Imagine sitting in a hospital bed, a doctor whom you have never met enters the room and tells you, the wound that started out as a blister on the tip of your left 5th digit, now has developed into black 4th and 5th toes and requires you to lose your leg. You are probably thinking why can’t my toes be healed with standard wound care and why do I need to lose my leg if only my 4th and 5th digits are affected. The doctor tells you tomorrow they can do the procedure for you. That is exactly what occurred with one of our current patients, whose foot can be seen below. What do you do?
Loss of limb not only affects one’s spirit and lifestyle but causes an increased demand for many end-organs in the body, which could lead to premature loss of life. It is my belief that preserving limb function by offering proper style fitting shoe gear, custom-molded inserts, as well as surrounding the patient with the right team of caring doctors, healthcare providers, and routine following-up appointments can provide an improved lifestyle and reduce the risk of adverse events.
This patient remembered our excellent service, from past experiences, and decided to call Dr. Tepper. Dr. Tepper told the patient to hold off on the procedure for now and once medically stable to immediately schedule an appointment in our office. This patient developed poor circulation over time, which contributed to his blister developing on 1 toe and affecting the adjacent toe and portion of the foot. I always tell patients it does not matter what type of wound care you provide or expensive tissues you apply to a wound, it will not heal without adequate circulation. Poor circulation is a supply and demand issue. In this patient’s case, his left 5th toe wound demanded a specific amount of oxygen and nutrients to help heal the blister, but his blood vessel was too severely calcified with plaque formation that its supply was unable to meet the demand of the left 5th toe blister and developing gangrene.
Our office has developed many unique relationships with many highly qualified vascular doctors. This patient received a small procedure that helped to open up his blood vessels to provide improved blood flow to the foot. With our advanced knowledge of wound care and the patient being optimized enough, the patient was fortunate to have only the 4th and 5th toes removed instead of the foot, ankle, and leg as suggested by the previous doctor at the hospital.
As you can see the patient completely healed and is back on BOTH feet.