New blogger Robert is at a life-changing crossroads. He finds out shortly if his foot can be saved.
Robert, 65, from Wimbledon, is at a life-changing crossroads. He finds out shortly whether his foot can be saved or whether he will need to have it amputated. He has agreed to let Diabetes UK follow his story over the coming months. Robert has Type 2 diabetes and does not depend on insulin to manage his condition.
“I was diagnosed with Type 2 diabetes in 2002. I had an ulcer on the bottom of my big toe of the right foot and a nurse at my health centre, who had been treating me for suspected swelling in my legs (lymphodaema), did a blood glucose test and discovered my blood glucose levels were extremely high.
Looking back, I’d been aware of a loss of sensation in my feet since the late 1990s, but as it didn’t hurt I didn’t take much notice. However, my blood glucose test results led to me being referred to the podiatry clinic at St George’s Hospital, London, and it feels like I’ve lived there ever since.
My big toe was amputated in April 2002, and I had another toe amputated in 2008. Mostly since then my right foot has been well behaved, with the help of a very expensive orthotic boot, which provides support for the foot to help prevent further ulcers. The idea is that it redistributes the pressure better.
Unfortunately, since 2004 I’ve had problems with my left foot too. I was walking to B&Q from my house one day when I heard an audible crack. I started limping, and when I went to hospital my foot was put straight into plaster. I discovered I have a condition called Charcot’s Foot which has weakened the bones in my foot, and as a result over time my foot has become more and more twisted. It is now twisted to the right, making it very painful to wear my other orthotic boot which holds it into a position that is very uncomfortable, but does enable me to walk in the house.
I’m not allowed to walk anywhere else – for all journeys outside the house I have to take a taxi. I get my food delivered and there is also a shop at the hospital. I don’t really go out much apart from to my various hospital appointments now.
I had to have a toe on my left foot amputated last year and we can’t seem to get my foot ‘stable’. The ulcers on my left foot are better at the moment but things can change very rapidly. Since December 2009, I’ve had 11 bouts of cellulitis which hasn’t helped – it’s an infection that attacks the red blood cells, making you feel absolutely lousy, with no appetite to eat or drink and no energy, but worst of all it undoes any healing and I get ulcers again. It comes so quickly – I’ve been at the foot clinic and everyone is pleased with my progress, then two days later I’m having a cellulitis attack. The only ‘cure’ is very strong antibiotics, firstly intravenously and then orally, but that’s not a long-term option.
I was referred to King’s College Hospital, London, last year and they arranged for me to have a CT scan on my left foot. I haven’t yet managed to have a discussion with them about the results from my x-rays and scan, and don’t think I’ll find these out till an appointment in May when, I’ve been assured, the multi-disciplinary team will be present. I also need to have a vascular scan of my leg and an ECG.
Of course I truly hope that my left foot can be saved and that reconstructive surgery can take place, but I need to weigh up all my options. The alternative is an amputation below the knee and I’ve discussed this with staff at Queen Mary’s Hospital, Roehampton. They were so positive about this option that I nearly signed up for it there and then! My biggest worry is that whatever happens with my left foot, the result will be a lot of extra pressure being put on my right leg, and I worry about this leg going downhill as a consequence.
Whatever happens I know I have a long road of recovery ahead of me. I will be in a wheelchair to begin with and will need lots of rehabilitation. At the moment my priority is to gather all the information so I can make an informed decision as so far I don’t feel like I’ve got all the facts. Ideally I’d like the teams who have treated me at different hospitals to talk to each other, but I’m not sure if that will happen.
There are other considerations I have to make too, like where will I live if I have the amputation. I’m not sure my home will be fit for purpose as there isn’t even a downstairs toilet. I live on my own so it won’t be easy.
I know it could be a lot worse. When I’m in the foot clinic I overhear all sorts of conversations – some people are dealing with similar issues to me, and then I hear they are on dialysis too. That brings some sort of perspective to my situation.
There is no doubt that having foot problems has messed up my retirement. So many events in my diary have ‘cancelled’ scrawled through them because I’ve been in hospital or have been too ill to go. In place of invitations on my mantelpiece, I line up all of my clinic appointments to help me remember where I have to be and when.
I think it’s important that people understand just how time consuming and difficult life is with serious foot problems. You can be in and out of hospital in a week even following major heart surgery, but this is a very different proposition.
There’s a lot for me to think about over the next few months. I’ll keep you updated on my progress. Wish me luck!”
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