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I have a parent in his 60's with diabetes. His doctors recommend amputation as infection has gone in to his bone. He refuses amputation. I know I cannot make him have his leg/foot amputated. I cannot get access to his medical information because he refuses along with making anyone his power of attorney. My question is, if he refuses amputation what will happen to him and what type of life expectancy does he have?

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My mother-in-law was 65 and already had had 2 toes removed when the ulcer on her foot would not heal. They recommended amputation, she refused. Said she wanted to die with her feet on and they were not cutting anything else off. And less than a month later she died.
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Peter, that is very unpredictable. There can be chronic infection if the person is immunocompetent, rather than gangrene that would have a timeline of a few weeks most likely. Chronic infection can go on months or years, and may be associated with draining sinus tracts and a lot of pain, plus in some cases it causes amyloidosis with renal damage. If the circulation is sufficient IV antibiotics and debridement rather than amputation could effect a cure but this is OT as likely the case in long standing poorly controlled diabetes. Sorry you are having to stand by and watch things happen. Legally competent people are allowed to be unreasonable..but they can also get second opinions, and that might be worthwhile.
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Loads of talk but nobody answering the question directly. What is the progression -time scale -and prognosis - to DEATH???
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aging,

I imagine that the Dr.'s want to amputate to save his life. I'm sure that the Dr.'s have told him this. Your dad must be in a lot of pain as well. He's probably on strong antibiotics too. Despite all these measures the infection will most likely spread to his blood which would cause your dad to die of sepsis, a massive infection.

I'm sure the Dr.'s have told your dad all of this. Is your dad able to make healthcare decisions on his own?
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Jana, your foot is not worth your whole life. It is hard to think about losing a body part though, for sure. At times IV antibiotics and maybe hyperbaric oxygen can salvage a limb - might be an option for either you or the OPs dad. People who do choose not to amputate when nothing else is going to work can die of sepsis and gangrene, sometimes in relatively short order.
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I am facing losing my foot i am just 30 it makes me whole right now i rather die with it then lose a big part of me people can say what they want but try being them its very hard i am going though it n understands
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I know that you love your dad. And may God bless you to always love him. Because when they act like stubborn jackasses, resentment can come into your heart. Tell your father the truth, cut it or it will kill you. Now if decides cutting is out, then death is in. Prepare yourself for his departure. No one is worth the stress for their mess.
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I know that you love your dad. And may God bless you to always love him. Because when they act like stubborn jackasses, resentment can come into your heart. Tell your father the truth, cut it or it will kill you. Now if decides cutting is out, then death is in. Prepare yourself for his departure. No one is worth the stress for their mess.
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My mother is 89. She should be 90 in October. One of the sweetest ladies that ever lived/ She got a darn pressure sore on her heel at a care center in Pepin, WI named Pepin Rehab & Care. They knew about it a year ago in July. Mayo Clinic is an hour away. She should have been taken there the minute it was discovered. There were several different doctors with the clinic who kept passing her care around...so no one person could be blamed. They wrapped it, and put ointment on it for a couple months. Then one suggested a fleece boot over the wrap, They propped her foot up. They gave her pain pills. My sister lives 2 blocks from the Pepin Rehab. There are: me near KCMO, and a brother in Iowa, and a sister in Omaha. The sister in Pepin is so naive she believed Mom was being taken care of. She has "Power of Attorney". So she convinced Mom that it would heal, and the doctors knew what they were doing. They DIDN'T!...or maybe they were saving Medicare a few bucks? Or they were med school flunkies in a couple of tiny WI towns?.Time went on, and every couple months they would come up with something new. The heel turned BLACK. so they thought maybe the outer skin should be removed with tweezers. They Did Not have it debrided or seen by a specialist. About 6 months into this thing they suggested a podiatrist. She picked at the loose flakes of skin and told Mom she should have a Dr check her circulation in that foot. Well by the time that Dr had an appointment free (after his vacation), Mom was very sick and they decided she probably should be taken to Mayo Clinic. Mayo said it might have been handled earlier, but now the bone was infected, her circulation was poor, and they could do nothing except amputate. At 89+years of age, Mom said NO Amputation. To be honest, she might not have come thru surgery or after-care.)She's frail. So now she's back in Pepin Rrehab, in hospice, and was given one or two weeks to live. She's on week 4 and still going. I cannot tell you strongly enough that if your loved one gets a darn pressure sore , get the fastest, best care you can find. It might have been cured if cared for properly, and now she's dying because of a darn pressure sore. And you can Bet the darn doctors will not put THAT on her death certificate.
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My mother has very little circulation in her leg, even though she had 2 surgerys to repair her condition, I just got back from the doctor who said that her leg needs to be amputated from mid-thigh. She refuse the surgery. Goctor stated that she could become septic and die, can anyone out there explain
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My mom had an infection in the bone of her heal. She was given a daily course of IV antibiotics. She was transported back and forth to the clinic daily. Vancomiacin and a number of other antibiotics were used.
Problem is that she ended up getting colitus difficultus (CDiff) from the month long couse. This can kill also. The infection went away, but because the clinic doc didn't bother to tell my mom to replace the "good" bacteria; the "bad" bacteria in the intestines which uses "spores" takes over.
If you choose this treatment: REPLACE the good bacteria...Lactobacilus (yogurt) and Sacromicies (health food stores) to avoid the CDiff.

