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I worked for Podiatrists, I saw quite a few seniors who has ties, often the big toe amputated. All were diabetic.
Generally they had not been compliant in managing their blood sugar levels prior to the infection that lead to the amputation. Getting their blood sugar under control prior to the surgery and maintaining it after is paramount.
Several who did not manage their blood sugar post op had ongoing infections and eventually needed below the knee amputation.
No I don't, but in the greater scheme of things losing a toe doesn't seem like such a difficult thing, especially if the alternative would be gangrene and sepsis.
I agree with Willie here, the alternative is the infection spreads and she/he loses his leg. Yes anesthesia may cause some problems but if there is no Dementia the person should bounce back in a couple of weeks or so. If Dementia is involved, there maybe some decline which may get better as the anesthesia leaves the body. Gangrene is a killer. So, I would have the toe done.
The person to ask about this is the patient's surgeon.
The prognosis will very much depend on the patient's general health and the reason for the amputation, I should have thought. So other people's experiences aren't much help to you unless those people are also very similar to the patient in other ways.
As you've listed your post under 'diabetes' I agree with CW and JoAnn that the risk of gangrene is likely to be much more dangerous than the risks of surgery. If that is the issue, it's better to do it quick and lose a toe than to hesitate and end up losing a leg.
General general anesthesia is more of a risk if it can be avoided. Since this is a foot, it could be done with sedation and an epidural or local anesthetic. Consult the anesthesiologist.
My mom was going to have a knee replacement at 87. She had already had her second hip replacement at 80 and I had insisted on no general anesthesia unless some crisis occurred during surgery. Consulting with the anesthesiologist MD before my mom's knee, she said that she never gives a senior general anesthetic if it can be avoided.
ALSO, at your mom's age, I suggest you discuss with the surgeon and insist ahead of time on an MD anesthesiologist, and not a nurse anesthetist !!!
My dad at 85 had two toes amputated from very poor heart function and circulation. It took forever for them to heal and he was non weight bearing for months. This really took a toll on his mental and physical health. He was sent to rehab directly from the hospital for 30 days. It was not a good situation but no other alternative since he could not weight bear. His toes were gangrene with osteomyelitis. No diabetes but he anesthesia made his vascular dementia worse. It took forever for his mental state to clear.
VERY individual dependent on degree of illness, whether or not there is diabetes involved (often doesn't heal well), and other things. The doctor can best answer this question as the doctor knows the individual involved. Of all the toes, the great toe (big toe) is most involved with balance, and loss of it can make a surprising change for some, and little change for others. This question best answered by MD, and will be guesswork on his or her part as well.
I (RN with Med/Surg and ICU experience) have taken care of individuals with diabetic amputations. It really depends on the health of the individual. If there is no infection, if the blood sugar is under control, if the remaining limb has good blood circulation... then there should be good healing. Usually 1-2 toe amputations do not affect balance or walking greatly. If the person already has problems with walking or balance, physical therapy will work with the person utilizing devices to help get them back the maximum mobility possible.
I know that my maternal grandmother was a long time diabetic and at the age of 87 had the large toe on one foot amputated. From that point over the course of a few months, they wound up having to amputate the whole leg. I also have a friend that was not quite as old as my grandmother but in his mid 70's when they started with the toe, and over time, the entire leg was amputated. This is one of the problems diabetics sometimes face.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Generally they had not been compliant in managing their blood sugar levels prior to the infection that lead to the amputation. Getting their blood sugar under control prior to the surgery and maintaining it after is paramount.
Several who did not manage their blood sugar post op had ongoing infections and eventually needed below the knee amputation.
The prognosis will very much depend on the patient's general health and the reason for the amputation, I should have thought. So other people's experiences aren't much help to you unless those people are also very similar to the patient in other ways.
As you've listed your post under 'diabetes' I agree with CW and JoAnn that the risk of gangrene is likely to be much more dangerous than the risks of surgery. If that is the issue, it's better to do it quick and lose a toe than to hesitate and end up losing a leg.
My mom was going to have a knee replacement at 87. She had already had her second hip replacement at 80 and I had insisted on no general anesthesia unless some crisis occurred during surgery. Consulting with the anesthesiologist MD before my mom's knee, she said that she never gives a senior general anesthetic if it can be avoided.
ALSO, at your mom's age, I suggest you discuss with the surgeon and insist ahead of time on an MD anesthesiologist, and not a nurse anesthetist !!!
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