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How Long Can I Expect To Live After Amputation From Diabetes?

Recovery After Diabetes Foot Amputation

Recovery After Diabetes Foot Amputation

If you’re getting a foot amputation due to diabetes, you probably have a lot of questions, especially about what will happen after the operation. Some of the things you can count on in the days, weeks, and months after surgery: medicines to fight pain and infection, help and advice on caring for your leg, and rehab with your new, artificial foot. It’s natural to feel scared or worried, but you won’t be alone in your recovery. You’ll work with a care team including your surgeon, your diabetes doctor, experts in artificial limbs, physical therapists, and others. They’re going to help you heal from surgery and get back to the things you love as quickly as possible. After your surgery, you’ll go to a recovery room. There, someone will monitor your blood pressure, pulse, and breathing. When those vital signs return to normal, you’ll move to your hospital room, where you can expect: Medical care, such as changing wound dressings and medicine for pain Physical therapy, such as gentle stretching and special exercises Information about your prosthetic, or artificial foot If the hospital sends you home after a few days, you’re off to a good start. That means your care team thinks you’re healing well and can take the lead on caring for yourself. To continue your progress, follow all your doctor’s instructions on bathing, activity, physical therapy, and caring for your wound. If you feel pain, don’t reach for whatever’s in your medicine cabinet. Only take what your doctor recommends because some pain medicines, even basic aspirin, can raise your chances for bleeding. Call your surgeon if you have any new symptoms, such as redness, swelling, bleeding, pain that gets worse, or numbness or tingling in the rest of your leg. Any one of these signs may be normal, Continue reading >>

Selection Of Amputation Level In Diabetic Patients

Selection Of Amputation Level In Diabetic Patients

Not all patients with diabetes and not all ulcerated limbs are amenable to salvage. When salvage is not an option, amputation can help improve patient function, but a number of factors should be considered when deciding how much of the foot—if any—should be retained. Diabetes patients and their physicians sometimes face life-altering decisions in the face of recurrent foot infections. The first choice is whether to continue efforts at limb salvage or to amputate; then, if they choose amputation, they must determine at what level to perform it. A number of options are available, depending on the depth and severity of the infection: toe, metatarsal ray, transmetatarsal, Lisfranc (a tarsometatarsal disarticulation), Chopart (disarticulation through the talonavicular and calcaneocuboid joints), and more proximal partial-foot amputations including the Pirogoff and Boyd (in which some of the calcaneus may be preserved), and the Syme, in which the residual limb ends at the distal base of the tibia.1 More proximal amputations include transtibial below-knee and transfemoral above-knee approaches. Different amputation levels offer different advantages and disadvantages, but the decision ultimately depends on individual clinical judgment and patient preference. The wound must heal, both to save the patient’s life and to prevent subsequent, higher amputations. Factors to be considered, then, include the patient’s vascular status, the presence and anatomical level of osteomyelitis, and, intraoperatively, the amount of bleeding in skin flaps.2 Some evidence suggests that sedentary patients may do better with limb salvage, whereas more active people may have better functional outcomes with early major amputation.3 But again, it depends on the patient and the type of activity. Continue reading >>

With Diabetes, Save A Leg, Save A Life

With Diabetes, Save A Leg, Save A Life

Each year in the U.S. diabetes results in the amputation of about 65,700 legs or feet. About 85% of those began with a diabetic foot ulcer. And for Dr. David Schwegman, the mission to educate people about the issue is personal. His father, a diabetic, had a foot ulcer that resulted in the amputation of his left leg, which contributed to his death, his son said. "He became a statistic," Schwegman said. "He was one of the 50% of people that died within five years after having an amputation." Diabetic foot ulcers, or DFUs, are usually located on the ball of the foot, the bottom of the big toe or sides of the feet. They can be a result of neuropathy, or nerve damage which leads to a loss of feeling. Although prevention is key, simply not treating an ulcer can lead to infection, particularly in the bone, and eventual loss of a limb. "If you have a DFU that leads to a major amputation, your risk of death in five years is greater is higher than that of breast cancer and prostate cancer combined," Schwegman said. "This is a very, very serious health problem that has very serious risks if not dealt with properly and quickly," the doctor said. "In order to do that, we really need to get the word out to both the patients and the physicians." That's where the Save a Leg, Save a Life Foundation , or SALSAL, comes in. On Saturday, Schwegman, along with the Atlanta chapter of the national group, are offering free foot screenings as part of the American Diabetes Association's Health Expo. You can find an expo near you by visiting the American Diabetes Association's calendar for 2011. Diabetics can be screened for cuts, blisters, discoloration of feet, and any signs of bacteria or infections, conditions that can lead to foot ulcers. Right now, 18.8 million adults and children in the U.S Continue reading >>

