My brother has gangrene

Miscellaneous and Personal Stuff I Must Share
1

This is a cautionary tale for any it may apply to. My brother, who is 77 this year, is diabetic. It’s adult onset, as with most diabetics, but his has progressed to his having to use insulin. In his younger years, he abused himself. It was almost a religion for him. The booze and the 4+ packs of cigarettes every day took an early toll on him and his family, and it took some mini-strokes for him to finally give up tobacco. He had gotten off booze earlier on, but the damage to his liver and other organs was done.

The diabetes hit when he was on blood thinners, and since he did little to change his diet or his sedentary habits, it was seldom under control by oral meds. But he managed to get by for a number of years before finally having to start with insulin. In the meantime, the circulatory problems were wreaking havoc with his feet and legs. He had major vein replacement surgery on both legs to improve things, but the neuropathy in his feet was unabated and very painful for him. He had numbness, cold and tingling in his feet, all forerunners to what is now happening.

A few days ago, I found out that he has gangrene in one of his big toes. It’s dry gangrene, not wet (do NOT Google either of these unless you have a strong stomach), which means that the skin mummifies rather than putrifies. In an otherwise healthy person, surgery would be an option to remove the affected area, but of course as circulation gets worse, more surgery is required until an area of stable tissue is reached and the condition stops progressing. In his case, repeated surgeries are not an option, as it would likely kill him.

What will happen now is what is called auto-amputation; in other words, dead flesh will just fall off on its own, a horrifying thought if ever there was one. Eventually, both feet and both legs will be involved, if he lives that long. This is a sad prognosis for my brother. He was always an outdoors-man, a hunter, and someone who enjoyed making or fixing things. He has struggled to be able to do any of these things for many years, but this will pretty much spell the end of most activities that require walking. Knowing his mindset, it would not surprise me to hear of his suicide at some point.

I have type 2 diabetes myself, which is controlled, but this is a serious wake-up call for me (I’m 11 years younger than him). I do walk and stay active, but I’m going shopping for a bicycle this week and will finally utilize the local trails. The prospect of ending up in his situation scares the ever-loving shit out of me.

Take care of yourselves, my fellow Dopers. Don’t think it can’t happen to you.

2

The above-knee amputation of my co-worker’s mother’s leg already scared the ever-loving shit out of me, and I’m not even diabetic. She is, and she is of normal weight and otherwise took pretty decent care of herself. Moral of the story: don’t get diabetes, and if you do, control it!

3

How often does this kind of thing happen? How many people are that neglectful that they go blind and have things rot off them?

4

That ain’t worth a damn, man. I’m really sorry to hear all this, Chefguy. Sounds like a plan with the bike and where you are the views alone ought to be worth the effort, to say nothing of the obvious health benefits. Happy pedaling.

5

I wasn’t trying to downplay the seriousness of the situation by trying to assert it’s rare, BTW; I know how serious it is. I’ve always said that if I ever got diabetes, it would literally kill me no matter what happened or what I did — either by killing my body or killing my soul. I was genuinely asking how common it was.

6

No, no it wouldn’t. It’s not that bad. It’s not cancer, nor is it any number of other more devastating diseases. It neither kills bodies nor souls, unless you simply refuse to deal with it altogether.

I’m Type 1, what most people think of as the “bad” kind (though what the “good” kind of diabetes is, I don’t know!) and went straight to insulin from being what I thought was perfectly healthy at age 38. I’m in tight control, and the chances that I’ll have any complications are minor. You know how much my life changed going from non-diabetic to Type 1? About 5%. And that 5% was stuff I’d been struggling to do anyway - I eat slightly healthier, and I exercise slightly more.

I’m not downplaying that it can be bad. It can be. But in almost all cases, that only happens because the person who has it cannot or will not make some very basic life changes.

7

Wow, 5%? Seriously? Is that a difference between T1 and T2? Then again, maybe you just had better life habits to begin with.

