Even President Obama Doesn't Understand the Cost of a Diabetic Foot Amputation

click here for President Obama's Video of Getting the Cost of Diabetes Wrong

http://www.youtube.com/watch?v=SG56B2et4M8

Diabetic foot amputations are preventable. True. But only with diabetic patients and doctors working together diligently.

The reality is that nearly all health problems related to diabetes could (in theory) be prevented if medical intervention was started early enough. But that is not what typically happens with diabetes.

On average, it is believed that most people are diabetic for 2-5 years before diagnosis. This has been changing in recent years with more screening and early testing. If a person has diabetes that is out of control, damage happens. If the diabetes is out of control with skyrocketing blood sugar for a number of years, lots of damage happens.

If the nerves to the feet are damaged one is placed at enormous risk of diabetic foot ulcers that can easily become infected and lead to amputation. Once a sore begins, poor blood flow to the feet (common in diabetes) makes healing slow. Infections set in. If the skin infection spreads rapidly or spreads to the underlying bone (osteomyelitis) then an amputation becomes necessary.

There has ben a great deal of discussion in the media about the cost of diabetic foot amputations. After all they are expensive. The talk however has reached conspiracy theory fever with the misspoken words of President Obama while he was running for the office.

He said that if a surgeon amputates a foot, Medicare directly pays the surgeon $30,000-$50,000.

That statement is, of course, ridiculous at best.

We do know that the total cost (to Medicare) of an amputation related to diabetes is upwards of $50,000. However that cost includes hospitalization for the associated infection, antibiotics (which can cost as much as $1,000 per dose), lab tests, Xrays, MRI studies, follow-up care after the surgery and custom made prosthetic limbs, wheelchairs, home-health care, etc.

You might be surprised to know how little Medicare pays a surgeon for an amputation. Depending upon the level of a diabetic foot amputation, the surgeon would be paid anywhere from just over $200 to just over $1,000. That fee included surgery AND all of the postoperative care for 90 days. That means office all follow-up visits, hospital visits, removing stitches, wound care to get it all healed, and the cost of all bandages applied in the office.

In most cases the doctor who performs an amputation related to diabetes actually makes very little money or actually loses money providing this care.

With this in mind see the video clip and you will understand where much of the confusion about health care reform comes from, given that even the President seems to misunderstand some of the details.

click here for President Obama's Video of Getting the Cost of Diabetes Wrong

Diabet Foot Treatment Skill #7: Continually Re-Evalaute After Surgery, In Order To Avoid Re-Ulceration, Re-Hospitalization, And Re-Amputation

In these discussions, we discuss each of the 7 essential skills that your diabetic foot treatment must possess. As a better educated person determined to thrive in spite of your diabetes, you’ll be able to evaluate the competency of your treatment team. A competent team will give you the best chance of avoiding a diabetes-related amputation.

Finally we’ll discuss essential skill number seven:

7. Continually re-evalaute after surgery, noting the risk of recurring problems in order to avoid re-ulceration, re-hospitalization, and re-amputation of the diabetic foot.

When you think about all of the things you know about how diabetic foot problems begin, this last skill at your diabetic foot treatment team should possess seems obvious.

But in fact, it is one of the frequently missing pieces. The unfortunate reality is that many doctors are trained to recognize a disease or condition and treat it successfully. Fortunately, many do exactly that. The problem is that modern Western medicine is based on disease cure or "management" and not disease prevention.

Because of this, doctors will often times "heal" a diabetic foot infection and then pat themselves on the back and send the patient on their way. They think they are done. While it is certainly worth applauding the foot doctor for healing a diabetic foot infection, and helping the patient to dodge a bullet so to speak, the patient is still actually in very dangerous territory.

Any patient with a prior history of the ulceration related to diabetes is at very high risk of developing another diabetic foot problem.

If the past episode actually led to an amputation, things are worse. Even if it was just one toe, the patient is at much higher risk of amputation in the future. Statistically, we know that one year after a patient undergoes a diabetic amputation, 26.7% will have another amputation. Three years after a diabetic foot or leg amputation, almost 50% will have another amputation. And five years after a diabetes related amputation, over 60% will have another amputation.

