Ulcers of the skin: Some medical knowledge, please?

Factual Questions
1

Yeah yeah yeah, don’t get medical advice from a message board, blah blah blah. Well, if the freakin’ doctors would learn basic communication skills I wouldn’t be doing this.

Three, maybe four months ago my grandfather showed me what looked like a slightly swollen, scabbed-over mosquito bite on the outside of his right foot (I have no idea how long it had been there before he showed it to me). Since it didn’t look all THAT bad I spent the next week or two making sure there was a large bandage on it to protect it, and he bought new shoes. It didn’t heal up so he went to the doc who prescribed a week-long antibiotic…and that’s when things kinda went kerflooey.

The antibiotic turned what was a small sore into a larger one - it went from dry to pussy to…well, a big hole. After the pus and scab went away it left a dent that looks like someone took a metal 1/4 teaspoon and carved a chunk out of the side of his foot. And it still didn’t heal.

So about a month ago he went back to the doctor who got him a same-day surgical consult. The surgeon determined the reason the sore wasn’t healing was because the blood flow to his right leg was SIGNIFICANTLY less than that to his left and scheduled an angioplasty to determine why.

Three weeks ago today he went in for the angioplasty [sub]rant about a hospital sending a diabetic, puking, dehydrated, 86-year-old man with heart problems HOME after the procedure (never mind that his loving daughter ALLOWED that to happen…) deleted[/sub] and the doc said he’d call back with the results by the end of the week. But he didn’t, and the following week he went on vacation. Also, a doctor (we don’t know which one) scheduled a follow-up visit for the following Monday…but no one told grampa or anyone who was with him about this, and now he’s stuck til next week, and in the meantime he’s driving me nuts.

Where ever the blockage is, it is below where an angio can reach. So (I bet y’all were waiting for me to get to an actual question, weren’t you :stuck_out_tongue: ):

When he goes into his long-delayed appointment, what possible options is the doctor going to lay out for him? Surgery? Drugs? Any such thing as a smaller angioplasty thingy? What else is out there?

2

IANAD

But, the type of blockage matters–was it a clot–then maybe anti-clotting agents such as heparin…the diabetes complicates things–how bad is it–is he overweight. Frankly, I think you’ll just have to wait…too many things in the air

3

Sorry, not enough data to even make me try to discuss this in general terms.

Maybe some of the other SDMB MDs will make a stab at it. But any response could be leading you far, far from the actual problem/solution set.

QtM

4

Bummer, Qadop. What else would you need to know?

5

It sounds like you may need to start with some general information about diabetes and its complications, especially what happens to feet and legs. Have you tried looking at any of the many web sites dealing with diabetic feet? You might start at http://www.nlm.nih.gov/medlineplus/diabeticfoot.html which has a lot of info and links.

6

Wounds like this are very common in elderly diabetics. Even with good care, they take a long time to heal. Many older diabetics have lousy circulation in their legs due to blood vessel damage from decades of elevated blood sugar and the accompanying errors in fat metabolism.

I would strongly suggest you take him to one of those free standing wound care centers that are being advertised. This kind of wound is their specialty and they will prescribe the proper way to dress and care for the wound. You can still address the poor circulation at the same time but a wound care center will get the darned thing healed much faster than a general surgeon.

Also, stay on his case about being meticulous in his sugar control. He should be checking his blood sugar at home several times a day and adjusting his diet and medication accordingly. High blood sugars will promote wound infections and delay healing interminably.