Does Type 2 Diabetes Affect Life Expectancy? Live Longer By Spotting These Symptoms

Does Type 2 Diabetes Affect Life Expectancy? Live Longer By Spotting These Symptoms

If type 2 diabetes isn't treated properly and well managed, it can lead to a number of other health problems including heart disease. However, there is no way of knowing how long someone with the condition is expected to live. It depends how soon diabetes was diagnosed, any other health conditions unrelated to diabetes and factors including how often people attend health checks and look after their own health. Knowing the symptoms of diabetes can boost the chances of living longer. Diabetes UK said: “Early diagnosis, treatment and good control are vital for good health and reduce the chances of developing serious complications.” Symptoms include urinating more than usual, feeling thirst, feeling tired, cuts or wounds which heal slowly and blurred vision. Type 2 diabetes occurs when the body does not produce enough insulin or the insulin produced does not work properly and can be linked to lifestyle factors such as being overweight. High glucose levels - also known as blood sugar can damage blood vessels, nerves and organs. If diabetes is not properly managed it can lead to serious consequences such as sight loss, limb amputation, kidney failure and stroke. Experts also suggest a mildly raised glucose level that doesn't cause any symptoms can also have long-term damaging effects. The condition can impact life expectancy, how experts have said the length of time people are expected to live with the condition has increased. Seven years ago, Diabetes UK estimated that the life expectancy of someone with type 2 diabetes is likely to be reduced, as a result of the condition, by up to 10 years. Wed, June 21, 2017 Living with diabetes - ten top tips to live normally with the condition. However, a report based on data collected by GP services in the UK between 1991 and 2014, Continue reading >>

How I Saved My Leg From Amputation

How I Saved My Leg From Amputation

By Carla Urff, Special to Everyday Health At the age of 11, I was diagnosed with type 1 diabetes. Saying I really did not understand how much impact it would have on my life is an understatement. Now, at the age of 53, let me share that impact with you. I have two beautiful children who have had to endure more than their share over the years. In March of this year I danced in heels with my 29-year-old son at his wedding (see us at left). Six years ago, I never dreamed that I would be walking, much less dancing. An Ant Bite That Wouldn't Heal My life drastically changed in 1998. I was bitten by an ant on the foot. When the wound had not healed after a few weeks, my doctor sent me to a podiatrist, who sent me to a vascular specialist. The vascular specialist told me it would heal, but that in 10 or 15 years I would probably be looking at an angioplasty with stents, whatever that meant. In time it worsened, and my left leg became affected too. I began having leg cramps when walking. Within two years my foot and leg had atrophied and begun turning purple, and they were cold as ice. I had very severe night pain. I returned to the same group of specialists and eventually got that angioplasty, eight years prematurely. The Threat of Gangrene and Leg Amputation Unfortunately, they informed me, I was too far gone: My foot had become pre-gangrenous, and there was nothing they could do. They told me I should prepare for amputation. This was just not acceptable to me. I was sure there had to be something someone could do. I had two small children, a husband and a job. How was I going to tell my children Mommy was going to have to cut her leg off? They were going to be so scared. I suffered immense pain, with many, many sleepless nights praying for God to please help me and spare me Continue reading >>

Physical Therapist's Guide To Above-knee Amputation

Physical Therapist's Guide To Above-knee Amputation

What is Above-Knee Amputation? Above-knee amputation (AKA), or transfemoral amputation is a surgical procedure performed to remove the lower limb above the knee joint when that limb has been severely damaged or diseased. Most AKAs are performed due to peripheral vascular disease, or severe disease of the circulation in the lower limb. Poor circulation limits healing and immune responses to injury. Foot or leg ulcers may develop and not heal. They may become infected, and the infection may spread to the bone and become severe enough to be life threatening. Amputation is performed to remove the diseased tissue and prevent further spread of infection. Above-knee amputations are performed when the blood flow is inadequate in the lower leg or infection is so severe it prohibits a lower-level surgery. If an AKA surgery is necessary, it is usually performed by a vascular or orthopedic surgeon. The diseased or severely injured part of the limb will be removed, keeping as much of the healthy tissue and bone as possible. The surgeon shapes the remaining limb to allow the best use of a prosthetic leg after recovery. The need for AKA is caused by conditions including: Peripheral vascular disease Diabetes Infection/gangrene Trauma, causing the lower leg to be crushed or severed Tumor/cancer How Can a Physical Therapist Help? Prior to AKA surgery, your physical therapist may: Prescribe exercises for preoperative conditioning to improve your upper and lower extremity strength and flexibility Teach you how to walk with a walker or crutches Educate youabout what to expect after the procedure Immediately after surgery: You should expect to stay in the hospital for approximately 5 to 14 days. Your wound will be bandaged, and you may also have a drain at the surgery site. Pain will be mana Continue reading >>

