Hi all.

to sum up, he has a recurring foot ulcer for YEARS. The doctor will debride it, it will then form a callus, the doctor will debride it again, etc. etc. It always used to heal.

He's not a diabetic, never was. Idiopathic.

He got the ulcer because after his stent, they sent him to cardiac rehab, he went on a treadmill, and got a foot ulcer. It ALWAYS used to heal.

Well, for whatever reason, this time it's not healing. His podiatrist has explained to us that he has some kind of bone impingement under the ulcer so that when he steps on it, it will come through and that's why he bleeds. He also explained that in other cases, they would shave down the bone and the ulcer would then heal and that would be that.

But because of Alan's neuropathy, he says (and he also says that they have discussions on Alan all the time because of the severity of his neuropathy), well, when I say "you can't operate, you can't do ANYTHING?'

He would respond. "We don't operate on Alan, if we operated the bones supporting each other (underneath where the ulcer is), well they might collapse so we don't operate on Alan'

I understand this. He's been our podiatrist for over 15 years. He operated on Alan's bunions and takes good care of him.

I then asked the doctor (this was about a month ago when his foot would not stop bleeding everytime he walked on it).

I said "we have a wheelchair in the house, why can't he sit in the wheelchair and wheel himself across the rooms, and do this until the ulcer heals, can't he do that??"

He responded "he needs to walk" I would gather he's afraid of blood clots or something??"

Alan also tried the crow boot last week when we had to go out. It hurt him on the front so he won't put it on.

He wears custom molded shoes. With a well dug out under the foot ulcer. I gather this is no longer doing the trick for him.

He sees the podiatrist on Tuesday to check on how is ulcer is doing and if it needs more debridement.

So what has been happening is that the little hole does not close and if he walks, it bleeds. Even if he walks to the bathroom.

I'm not talking gusher here, but still, he has an open wound. I watch it carefully, dressing it, (following the doctor's instructions) and he always says to me "Melody I'm never worried because you know how to take care of that foot".

And we have an appointment with the vascular guy on Friday. Alan has a bit of edema going on, (the water pill does help). His primary care doctor, Dr. Fred referred us to his buddy, the vascular guy and he explained to me "He's also a wound care specialist"

I said "Oh maybe he'll put Alan in one of those oxygen tanks" and he said "yeah, might be"

So we ARE on top of this, AT LEAST I AM, and if any of you have dealt with foot ulcers that eventually do not heal, and what you did about that, I'd appreciate hearing from you.

Also, what happens during the first visit to a vascular wound specialist. Do they put dressings, ointments, do they put you in oxygen chambers??

We have no clue.

And what can we do about his bleeding every time he gets up and walks anywhere. I mean, there is always blood on his socks. I make him change them all the time. And I use bacitracin. So far, and he's been going every two weeks to the podiatrist, so far, no signs of infection, thank goodness for that.

When I asked Alan, "but your ulcer always healed before?" he said "yeah, but this time the hole is bit bigger". He's right, the previous times it was a pinprick. This time it's a little hole (where the doctor debrided it).

I hope the wound care guy will do SOMETHING!!!

Thanks for any input
Melody

Well, I would be putting a dressing on that all the time.

Change it daily. Something cushiony --let the podiatrist recommend something.

Zinc is a great healer... perhaps Alan needs some oral zinc?
This is given typically to people with bedsores and other hard to heal wounds. You have that zinc at home anyway still?

Also l-arginine helps too. In nursing homes there is a drink called ArginAid but you can give Alan tablets...same thing. This heals skin wounds/ulcers. Vit C. Also.

If you go to a wound center they have special dressings that you leave on for days... and are designed to help the wound build a matrix of tissue for healing. They are very expensive, so see what would be needed, and call your insurance to see if they pay for it. Since Alan is not diabetic there may be resistance for them.

I would not let this wound be leaking into socks. I would be putting a sterile pad on it. Some wound healing products have silver in them. But since Alan is allergic to sulfa, the typical silver sulfadiazine cream cannot be used.

I think he will need to go to a wound clinic. These are more common now, and very useful. It is a miracle he hasn't had a severe infection yet IMO.

Hi. THANKS MUCH

I do have the Optizinc that I take, I'll give it to him 3 times a week starting tonight.

