Case study ( 2676 views as of October 22, 2018 )
Fred is a 66-year-old man who was diagnosed with type 2 diabetes when he was in his 30's, due to a history of alcoholism. Fred managed to live for some time with little changes to his health, other than regular insulin injections. About 10 years ago, Fred went into kidney failure and needed regular dialysis before finally receiving a kidney transplant 5 years ago. Fred has recovered well from the transplant and his kidney is monitored regularly.
Unfortunately, Fred began having circulation problems in his feet over the past 2 years, and has been struggling to get the sores on his feet under control. His physician is beginning to talk about the possibility of amputation to all of his toes to control the issue and prevent the spread of his circulation issues.
Fred would benefit from a referral to an orthopaedic surgeon to review the necessity of amputation. He could also speak with his endocrinologist about the current state of his diabetes management, and his pharmacist to review his medication list for any possible interactions. Fred could consult with a dietitian who is a Certified Diabetes Educator about his nutrition intake, and an athletic therapist to review safe exercises to promote his circulation. Finally, Fred will likely need some kind of prosthetic or custom footwear to maintain his mobility following his amputation surgery.Author: Dr. Richard Bebb