Some stories are so out there only time makes them humorous in hindsight. This story has been a favorite of my coworkers and friends for years.
The first homecare agency I worked for had a policy for what to do in case a person lost a digit to necrosis(side note: sometimes people with severe vascular disease and diabetes will have toes or fingers get necrotic and the doctors will allow the diseased digits to just die and fall off instead of risking the patient going through surgery, this is way more common with toes). The policy was that we would have to collect the toe and put it in a biohazard bag to be sent to pathology at the hospital. I know it is a glamorous job try not to be jealous.
Fast forward about 2 months and I have a patient John Doe who was a very brittle diabetic and we were seeing him for wound care on 3 of his toes. Basically we were just wrapping his foot with gauze and checking to make sure the skin on his foot was not becoming necrotic or dead like his toes.
The toes were becoming very black and brittle and I held my breath every visit just hoping those toes stayed where they were supposed to be. Well that idea was shot to shit one visit and I have been traumatized every since. I unwrapped his foot as usual and 2 of the toes had come off in the dressing. So I was getting in my nursing bag to get out a biohazard bag and THE PATIENTS DOG GRABBED ONE OF THE TOES RIGHT OFF THE BANDAGE! So here I am totally freaked out chasing this little dog all over the house while the patient is laughing at me telling me not to worry about it because he could not use the toes anyway. The dog totally ate one of his toes!!! I called my office to let them know I would only be bringing in one specimen and after they picked themselves up off the floor from laughing at me they told me I had to let the doctor know. That was one of the most awkward calls I have ever made. The doctor thought I was just messing with him but ended up being very amused by the whole situation. The patient teased me about the incident until the day we discharged him. I still shudder when I see necrotic toes to this day.
*because I like you all I will spare you images of necrosis of the toes but for anyone wondering how a toe just falls off, please feel free to google it, although I must warn you it is not for the faint of heart*
OMFG. Why do diabetics get wounds on extremities anyway? I don't understand. And can it be prevented?
ReplyDeleteYeah it can be prevented by proper diet and foot care. Unfortunately most of our patients do not follow a proper diabetic diet, nor follow a diabetic foot care regime. This particluar patient wore shoes that were ill-fitting which is means most certain foot wounds for a diabetic. He then did not care for them properly nor see a doctor until they had already developed necrosis or gangrene as you may have heard it called. Since diabetes decreases sensation to the limbs, they may injure themselves and nto notice until it is too late. That is why you hear of people who are diabetic getting limbs amputated. A diabetic should not even cut their own toenails because of the risk of wounds to their feet. They should have a nurse or Podiatrist do it for them. Diabetes also causes Peripheral Vascular Disease which decreases blood flow to the extremeties. So you can see with the decreased sensation, slow healing, and decreased blood flow how detrimental a foot wound is to a diabetic.
ReplyDeleteOMG and I'm just about to eat my dinner..
ReplyDelete