My mother 82 has a blood flow issue, I asked the vascular surgeon could he give her an angiogram/angioplasty. They refused to do so, I asked could they do tests to see where her blood flow is weak, they said, no. I asked for a meeting with the doctor's in the morning, I was there, but no one showed up. Then finally in the afternoon, a hospice doctor, and wound care nurse came in to talk to me, about my mom.
The hospice care Dr. said, if I did not want my mother's leg amputated they would do hospice. I am still trying to get them to help get blood flow re-established. Wound care nurse just told me my mom has gangrene! NO ONE TOLD ME MY MOTHER HAD GANGRENE!! I asked how long had they known she had gangrene, because this was the first I knew of it. Nurse said 3 to 4 days ago! I said, you got to be kidding me! no one told me! The Dr. says that is water under the bridge, I said no sir, this is important, If I had not asked the wound care nurse, NO ONE WOULD HAVE TOLD ME! I saw my mother's wounds and I could not believe how bad they had gotten!
I finally found the network of hospitals who had done my mother's procedure previously. The doctors kept telling me the procedure could not be done, but my mother had it done last year! How do you trust people who are withholding information from you. Do not want to TRY to figure out a solution before an amputation. So, I found a vascular surgeon who will give a SECOND opinion. Mom got sick, had to go back into the hospital, right before the appointment, I made another and she got sick 3 days before that appointment. Because I do not agree with this doctor's opinion, because he has not AT LEAST TRIED something else before suggesting amputation. I think about amputation it is a MAJOR SURGERY, not a routine procedure which is what I asked for him to try to do. The complications and the pain after amputation...I am trying to save my mother's leg if I can, If I cannot save her leg, I AM JUST TRYING TO GIVE MY MOTHER A CHANCE AT OTHER OPTIONS FIRST. Oxygen Therapy, Debridement & Irrigation. NONE OF THESE HAVE BEEN TRIED. THIS IS A HUMAN BEING!
I take of my mother at home, have been her and my father's caregiver. Lost my dad last year...But now, I have my mother, so much negligence here from nursing facilities, and all I am trying to concentrate on is my mother, and her well being. If you have any suggestions, of my mother's rights, much appreciated, I am her POA, guardian. Thank you ahead for any help on this subject.
Gangrene can set in very quickly. It does sounds like the nurses are monitoring your mother closely as they picked up the change in 3-4 days.
Ask the surgeons if they would consider an ultrasound (Doppler studies) of the lower extremities- but it sounds like they may probably have done those tests in the past and that led to your mother having stent placement last year. If that’s the case then it sounds like they have done all they could to reestablish the blood flow and all has failed. Thus gangrene has set it.
Unfortunately once gangrene is present the surgeons need to act quickly before it spreads and the tissue dies from lack of blood flow & infection sets in,thus the urgency. The longer you wait the more tissue dies and the area that must be amputated will increase - meaning a below the knee amputation may progress to an above the knee amputation.
It’s a hard decision & the options are limited. Your mother’s comorbid conditions - if she’s diabetic, hypertensive, etc - add to this. You say your mother was sick at least twice in a short period of time & this caused her appts to have to have been rescheduled so I’m thinking your mother has other health issues as well.
I am a RN & have seen many people that needed an amputation & have adapted to it. There are many good prosthetics available these days. Your mom may be feeling pain in the gangrenous foot. Debridement & irrigation won’t heal the wounds if there is no blood flow to the area. Hyperbaric therapy probably won’t work either because, again, compromised blood flow due to small peripheral vessels & narrowing.
Not to discount amputations but they are often successful.
And yes, unfortunately if the area isn’t amputated then Hospice is often the next step as your mother will continue to decline and will need palliative care/hospice will keep her comfortable and pain free during the end of her days.
Again I am so sorry & I wish you and your mother peace.