The fact is the odds are not in the favor of the diabetic patient. So diligence is required on the part of both the patient and the diabetic foot treatment team.

Whether it is an amputation of a toe or diabetic foot surgery to remove infected bone, bone spurs, or other deformities, the biomechanics of the foot are altered. The patient may then walk differently. The changes in the way someone walks can increase pressures tom part of the foot and put the patient at risk for developing another open sore.

This is why intensive monitoring after one of these episodes is so essentional.

The unfortunate reality of this however is that many doctors believe that following the patient closely is not within the guidelines of insurance coverage. In essence, they feel that this care will have to be free if they provid it. And in today’s turbulent healthcare environment, most doctors are struggling to see as many pain patients as they can.

The insurance companies have it set up in such a way that if you have diabetic foot surgery, all of your care is included in the surgical fee for 90 days. To the doctor this means that all the care that you need for the next three months is free. This only applies to doctors that Medicare or accept other insurance assignment. They are bound by the contracts that they signed.

For this reason, in most cases, the doctors will tell patients, “Just call my office if you have a problem.” But this usually is not enough. It is much more appropriate for doctors to see their patients at ever increasing intervals following surgery so that they can actually monitor the foot they operated on themselves. This type of intensive monitoring by the foot surgeon is just good medicine.

In my private practice, I would see every surgical patient within one week of the date of surgery. I would then see them one week later and one week after that. And depending on their progress might put them off for two weeks following that. But on average, most patients and had surgery would be seen six to 10 times during the postoperative period. In talking to my colleagues, I discovered that I see patients far more frequently than virtually every other podiatrist I know. But this is just good medicine.

When evaluating your diabetic foot treatment team in order to determine whether or not your doctors are providing the very best care for you, you must look closely at how often they want to see you. They should see you often.

If you have a concern and feel that you need to see your doctor, they should see right away. If you ever hear the phrase “I’m sorry, but your insurance company will not cover that.” You should become concerned.

All doctors take an oath to provide the best treatments and care for their patients. They do not take an oath to only take care of patients if they’re going to get paid well by the insurance companies that they agree to work for. Sometimes doctors just have to do what is right and not just what pays.

As long as your doctors have your best interests at heart, they will take very good care of you and you will get very intensive monitoring. This intensive continued evaluation after a diabetic foot emergency can help you prevent a diabetic foot amputation. As stated before, however it requires a great deal of diligence both from the patient and the diabetic foot doctor and team. But with this care, most diabetic patients will do well.

Diabetes amputations are preventable. Don't just survive...thrive with diabetes!



Dr. Christopher Segler is an award-winning diabetic foot doctor and foot surgeon. He firmly believes diabetic foot problems and related amputations are preventable. It is his mission to share his expertise ad teach strategies that can empower diabetic patients and stop diabetic amputations. 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.

Essential #5 of Your Diabetic Foot Team: Be Prepared to Surgically Drain Infection or Remove Gangrene.

In these discussions, we discuss each of the 7 essential skills that your diabetic foot treatment must possess. As an educated patient you will be able to evaluate the competency of your treatment team. Having a competent team will help you prevent an amputation related to your diabetes.

Today we will discuss essential skill number five:

5. If necessary, be prepared to surgical drain any infection or surgically remove any dead tissue (gangrene) at the bedside (debridement).

This is a topic that is not for the squeamish. So prepare yourself.

All amputations in diabetic patients start out as some type of foot infection. The foot infection becomes worse, the bacteria rages out of control, and gangrene sets in. Gangrene is a scary term but simply means death of tissue. Dead tissue happens to be a fabulous medium for bacteria.

This skill is the one most typically referred to as “limb salvage.” If you look up the word “salvage” in the dictionary, you will find “property saved from destruction in a calamity (as a wreck or fire).”

Only by aggressively removing infected and dead tissue can the destruction of a diabetic foot infection be halted.

Emergency surgery is very common in treating diabetic foot infections. The very best way to treat a bad diabetic foot infection is by physically removing the infection…not by giving antibiotic pills. This means opening any area of infection to remove all of the bacteria. The infected compartment of the foot has to be irrigated. This is in addition to antibiotics, not instead of antibiotics.

