One of my good friends is facing amputation- any alternatives?

[Vash01]

A good friend of mine (Bobbie)called me today to give me an update on what was happening to her. I knew she was in the hospital with a foot infection and she had indicated earlier that she may have a long recovery time. She gave me the details today.

It started with a spider bite, but turned into something much more serious. The doctors found stress fractures and infection in that foot. The infection had spread to the bone (but the blood came out OK, after lab tests). They removed parts of the bone in the first surgery, but now they are talking of amputating her below the ankle or below the knee. She has not received much information from the doctors, and she has been told not to eat or drink anything. She is afraid that they are preparing her for surgery.

I don't have a medical background, but wouldn't they require the patient's permission to perform surgery on her? She needs to get approval from her insurance, and the hospital has not contacted her insurance. She feels comfortable with one of the doctors that are treating her, but she has not been seen by a doctor since yesterday. That sounded odd to me.

My first thought- as a non-medical person- is: Is there a way to avoid amputation? I am wondering if there are any alternative therapies that could cure an infection (I am probably being very naive here)? I just asked her not to rush into anything and get all her questions answered first by the doctors. They have not even told her which rehab facility she would be moved to, two days after the surgery. That seems very odd to me.

She is taking this bravely but I know that it's going to be really tough for her to adjust to a new life. I am hurting for her because she has been a good friend not just to me (I always call her as a sounding board, or if I have a question, need help, etc.) but to a lot of other people. I just want to help her, and will, but I am also interested in finding out if she has an alternative to an amputation.

She mentioned to me today that she has diabetes (I didn't know that) and she has staff infection in her foot. It's just a terrible turn of events for her that's going to permanently change her life.

[Coco]

I don't have anything to say, but I'm so sorry for your friend. That sounds scary and horribly overwhelming.

[danceronice]

Well, not a doctor, but absolutely, unless she's a minor child they cannot operate on her without her consent. She should definitely be asking for second opinions and she needs to give informed consent.

However, from what I do know of it, if she's diabetic and has a deep bone infection and they're talking amputation it is probably VERY serious and that may be the best option. Doctors generally do not go around cutting limbs off if there are alternatives available and toe and foot amputations do happen in diabetes cases.

[aliceanne]

I had a diabetic co-worker who died from an infection that he got by trying to cut an ingrown toenail. The whole episode happened in a matter of days. I believe the cause was gangrene.

[dbell1]

My dad lost his right leg below the knee to an infection. It was back in 2002. The first infection was in the sole of the foot. Squeamish alert here - the doctor literally dug around the hole and dad felt nothing. Quick recovery, he went to rehab, learned to drive, walk, worked for 3 years after that - he was in his late 60's at the time.

In February 2008, he lost the left leg below the knee to another foot infection. It was MRSA. They tried everything to save the leg - another squeamish alert here - the doctor cut bits of the heel off for months trying to save it. By the time they amputated, he was weak, in poor health, and out of hospital days allowed with no rehab time available - he came home 6 days later. He died within 3 months.

A coworker last year was walking his dog and was hit by a car that pinned him into a phone pole. He almost died several times while they tried everything to save the leg. Finally, it was decided to amputate. He left the ICU finally and is now getting a special prosthetic so he can run again.

So, I'd say have her do a few things. Ask to talk to the infectious disease specialist. If they don't have one, she needs to get to a hospital that has one. Get a second opinion. Get another one. And this 'don't eat or drink thing' - have her find out why. A patient needs to ask questions. They need to be well informed. And if she's too freaked out to do it, then get involved with her permission or get her family involved and have them start asking questions about treatment information, the future, options, and prognosis.

Good luck to your friend and PM me if you have any questions.

[Vash01]

My dad lost his right leg below the knee to an infection. It was back in 2002. The first infection was in the sole of the foot. Squeamish alert here - the doctor literally dug around the hole and dad felt nothing. Quick recovery, he went to rehab, learned to drive, walk, worked for 3 years after that - he was in his late 60's at the time.

In February 2008, he lost the left leg below the knee to another foot infection. It was MRSA. They tried everything to save the leg - another squeamish alert here - the doctor cut bits of the heel off for months trying to save it. By the time they amputated, he was weak, in poor health, and out of hospital days allowed with no rehab time available - he came home 6 days later. He died within 3 months.

A coworker last year was walking his dog and was hit by a car that pinned him into a phone pole. He almost died several times while they tried everything to save the leg. Finally, it was decided to amputate. He left the ICU finally and is now getting a special prosthetic so he can run again.

So, I'd say have her do a few things. Ask to talk to the infectious disease specialist. If they don't have one, she needs to get to a hospital that has one. Get a second opinion. Get another one. And this 'don't eat or drink thing' - have her find out why. A patient needs to ask questions. They need to be well informed. And if she's too freaked out to do it, then get involved with her permission or get her family involved and have them start asking questions about treatment information, the future, options, and prognosis.

