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How to treat gangrene on legs and avoid amputation?

May 2014
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Practicing since : 2002
Answered : 6498 Questions
My father has late stage Alzheimers disease and has been admitted to the hospital with a black toe (bad circulation). We have been told today that there are blockages high up in the leg and that the whole leg would need to be amputated. Because he is very frail they are worried that he would not recover and more importantly we can't imagine doing that to dad at this time. They need to amputate the toe but they say it won't heal. What will happen to Dad if we don't let them take the leg. What I really need to know is how is he likely to die. Will be be able to do anything to make it peaceful and not too long?
Posted Wed, 12 Mar 2014 in Hypertension and Heart Disease
Answered by Dr. Vivek Chail 51 minutes later
Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing in to us. Sorry to hear about your ailing father. The most likely problem being faced by him is blockage in the arteries (vessels) supplying blood to the lower limbs. Due to diminished flow he might have developed gangrenous changes on his toe. It is important to mention that diabetes causes slow healing and also leads to complications which includes spread of the gangrene to surrounding areas. It is unimaginable to see your loved one get amputated. You may take another opinion from a vascular surgeon and then decide. If amputation is not done, the gangrene will involve the other toes, foot, lower leg and then his entire leg might be affected. During this process there will be development of sepsis (severe infection) which is a difficult phase for patient and care givers. Death is due to spread of infection through out the body leading to heart failure. I personally dont believe you must think about his end so soon. You please discuss the medical treatment options and supportive care and then decide. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek
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