Your team must be prepared to perform emergency surgery if the infection is bad enough that it is deemed a “limb threatening infection.” You have to keep in mind that the diabetic patient has an immune system that is weak. Because of this one is often unable to fight off an infection.

You have to also remember that poor circulation in the feet and legs (called peripheral arterial disease) is very common in diabetics. Most people with diabetes who are at high risk of a diabetic foot or leg amputation suffer from problems with the circulation in their legs and feet. Any antibiotics are delivered through the bloodstream. So poor circulation means poor delivery of the infection fighting antibiotic drugs.

In 2005, there was a research paper published in medical journal that discussed the risk of hoping to avoid surgey in diabetic foot infections. The article was entitled “Osteomyelitis of the Foot and Toe in Adults Is a Surgical Disease Conservative Management Worsens Lower Extremity Salvage.”

Osteomyelitis is the medical term for a bone infection. The point of this paper was to stress to physicians that hoping for the best and just giving antibiotics does not work. In fact, as the title suggests, that actually makes things worse. Surgery is necessary in order to save a leg from a diabetic foot infection.

Diabetes is a scary disease. Diabetic foot infections likewise can be simple or complicated. In either case, an evaluation is warranted given the potential for the loss of a limb. This should never be taken lightly. Keep in mind that most diabetic foot ulcerations do not need to end up as an amputation.

Although all of this talk about surgery, infections, gangrene and amputations can certainly be alarming, you should remember that your diabetic treatment team is on your side. As long as they are vigilant, you should be able to avoid any of these complications. Make sure you get an evaluation early whenever you notice an open sore. And if necessary, evaluate your team based on these criteria.

Diabetic foot amputation is preventable. Live long and enjoy your life!


Dr. Christopher Segler is an award winning diabetic foot specialist. Although he has performed diabetic foot amputations, he still believes that diabetic foot amputations result from the dismal performance of a failing health care system that prevents adequate patient education. It is his passion to teach strategies that can stop diabetic amputations. 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.

Your Diabetic Foot Treatment Team: Why they must evaluate the depth and character of the wound.

In these discussions, we discuss each of the 7 essential skills that your diabetic foot treatment should possess. As an educated patient you will be able to evaluate the competency of your treatment team. Having a competent team will help you prevent an amputation related to your diabetes.

Today we will discuss essential skill number four
4. Evaluate the depth and character of the wound. (Perform a wound assessment that includes both staging/grading of infection and ischemia.)
Open sores on the feet of diabetic patients are very common. These of course are referred to as diabetic foot ulcerations. Not every diabetic foot ulcer will lead to an amputation. Having said that, most diabetic foot or amputations start as a diabetic foot ulcer.

Because of this, it is extremely important for you ta make sure your diabetic foot treatment team thoroughly evaluates any diabetic wound.

Anytime you have a serious medical condition, the first question is…how bad is it? For example if you have cancer, you want to know what stage of the cancer. The stage of the cancer will tell you the extent of the spread and likelihood that you will live or die.

In the same way, staging a diabetic foot ulcer can determine whether or not your foot will live or die. Determining the wound stage will help to determine whether or not you will need to be hospitalized, have intravenous antibiotics, surgery, or even an amputation.

Before describing the staging process, let me caution you as a patient. It is my long-held belief that medical school is a way for doctors to teach student doctors how to lose their ability to communicate with patients.

Classification systems are a very good example of this. In my residency (that had a heavy focus on diabetic foot training), my director understood this more than most. In our surgical conferences if a student or resident doctor mentioned a classification of any condition, Dr. Young would always demand that they explain exactly what that classification meant. This is a vital skill for clear communication. It shows that the doctor can know and explain what is really going on.

Many doctors lose disability. They become so familiar with the technical language and classification schemes, that they are simply unable to describe in simple terms what they see when they evaluate a wound, an illness or a condition.

So without giving you all the specifics about each of the different classification schemes, we will explain what the components are that need to be evaluated and why each is important.

