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He is 60 years old.

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If he is competent and this is a matter of vanity or being obstinate, you cannot force him to do anything unfortunately. But at some point the
decision will not be his choice.

Ages ago my paternal grandmother had gangrene set in on her toes
due to complications from diabetes. She was good about taking medication but not about hygiene. MD wanted to remove 3 toes. She refused. It spread to her foot. When the pain got unbearable about year & half later, she decided that NOW she wanted the toes removed. At that point, they had to remove above knee and also removed all the other toes on the other foot. Any decision making ability had been taken from her as she waited too long/too late. She got fitted for a prosthetic but refused to work with rehab. Her MD's were totally over her and who could blame them. She could not return to her apt and dog, as she HAD to be ambulatory to live there- this was before ADA. Ended up in a sub-par nursing home just miserable as it was all avoidable. This was ages ago.... point is she had a choice and made the worst decisions.

Have you met others who have gone thru the surgery and have a prosthetic? Their really amazing. Maybe you can contact the
Amputee Coalition of America for help not just for him but for you to understand what the situation will be like for you.

60 is really young, is this a matter of pure vanity or is it fear? Are there other issues - like diabetic eye problems? Does he take his meds and watch his diet? If not, who is going to take care of him when he can't?
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Yes, it is vanity and fear, no doubt. He has had three amputations on the same foot in the past 8 years because of gangrene, he now has only a partial foot. He takes his meds, however, we do not have insurance, which is another difficulty in itself. Even when we did have insurance he has had an open sore across the entire width of his foot. I believe he is getting gangrene again. He has just started receiving disability, from what I understand he can not apply for Medicare for two years, and makes too much money for Medicaid. I have contacted Amputee Coalition, but have not heard back from them.
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It's a difficult situation.
3 in 8 years that's such commotion to go through. Maybe reflecting on that is keeping him from going through another surgery. Also none of these have solved the problem so perhaps he thinks another surgery would be the same. Were these all the same surgeon - or three different ones?
If it's always been the same MD, it might be a good idea to see someone
totally new, if they were all different maybe go back to the one that you all got along best with. What does his internal medicine MD recommend?
Are you going with him when he talks with his doctors? If not ,you really should as they may have been more conservative with his 3 amputations
because that's what he insisted upon and they wanted to do more.

The key seems to be having it done below the knee as it's a more sucessfull prosthetic "fit" and your knee is easier to make it work.

What is his pain level? Will he tell you? Is it constant?

Yes, you're right about Medicare - it's 62 and older. You can sign up 6 months in advance of his birthday. However, if he starts drawing his
Social Security and Medicare at 62 it will be at the lowest possible monthly payment. If you can wait till 65 or even longer, the payment will
be substantially more over time. Finances are such a part of what can be done. The New York Times has a blog - "The New Old Age" that is really realistic on $$ issues you might want to check out. Good luck
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If he is considered disabled which it sure sounds like he can get medicare earlier than 62 someone needs to look into this for him but if he refuses surgery you can not make him but when the pain gets worse he will want the surgery but it may be too latgive him another chance maybe another MD who might get through to him-there are people who can not imagine losing a leg you can only try to make him understand and if you have done all you can you may just have to step back and let him make up his mind but have him tell you why he does not want to have medicial attention-let us know how it goes.
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Yes, please contact us for information. That's why we're here!

What an agonizing decision he had to make! Amazing spirit and bravery. If he or his family needs information, they can contact us.

For information about limb loss, limb loss prevention, prosthetics, the ACA Youth Camp and the ACA Peer Visitation Program, contact the nonprofit organization The Amputee Coalition of America, at 888/267-5669 or visit them at Amputee-Coalition.org
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Maybe showing him a video of gangrene and what happens to bodies and limbs? That is not a good thing for anyone, let alone a diabetic to ignore, especially if there is a break in his skin. Good luck! It is nice that others have shared resources that are available to you.
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Many thanks to everyone that has responded. Your words are helpful.
and encouraging. I have indeed had to take a step back, and he has asked me today to make another appointment for him. This too is very encouraging. I appreciate all of the advice here.
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Best of luck to both of you.