Good luck to your friend and PM me if you have any questions.

So sorry for your father.

My friend is not afraid of asking questions, but somehow nobody is around her (doctors, nurses) which sounded odd to me. That was in the morning. May be she has been able to talk/ask questions later in the day. I will pass on to her the information about infectious disease specialist.

[Anita18]

I had a diabetic co-worker who died from an infection that he got by trying to cut an ingrown toenail. The whole episode happened in a matter of days. I believe the cause was gangrene.

That's so sad and scary.

I definitely agree that she needs to ask second opinions, but if she has diabetes, infection on her extremities can spread VERY fast because of poor circulation. Her immune system won't be able to get to the infected spot, so it basically runs rampant. So if they have an infectious disease specialist on site, definitely ask to see them right away. And if they don't, start asking questions NOW about how serious this is and about a timetable. If she's still at the hospital, have her flag someone down. Push that "I'm stuck on the toilet" button if she has to. There's no time to lose. Her having diabetes changes everything.

[Cheylana]

No suggestions, I just hope things work out ok for your friend.

[heckles]

It started with a spider bite, but turned into something much more serious. The doctors found stress fractures and infection in that foot.

Was it a brown recluse spider? Those are bad news. How much does your friend weigh? I've known of cases in which a doctor has assumed gangrene on an obese patient's has spread so much that amputation was in order, but once it surgery, it was determined out that the patient's fat had literally protected the muscle and bone from the gangrene. You don't hear about obesity benefiting someone's health often, but there you have it. Might be something for your friend to consider. Hope she'll be able to avoid amputation.

[GarrAarghHrumph]

It's not that unusual that they don't yet know which rehab she'll be sent to. The hospital has a social worker on staff that can help her with that part of it. She or her family can ask to speak to the social worker.

[TheGirlCanSkate]

If this is the US - hospitals offer a social worker who is the patients liason with the hospital. They introduce themselves as you are admitted. She might want to ask her back to help her get questions.

The most important is for your friend to have a family member or friend who can stay with her to help her get answers and make sure she understands the answers. To be alone is an awful thing.

[Scrufflet]

A good friend of mine (Bobbie)called me today to give me an update on what was happening to her. I knew she was in the hospital with a foot infection and she had indicated earlier that she may have a long recovery time. She gave me the details today.

It started with a spider bite, but turned into something much more serious. The doctors found stress fractures and infection in that foot. The infection had spread to the bone (but the blood came out OK, after lab tests). They removed parts of the bone in the first surgery, but now they are talking of amputating her below the ankle or below the knee. She has not received much information from the doctors, and she has been told not to eat or drink anything. She is afraid that they are preparing her for surgery.

I don't have a medical background, but wouldn't they require the patient's permission to perform surgery on her? She needs to get approval from her insurance, and the hospital has not contacted her insurance. She feels comfortable with one of the doctors that are treating her, but she has not been seen by a doctor since yesterday. That sounded odd to me.

My first thought- as a non-medical person- is: Is there a way to avoid amputation? I am wondering if there are any alternative therapies that could cure an infection (I am probably being very naive here)? I just asked her not to rush into anything and get all her questions answered first by the doctors. They have not even told her which rehab facility she would be moved to, two days after the surgery. That seems very odd to me.

She is taking this bravely but I know that it's going to be really tough for her to adjust to a new life. I am hurting for her because she has been a good friend not just to me (I always call her as a sounding board, or if I have a question, need help, etc.) but to a lot of other people. I just want to help her, and will, but I am also interested in finding out if she has an alternative to an amputation.

She mentioned to me today that she has diabetes (I didn't know that) and she has staff infection in her foot. It's just a terrible turn of events for her that's going to permanently change her life.

OMG OMG! I just about gagged when I saw this! I have had an infection in my bone in my foot, am diabetic and have come across doctors who want to amputate! Get to an infectious diseases doc ASAP! Infection is a really big deal for diabetics and we simply don't have the immune systems to ward it off. My doc was committed to saving my foot and put me on a portable drip antibiotic for 6 months. The name of the drug is Ceftazadine (most medicalpeople have never heard of it) and I got 3 huge doses per day. Many doctors will prescribe for about 2 weeks and then the infection returns. So many docs don't know what to do and are too quick to amputate! Along with an infectious diseases doc, your friend needs to have a really good chiropodist who specializes in diabetic wound management; needs to be done every few weeks. Egads, I am rambling but this is so serious! Please pm me or write here with any questions. Time is of the essence! If your friend is in or near Toronto, I'll be happy to give contacts!

[Vash01]

Was it a brown recluse spider? Those are bad news. How much does your friend weigh? I've known of cases in which a doctor has assumed gangrene on an obese patient's has spread so much that amputation was in order, but once it surgery, it was determined out that the patient's fat had literally protected the muscle and bone from the gangrene. You don't hear about obesity benefiting someone's health often, but there you have it. Might be something for your friend to consider. Hope she'll be able to avoid amputation.