The first component of a diabetic foot ulcer (open wound) classification system that should be evaluated by your treatment team is the size of the hole. It doesn’t really matter how big it is across your foot, but it doesn’t matter how deep. The skin on the foot is very thin and when a diabetic ulcer gets deeper, tendons, ligaments, and bone can become exposed and damaged or infected. Bones and joints that is clearly exposed to the external world through an open diabetic wound can only very rarely be saved.

Not surprisingly, as the wound becomes deeper. The condition is taken much more seriously. In general, skin will not just grow in and cover exposed tendons and ligaments, joints or bones. Action must be taken. In many cases this means surgery. A hope and a prayer is rarely enough.

Once your team has decided how deep it (and what tissues are exposed through the wound) they should next determined whether or not infection is present. This is usually not difficult. Any experience treatment team should be able to determine easily if the wind is infected or not. By definition, if your team cultures the wound, they believe that it is infected. See essential number three.

Next they should determine whether or not there is sufficient blood flow to heal the wound. Poor blood flow to an area is referred to by doctors as “ischemia.” You have to remember that any antibiotics are delivered to the foot through the bloodstream. If the blood flow is poor, the antibiotics can’t even get to the site where the battle is taking place. In addition, there is very little chance of the wound healing without good blood flow.

If the ischemia (or poor circulation) gets bad enough, gangrene can set in. Gangrene is nothing more than death of the tissue. It is often related to infection. Obviously is critical to your team and evaluates the blood flow to your feet whenever you have a diabetic foot wound.

If you have ischemia and an open sore on a single toe, and your treatment seem decides to amputate that toe, it is possible that the blood flow is so bad that the amputation site won't heal. This could create an even larger problem hole in your foot. It is a very basic tenant of diabetic foot surgery that the level of amputation must have sufficient blood flow to heal. Otherwise you may end up with each of your little piggy’s going to market one at a time.

By evaluating the depth of the wound ( including skin, tendon, joint, and bone involvement), presence or absence of infection, and presence or absence of ischemia, a much more realistic prognosis can be determined. All of these factors must be considered in order to determine whether or not the wound is likely to heal without hospitalization and/or surgery.


If you have a diabetic foot ulceration that is being treated without evaluating all of these factors, it might serve you well to seek a second opinion. You should also feel you have the liberty to ask your doctor whether or not you have an infection, any ischemia, or exposed tendon or bone. This is your right. Expect your doctor to explain what is going on.

Beware of doctors who feel you don’t deserve answers.

Diabetes is a complicated disease. Diabetic foot problem likewise can be simple or complicated. In either case, an evaluation is warranted given the potential for the loss of a limb. This should never be taken lightly. Keep in mind that most diabetic foot ulcerations do not need to end up as an amputation.

Although all of this talk about amputations can certainly be frightening, you should remember that your diabetic treatment team is on your side. As long as they are vigilant, you should be able to avoid any of these complications. Make sure you get an evaluation early whenever you notice an open sore. And if necessary, evaluate your team based on these criteria.

Amputations are preventable. Live long and enjoy life!


Dr. Christopher Segler is an award winning diabetic foot specialist. Although he has performed diabetic foot amputations, he still believes that diabetic foot amputations result from the dismal performance of a failing health care system that prevents adequate patient education. It is his passion to teach strategies that can stop diabetic amputations. 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.

New Technology For Treating Diabetic Wounds Has the Potential to Increase the Rate of Operating Room Infections.

Diabetic foot ulcers or an increasingly common problem. In fact, the majority of Americans will at some point require wound care treatment in order to heal diabetic ulcers, venous ulcers or pressure ulcers. To meet this growing demand, those in the wound care field are developing in producing new technologies which have a great deal of promise in helping to treat these wounds which are typically difficult to heal.

One new such technology is a water scalpel. I have personally used these devices in surgery when in residency training. I found them to be extremely helpful at removing dead and infected tissue when preparing a difficult to heal diabetic ulcer for a skin or tissue graft. Unfortunately, recent research has shown that these water scalpels can send bacteria flying through the air in the operating room and lead to potential contamination of other surgery patients.

