Friday, August 5, 2011

Toe be or not to be a toe

Okay...I have a tough decision coming at me in about two weeks, and I kind of need those who read my blog to understand, and perhaps weigh in if their feelings are strong about it. It's about this wounded toe of mine, and the thoughts I have about it. I've discussed it at length with my beloved Becky. She's not happy with my basic decision, but understands that it's my body, and so I should be the executive in chief who decides what happens to it.

As explained yesterday, I went through the terror of facing an enforced amputation of my second toe on my left foot. Part of my discussion with my podiatrist was my superstitious concept that once body parts start coming off, a diabetic has about 10 years to live. When I tossed this concept out to the doc, he actually found himself struggling with a way to say, "You may be right." But he was quick to explain that there's a difference between me and those who pass after that first amputation, in that I'm actually making an effort to regain control of my health. Heck, even if it's just a discussion, I'm doing more about my smoking than most people, who don't even want to talk about it.

As a pleasant surprise, I discovered that I did not, in fact, need to be thrown into the hospital for emergency surgery. My toe may be infected, but it's not infected enough.

This problem with the toe sprung up around the same time I started staring Charcot foot in the eye. Mind you, there was initial confusion, where I thought it was Charcot Marie Tooth's disease, and not Charcot arthropathy. So the care of this wound has been going on for at least three and a half months. And what's happened? It hasn't done any healing, and has actually gone deeper, right on down to the bone, which isn't showing signs of being infected...yet.

I don't see a win coming out of this battle with my toe wound. It's surrounded by some of the worst bacteria the human body can generate. It's an open wound that goes as deep as it can, without going on through to the other side. It hasn't been getting better; it's been getting worse. And so I spend part of my free time wondering when this wound will go from mere severe nuisance to major problem. And so I am thinking that it's time to euthanize the toe.

Becky has bought into my 10-year fear. If I start losing body parts, I'm liable to only survive another 10 years before it's the end of the road. However, my argument against that theory is that this would not be an enforced amputation. This is not a decision being made by doctors on my behalf, but a decision made by me to improve the quality of my life.'s just a toe. There are a dozen ways that this toe issue can rapidly turn into the full-scale amputation of my foot. An infection serious enough can jump from bone to bone, until the middle of my foot is looking black and dead, and requiring that they start cutting at mid-shin, just to be sure they got the infection out, free and clear. And that's what I feel like I'm waiting for. I'm sitting here, just waiting for this to become serious enough for someone else to say, "It's gotta go." I don't see anything wrong with me making the decision in advance, preventing things that are much worse... what the podiatrist called "seeding." It's the idea that I end up with an infection serious enough that I MUST receive an amputation. They do what cutting they need to, and get me clear of the infection...only to have a similar infection pop up somewhere else, as though my body becomes an incubator for the infection, allowing it to pick and choose the next body part to victimize. My personal idea - the idea of a complete layman - is that I can nip that process in the bud by removing a defective toe before it becomes a crisis toe.

I need to discuss this with my doctor, so understand that it's not going to happen blindly. I'm going to get information before I leap blindly into this surgery. But I think it may be for the best. Meanwhile, I'll continue my antibiotics, as instructed, and tend to the wound with all the free wound care material that was passed on to me at the hospital where I was molded for shoes today.

So...Objections? Agreements? I leave it to you folks to let me know if I'm making sense, or if I'm out of my mind. But understand that I've already sold the idea to Becky, who said, "I'll still love you, even if you can only count to 19." =P

Be well, and DFTBA!

PS: I linked this post to the DT at GitP. Those with access can PM me there if they'd like to give me feedback through that venue.


WalkingTarget said...

I can only imagine how nerve-wracking it must be to seriously have to contemplate the removal of a body part. By all means, discuss things with whatever doctors you have access to, but I think that it's something you might consider doing.

I know you've had the 10-year theory for a long time now, but thinking of it as a preemptive strike rather than an emergency action could be a way around that.

Whatever you decide, though, keep us posted. As I so often find myself thinking when you post what you're going through, my life has not prepared me to offer advice from a position of common experience. The best I can offer is support and the assurance that you're being heard by somebody who wishes you well.

Be well, Rob.


Zeb The Troll said...

Yeah, I'd be speaking out my ass here.

If it helps, with your explanation of what's going on and my understanding based on that (meaning I'm getting at best third hand info instead of direct from the Doc's mouth), I think I would make the same decision you have up to this point. Assuming the doctors are in agreement, of course, because that's what they get paid to know. I might get a second opinion, though. Sometimes doctors disagree on the science. Your doc won't fault you for that. You're talking about amputation, not whether or not to go generic on the meds or something equally menial.

Good luck, Rob, and I hope that your health will benefit whichever way you go.