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posted by martyb on Saturday October 29 2016, @09:21PM   Printer-friendly
from the VERY-stiff-upper-lip dept.

"A former soldier cut off two of his gangrene-ridden toes with a pair of tin metal pliers without anesthetic in his living room after becoming frustrated at a six-week delay to being operated on by the National Health Service (NHS)."

[...] "He says he eventually developed gangrene and his doctor said his infected toes would have to be removed. Rather than wait six weeks for the operation, Dibbins took matters into his own hands.

He says the operation, performed without pain killers and in his living room while biting on a rolled up towel, took about an hour. His wife of 40 years was in the house but says she did not want to look.

“Knowing that it would take at least another six weeks to get me in front of a surgeon again, that’s when I bit the bullet and cut off the toes,” Dibbins told the North Devon Journal.

“I did it because it’s what had to be done. My doctor told me my toes were going to kill me."

https://www.rt.com/uk/364152-gangrene-frostbite-toes-cut/


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  • (Score: 1) by Francis on Saturday October 29 2016, @10:36PM

    by Francis (5544) on Saturday October 29 2016, @10:36PM (#420299)

    There's that, but who amputates because of infection these days? It's been decades since that was medically necessary, but it still happens because quacks don't know how to properly kill the bacteria.

  • (Score: 2) by sjames on Saturday October 29 2016, @11:08PM

    by sjames (2882) on Saturday October 29 2016, @11:08PM (#420323) Journal

    From what little I could gather from the incoherent rambling, he apparently has poorly controlled diabetes bad enough that he is up for a below the knee amputation anyway, which would take care of the toes as well. If his circulation is that badly damaged, antibiotic treatment would be futile.

    • (Score: 2) by dyingtolive on Sunday October 30 2016, @04:52AM

      by dyingtolive (952) on Sunday October 30 2016, @04:52AM (#420437)

      From what I understand, amputation is a common occurrence with diabetics. Something about the immune system going bad that I'm either not sober enough or smart enough to grasp. A rather large CS professor that I took classes from took a few months off some 10 years ago due to an infection in a toe resulting in such an amputation.

      --
      Don't blame me, I voted for moose wang!
      • (Score: 3, Informative) by sjames on Sunday October 30 2016, @07:22AM

        by sjames (2882) on Sunday October 30 2016, @07:22AM (#420452) Journal

        As I understand it, the cause is not well understood. For a long time the leading theory was that the excess blood glucose itself caused nerve and capillary damage. Now, the idea that the same immune malfunction that destroyed the beta cells in the first place might also attack the lining of the blood vessels is gaining ground.

        The conventional wisdom was that tightly controlling glucose levels would prevent amputations. However, since that is not proving out even now that we can control levels very closely with a pump, the immune theory is gaining ground.

        In any event, the guy in TFA was supposed to have his lower right leg amputated. If his toes condition was diabetic related, it would be dry gangrene which moves slowly and doesn't invade healthy tissue. If he had done nothing, they would have literally dropped off on their own. Antibiotics wouldn't have changed anything.

      • (Score: 1) by Francis on Sunday October 30 2016, @04:08PM

        by Francis (5544) on Sunday October 30 2016, @04:08PM (#420537)

        Amputation in diabetics is usually a matter of circulation and nerve damage.

        Basically, if you've got pain insensitivity you're more likely to hurt yourself without knowing that you've hurt yourself, so you're less likely to clean the wound or even know it's there. That's one of the main reasons that diabetics are encouraged to come in regularly to have their feet examined by doctors for things like that.

        To add insult to injury, diabetics often times have circulation problems which means that if there is an infected wound, the body has less of a chance of being able to fight it off or remove the buildup of puss and whatnot that results from the blood cells killing the bacteria.

        But, amputating because of an infection is something that shouldn't happen anymore because the techniques necessary to save even extremely infected limbs has been around for decades now and is less expensive than the cost of amputation.

    • (Score: 1) by Francis on Sunday October 30 2016, @04:04PM

      by Francis (5544) on Sunday October 30 2016, @04:04PM (#420535)

      Nope, I've seen pictures of those kinds of infections and amputation isn't usually necessary unless there's more than just a massive infection. If a 2nd world country like Georgia doesn't need to amputate for that, then I'm not sure why a developed place like Britain would still be doing it.

      The only reasons to amputate a limb are because the vascular system, bones or nervous system has become so damaged that the limb no longer functions. Basically, if you haven't got adequate bloodflow the tissue will die, infection or no infection. And if it no longer has connections back to the brain, it's pretty much inevitable that something will happen to require amputation.

      The pictures tend to be rather gruesome, but I've seen feet that were black with infection that were ultimately saved through appropriate treatment. Basically they cut the foot open and slather a mixture of phages into the wound and let it drain. In most cases the amputation isn't necessary.

      The worst thing about it is that the only reason that treatment isn't available in the UK is that it can't pass the necessary drug trials fast enough to be approved. You use a different strain on each infection and those would have to be independently approved.

      • (Score: 2) by sjames on Sunday October 30 2016, @04:41PM

        by sjames (2882) on Sunday October 30 2016, @04:41PM (#420545) Journal

        I have seen phage therapy and it does look promising for infections. However, in diabetes the problem is generally loss of circulation due to damage to the blood vessels and nerve damage. Frostbite is similar It is not not an infectious process.

        Diabetic ulcers might be helped by hyperbaric oxygen, but dry gangrene means the disease process is too far along for that.