This week at the Annual Symposium on Advanced Wound Care and the Wound Healing Society Spring Meeting hosted the largest gathering of multidisciplinary wound care specialists in America.

Research conducted by clinicians at the University of Arizona won the top award in the research poster category which demonstrated that bacteria found in diabetic ulcers and other wounds can become airborne when using the water scalpel in a mock operating room environment. This study suggests that additional precautions are needed when using these devices in the operating room to prevent the spread of dangerous infections from one wound patient to another.

Additional research is needed in order to determine ways to confirm the risk of contamination as well as develop new ways of shielding patients from these dangerous types of infections. It is already known that hospital acquired infections are increasingly common and often involve the transmission of the most dangerous types of bacteria such as MRSA.

Dr. Christopher Segler is an award winning diabetic foot surgeon, author and inventor. He is the founder of a groundbreaking private consulting firm that specializes in diabetic amputation prevention. If you or someone you care about has diabetes, you can learn more by simply 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.

What Does it Cost to Save a Leg and Prevent a Diabetic Foot Amputation?

Whenever a person with diabetes discovers that the problems leading to diabetic amputations are preventable, the first question is...what does it cost? In this video, the Director of the American Limb Preservation Society discusses the cost of limb preservation as well as the cost of having a diabetic amputation.





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.

High Rate of Diabetes and Diabetic Related Foot Amputations

Monday, December 29, 2008: the Pittsburgh Post-Gazette reports on the high rate of diabetes and diabetic related foot amputations.

It has been reported that between 2003 and 2006, the national average diabetic amputations is 1.1 amputations per 1,000 per Medicare beneficiaries. By contrast, Pennsylvania has 1.23 lower-limb amputations per 1,000 Medicare beneficiaries. That is a rate that is about 38% higher than nearby state of Rhode Island and Michigan.

The newspaper article highlights a 77-year-old type 2 diabetic who ended up with partial foot amputation. The story explains that the gentleman had a bone spur and persistent diabetic foot ulcerations, which lead to an infection. Because of the spread of the infection, it was necessary to perform a partial foot amputation in an attempt to save his leg. He had been borderline diabetic for about 10 years prior to the amputation. Amputation was followed by a stay in a nursing home, where he received powerful antibiotics.

Unfortunately many Southern states actually have even worse rates of amputations than Pennsylvania. Geography is the not the only contributing factor. It was also reported that African-Americans nationwide have a risk that is about four times the amputation rate for Caucasians. The rate is actually nearly 7 times as bad if they live in Louisiana, South Carolina or Mississippi.

Poor diet and lack of exercise are all contributing factors to these sorts of complications related to diabetes. Patterns of diet and exercise appeared to have geographic correlation.

The Dartmouth Atlas also reveals that African-Americans nationwide have four times the amputation rate of whites, with nearly seven times the national average in portions of Louisiana, South Carolina and Mississippi. Texas actually has some of the highest rates of amputation with McAllen, Corpus Christi and Harlingon being the worst areas. These areas have imputation rates that are nearly twice the national average.

The diabetic foot partial amputee highlighted in this story credits his podiatrist with saving his legs so that he can still walk. Early detection with these sorts of complications is essential to preventing a worse amputation.

Is absolutely necessary for your doctor to check your at your visit, if you are a diabetic, any new open sore or concerning area on the foot must be checked immediately. We know that early intervention can prevent open sores, infections, and amputation related diabetes. It’s hard to believe, but true, that something as simple as ingrown toenail can lead to the sort of infection results in a diabetic amputation.

Lower limb amputations related to diabetes, are often the result of poor blood sugar control, diabetic foot neuropathy, and a compromised immune system. Unfortunately, these are not the only problems and develop diabetes. Many diabetics also develop heart disease, kidney disease and blindness.

Of all of these complications, diabetic foot ulcers, wounds, and other problems that can lead to gangrene and amputation may be the most preventable. Although there has been increasing awareness of the problems related to diabetic orders, it seems to be very slow progress in the area of actual prevention of these problems. Many new technologies do exist which can aid in the detection and early prevention of the open sores that the heat infections in amputations among diabetics.

