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1281603 tn?1283798699

blister care

my 80 year old fatherinlaw is a type 2, insulin dependant diabetic. He has neuropathy and no feeling in his feet. This morning I saw a fresh blister on his big toe. There is no sign of infection, but his feet are chronically purple so it's hard to assess. My plan- soak twice a day with epsom salts, dry carefully and wear clean cotton socks after each soak. Anything else I should be doing? Should he be on prophalactic antibiotics?
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Avatar universal
Good luck, Helen and that is good advice for others. I personally had no idea how quickly something could progress! I would like to add to that advice that diabetic complications are very real and to encourage everyone diagnosed with either form of diabetes or even pre-diabetes to take responsibility to monitor and control your blood sugars on a daily basis. We tend to trust doctors to keep us well and especially here in the U.S. we rely on medication for EVERYTHING. No doctor can follow us around 24/7 and make sure we eat right, exercise, maintain healthy weight and take the meds they actually prescribe. (Education and self-management is even more an issue for those of us on insulin)

Again, good luck; I hope they save the foot. Nobody should have to go through that at that stage in life.
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1281603 tn?1283798699
I ended up not waiting and taking him to Emerg. They are going to try to save the foot, using IV, oral and topical antibiotics, but they aren't confident. We'll go back to the hospital daily for assessment. I am astounded at how fast things can progress. This morning there was no sign of infection, only a blackened toe. This afternoon it was cellulitis, purple and very swollen with red lines travelling up the leg. They were appalled at the hospital, but it actually has been seen by 2 different Drs in the last couple of days and it really did not present that badly! If other people are monitoring this site, they do need to be aware how quickly things can change with poor circulation.
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Avatar universal
I'm so sorry to hear that, Helen, it is every diabetic's worse nightmare.
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1281603 tn?1283798699
You were right. I actually took my father-in-law to a clinic yesterday, they examined his foot and we got some antibiotic cream. This morning I noticed a different toe on the same foot going black. I brought him back to the clinic and now we are waiting for a vascular surgeon to call re an appt, presumably to discuss amputation.
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Avatar universal
I'm sorry to hear your father in law's situation, Helen. It's all too easy to think "it won't happen to me" . That's why I'm on a website with 15,000 people with diabetes. I learn from others and get motivated! You sound like a very caring daughter-in-law. He's lucky to have you.
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144586 tn?1284666164
The plan should be to get him to a diabetic wound care specialist for a consultation and recommended treatment. These wound care centers are very good at what they do.

Oral antibiotics do not travel well to the extremities and there is no rationale for prophalactic antibiotics.

If he needs antibiotic for infection they will probably be administered intravenously.

Antibiotic creme is a good idea and the salt baths are reasonable, but he is in a situation where in  twelve hours he could end up with a situation  where the foot would have to be amputated.

If you can observe the foot carefully at least twice a day.

Niacin supplements will improve microcirculation, as well as 1000 mg daily of omega-3 oils.
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1281603 tn?1283798699
thankyou Zoelula. I'll take your advice.
He's in one of those regretful stages of life. He was pretty noncompliant for years, and only now is discovering why we nagged him. I do all his cooking now so his sugars are stable, but sadly, he has done himself damage.
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Avatar universal
The most important thing your father in law can do is to control his blood sugar. Complications such as neuropathy are the result of sustained high blood sugars. With tighter control these complications will lessen and not progress. I would use antibiotic creme on the toe. If it doesn't heal in a day or two you might want to bring him to the podiatrist.
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