And about why he hasn't had an infection yet. THAT'S BECAUSE HE HAS ME!!!!

Even his doctor says this.

I never in all my days thought that besides his not being allowed to get special shoes because he's not a diabetic, that they wouldn't pay for special dressings??? Oh my god.

Never even thought of that.

We shall find out on Friday. I will update.

Oh, I have a question.

I have Silver biotics in the house.

Might I take some drops of that, place in water, and then take a q tip and put on his wound. At least as a start?

What do you think?

Thanks much

Melody
P.S. I just asked him to please use the wheelchair in the house, just to go form one room to another. He said "not until the doctor says so".

My goodness, he is so stubborn.

Mel

Well, I wish I could say, it would work... but I really don't know
Mel.

So it is your decision to use the silver that way.

Well, it can't hurt, so I'm going for it.

Will update AND THANKS MUCH.

Melody

P.S. Just did it. Put a drop on his ulcer. Put a bandage over it and then the sock. He's lying down on the couch with his leg up.

Will continue this tomorrow. Hey, can't hurt, might even help. Reminds me when I told one of his doctors that I use Methyl B-12 for my neuropathy and it went away and the doctor pooh poohed me and said "I would NEVER use B-12 for anything other than anemia".

And sometime later, this same doctor came down with neuropathy, and asked me "Tell me about Methyl B-12 again". See, doctors are smart and they know stuff but sometimes we have to experiment and use non-medical interventions. That's what I'm doing now with the Silver biotics. And I am diabetic and haven't had a UTI for over 15 years. you gotta love that silver!!! lol

you have to be stubborn to live this long.

since the wound hasnt healed basically in years i dont think that it should be an insurance problem to get a special dressing at this point if it is coded properly.

things get complicated when you have one thing that affects something else and then cant be treated without more complications.

i just found a pretty nasty looking crack wound on the bottom ball of my fight foot which of course i hadnt felt. this winter has been a killer. its taking a while to heal.

too bad Alan is allergic to sulfa, silvadene is very effective for healing and preventing infections. i have a big tub of it from my past life that i use when needed.

make sure that whatever dressing you are putting on the wound does not "fill in" the space that was left in the shoe to "off load" pressure from that spot.
Think "princess and the pea". Has Alan ever had a 5 hour GTT? Just because he wasn't diabetic last year, doesn't mean he can't be this year.
Good luck

They have given him various diabetic tests. He just got blood tests results back two days ago. His fasting blood sugar is 80. It NEVER goes above that.

We even filled him with sugar once (to see if it could register above 120). It went to 100.

So no, he's not a diabetic.

I hope whatever dressing they use, works, and that's it covered because his insurance WOULD NOT COVER CUSTOM SHOES OR OTHOTICS.

Nasty people these insurance people.

And I am very careful to not have the dressing that I put on, fill in the hole in his foot. Very careful.

Thanks much

Melody

Do they do an A1C on Alan? That would show much more than a fasting glucose.

He has had numerous glucose tolerance tests. He gets a blood test every 3 months (for years). His sugar has NEVER gone over 80. And I just checked the test and his a1c is 5.7.

How could this man be a diabetic? And we truly believe his neuropathy stems from his back. Even his neurologist is sending his mri results to a back specialist. She saw something on the mri and someone once told him "your back is really screwed up and if you have an operation it's going to be a big one"

They could never in the past associate his neuropathy with his back, but now that he is 63, his back is so bad I have to massage him 2 times a day (especially if his neuropathy is going nuts), and when I pound on his back and massage his spine, the pain in his feet goes away).

To me, this smells of a back issue. He has another appointment with his neurologist soon. He couldn't make the last one because of the snow around the end of December.

He can't walk long distances because of his back. To me, that tells the tale.

They might not have seen anything on previous MRIs but this last one (so they say) was a doozy.

He has degeneration and spinal this and spinal that. Too many things on that paper. He will go over everything at the next appointment and I'll post here and tell you what his neuro says.

Yesterday he was taking a nap on the bed and he was moaning, Oh my feet are killing me". I went over, starting massaging his spine and doing what I do and he immediately fell asleep.

It that is not a back connection, I dont' know what is.

Melody