Alan just came home frome the podiatrist. (He met me at the laundromat and told me what the doctor said.

As you know he has a recurring foot ulcer on the bottom of his foot. Sure it heals, then it gets irritated, etc. etc. Well, he just came home and said "well, next week he'll decide whether to operate or not. He's not happy with this foot". I said "so how long will you be out of commission, 6 weeks like when you had the tailor bunion??"
He said "no, more like 3 weeks". He looked so sad. I said "not to worry, you'll just have me to wait on you hand and foot for 3 weeks" We laughed.

He said the doctors are deciding whether to shave down the bone or re-position it (I wasn't with him during this visit). He also asked the doctor: "Doctor, this question is from my wife, not from me, she just wants to know how you are sure I don't have Morton's Neuroma because my sister has Morton's Neuroma"? And the doctor said "Because I wrote a paper on this in medical school and I know you don't have Morton's Neuroma, and tell your wife not to call me next week over this". Now (I never call him but when I'm at an appointment, I do ask questions. PERTINENT QUESTIONS!!! but I just don't sit there and be silent. He has never minded this and even gave me a compliment during Alan's last visit about how he knows I take good care of Alan's foot.

So I finish up at the laundromat, arrive home, and there's blood all over the floor from where he walked into the kitchen. I said "Alan, there's blood all over the floor" he looks at his foot and there's blood on his sock. He said "oh, the doctor must have debrided me realy good". Now he is all wrapped up. I just put some plain gauze over it and a clean sock. (I didn't want to disturb anything and take the bandage off because I'm afraid I'll peel something I shouldn't peel). The doctor had told him he could take a shower on Thursday.

I told him to stay in the chair and keep off the foot as much as possible.

This usually happens but once he stays off the foot, it heals.

oh well!!

Mel

Mel,

What does the neurologist say about this foot and operating on it?

NEUROLOGIST???? What neurologist???

Haven't heard a word from Alan's neuro AND HE WON'T PUT A CALL INTO HER. He says "I'm fine, the IVIG didn't kill me, why should I call her?"

When Alan would have an appointment with the neurologist, she would also examine his feet and they would discuss the podiatrist. But.... he started seeing this Neurologist AFTER he had the Tailor Bunion surgery. He's never had to undergo foot surgery while he has been under the care of his present neuro.

Now here's my question. Let's say next week during the podiatry visit, his doctor says "Okay Alan, we've decided to put you in the hospital and shave down the bone (or reposition it or WHATEVER SURGERY they plan to do to him). Since we don't know when he's going to have this done, well, his next appointment for IVIG is June 18th.

Do we wait for AFTER THE IVIG to get him the surgery.
What if they say "he is being operated on June 11 or right around that time". Does a person have an operation and that same week, can they do the IVIG?? Or do they suspend IVIG until a person heals???

I am clueless here.

Thanks,
Melody

So w

Mel

Does the podiatrist know that Alan has PN, that he is on IVIG, and all the other meds he is on, whatever they may be? I am wondering if the neurologist would approve of the surgery...at times, the surgery makes PN worse. I can't remember if Alan is diabetic, but I do think you brought up peripheral vascular disease at one point....eh, call me paranoid, but I am wondering it this surgery might be a topic for interdisciplinary discussion between specialists, and perhaps done by an orthopedic surgeon in conjuntion with neurology? Or at least the podiatrist in consultation with the neurologist. It just sounds too 'targeted' to me. The 'targeted exam' and 'target treatment' is the catch phrase for the corporate medicinal approach of the last decade. It is quite unsuccessful for us, the patients, but lucrative for docs and insurance companies, well, at least in the short run. The short run seems to be all that companies think about any more anyway. I am used to thinking about futures....perhaps this is an affliction of the younger generations, who face far more uncertain futures than we 'older' folks did.

I would call the neuro and let them know that Alan has a foot ulcer, and the podiatrist is contemplating surgery and what do they think is the best approach. If you get no human to human contact in your call to the neuro, fax them, and keep a copy of the fax....or mail it certified.

I agree totally with C. no jokes this time. I'm serious why doesn't the
Podliatrist not want to speak to you.? I don't care how many papers
he wrote on this subject.

Also no call from Neuro..Has he ever seen a wound Dr. about his foot?
Bob ended up battling a horribal and awful situation when a Pod. screwed
up a surgery on the bottom of his foot. It ended up taking almost
6 months and grafting to fix that mess.They even tested him for cancer.

I would do nothing until i got that Neuro on the phone. You do not
aways show symptomes of MRSA. Many people are carriers and have no
promblem with it, while other people get infections from it. Once you have
it,you may carry it for several weeks to months.I had Mrsa Last year
didn't have a clue People at risk,tend to be older,be in the hospital
frequently or for long periods of time,receive many antibiotics and have
skin that is not intact. Healthy people are usually not at risk of getting
the germ.