If the infection continues untreated he may get gang-green or the infection may spread & kill him.

I'm praying for us.
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Aging-back to you once again--Sorry to hear the news is not good from any of the doctors-Not sure of the life expantancy may be however---however the poison he might develop may eventually travel thru his entire system--and cut short any quality of life-or life altogether. I would think this doctors would be the b est people to ask this question-on a time frame of life--and even with that it can be shorter or longer. Is their any information on the web about this--give it a try. I am sure that many others here in this forum would be interested in hearing your results
Best~
Hap
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Hi:

I agree that your father's opinion is the one that matters most. Have you asked his doctor what will happen if he does not get the leg amputated? I believe that would be where to start. Make sure your father understands the implications of both quality and quantity of life without the operation. If he fully understands the risk to his life, you may eventually want to involve hospice.

I do beleive everyone has the right to make decisions. Recently, my mother was told she needed brain surgery. And while the issue didn't pose an immediate threat to her life, she would continue to deteriorate without it. It was extremely difficult, but I made her be the one to decide. I gave her guidance and support and even set up a conference call with my siblings. We went to great lengths to share both the pros and conns. And, even with limited cognition, I am comfortable that my mother ultimately made the decision she was comfortable with. By the way, this included a consult with hospice so she would know what treatment options were available if she chose not to have the surgery. Some of these conversations were difficult and sensitive and I felt it was important for my mother to have privacy with the doctors, so I did not attend. I did get a report from the doctors.

One thing I have learned: It is crucial that there is someone in your father's group of professional care givers who can mirror your role as quarterback. In a best case scenario, this would be a family physician. However, it might be a specialist or other professional. It is crtically important that you trust this person to keep you informed while understanding his/her commitment is to your father. Additionally, both of you must trust this person. Then, you can feel comfortable that you can be guided.

The mere fact that you are reaching out for support and guidance on such an important and life impacting decision makes me ask if you have such a person in your support network. If not, I would discuss this issue with your father before even beginning to debate the amputation.

You are in my thoughts; best wishes.
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Sadly, I agree that your Dad's quality of life would be poor due to any spreading infection. I would be surprised if any doctor recommends amputation lightly. It's a treatment of last resort. Gangrene is an undesirable path. Hope you are able to enlighten your Dad. If not, and he is of sound mind and knows what all may lie ahead, he has every right to make medical decisions for himself. 60's is so young these days. God bless him and help him - and you! Wishing you the best outcomes possible in his care. Either way, it sure is hard on you.
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I'd say only the doctor would have an idea on life expectancy; it would be hard for anyone to say without more information on the wound and the infection. As for quality of life, I would imagine it would be rather poor, unfortunately. If he's had two doctors suggest amputation, I would think they would have to have a good reason for suggesting amputation; it's not a decision that's made lightly.
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Thank you for your replies. His doctor that recommended amputation had him see another doctor to see if there was anything different to recommend than amputation. The other doctor recommended amputation, too. I have brought up taking him to some type of specialist and he refuses to see anyone else. His doctor continues to do debridement and give him oral antibiotics. He will not give anyone access to his medical information nor tell anyone exactly what it is he has except to tell us the x-ray shows infection from his ulcer his gone into the bone. Based on the little I do know and have seen, I believe he has either fetid foot or chronic osteomyelitis.
My question is, if he chooses not to have the recommended amputation nor see another doctor for a possible alternate treatment what kind of life expectancy and quality of life can he expect?
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Thank you for you comment---I strongly feel they deserve respects
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hapfra, yours is a voice I admire for respecting elders' opinions and voices. They already have so little by way of independence, it is great when we allow their opinions to count. Your sharing is refreshing.
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Hi--If this were my parent-I would get a 2nd opinion before such a drastic procedure---If both opinions do concur---then by all means amputation would be the way to go---to prevent t further complications down the line. If your dad is able to fully understand the pros and cons of the situation-then-after you do receive the opinions from both doc's---I would respect his opinion, knowing in full what the conseqence could be.
Best to you both with this difficult decision-
Hap
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If we can help in any way, please let us know. Maybe we can help provide you with information. You can call our National Limb Loss Information Center for the information you need.

For information on diabetes and limb loss, amputation, prosthetics, and the ACA Peer Visitor program, please contact the nonprofit organization Amputee Coalition of America at 888/267-5669 or visit them at Amputee-Coalition.org.
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