How a doctor saved my uncle’s leg

Couple of months age, during one of my trip to the village, I happened to see my uncle who had a small injury on the left foot in between the fourth toe and the little toe . As the injury was small, their family hadn’t paid much attention to it and had their life going on. As several weeks passed by, the injury wasn’t healing and instead kept slowly growing. They started visiting doctors locally and he was given many medications to help cure it.

They were now very hopeful that wound will start to heal. But on the contrary the wound slowly started to increase further. Now they started to feel that they need to try something different. It was during this time that we happened to visit him. I felt pretty sad to see my uncle ridden to a chair and walking with a support stand with my aunt slightly holding his hand and making sure he doesn’t fall back.

We discussed several measures that could help him heal i.e. giving him a massage to help with blood circulation, cleaning the wound every day and keeping it in sunlight etc. During this time I also came to know that, based on the doctor’s (lets call him Dr A) suggestion they had got an angiograph done for the lower limbs, which had shown that there was 40–50% blockage in one artery and 70–80% blockage in another one, which was leading to gangrene (decomposition of tissue due to obstructed circulation). The doctor also explained that, as my uncle had a history of smoking, there is a blockage at several different locations with varying levels.

Dr A, also suggested medications to help improve the blood circulation, there by helping cure the wound. He also suggested that if the would still doesn't heal we would need to do a surgery. My cousin had asked me to check his dad’s case with the doctors that I knew, so I talked with two good doctors and both of them suggested us to visit a vascular surgeon.

On their follow visit to the doctor (Dr B) who had performed a hip replacement for my uncle couple of months ago, my cousin had requested me to join them during their doctor’s visit, which I did. My uncle was happy with the hip replacement as he now did not have any pain. The only concern now was that, foot injury was not healing and it was paining in the night.

We also got to see Dr A, who had suggested medications for the wound on the previous visit. I joined my cousin while meeting this doctor too. The doctor told us as the injury was not healing through medications, he suggested a surgery, where they would place a stent at two locations and perform a by pass at another location. He gave us an estimated cost for the surgery and also informed us that, in the worst case we should also be prepared for amputation of the leg.

While my cousin had pretty much agreed to what doctor had said, wanted to go ahead with the surgery, I interrupted him and told the doctor that we needed to discuss about the surgery before we confirm. So we sat down in the reception analyzing what the doctor had said and I explained to my aunt everything the doctor had said.

While we were waiting in the reception, the receptionist understood our dilemma and suggested us to seek guidance from the doctor (Dr B) who had done the hip replacement surgery, So we went back to see him. We explained everything what the vascular surgeon (Dr A) had told us and I asked doctor (Dr B), whether he would recommend his colleague’s suggestion on a surgery and whether he was a good doctor to trust. For which he replied, you can seek a second opinion if you want and feel free to take it. He also suggested a doctor (Dr C) whom he knew and who was working in an other hospital. He picked up his phone and called the other doctor (Dr C) right away and explained my uncle’s problem.

He also told doctor at the other hospital, that he was sending this patient and he didn’t have a problem even if he performed the surgery. The doctor on the other line asked us to see him in about an hour with his room number.

So leaving my aunt and uncle at the hospital, I and my cousin started to the other hospital with pictures of the wound and the test reports. After taking an appointment and mentioning about the referral to the receptionist we were asked to wait. The doctor, as he arrived from his surgery wanted to see us before the other patients (I guess may be because we had a referral). As we entered his large room, I was pleasantly surprised to see pictures, medals, trophies & certificates on the wall. Honestly, I never met a doctor with so many recognitions. So I thought we were in a good company, with a bit a skepticism.

Meeting the Doctor

I explained the case to the doctor, after patiently hearing the case he reviewed the test reports. My cousin also showed medications and some of the injections that they have used based on the prescription of other doctors. The doctor looked at the injection and said, that would be the absolute last injection that they would ever try, after trying everything else.

The doctor then asked for culture reports for the wound, I asked my cousin if they had done a wound culture test. For which he replied, that they haven't done it. So the doctor prescribed a wound culture test to determine the antibiotics that would be suitable to treat the wound.

The doctor said, that our was a complicated case and he couldn't confidently say if a surgery could resolve the problem with the wound. He also suggested that they may need to amputate the leg as the last measure. However, he said he preferred not to put the patient in pain as my uncle was already 80 yrs old. Instead, he suggested a course of medications and injections that he prescribed to use over the next week and suggested us to get back to him with a blood test report after using the medications, so that he can check if the infection is subsiding or not.

In the meantime

It was already late evening by the time we finished seeing the doctor (Dr C), we returned back to the previous hospital where my uncle waiting in a wheel chair with my aunt sitting beside him. We got a wound culture test done where they took a swab of the wound. Following that my uncle and aunt were on their way back to the village which was about 100 miles away.

After 2 days we got the wound culture test report and I forwarded the test report to the doctor (Dr C), while I spoke to the doctor over the phone, he told me that we my uncle was resistant to many antibiotics, and he was glad that the antibiotics that he suggested would still work and asked us to continue the medication.

Progress

After 2 week of using the medications, the wound started to slowly heal and I got a call from my aunt who was really pleased and was thanking me for sparring my time to help them through, which I felt was not necessary. As per the doctor’s recommendation we got the weekly blood test done and we forwarded it to him in order to check if the infection was under control. He said the infection was under control and asked us to continue the medications that he had prescribed.

They were now focused on improving his stamina, so that he could stand and walk on his own. As he was not diabetic doctor suggested Protien rich food.

Summary

We were really glad to see the progress of the wound healing, as of date it stopped spreading and healed nearly 40%, which is significant compared to what we had anticipated, and more importantly this was without a surgery.