The Choice Between Limb Salvage And Amputation: Major Limb Amputation For End-stage Peripheral Vascular Disease: Level Selection And Alternative Options

The Choice Between Limb Salvage And Amputation: Major Limb Amputation For End-stage Peripheral Vascular Disease: Level Selection And Alternative Options

Chapter 2C - Atlas of Limb Prosthetics: Surgical, Prosthetic, and Rehabilitation Principles Peter T. McCollum, B.A., M.B., B.Ch. Michael A. Walker, M.B., Ch.B., M.D.,M.Ch., F.R.C.S.I. F.R.C.S.Ed. Major amputations of the limbs are essentially disfiguring operations that carry a fairly high perioperative mortality and morbidity in elderly, debilitated patients suffering from critical limb ischemia (CLI). Estimated incidence rates of major amputations (Table 2C-1.) suggest that in the United Kingdom, as in other parts of Europe, the amputation rate is likely to be between 10 to 15 per 100,000 per year, up to half of whom may be considered unfit for referral to a limb-fitting service because of widespread chronic arterial disease. These figures, taken in conjunction with recent advances in both limb prosthetics and surgical techniques, highlight the need for further critical appraisal of available options open to all involved in the care of patients with a limb that may require amputation. Although trauma, tumor, and infection are significant disease entities that can require primary or secondary amputation, over 90% of all limb amputations in the Western world occur as a direct or indirect consequence of peripheral vascular disease (PVD) and/or diabetes. This chapter seeks to explore the moral and ethical dilemmas faced by both the patient and medical team presented with such a problem and describes investigation and treatment options open to those faced with a decision whether to amputate a limb or to attempt some form of limb salvage procedure. LIMB SALVAGE OR PRIMARY AMPUTATION-GENERAL CONSIDERATIONS The presence of a chapter on alternative options to amputation in a book on amputation and prosthetics highlights the difficulties and importance of decisions confronting Continue reading >>

How To Avoid Amputations If You Have Diabetes

How To Avoid Amputations If You Have Diabetes

In people with diabetes, a trifecta of trouble can set the stage for amputations: Numbness in the feet due to diabetic neuropathy (nerve damage) can make people less aware of injuries and foot ulcers. These ulcers may fail to heal, which can in turn lead to serious infections. "Normally a person with an injury on the bottom of their foot, such as a blister, will change the way they walk. Your gait will alter because you are going to protect that blistered spot until it heals up," says Joseph LeMaster, MD, an assistant professor at the University of Missouri–Columbia School of Medicine. "People with a loss of sensation don't do that. They will just walk right on top of that blister as though it wasn't there. It can burst, become infected, and turn into what we call a foot ulcer," he says. "That ulceration can go right down to the bone and become an avenue for infection into the whole foot. That's what leads to amputations." Foot injuries are the most common cause of hospitalizations About 15% of all diabetics will develop a foot ulcer at some point and up to 24% of people with a foot ulcer need an amputation. You're at extra-high risk if you're black, Hispanic, or Native American. These minority populations are two to three times more likely to have diabetes than non-Hispanic whites, and their rates of amputations are higher. "It's the most common reason that someone's going to be hospitalized with diabetesnot for high blood sugar or a heart attack or a stroke," says David G. Armstrong, DPM, a specialist in diabetic foot disease at Rosalind Franklin University of Medicine and Science in North Chicago. "It's for a hole in the foot, a wound." About a year ago, Dr. Armstrong treated a 59-year-old man with type 2 diabetes who had been working out at a local health club; 12 Continue reading >>