Special precautions called contact precautions reguired to prevent the
spread of Mrsa. Drs. and Nurses must be especially careful not to spread
MRSA from patient to patient on their hands or equipment..It can happen
at home that nurse messed up. Before anything more like surgery is
done i would have a infecious disease Dr. take a culture of his sore.

A Dr. who will poo poo this idea would worry me,also one who said don't
have your wife call me. You have to report MRSA years later to Dr. and
hospital's. I just had it again at this hospital visit,and it's been a year
between hospital visits. 2 different hospitals,This last hospital used rubber
gloves but didn't wash hands the way i thought they should.I came home
do my own wound care,with gloves,everyone has own soap and big bottle
germ x. Also they will put me in private room and back to hot gowns,ect.
when i go back to hospital in day or 2. I checked with the sw and there
me a one of there laptops. Good luck Mel and bless your Alan Sue
I'll do a no Mrsa for anyone chant. And heal all boo boo's

Cyclelops:: The doctor knows all about Alan's PN. He's been Alan's podiatrist for over 10 years. He has operated on Alan's foot. Did a beautiful job on his tailor bunions. He knows all about the IVIG and when Alan told him what happened during the recent IVIG thing, Alan said the look on his face was priceless. He knows all of Alan's medical history and what meds he is on.

Sue:
Alan does not have MRSA (at least not that we are aware of). And he's not going to go to any doctor and get a MRSA consult. Trust me on that, I know the man. Thankfully, he is fine (except for his re-ocurring foot ulcer!!!

Alan has had an ulcer dating back from last year. It would be healed, then he would go to the gym, and it would re-occur.

He initially got it because he went on the treadmill and he couldn't feel the friction and he got the sore on the bottom of his foot. He had an infection in this ulcer over one month ago, but the foot doctor (and me) took care of it very nicely. No more infection!!!

The ivig thing happened last week. Has absolutely nothing to do with his foot ulcer and he has no infection. All the doctor did today was debride it (like he usually does).

And the fact that the Doctor said "Don't have your wife call me". Well, maybe he thinks I'll ask him too many questions. He teases me about this all the time. I do know that if I called him with an emergency, then of course he will speak to me. (Right now this doctor is trying to get me Diabetic Shoes through my insurance, and I'm bugging him about that!!! I'm entitled to them, but today I got a denial from Empire Blue Cross (something about the wrong codes). Alan called the foot doctor's girl who takes care of these things and she said she would get right on it. So we BOTH go to this foot guy!!!

So, next week the doctor will tell Alan, "yes, I will operate", (probably this will happen)or No, I won't!!! He also told Alan he may "sew up the ulcer", then he shook is head and said "no, I don't think so". The doctor once told us that he often consults with other doctors about Alan's case because of his neuropathy.

Now as far as the neurologist goes, of course I'll tell her that they want to operate,(I will do this only after we find out that they WILL operate,) but if she doesn't call us back, what the heck are we supposed to do????

And tomorrow we see Dr. Fred, so I'll make him look at Alan's foot too!!!!AND WE'LL DISCUSS THE WHOLE IVIG DEBACLE!!!!

Such excitement, my goodness!!!!! Know what I wish?? I wish all these doctors would contact each other and do a consult and say "oh, Alan needs this, or Alan needs that".

Like that's gonna happen!!!

Mel

I just saw this on my MSN homepage.

Here's the link. Very interesting!!!


http://www.msnbc.msn.com/id/18881802/site/newsweek/

Your a dabectic Mel you can get a script from your family Dr.,Neuro,
Pod. for your shoes.

The nurse was not good,and you don't need a MRSA consult. Bob went
through the same as Alan. If he get's surgery after what happened a MRSA
test is not out of line.But last i will say Sue

Sue:

I got a script, a letter saying, I needed shoes, I picked out the shoes I did the whole thing. And I called up Empire and they agreed, YES, I'M ENTITLED TO SHOES.

But when the doctor's office submitted the request (with all the paperwork included), it got denied "BECAUSE EMPIRE SAID THEY USED THE WRONG CODES".

So now we have to do the whole thing over again.

Oh, I misread you about the MRSA test, I apologize. I thought you said that Alan should go for a MRSA test now. Well, as a matter of fact, the day after the infusion, Alan went for all Blood work. We get the results today.

I will ask Dr. Fred about MRSA. (Believe me, I'm as concerned as you are).

I just took a look at his foot. It looks fine. Still the little hole there (after he debrided all around it. It's nice a clean, but still there's the little hole.

I think Dr. Baird will shave down the bone so Alan stops getting this ulcer.
It re-occurs because of the bone underneath it. Puts pressure on it. I mean, it's over a year now. I think they have no other choice.

So we're keeping him off his feet (only going out to see Dr. Fred).

One good thing about Alan, he heals like a champ. I mean the last time, he had a whole the size of a quarter on the bottom of his foot, and three days later, it was healed. He's amazing.

BUT THEN AGAIN, HE'S NOT DIABETIC!!!!!

will update and thanks for being so nice.

Melody