The more traditional methods of preventing these problems include seeing a podiatrist to check the pulses in the feet in order to assess blood flow. If there is any compromise of the circulation referral to a vascular surgeon may be arranged. Often times blood flow to the feet and legs can be restored through stent placement or angioplasty. Sometimes a bypasses performed in order to restore blood flow to defeat. Checking for neuropathy, or diabetic nerve damage, is also important. Diabetic shoes are also helpful in reducing friction and shear forces to the feet that can lead to open sores.

Unfortunately, even these well-documented interventions are not available to everybody. It is well known that poverty and a lack of access to podiatrists and other healthcare practitioners can increase the rates of complications leading to diabetic foot amputation.

The worst part about all of this is that we know that once in amputation does occur, life expectancy and dropped to only about 18 months. This is often because of decreased mobility, increase risk of developing pneumonia and other health-related problems.

Source: http://www.post-gazette.com/pg/08364/938218-114.stm


Dr. Christopher Segler is an author, inventor and award winning diabetic foot specialist. He is the founder of a private consulting firm specializing in the prevention of diabetic foot amputations. If you or someone you care about has diabetes, you can learn more by simply 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.

Gene Therapy may be the Future in Amputation Prevention in Diabetics with Poor Blood Flow

Cardiologists and vascular surgeons at Rush University Medical Center are now studying in innovative but investigational new medication that involves gene therapy. Researchers are working to determine whether or not gene therapy can promote new blood vessel growth in the feet and legs of patients who suffer from critical limb ischemia.

Critical limb ischemia is a condition that results in a severe lack of blood flow to the patient’s feet and legs. This often occurs in patients with diabetes. Peripheral vascular disease and disruptions in blood flow to the feet and legs are a major cause of amputation in the United States. At present, about 70% of all amputations are related to diabetes.

When a patient has diabetes, the process of atherosclerosis which clogs the arteries happens faster. If this process goes on for long enough, critical limb ischemia can develop. Because the arteries become clogged, there is less circulation to the feet and legs.

This results in a lack of oxygen and, in a sense, starves the tissues of nutrients. Without nutrients, the tissue start to die off and ulcers (or diabetic foot sores)can develop. “The goal of gene therapy is to stimulate the growth of new blood vessels. The additional blood vessels will carry more blood into the legs, alleviating pain and healing ulcers,” one of the researchers said.

The research is presently being done at Rush University involves Phase III clinical trials which will evaluate the effectiveness of gene therapy in preventing amputations in people with critical limb ischemia.

At present there are no prescription drugs at all available which can effectively treat critical limb ischemia. Because there are so few interventions that are effective, new therapies are needed in order to prevent the sorts of amputations.

This type of gene therapy is known as angiogenesis therapy, which means growth of new blood vessels. This sort of gene therapy appears to induce the production of a protein called fibroblast growth factor (FGF-1) which stimulates the growth of blood vessels at the site of injection.

The clinical trials that are now under way will last for one year. Participants are over 50 years of age, have stable ulcerations of the skin and noninfected gangrene on a foot or leg. All have also been diagnosed with peripheral arterial disease and critical limb ischemia. The participants will receive for injections of the investigational medication or a placebo into the leg muscle a two week intervals.

It is known that about 8 million people suffer from peripheral arterial disease. In the United States, that means one out of every 40 adults. It is a very common disease. It is often underdiagnosed. Because it is so common in diabetic patients, this might provide new hope for the prevention of diabetic foot amputations.


Dr. Christopher Segler is an author, inventor and award winning diabetic foot specialist. He is the founder of a private consulting firm specializing in the prevention of diabetic foot amputations. If you or someone you care about has diabetes, you can learn more by simply 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.

UNC Basketball Player: Diabetic Foot Amputation?

The Asheville Citizen just reported that UNC Asheville basketball player Kenny George has been released from the hospital after having a foot amputation. Although the patient and his parents have declined comment, is suspected that this was a similar episode was expected with diabetes and amputations.