I don't know what kind of spider it was (I did not ask her). She is overweight, however, so what you wrote may apply to her. I will pass on the info.

[Vash01]

OMG OMG! I just about gagged when I saw this! I have had an infection in my bone in my foot, am diabetic and have come across doctors who want to amputate! Get to an infectious diseases doc ASAP! Infection is a really big deal for diabetics and we simply don't have the immune systems to ward it off. My doc was committed to saving my foot and put me on a portable drip antibiotic for 6 months. The name of the drug is Ceftazadine (most medicalpeople have never heard of it) and I got 3 huge doses per day. Many doctors will prescribe for about 2 weeks and then the infection returns. So many docs don't know what to do and are too quick to amputate! Along with an infectious diseases doc, your friend needs to have a really good chiropodist who specializes in diabetic wound management; needs to be done every few weeks. Egads, I am rambling but this is so serious! Please pm me or write here with any questions. Time is of the essence! If your friend is in or near Toronto, I'll be happy to give contacts!

I just saw your PM, so here I am to read your post. I will definitely pass on the info to my friend. I hope she does not rush into a surgery. I will call her right now.

[Vash01]

It's not that unusual that they don't yet know which rehab she'll be sent to. The hospital has a social worker on staff that can help her with that part of it. She or her family can ask to speak to the social worker.

She did not mention a social worker, but this is a very reputable hospital (Banner health), so I am sure they have those.

If this is the US - hospitals offer a social worker who is the patients liason with the hospital. They introduce themselves as you are admitted. She might want to ask her back to help her get questions.

The most important is for your friend to have a family member or friend who can stay with her to help her get answers and make sure she understands the answers. To be alone is an awful thing.

Yes, it is the USA (Arizona). She has a friend with her, from what she told me. Her brother is arriving March 7th. Not sure why he wants to wait that long. If it was my sibling, I would take the first flight out to be with her/him. I should not judge others; he must have his reasons.

[Scrufflet]

She did not mention a social worker, but this is a very reputable hospital (Banner health), so I am sure they have those.



Yes, it is the USA (Arizona). She has a friend with her, from what she told me. Her brother is arriving March 7th. Not sure why he wants to wait that long. If it was my sibling, I would take the first flight out to be with her/him. I should not judge others; he must have his reasons.

The brother may not be clued in to how serious diabetes is. My family doesn't get it. A lot of people don't. I have had this disease for over 40 years and, thank goodness, have a husband who does get it (he has a medical background). I've been close to death several times, had hip surgeries, and other countless problems related to this disease. It's not an easy fight but there is hope. Even my friends don't "get" it. Some will think you are whining or exaggerating. They will not believe that there are some things you can't do because you look good, don't you? Or, there will come a day when you'll be better. You won't! You will either maintain or get worse; that's the nature of the disease.

It might be a good idea for the friend to urge the brother to come sooner. She certainly needs someone to advocate for her. Really wishing the best for your friend. Can't stop thinking about this.

[skatesindreams]

Staph infections are very serious and can lead to even more severe complications.
Advise your friend to get to a specialist/second opinions, ASAP.
With the correct treatment, the outcome doesn't have to be terrible.

However, time can be of the essence, depending on the bacteria involved; and whether it responds to antibiotics.

[Vash01]

I had a brief conversation with her this morning (she had to answer another phone call in the midst of it, so it was a short conversation). She was in good spirits. She had discussed the situation with her doctors (one of them is an infection specialist) and it sounded like her infection is quite advanced/serious, and that surgery is unavoidable. She seems to have accepted her situation, which is always helpful emotionally. All of us are sending her positive vibes.

This has been an eye opener for me. I have long thought of preparing a speech about Diabetes (I will need to do more research before I am ready). After reading Scrufflet's post, I think it is important to educate people on how dangerous this disease is. It's not completely avoidable because a part of it depends on genetics, but once you have it, it can lead to very bad complications. Luckily we have medicines that help manage it. My grandfather died from complications resulting from diabetes because early detection was not possible those days. I have a cousin who had to go for dialysis, and I have heard of even worse cases. People are less afraid of diabetes than they are of cancer, and probably with some justification, but diabetes affects the quality of life so much! This event is going to completely change the lifestyle of my friend. She has always been a very independent person; rarely asking others for help. Now she has to depend on others to some extent.

[heckles]

The brother may not be clued in to how serious diabetes is. My family doesn't get it. A lot of people don't. I have had this disease for over 40 years and, thank goodness, have a husband who does get it (he has a medical background).

Some people overestimate the power of modern medicine. They think that every condition just requires a quick surgery or round of medication, and then you're as good as new.

[milanessa]

They think that every condition just requires a quick surgery or round of medication, and then you're as good as new.

My mother to a T.

Good luck to your friend, Vash.