Anyway, I explain myself in this thread so we don’t hijack this one. :slight_smile:

8

He has other health problems that contribute to this, as mentioned above, including bad knees and bad hips. They basically took both legs and deveined them like shrimp, then put in synthetic replacements. Those don’t always work all that well, apparently. He takes a lot of meds to cope with his problems and has been in and out of hospitals a number of times in the past ten years. When you take a lot of meds, they often don’t play well with the others. His inability to get proper exercise means that he is unsuccessful at controlling his weight, so he gets a double dose of bad. The irony of diabetes is that fat and protein don’t usually cause problems with glucose, but a lot of that is, of course, bad for you too.

I was meeting him twice a week at the gym when I lived in Anchorage up until 2009. He would do some half-hearted weight work, but was absolutely unable to do anything on a treadmill. I would walk around the B-ball court with him; he was winded after one slow lap, and unable to do more than two because of the pain. So he ends up sitting a lot, which is a Very Bad Thing for circulation. Since diabetes also affects circulation, the outcome is predictable.

There’s no doubt that most of his problems are self-inflicted from a dissolute lifestyle. Although he quit those behaviors probably 20-30 years ago, the damage is permanent. It’s doubly hard to see him this way, as he was my boyhood hero. He taught me how to shoot, how to fish, and how to camp; I owe my sense of humor to him. I spent many summers out at his place and he was a surrogate father during those times. It makes me sad that his life has spiraled down to this state.

9

It shocks me that so little can be done for your brother Chefguy.

I’m so sorry for your distress and sadness. Self-inflicted or not, nobody imagines this as a possibility.

My kindest thoughts to you, and your brother. (Like that helps :rolleyes:) I hope he finds a way to deal with it, and that your boyhood hero remains untarnished. He earned it - keep it that way.

10

I have type 2 diabetes, and I’m on insulin. A lot of insulin. I had open-heart surgery last year (new aortic valve and quadruple bypass). I also have a severely damaged knee. I can’t have a total knee replacement, because it would impair the circulation in my lower leg. And the knee pain prevents me from getting much exercise. So I live day-to-day, and hope nothing else goes wrong.

11

I’m sorry to hear about your brother, Chefguy. And I agree that we should all do our best to look after our health. But the sad reality of aging is that often we inexorably fall apart over time rather than having a quick, clean end, no matter what we do. So don’t be too hard on your brother. He’s just flesh, like all of us.

12

I’m not being hard on him; as I said, it’s a cautionary tale for those living a hard life (although that’s not a requisite for diabetes) and thinking that there are no consequences. It exacerbates what is already a nasty illness.

His personality has changed over the last ten years or so, to the point where we don’t really communicate. I chalk it up to illness and him seeing his mortality, but it doesn’t make it any easier to deal with. Being treated like an asshole by somebody you used to respect can only be tolerated to a certain extent. I don’t want to end up hating the guy, so I keep my distance. My sister and everyone around him don’t have that luxury.

13

Gangrene.

Never a word you want to read.

Luck to him.

14

In your brother’s defense, it’s possible he knew the consequences but chose his lifestyle anyway. That’s pretty much where I am, and I’m happy as a clam.

15

It’s human nature, of course. I drank pretty heavily for 20+ years (though not nearly to his level), and I smoked until about 32 years ago. I knew what I was doing to myself, but was young and didn’t give a shit, like most people who do that sort of thing. Addiction is a bitch.

16

My uncle didn’t get a cut on his foot treated. They amputated below the knee. He never bothered to learn how to navigate outside a wheelchair.

A few years later, they went in and amputated partway up the thigh on the other leg. He didn’t make it out of the hospital.

That is why, ladies and gents, I’m being proactive in my approach to diabetes.

17

Hey, last night I had my first salad in ages basically because of this thread.

18

My grandfather was diabetic and cut his foot, which became infected. He entered the hospital just before Christmas and died on New Year’s Eve at age 53. Of course, that was 1915 and antibiotics were still in the future.

19

Good for you Leaper. My Mom and my older brother have both been diagnosed diabetic, and it scares me. I’ve lost some weight and am exercising more, but I wish I knew how much was enough.

20

This gave me a touch of the warm fuzzies. I’m sorry your brother is going through this, OP, but thanks for sharing your cautionary tale - look, it already did a smidgeon of good!