What we do know is that the 7-foot-9, 375-pound center had to have part of his right foot amputated earlier this year. As part of that treatment he also spent three months in the hospital. The reason for such a prolonged hospitalization and amputation was that he contracted MRSA.

MRSA (or methicillin-resistant Staphylococcus aureus), is a type of bacterial infection, which is resistant to many antibiotics. This is now a much feared complication of hospitalization and surgery performed in hospitals throughout the United States. About 10 years ago, the vast majority of these infections were contracted while patients were in the hospital. Today these infections are growing more and more common. In some communities 85% of all skin and soft tissue structure infections involve the drug-resistant bacteria.

Because these bacteria have become more resistant to most of the antibiotics that are taken by mouth, it is often necessary for a patient to be hospitalized in order to treat the infection. These intravenous (I.V.) antibiotics are typically very expensive. Often times the antibiotics can cost $1000 per day. If these infections move into the bone, surgery and up to six weeks of antibiotics can be necessary.

In diabetics, the only effective way to reliably treat these infections is through amputation of the foot. Diabetes substantially reduces a person’s ability to fight off one of these infections. MRSA infections are much more common in people with diabetes. Recent research has shown that about 70% of all amputation to related to diabetes. Although it is not clear that this basketball player is diabetic, it is certainly unusual for a non-diabetic patient to end up with a sort of problem particularly at a young age.

At the end of November, the patient was released from the hospital and is at home recovering. It is hoped that the infection has now been completely cleared.


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.

National Health Service Increases Funding for Diabetic Foot Programs Related to Podiatry

Children with diabetes in certain areas of the United Kingdom will be getting extra financial support.

The National Health Service has recognized the critical nature of funding diabetic programs for children. His most recent funding will help to pay for pediatric diabetic nurses as well as psychological support for children with type 1 diabetes. It is known that type 1 diabetes in children is linked with high levels of depression as well as eating disorders.

In addition to counselors who specialize in diabetes related to children and pregnancy, extra podiatrists have been added as well. For many years podiatrists in the United Kingdom have been recognized as critically important to preventing complications lead amputation. They have recognized that intensive monitoring by foot and ankle specialists, particularly podiatry, lead to early interventions and help to provide rapid treatment for diabetic foot ulcerations and open sores that can lead to amputation.

It has long been known that open sores in diabetic patients can rapidly become infected and lead to gangrene. Is also known that bone infections known as osteomyelitis are typically preceded by diabetic foot ulcers.

The hope of the additional funding is that diabetic patients will taking off of waiting lists and will be able to be evaluated sooner.

In addition to funding for type 1 diabetic patients, there’s a great need to assist with those with type 2 diabetes. Type 2 diabetes is becoming increasingly common. This rising type 2 diabetes, directly correlates with the increase in obesity within any given population.

At present, approximately 10% of the entire National Health Service annual budget is spent on treating diabetic foot ulcers, open sores on the feet, diabetic foot infections, and other diabetic foot complications.

Is well known that by having patient work closely with their primary care doctors and podiatrists, it is easier to keep diabetes under control and prevent diabetic foot amputations. It is also important to make sure that they podiatrist is closely involved one of diabetic patient begins a new program of exercise to help control the persons blood sugar.

Diabetes is not have to lead to amputation. With good blood sugar control, proper diet and exercise, diabetic patients can hope to lead a healthy and active life.



Dr. Christopher Segler is an award winning diabetic foot surgeon, author and inventor. He is the founder of a groundbreaking private consulting firm that specializes in diabetic amputation prevention. If you or someone you care about has diabetes, you can learn more by simply 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.

American Limb Preservation Society Site is Up!

The new website for the ALPS is now up. It will be full of diabetes facts and information about diabetic foot sores (diabetic foot ulcers), foot infections, and diabetic amputation prevention. Go to www.ineedmyfeet.com to learn more about staying healthy and active, in spite of your diabetes.


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.

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.

Statistics on Life Expectancy After Diabetes Leg Amputation from Gangrene

One question I was asked recently is was... What are the statistics on life expectancy after diabetes leg amputation from gangrene?