Toe Amputation

Toe Amputation

Background Toe amputation is a common procedure performed by a wide variety of health care providers. The vast majority of toe amputations are performed on patients with a diabetic foot. [1] Although regional variation is noted, most of these procedures are done by general, vascular, and orthopedic surgeons (particularly those subspecializing in foot and ankle surgery); in some countries, podiatrists are involved. There are three broad indications for amputation of any body part, as follows (see Indications) [2] : Before any amputation, the clinician should ensure that the patient’s medical circumstances have been optimized (ie, should "reverse the reversible"). With impending toe amputation, this step encompasses such measures as glycemic control and consideration of revascularization when severe macrovascular disease is contributing to ischemia. The method of toe amputation (disarticulation vs osteotomy) and the level of amputation (partial or whole phalanx vs whole digit vs ray) depend on numerous circumstances but are mainly determined by the extent of disease and the anatomy. With any amputation, the degree of postoperative functional loss is generally proportional to the amount of tissue taken. The great toe is considered the most important of the toes in functional terms. Nevertheless, great-toe amputation can be performed with little resulting functional deficit. [3, 4] Continue reading >>

Amputation Of The Toe

Amputation Of The Toe

What is it? There is not enough blood getting into your toe to keep it alive. The lack of blood causes severe pain and allows serious infection to take hold. If left untreated, the toe will eventually get necrotic (go dead) and be life threatening. The only choice is to take off the toe. Sometimes the toe has shrivelled up and become a nuisance or more than one toe needs to come off. Sometimes the operation is done at the same time as an operation on the blood vessels. You will probably have a general anaesthetic and be asleep for the whole operation. Sometimes patients are numbed from the waist down with an injection in the back. If the latter takes place, you will be awake. You might feel that 'something is happening' in your toe, but you will not feel any pain from the waist down. Your toe is taken off. The surgeon may need to take off some of the skin from the foot near the toe to help it heal. Usually the skin can be stitched up over the wound after removing the toe. Sometimes it is better to let the wound heal up by itself without any stitches. This takes three or four weeks, but could be more. How long you stay in hospital depends very much on your general condition. Ideally you can go home after a day or so. Often patients find it more convenient to stay for a week or longer. If you leave things as they are, your toe will certainly get worse. Infection may spread to your other toes and foot. An operation to bypass or core out your leg arteries to improve the blood supply to the toe will not work in your case. Laser treatment and X-ray guided stretching of the arteries will not work for you. Injecting the nerve to your blood vessels will not work. Antibiotics are not enough by themselves. An alternative to a toe amputation is an amputation higher up. This may hel Continue reading >>

Ignore Warning Signs, Lose A Limb

Ignore Warning Signs, Lose A Limb

For eight years, Jeanne Houtz, who has a family history of diabetes, ignored all the symptoms — visual problems, weird sensations in her feet and blisters that would not heal. The San Diego woman was diagnosed with type 2 diabetes at age 40, but she refused to take her medications or to lose weight. Houtz never realized she was in danger until the bones in her right foot collapsed, causing wounds that eventually led to infection. But attention to this insidious disease came too late, and it finally cost her a leg, which was amputated in 2005. "I know I am the worst person on the planet, acting like this," said Houtz, now 56. "My mom had it, everyone had it," she said. "When I was a young girl, I had an aunt who had it and she was told not to eat brownies. She would crave them and I thought, 'Why does she eat them?' I later realized it's an uncontrollable urge." Houtz is one of 20.8 million Americans who have been diagnosed with diabetes, a disease that is now epidemic and is linked with the increased prevalence of obesity in the United States, according to the National Diabetes Education Program Progress Report 2007. About 6.2 million Americans have the disease, but go undiagnosed. Diabetes Epidemic The total number of people with diabetes in the United States is projected to rise from 17.7 million in 2000 to 30.3 million in 2030, placing the United States third in global prevalence, second only to India and China, according to the report. About 66 percent of all adult Americans are overweight, a major risk factor for type 2 — or adult onset — diabetes. Left untreated or not managed well, the disease can lead to peripheral neuropathy, which can lead to foot deformities and eventually amputation. Today, Houtz listens to her doctor, though at 5 feet, 9 inches tall, Continue reading >>

