Help!!! Bad Sore!!! Amputation!!!

[GoTWHeeLs]

Things have gone from bad to very bad in three weeks time. About two months ago we noticed I had a sore on my foot(under and on the side of my right pinky toe knuckle, so we went to the wound care center to have it looked at and the doc tells me "it's not bad at all, you must have had your foot in an akward position and this is the result. I want you to switch the style of shoe your wearing and apply this Iodasorb to the wound daily and dress it thickly with gauze which will absorb the drainage and will also provide a cushion." That was that. I was familiar with the doctor because he had helped me heal two other wounds previously, but we had heard alot of bad things about some of his methods. So anyways, I go back weekly for about a month and it continues to get worse, but he wouldn't suggest any changes so I switched doctors. The next week the new doc tells me how bad it really is and that its infected and going threw the muscle. He wanted X-Rays taken to make sure the infection wasn't setting into the bone and for us to return in two days. We return and two days later not only was the infection not in the bone but it had gone away due to the antibiodics. He switches me to an ointment called Mupirocin, tells me to dress it twice a day and come back in a week. Since then I have been there 5 times in three weeks and we are NOT seeing any improvements. On tuesday he told me that he is considering a surgery in which he will remove my right pinky toe and its knuckle along with alot of tissue.I have recently purchased a boot made of egg-crated foam that is ridiculously oversized, and I have constantly been elevating my feet. Is there anything else I can do? Do I have other options than amputation? Should I consult with another doctor? I can't stay in bed classes start next monday, should I drop this semester? What in hell can I do? I've been very positive threw this SCI thing, but im starting to get a little frustrated. I need your alls help, please. Thanks.

-Chris

PS- The edit was me removing the bad words, they felt good coming out, but they werent appropriate.

[darkeyed_daisy]

Chris, I almost lost my foot in a similar episode in 1993. Mine had turned into osteomylitis though and I had to have a muslce transplant and flap.

If these doctors are not wound clinic doctors then I would not waste my time. You need a wound clinic doctor. Have they done any debridement or whirlpool to encourage the tissue to regenerate? If not, I would try that route before surgery. Salve will not cure these kinds of wounds....

I hope it heals soon....

[GoTWHeeLs]

What's salve? They are wound doctors and he debrides it every week. I will be sure to mention the whirlpool. Whats an oxygen chamber?

[Wise Young]

As I understand it, you are making progress. You had an infected pressure sore that has responded to antibiotics. Now, the task is to get to to heal. Your doctor has recommended amputation of part of the food to speed the healing. You are panicking due to this recommendation.

Every situation differs and it is difficult to second-guess a doctor's recommendation. Certainly before you have the surgery, you need to get another doctor's opinion. Note that this is not always resolve the situation because doctors can disagree with each other. But at least you have a choice.

In general, my experience is that people can get even the worst pressure sores to heal without amputation. There are many approaches and it takes time. Many doctors make the recommendation thinking that you will never walk again and therefore don't need the foot. On top of this, you are probably putting a lot pressure on the doctor, asking him why it is not healing etc.

Regarding school, it is unfortunate that this occurred at this time but you should understand that it will not heal in a few weeks. It may take months. The good news is that you have stopped the infection. Ways of speeding up healing include eating well (a lot of protein and vitamin C).

Wise.

Things have gone from bad to very bad in three weeks time. About two months ago we noticed I had a sore on my foot(under and on the side of my right pinky toe knuckle, so we went to the wound care center to have it looked at and the doc tells me "it's not bad at all, you must have had your foot in an akward position and this is the result. I want you to switch the style of shoe your wearing and apply this Iodasorb to the wound daily and dress it thickly with gauze which will absorb the drainage and will also provide a cushion." That was that. I was familiar with the doctor because he had helped me heal two other wounds previously, but we had heard alot of bad things about some of his methods. So anyways, I go back weekly for about a month and it continues to get worse, but he wouldn't suggest any changes so I switched doctors. The next week the new doc tells me how bad it really is and that its infected and going threw the muscle. He wanted X-Rays taken to make sure the infection wasn't setting into the bone and for us to return in two days. We return and two days later not only was the infection not in the bone but it had gone away due to the antibiodics. He switches me to an ointment called Mupirocin, tells me to dress it twice a day and come back in a week. Since then I have been there 5 times in three weeks and we are NOT seeing any improvements. On tuesday he told me that he is considering a surgery in which he will remove my right pinky toe and its knuckle along with alot of tissue.I have recently purchased a boot made of egg-crated foam that is ridiculously oversized, and I have constantly been elevating my feet. Is there anything else I can do? Do I have other options than amputation? Should I consult with another doctor? I can't stay in bed classes start next monday, should I drop this semester? What in hell can I do? I've been very positive threw this SCI thing, but im starting to get a little frustrated. I need your alls help, please. Thanks.