Well, I wish I had good news. Whenever a loved one gets gangrene, it can be traumatic. Not just for the diabetic who winds up with an amputation, but the spouse as well. The kids, the whole family take a beating emotionally. They see the foot turn black, they smell the foul odor. They watch their loved one go from a lively person to someone who will be luckey to ever walk with a prosthetic leg.

Dancing on your 50th wedding anniversary..nope. Going for 18 holes of golf..nope. Running down the street to teach your grandson to fly a kite...nope. So the patient sees all these things that were taken for granted, drifting away. And the family sees it too. Then they start to wonder about the bigger picture. How long can you live after an amputation?

The statistics regarding diabetic life expectancy after an amputation related to diabetes complications (such as gangrene, diabetic foot infections, and bone infections (osteomyelitis)) are quite bad. Every 30 seconds a limb somewhere is amputated as a consequence of diabetes.

In fact, we know that diabetes makes you 46 times more likely you will have an amputation. Within one year after a diabetic foot amputation, 26.7% will have another amputation. Three years after the first diabetic amputation, 48.3% will have another amputation. Within 5 years of a diabetes related amputation, 60.7% will have another amputation.

If that isn't bad enough, diabetics with amputations don’t live very long. We know that about 50% of all diabetics with an amputation are dead 3 years after the amputation.

65% of all of those with a diabetic amputation are dead 5 years.

In spite of this, there is hope... most are preventable. Watch your blood sugar. Check your feet every day and see a podiatrist, podiatric surgeon, or foot surgeon specializing in diabetic limb salvage if you start to get any open sore or wounds on your feet. Do not wait until it is infected.

With these simple interventions you can keep your feet. And maybe you will dancing on your 50th after all.


Dr. Christopher Segler is an award winning diabetic foot surgeon, author and inventor. He is the founder of a groundbreaking private consulting firm that specializes in diabetic amputation prevention. If you or someone you care about has diabetes, you can learn more by simply 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.

Diabetic Former Pro Baseball Player. No Legs and No Hall of Fame.

Ron Santo is true icon in baseball. And he has seen some tough times. If nothing else, he knows how to persevere.

If you don’t know him, he has too many records to list. Here are a few. Santo played third base for the Chicago Cubs from 1960 to 1973. During his career, he was a 9-time All Star, won 5 consecutive Golden Glove Awards, and is the only third baseman in history to go 8 straight seasons with 90 runs batted in. In addition he is true team player as evidenced by the fact that from 1966 to 1974 he held the NL record for assists in a single season.

By any measure he should be a Hall-of-Famer. But again this year its not in the cards. "Everybody felt this was my year," Santo told the Chicago Tribune paper on Monday, in his typical gracious manner, even though the years are slipping away.

He is already 68 years old. No spring chicken for a double amputee with diabetes. "To me, two years, because of what I have with the diabetes and [getting] older, it's like eternity," he recently said. He is not alone, because every 30 seconds, another leg is cut off due to diabetes related complications. Statistically, most people who have diabetes are dead within 5 years of having amputations of both legs.

Santos has fought with diabetes for decades, but kept it a secret for most of his career with Cubs. In the late 1960’s he started having trouble. The pro baseball player ended up with the common diabetic sores that led to more than 24 surgeries and partial amputation of both legs. But he still roots for the Cubs from the bench.

"I don't know how he does it; his spirits are always up," said his friend Savelli. "I'm sure he's taking it like a man. Ronnie's a hard-core guy. He has to be to take all he's taken. I'd have been dead a long time ago."

Santos is one of those lemons-from-lemonade types. Whenever he is not working as a member of the Cubs broadcasting team, he is fighting diabetes through community involvement and fundraising. He started the Ron Santo Walk to Cure Diabetes about 30 years ago. Through that effort he has raised $60 million for juvenile diabetes research. He keep high hopes both about a cure for diabetes, as well as his chances for induction into the Hall of Fame.

Personally, I hope he gets both.


Dr. Christopher Segler is an award winning diabetic foot surgeon, author and inventor located in Chattanooga. He is the founder of a groundbreaking private consulting firm that specializes in diabetic amputation prevention. If you or someone you care about has diabetes, you can learn more by simply 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.