My father going into hospital tomorrow to have at least a toe amputated, possibly more. :(

[duchesse]

To cut a long story short, he's had an injury on his toe from dropping a log on it in January that has refused to heal, and in the last couple of months his foot has gone black. We've all been nagging at him to see a doctor but he refused until today . He's been told he has gangrene in his toe and will lose it, and may lose his foot or even up to his knee. It appears that he has circulation issues in his legs (his veins are blocked) and he may need a bypass.

He's a hospital and doctor-phobic who is now going to be in hospital for at least 10 days.

Does anyone have any experience of this and is there anything he can do that the doctors may not advise him on (supplements etc.?) I was thinking that Gingko may be a good idea.

We are all very worried obviously.

Bumping as I don't want to keep googling- it's too horrible. Hoping for some advice that comes without hideous amputated toes and feet pics.

Very sorry to hear this - hope he, and you, are as well as can be.

I have no helpful advice, alas. Other than to say avoid the supplements for now and speak to the docs and see what they'd advise. You really don't want to be adding in anything that may react with any of his meds, or add in new clinical effects of their own.

If the docs are happy, maybe arnica tabs? Some people seem to feel that there have been clinical studies proving the effectiveness (in promoting healing); others might feel they have no effect so would prefer you not to; and others might think as they seem to have no effect, why the hell not?!

Better surely to ensure that he is getting enough rest and a healthy diet, and taking exercise as and when he should. Keep an eye in particular on the diet as hospital food can be shite. Maybe supplement with extra healthy stuff?

Best of luck.

Ah, he's in France- they have 3 course meals twice a day there. Malnutrition shouldn't be too much of a worry thankfully! Everything else is.

Hi duchesse, I am a vascular nurse. Are they planning on doing the bypass at the same time as the amputation? If they are able to repair the blood supply and your father doesn't have other medical problems that will impair healing (i.e. diabetes, smoking) then he should heal well. They will remove the minimum they can to the point of adequate blood supply and even if they amputate to below the knee, he will still be able to use a prosthesis. In terms of recovery, if he has toe or partial foot amputation he will be able to sit out the day after surgery and usually start to mobilise on day 2 (with physio input). If he requires leg amputation then things obviously take longer, but he will still be encouraged to sit out of bed day 1-2 post-op. I find the delays are caused by awaiting wheelchairs and home adaptations but this will probably vary from area to area. The district nursing team will be able to continue his wound care at home so it's usually mobility and social care issues that cause longer hospital stays. In terms of what he can do, ensuring he has a good diet to promote wound healing, stopping smoking (if he does), sitting out of bed/mobilising as and when he can to reduce the risk of post-op chest infections. I hope some of that helps

Has he got diabetes by any chance?

oh goodness what luck bettyboo. We don't much apart from what his partner has told us. He doesn't want anyone told as he is so very scared that he doesn't want to have to deal with us being scared as well ifswim.

He doesn't smoke but does drink a lot.

He's in France and as far as I know he is staying in for at least 10 days. The problem is that he has neglected this injury for so long that they don't know what they'll find. We don't think he has diabetes (no obvious symptoms) but since he won't ordinarily go anywhere near doctors we really don't know.

We are crossing our fingers that they only have to take the affected toe.

His partner will keep us updated after his op. He will have at least the toe removed on Friday and I think they are doing the bypass at the same time. We are just so worried because we've been nagging at him for months (ie it's been going on for months) and he's just been saying it's gout. He only went when my sister went ballistic at him and threatened to send her GP down to him when she saw the state of his foot.

Double luck:

1. that he's in France, so will eat well, and
2. that a vascular nurse should chance upon this thread.

Probably luck also comes in three's, so this is a Good Omen !

Just spotted he was in France after I posted! Discharge planning will probably be different but otherwise care should be the same. You're right about better food though That's good that they're doing the bypass at the same time as only the one anaesthetic to go through. We would usually check glucose alongside routine pre-op bloods (as often people with circulatory disease are diabetics). If he drinks a lot more than he should this can sometimes cause confusion after anaesthetic - due to the body withdrawing. It is a short term problem and can be managed with a 7 day course of medication so it might be something to bear in mind should his partner voice any concerns. Try not to worry, he sounds like he is normally fit and active which all leads to a quick recovery. Let us know how he gets on

They should be able to see that his blood is 70% pure ethanol on all the tests they run shouldn't they? And compensate for it. I think he's having loads of tests today and the op tomorrow.

I have no knowledge of this op., but read your post and wanted to wish your Father all the very best and a speedy recovery, also thinking of you as I know how worrying these sort of things can be

Thanks all. I just spoke to my sister and she said that as far as they know they are only taking the toe off, but of course they do not know what they will find after they've done that. We are so hoping that they only have to take off the toe and can sort out his blood vessels so that the circulation recovers at least a bit.

So fed up with my bloody 3rd sister- she's now wading in by phone and email from Thailand to chip in about bloody homeopathy! Has sent me a crazy email full of exclamation marks telling me exactly what he should be having before/instead of taking the toe off. I emailed to tell her about the dodgy veins- no amount of homeopathy is going to reopen those I'll wager.