-Chris

PS- The edit was me removing the bad words, they felt good coming out, but they werent appropriate.

[GoTWHeeLs]

Your doctor has recommended amputation of part of the food to speed the healing. You are panicking due to this recommendation.

Are you saying that he said this to make panic? If that is the case, how am I suppose to trust him now? I don't understand.

[Broknwing]

Are you saying that he said this to make panic? If that is the case, how am I suppose to trust him now? I don't understand.

If I understood what he said right, is that maybe you were asking/pressuring the dr why it's not healing faster, he suggested surgery as an agressive route to wound healing...and that is what you are panicing about...Personally I think that amputation is an awfully agressive route to go at this point...No, it hasn't shown signs of improvement over a couple weeks, but sometimes that happens, yes it's frustrating as h*ll...I went through that w/the sore I just healed up...but healing takes time...I'm sure Kristi or Lynnifer could give you TONS of advice about healing a sore on the foot...Have you talked to the dr about the feasability of using a Wound Vac on it? I know it's an awkward place, but the wound vac is def what healed my sore... I would be looking at that as an option LONG before the thought of surgery and amputation crossed my mind...

Please let us know how it's going and if you find a new dr/second opinion...

[mattblan]

Dude if it end up being bad I would definitely drop your classes this semester. What's more important: 16 units or your toe? We have it bad enough not being able to feel or move below our injury line. You definitely don't want to be SCI and an amputee at the same time.

[SCI-Nurse]

I would recommend you get a second opinion, both from an infectious disease physician (regarding treatability of any osteomyelitis you have) and a plastic surgeon or podiatrist who does a lot of diabetic foot problem work. Generally a bone biopsy is needed to determine the correct antibiotics to use, and an MRI to determine the extent of any osteomyelitis. If you don't have osteomyelitis, or if you have it and have not been on the right antibiotics (usually IV for 6 weeks) then amputation sounds a little drastic.

(KLD)

[lynnifer]

I definately wouldn't consider amputation unless the bone is involved. You're not going to miss a pinky toe ... but who's to say what's left will heal? Definately see an infection specialist ... most major hospitals have them on staff and in my experience, they're against amputation without a 'crack' at trying to heal it. A swollen foot won't heal ... you said you're elevating it but is the swelling going down when you do that? Are you putting it above your heart?

Don't panic yet. Stress always makes things psychologically as well as physiologically worse. I know it sucks and it's like the crappy gift that paralysis keeps on giving - not your fault.

I agree with the others, you're not going to make classes next Monday. Can you take one or two online so you don't completely waste a semester? Heal now so you don't have to face amputation of a foot, or worse a leg, later.

I've no experience with the wound vac ... but I wonder about trying electrical stimulation in that spot? (Damn micro-capilliaries in the damn skin get no circulation and therefore no red blood cells carrying oxygen to heal!) Get a blood screen for anything that may impede healing (iron levels, thyroid, diabetes, etc). You have to be your own advocate against a doctor who wants to swish his scalpel - show them who's in control of your medical treatment!

There's a million things to try before lopping it off. If you're seeing necrotic tissue (dead looking flesh), get on antibiotics pronto! Skin isn't far from bone there and you don't want osteomyelitis or you can write the year off (did they even xray your foot yet?)

[darkeyed_daisy]

What's salve? They are wound doctors and he debrides it every week. I will be sure to mention the whirlpool. Whats an oxygen chamber?

Oopss I meant ointment(salve)...my hillbillyness is showing.LOL

The therapist I worked with packed mine with seaweed but it was already too late. I had lost too much tissue.

It takes a long time to heal these kinds of sores. They suggested amputating my leg from the knee down at the second hospital I was in. I signed out AMA with a 104 fever and my mom drove me to Duke University (6 hours away). I cringe because my very first doctor (for 3 months) kept telling me to use ointment and it was obviously not working.

If a second opinion would make you feel better then I would find another doctor. I also had a failed skin graft at Emory University during all this and they were wound doctors too but not very attentive (IMHO).

You have to keep getting opinions until you find the right one. All doctors have different ways of treating...some are more apt to try new techniques and some want to treat using old techniques.

Amputation should be a last resort when all other methods are exhausted. As Wise said if you are having trouble getting this healed then the amputation may not heal either.

There are lots of experimental treatments out there that work...as I mentioned the seaweed....

I had to drop out a couple of semesters to heal from my surgery but I didnt lose my leg.

I hope it heals soon.

[van damn]

Dude

Get a second opion.Hope it heals ASAP.