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My husband has just recently been taken off half of his Metformin intake. Where his skin abrasions where healing the wounds are now starting to open up again.

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Yesterday dermatologist said foot is healing, stay on Augmentin, topical antibiotic and moisturizer, soak foot in bleach water 1xweek, for 30 min.

Doctors 1st orders were soak daily 1x day til we return for next appt in 2wks which was yesterday. My dad said they only soaked it once! Doctor gasped and said that wasn't what he ordered...he doubled checked his orders and confirmed that was what he ordered.  So now I have to call assisted-living to find out if they were soaking it every day or not, to see if my dad was lying or what.
On the way home my dad complained about everything at his assisted living, said the nurses don't help at all only when they want to, they give him handfuls of pills every day, and the food is terrible, talked nonstop all the way home.  He said, everyone tells me since I'm diabetic that I need to take care of my feet and went on to say "I know that!!!   When I discovered his foot sore it had been festering for weeks by the looks of it but who knows how long it was that way ?   It's not the assisted-living's job to check his feet, and he's legally blind he couldn't see them anyway !!
I told him to eat lunch before I pick him up at the assisted living.
Well, he did not and had Low blood sugar event as we were driving. I have glucose tablets in my purse and gave him one...then he asked for another and I let him have it...soon he said he felt better. I'm not experienced with these glucose tablets so not sure if I should let him have two or not but I did. I had no way of checking his sugar at the time. Ate lunch after the appointment and oh my his table manners are gross! Ever since he has had diabetes he never ate right and is never going to change and this man is still insisting on coming home!
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Take it one day at a time Miss Bella. You have to look forward not backward. So far you have taken the best steps in caring for this wound; to me no one has made any detrimental decisions in his care, you just have to go with the flow now and monitor each step going forward.  You can't go back and fix his behavior you just have to deal with what you have now & try to save that foot. The providers still can do a lot to prevent that. 
Good luck! You are a great daughter!
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Ok thank you sunny girl!

I do know his assisted living will not do wound care, someone would have to be called in they said, if even that can happen. We've been lucky with all the dressing changes etc. that they have been doing for him so far.
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Bella,
I'd just be honest with the doctor, but, that's how I am. I'd say that I was very anxious about dad's foot and I needed to know what the doctor was expecting to see and if we needed to get more aggressive with treatment. What other treatment options are there? And how long was she going to wait for progress on the healing before other options were tried. I'd ask for time lines and also, how close are we to looking at surgery.

I'd also ask if the AL staff are sufficient to care for his wound.

I hope you get good news!
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If anyone has other suggestions of what I need to ask the dermatologist today please tell me!!!
And for the endocrinologist on Thursday too!
I always think of questions after I'm driving back home or 2-10 days later!

So exhausted of waking in the night thinking about all this....I think I'm getting dementia for real

Oops! That was SHANE who recommended wound care AND thank you too CDNREADER, I'm interested in what your experiences/outcomes were?
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His long time primary is aware.  I've been advised here to find a new one and have...appt late April with a much younger doc...geriatric docs close to us aren't taking new pt. Endocrinologist appt this Thursday. Years ago I would go with dad to his primary and be his "ears"...would try to encourage him to eat/take meds right etc...he basically did what "he" wanted "when" "he" wanted!! He was never rude to me but I was watching him manage his health opposite of what his doctor tried to help with. I had a long talk with the doctors nurse recently regarding his advanced condition and I concluded that dad needed to play an active part in his health starting a long time ago!!! Although, I've always known this! and that's why over the years I would back off and let it go.
I believe all doctors, nurses, and including Me ( his only child)  who were involved trying to help we're sincerely trying "help" a stubborn, bullheaded man over the years.  HE chose his way of living/eating carelessly! Now he's all messed up and wants "fixed", but still not comply!!
The doc appts have been endless since last July, today we go 1 hr away to dermatologist....Thank you CDNREADER for suggesting wound care!!!!  At the beginning of this "fiasco" with his foot someone at AL mentioned wound care...Podiatrist didn't think it was needed!! Tsk Tsk!! His nurse was the one not wearing gloves then went to type on computer! We have 1 podiatrist in town that's why I chose him.
Anyway, just tired of placing bandaids on top of bandaids for dad. I don't even know if he can get somewhat better if the Endo changes meds because of the damage already done.

For my mom I would drive hours to a doctor and would for him too but  dad chooses to stay in lala land and won't face reality.  Been like this forever.

Thank you too for your suggestions, I appreciate it bunches!!
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I would be very careful and make sure the doctor is aware of his condition and he gets the proper care. Diabetes is a terrible thing to have and manage. There are so many devastating consequences. My father did not get diagnosed till his stroke at age 81. He too had skin issues that I believe were related to his diabetes.
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Okay, big thank you for your input Shane!
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You may want to ask the dermatologist for a referral to a wound care doctor and/or infection control doctor tomorrow as well. Usually dermatologists don't treat wounds for long.
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P.S. my dad also does not choose to eat right so there's only so much that I can do to help him, he's 82 and lives in assisted living
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Hey munchkin,
My diabetic dad has a foot ulcer that is not healing...on three Metformins a day and injecting insulin. February 14 of this year I discovered him sunning his red, swollen, cracked skin foot oozing with pus dripping
on the patio!  By the looks of it I could tell this has been festering for quite awhile.   
Long story short...
Docs should have swabbed it to declare what type of infection to determine which antibiotics to be given.  In my dad's case, the two infections he acquired in his sore were resistant to all antibiotics so far given...so the wound was not healing, and all the while the sugar in his blood was just feeding on the sore! He was put on three different antibiotics starting February 14, numerous antibiotic creams, to this day. Took him to a,now questionable" podiatrist first, after five weeks he sent dad to dermatologist cuz it wasn't healing. Thats when we got the bacterias identified after the foot swab. Monday we go back to dermatologist to see how it is healing, if it is! Just hope it's not too late!!

 My dad is legally blind from diabetic retinopathy and also because he did not take care of his diabetes and keep his blood sugars in range !!
Friends here on the site advised me so well on what I needed to do to help my dad.
1.  Top notch I doctor to check for bleeding vessel's in the eye
2.  Get to an Endocrinologist that knows about diabetes
3.  A competent primary care physician that follows him well with his blood sugars etc
4.  And keep reading here/asking questions from others who have been there and done that 
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Does he take his blood sugar readings regularly? Are they different since the decrease in Metformin?
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High sugars as people said definitely can affect healing as can excessive low sugars. My grandma had an open wound on her leg along with a broken bone that needed to heal. Until she was home and had stable blood sugars, her wound and bone would not heal. At rehab they had her with 500 sugars dropping down to 50s so she was definitely not stable there at all.
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Sugar is a breeding ground for bacteria. And like a low level battery acid, it slowly corrodes the nerves and vessels which is why diabetes affects all the systems and organs if left unchecked. If your husband was on metformin and taken off he should still continue to check his blood sugar levels.
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Yes, there is a strong connection between diabetes and healing. Is your husband taking his blood sugar readings? High blood sugar can cause problems when it comes to healing. I would have him talk to his doctor about the sores and have his A1C checked.
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