital to call, to tell me when we could start. After Alex went to sleep, I headed back to the hospital.

In the operating room, I took a scalpel and opened the end of the big toe. The bone in the end of the toe was mushy and soft. I took some pieces to send for culture (to see what kind of bacteria is growing in there). I removed the bone and flushed it out to wash away the pus and bacteria. I packed the end of the toe and wrapped it up.

In a few days we will go back to the O.R. and remove whatever looks dead or infected. Or if all is well, I will close it so he can go home for Christmas.

The reality is that this episode was preventable. With proper monitoring and careful attention to the feet, this man would not be in the hospital. I would have been at home with Alex. He would have been home with his family instead of in the hospital.



Dr. Christopher Segler is an author, inventor and award winning diabetic foot doctor. After discovering how amputations resulted from a failing health care system, it became his passion to teach strategies to stop diabetic amputation. If you have diabetes, you can learn more by requesting your FREE report “No Leg Left To Stand On: The Secrets Insurance Companies Don’t Want You To Know About Diabetic Foot Amputation” at http://www.ineedmyfeet.com.

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