My mom is 86 yrs old & is diabetic. Her 2 toes on her left foot were infected to the bones in Dec 2015. She had her 2 toes amputated in Dec 2015, then another 3 toes amputated after a week. Her left foot is still full of pus so Dr. in Vanuatu had her operated each week. In total, she had had 5 operations since Dec 2015 till now. With the lack of professional & technical resources and total absence of laboratory for research & testing in Port-Vila hospital, would my mom be better off being amputated continuously OR stop further operations. She's had 5 operations already and suffers greatly. She's been given panadol to minimise her pain daily. Dr. recommends she returns home even though her foot is still full of pus & advises her wound be cleaned twice daily & bandages changed. She can't stand nor walk anymore with her age & does her toilet in bed. She wishes euthanesia but ending one's life is not allowed in Vanuatu.
If she refuses further operations, what will be the consequences to her, in terms of painfulness, life expectancy etc...? Will she be better off with further amputations given her age & condition or live the rest of her life with her current condition? Please note that the public hospital in Vanuatu has very limited facilities. Most doctors are volunteers from overseas. Her Dr. in charge is on holiday overseas so a local doctor did the last 4 amputations.
Panadol (Tylenol in the US) is totally inadequate to control the pain associated with gangrene. She needs some kind of narcotic. Is it possible to obtain something like morphine?
Cutting another piece of foot or toe cut off is only going to prolong the agony. Mom needs an amputation further up the foot or leg where there is still a good blood supply. If that is done she might stand a chance of recovery. Her desire for euthanasia is very understandable and I will not comment either way.
Stopping all further surgery will give her a prolonged painful death from septicemia. If she was somewhere that had good hospice services it would be possible to keep her comfortable during the dying process. The same thing is likely to happen if the small surgeries continue especially if adequate antibiotics are not available. This kind of infection will also make it impossible to properly control her blood sugars.
So I see there are several options, the best of which is to get her to a modern mainland hospital. If you can not afford to do that contact charities on the country of your choice and see if there is help available. You could start with the Red Cross. The next is do nothing and care for her at home obtaining whatever pain meds you can. Continue with the small surgeries. Amputate up to good healthy tissue. The last one would be to consult local faith healers if you have some and see what they can do to at least ease the pain. This is something hard to comprehend in the West but totally understand and wish there was a way to help more.
Pain management is the problem to tend with now, that and the care she's going to need since she doesn't walk. Are you able to care for her? If not, then you need to tell someone she has nowhere to go and let her be taken into a state facility who has the nurses who can administer her care. I know that's going to be very hard to do, but you also have to think of what's best for you, your family and her care. If you can care for her, don't think of it as a burden...think of it as giving back and paving the way for the time when it's your turn to need help by being a good example to those who might be your care givers in the not too distant future.
I sleep in a recliner at night, and for a couple of hours several times during the day and evening. No, I don't have diabetes, but a foot specialist at a wound care center encouraged me to do this as I have poor circulation.
Even though the infected areas on my feet have healed now, I continue to elevate, hoping to prevent sores from becoming infected again.
I am 75 years old, living in California.
I hate to acuse a poster with such a devastating story but are we in troll land again.
This island has been the subject of dispute between Britian and France and now receives most of it 's assistance from Australia. There is a medi vac service from the island to Australia and New Zealand but can cost up to $10K to make the trip
there appear to be specialist Drs on staff at Porta Vila hospital. In addition it would not be surprising to find volunteers from overseas anxious to practice in a remote area to hone their skills The local languages are English and French plus a native language. France and Britain were interested in the area because of manganese deposits. Well that's my ?history/geography lesson for the day. So if you are real Fion please contact again
Continuing to cut body parts away is not the answer.
I am not familiar with IXPRIM but I think it is Tramadol which again is a wise move given the inevitable pain of the amputation. Again I also have no experience with Tramadol, personally or professionally but hear it is effective.
The important thing now is to keep Mom comfortable and prevent secondary infection of her stump. I envision her as a large lady but if possible get her out of bed and exercise her good limbs. If you can also borrow a wheelchair short periods outside or wheeling her to a cafe or stores may improve her depression. Try and keep the diabetes well controlled and feed her a healthy diet. I imagine on a tropical island you have plenty of fresh fruits and veg.
Home is actually the best place for her to be right now even though the family may not be trained caregivers they are the people she loves and trusts.
In our well insulated lives in the US we have no idea of the difficulties people face in remote corners of the world.
Peace, strength and love!