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.
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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