Remember to write any & all your ??'s down between now and the next appointment. Let us know how it goes.
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Thanks! Will do!
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Well, all I can say is you need to call him a big baby...there are thousands of amputees living a full active life with prosthtetic legs, arms, hands...I realize he is used to having his legs he was born with, but you need to lay before him how if he dies, he won't be able to be with his family anymore. If he DOES have to have his leg removed, (and agrees) then it should be cut where a prosthetic can be put on after it heals. I have seen blotch amputee jobs where the patient had to go back and have it cut AGAIN to be able to fit a prostheitc. My heart goes out to you, and your Dad, but sometimes tough decisions have to be made in this unfair world that we live in. Remind him, when the going gets tough, the tough get going.
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I'm not sure about all states but I was under the impression that if a person was deemed disabled by receipt of disability insurance, that they are then qualified for Medicaid under the 1619B status. You might also want to check with free clinics or your physician for prescription assistance. As far as your husbands decisions..he has the right to make poor ones. All you can do is make sure that he has accurate understandable information.
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OMG, my husband has diabetes as well, and now we are noticing that it is becoming harder and harder to manage with medication, I hardly know alot of what I should to help him, as I have my sick mom and him to care for, but his meds arent helping anymore, I have to get him to the doctor, he may need insulin now, sometimes he forgets to take his meds, is constantly cheating the system, eatting HUGE bowl of icecream, and twinkies, and stuff he shouldnt! BUt I cannot control him, ( I applied for disability for him and medicaid) thats not true about the medicaid it only takes 3 months and thats all to make their decision, and I can tell u from what u have said that they will NOT refuse him. Try talking him, tell him that u dont care if he loses a leg! that u love him even if he lost his freaking head! Be gentile and try to get his fears out in the open, so it doesnt become to late to do anything about it! unfortunately this is something that cant be put on the back burner, til later, it progresses with a vengence, and I know I am going thru it, my husband also does very dirty work, and doesnt really concentrate on his hygiene as he should, and that is very important, especially when getting knicks and cuts that dont heal up fast etc............he also has a HUGE overproduction of yeast, which also comes with diabetes, we have tried everything, but now its time for the doctor! good luck in your plight, as I know its a hard one, and yes please let us know how things work out!!!!! what state are u in ? It may matter when doing medicaid, I am working on it as we speak for my mom, who is in a nursing home...................If I can at all be of any help let me know!!!!
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UPDATE: My husbands leg went septic, he is in the hospital, because of the infection and the diabetes, they say that he has heart damage, a heart attack while in the ER. He had no pain with the heart attack, the ER doc says that often a diabetic does not have chest pain, just chest pressure and shortness of breath, which is what he had. He has agreed to let them take the leg, but now he has to wait until the infection and his heart damage has healed somewhat, before they can do the surgery. Thanks again everyone!
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VA:

Have you, after consulting various doctors of course, discussed with your husband what's going to happen if he doesn't agree? I don't think he's being "stubborn," but merely contemplating what his self-image and life will be like with just one leg. This man is supposed to be the love of your life, and he feels vulnerable right now. He needs reassurance ... from YOU, not really the doctors.

-- ED
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I can see how losing a leg would be a great blow to my own husband's self-esteem and that he might despair of living any more. Ed's suggestion to do what you can to bolster your husband's self-esteem is a good one. Hadn't thought of that until I read his post. Reassure him of how loving and attractive he appears, and will always appear, to you. And how much you love him and need him.

If your husband isn't getting the proper emotional support he needs from his doctor, you might want to find a new doctor. In my own life, I have found that the doctor I have leading me through whatever health crisis I am experiencing ---makes a big difference in my level of hope for the future and ability to cope.
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What are YOUR options? Shouldn't the question be: What are HIS options? Please honor his wishes. If he does not want amputation, he does not want amputation.
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I would be SO mad at my husband if he put his vanity ahead of growing old with me. I would probably just save him the suffering of dying from an infection, and kill him outright.
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