Bettyboo- I meant to ask if you thought that it would be possible for a person's veins to be badly damaged by 6000km of driving on dirt roads in a jeep with no suspension. This was their big trip last year- Quebec, Labrador and Newfoundland. He did all the driving and the foot that's affected is the accelerator one, that had the heel resting on the floor for 3 weeks on bumpy tracks. Is it possible that it's some kind of extreme RSI a bit like pple who use chainsaws are supposed to get? Just asking because that would limit it to one side only which would be even more manageable.

I don't think it would affect his circulation, the only thing it could cause would be a sore to his heel which the poor circulation could affect the healing of. The circulation to his other leg may be ok anyway, they should know that already from the MRI scans they'll have done on his legs to identify the need for a bypass in the first place.

Hi there, just to say I've been there, and good luck for it all - the vascular nurse will give much more detailed info, but here's my story for what it is worth.

My dad had excruciating pain in his toe, and it turned out to be vascular disease, linked to undiagnosed diabetes, rather than an injury like your dads.

He ended up very ill with the gangrene, after attempts to repair/replace the artery failed, and had a below the knee amputation.

Traumatic as that clearly was, he felt remarkably better after the amputation, he had not realised just how ill he had been feeling till he had it removed. He walked again very well once he got his new leg, and went on to fulfill some career ambitions too, not letting it hold him back at all.

Hope your dad gets on well.

Thanks apprentice- we're extra-worried about my father because he is 72 and tends to have a rather pessimistic outlook. Losing his leg would be hideous for him- he may not recover. He's a big man and proud man and he will not cope well with the temporary indignity.

Just spoke to my father. He hasn't had the op yet but has had a battery of tests which have shown that his arteries in both legs are blocked. They are going to do a leg bypass op as soon as the surgeon has worked out exactly what he's doing. Apparently as he has had no other health problems there was no way of working out about the arteries until this toe injury refused to heal.

Duchesse, my dad was told that he 'must' have diabetes, as he too had no other symptoms etc, until the pain in the toe. However, the arterial disease is the problem, what caused it is I suppose immaterial.

Glad to hear they are going to try the bypass - he will be very relieved that every option is being considered before the radical.

had you asked me before this happened I would have said my dad would not have coped - but he did, very well, and I was very proud of the way he handled it over the longer term, although he was in denial/disbelief about the need for it for a while before hand.

This was around 12 years ago, when my dad would have been about 65 or so, so not so far off your dad's age.

Once again, I hope all goes well.

Apparently my father had been soaking his foot in strong antiseptic twice a day for several months. His doctors think is the only reason he is still alive and not dead from septicaemia. His foot has appears to have very little bacterial infection in it at all. He's not is bad physical shape at all for a 72 yo heavy drinker. He hadn't even been near a doctor for 50 years until last Tuesday but finally had to admit defeat with the TCP. Thank goodness he was soaking the foot so obsessively, eh?

I only have experience of a toe amputation. My father lost one through diabetes about 8 years ago. Got an infection in it, went to the dr who gave him antibiotics and told him to come back in a fortnight. He got very sick but insisted he would be ok.

He ended up in a and e thank goodness where they actually looked at it and took proper action. We were told they would have to take the toe off, possibly the foot depending on how far the gangrene had spread. Luckily he only lost a toe.

He was told that the others would move over and, sure enough that's what's happened. Now you have to look twice to notice. However, since the operation he has been left with something called Charcot foot which affects bones in the foot from what I can remember. He has to wear a special show insert all the time and should never go barefoot. The sole of his foot is completely flat but otherwise he's now fine.

That's all I know. I don't know about the rest of it. I hope your dad is ok.

my fil had two toes amputated, but then about 10 months later the rest of his lower leg. In his case he got blood poisoning after another op and the veins packed up. He was told they would always take off the smallest possible amount.

it took him a week or so to come home, then had a wheelcahir, and prothesis. He adapted well and the leg was in fact the least of his problems. He stayed independent but had physio and check ups.

the real irony was he was turned down for DLA on the first application (despite the fact that he also had an ileostomy and had endocarditis and therfore also had a artificial heart valve and drugs etc to control the log term effects of that)

My father is having the last two knuckles on the middle toe taken off on Tuesday, and a leg bypass on the worst affected leg at the same time. They have been running tests on him for 10 days now to assess whether his heart is strong enough for such a long operation. Apparently though he has the heart of an ox despite the legs of a pigeon and now he's all marked up and ready to go under the knife. He is very afraid.

My father's operation has started- it's a 5-hour op as they are doing a leg bypass at the same time. Keep fingers crossed for him please. Thank you to everyone who has related their relatives' experiences of this.

Fingers crossed fro him duchesse, - I hope everything goes well and he makes a good recovery

that he is afraid, - its very natural to be scared, but they are usually very good at reassuring people in hospital.

Just wanted to say that my mum had this op about 8 years ago. She was told she might lose the whole leg but in the end it was just the toe. She was worried about walking afterwards as she had been told that the big toe was needed for balance. She has had no problems walking. She does not have diabetes but had been a smoker years ago the vascular surgeon said her veins (?arteries) looked like smokers ones. She has had no problems in her other leg until fairly recently (she is 83) but they do not want to do a by pass yet. She was put on cholesterol lowering drugs afterwards.