Above-the-knee Leg Amputation: What To Expect At Home

Above-the-knee Leg Amputation: What To Expect At Home

Your Recovery An above-the-knee amputation is surgery to remove your leg above the knee. Your doctor removed the leg while keeping as much healthy bone, skin, blood vessel, and nerve tissue as possible. After an above-the-knee leg amputation, you will probably have bandages, a rigid dressing, or a cast over the remaining part of your leg (residual limb). The leg will be swollen for at least 4 weeks after your surgery. If you have a rigid dressing or cast, your doctor will set up regular visits to change the dressing or cast and check the healing. If you have elastic bandages, your doctor will tell you how to change them. You may have pain in your remaining limb. You also may think you have feeling or pain where your leg was. This is called phantom pain. It is common and may come and go for a year or longer. Your doctor can give you medicine for both types of pain. You may have already started a rehabilitation program (rehab). You will continue this under the guidance of your doctor or physiotherapist. You will need to do a lot of work to recondition your muscles and relearn activities, balance, and coordination. Rehab can last as long as 1 year. You may have been fitted with a temporary artificial leg while you were still in the hospital. If this is the case, your doctor will teach you how to care for it. If you are getting an artificial leg, you may need to get used to it before you return to work and your other activities. You will probably not wear it all the time, so you will need to learn how to use a wheelchair, crutches, or other device. You will have to make changes in your home. Your workplace may be able to make allowances for you. Having your leg amputated is traumatic. Learning to live with new limitations can be hard and frustrating. You may feel depressed Continue reading >>

Amputation

Amputation

Recovery After surgery, you will be transferred back to a ward. You will normally be given oxygen through a mask and nutrients and fluids through a drip for the first few days after surgery. Your amputation wound will be covered with a bandage or plaster dressing and a tube may be placed under the skin next to the wound to drain away any excess fluid from the site of the surgery. This will help prevent excessive bruising and swelling at the wound. It is usually recommended that the bandage remains in place for the first five days to reduce the risk of infection. A small flexible tube, known as an urinary catheter, may be placed in your bladder during your surgery to drain away urine. This means you will not need to worry about going to the toilet for the first few days after surgery. It is likely that you will experience considerable pain at the site of the operation, so painkillers will be supplied as required. Let your pain nurse know if the painkillers are not working as you may need a larger dose or a stronger type of painkiller. Preparing for discharge As you gradually recover from the effects of surgery, you will meet a number of different health professionals, such as a social worker, occupational therapist and physiotherapist, to help plan for your discharge. Your physiotherapist will also teach you a number of exercises to help prevent blood clots and improve blood supply. Compression shrinker sock You will notice swelling (oedema) of your stump after surgery, which is normal. This swelling can also continue once you have been discharged. Using a compression shrinker sock will help with swelling and the shape of the stump. It may also reduce phantom pain and give a feeling of support to the limb. Your physiotherapist will measure you for your sock once your wou Continue reading >>

Amputation And Diabetes: How To Protect Your Feet

Amputation And Diabetes: How To Protect Your Feet

Good diabetes management and regular foot care help prevent severe foot sores that are difficult to treat and may require amputation. Diabetes complications can include nerve damage and poor blood circulation. These problems make the feet vulnerable to skin sores (ulcers) that can worsen quickly. The good news is that proper diabetes management and careful foot care can help prevent foot ulcers. In fact, better diabetes care is probably why the rates of lower limb amputations have gone down by more than 50 percent in the past 20 years. When foot ulcers do develop, it's important to get prompt care. More than 80 percent of amputations begin with foot ulcers. A nonhealing ulcer that causes severe damage to tissues and bone may require surgical removal (amputation) of a toe, foot or part of a leg. Some people with diabetes are more at risk than others. Factors that lead to an increased risk of an amputation include: High blood sugar levels Smoking Nerve damage in the feet (peripheral neuropathy) Calluses or corns Foot deformities Poor blood circulation to the extremities (peripheral artery disease) A history of foot ulcers A past amputation Vision impairment Kidney disease High blood pressure, above 140/80 millimeters of mercury (mmHg) Here's what you need to know to keep your feet healthy, the signs you need to see a doctor and what happens if amputation is necessary. Preventing foot ulcers The best strategy for preventing complications of diabetes — including foot ulcers — is proper diabetes management with a healthy diet, regular exercise, blood sugar monitoring and adherence to a prescribed medication regimen. Proper foot care will help prevent problems with your feet and ensure prompt medical care when problems occur. Tips for proper foot care include the followin Continue reading >>

Leg Amputation Gangrene Diabetes Life Expectancy?

Leg Amputation Gangrene Diabetes Life Expectancy?

The statistics regarding diabetic life expectancy after an amputation related to diabetes complications such as gangrene, diabetic foot infections, and bone infections (osteomyelitis) 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. 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,. Dr. Christopher Segler is an award winning diabetic foot surgeon, author and inventor in Chattanooga Tennessee. 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 *** **edited by moderator** **web addresses are not allowed** Continue reading >>

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