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Foot Gangrene Control: Amputation Surgery Defined
The purpose of this website is to present, to all who want the knowledge, a safe and dependable alterantive through which individuals may avoid toe, foot, or leg amputation. If you put your mind to it you can achieve astonishing results. By having the whole page printed, you can read it in a nice easy chair, away from that glaring monitor.
Amputations are done for a variety of reasons, including:
Amputation, however, should be attempted only after all forms of treatment have been exhausted. In the United States people over the age of 60 account for approximately 85 percent of all amputations, the majority of which involve removal of a lower extremity.
The arteries of the legs have become narrowed, hardened and, finally blocked due to a disease called atherosclerosis or arteriosclerosis. Blockages in the arteries result in insufficient blood supply to the limb.
When narrowing or hardening of the arteries becomes severe gangrene develops and amputation may be the only option. If left untreated - depending on the severity of someone's condition - infection can develop and threaten the life of the patient. If amputation is not performed, in these circumstances gangrene can be fatal. Sometimes bypass surgery may help avoid amputation, but not all patients are suitable for bypass surgery. Many patients with diabetes - by itself a risk factor for atherosclerosis - develop foot or toe ulceration. In fact, about 7 percent of diabetics have an active ulcer or a healed ulcer. Ulcers are recurrent in many diabetic patients and approximately 5-15 percent of diabetics with ulcers require an amputation.
When he was first diagnosed with type 2 diabetes, he thought, "Oh, I feel fine, there's nothing the matter with me." In late August [2005], he noticed a small "bruise" on his left foot but didn't think much of it. When the "bruise" began to spread, he soaked his foot in hot water, but didn't notice that he had scalded his foot badly, making matters worse. Gangrene set in and he lost a couple of toes. Despite his best efforts, the problem only grew. Doctors said the only treatment was an amputation. He was scared. He certainly didn’t look forward to losing part of his leg. Unfortunately, while the surgery went well, another complication of diabetes hit Doug. He suffered a fatal heart attack days after the operation.
Amputations can be divided into two types: minor and major. Usually, before the operation (although not always) the surgeon decides at what level the amputation will be performed. Minor or limited amputations are amputations where only a toe or part of the foot is removed. A ray amputation is a particular form of minor amputation where a toe and part of the corresponding metatarsal bone is removed; and the wound is usually left open to heal. This sort of operation is performed frequently for foot infections in patients with diabetes. A partial foot amputation through the metatarsal bones is called transmetatarsal (TM) amputation. Major amputations are amputations where part of the leg is removed. These are usually:
Occasionally an amputation of just the foot can be performed with a cut through the ankle joint. It can be an option in some patients with diabetes. Usually, before the operation (although not always) the surgeon decides at what level the amputation will be performed. In the below the knee operation (transtibial amuptation), the bone in the lower leg (tibia) is divided about 12-15 cm below the knee joint. This produces a good size stump to which a prosthesis can be fitted.
One of the most important factors in healing of the wound is the sufficient blood supply to the tissues. If the blood supply is damaged or impaired it may not be possible for the tissues to heal even after a minor amputation. If the conditions are right for healing the wounds can heal well over a period of 1-3 months and leave a fully functioning leg and foot. Unfortunately, it is difficult to predict in every patient whether healing will take place. Physical exam, surgical judgement and experience, PVR (pulse volume recording), and segmental pressures are not able to make this prediction accurately. The question whether a wound is likely to heal or not can best be answered noninvasively by a measurement of the pressure of oxygen on the surface of the skin, i.e., the transcutaneous oxygen pressure (TcPO2). This pressure reflects the amount of oxygen coming out through the skin, which in turn reflects the amount of oxygen delivered to the skin by the blood. Studies have shown this test to be an accurate predictor of wound outcome. Even so, the predicted outcome is wrong in 10 to 15 percent of cases as other factors in addition to oxygen supply can affect wound healing. The test can be applied equally well in diabetics and non-diabetics. Normal TcPO2 at the foot averages about 60 mmHg, but 50 mmHg or greater is considered normal. With severe arterial occlusive disease TcPO2 is decreased significantly. The average TcPO2 at the foot in patients with rest pain or gangrene is about 4 mmHg. Wound healing is predicted, though not a certainty, for a TcPO2 greater than 20 mmHg and wound failure is predicted for a TcPO2 less than 20 mmHg. However, studies have shown that wound healing can occur (though only in about 10 percent of cases) when the TcPO2 is zero.
Unfortunately, many people need to have an above knee amputation. This may be because the blood supply to the lower leg is too poor and a below knee amputation would not heal properly. In this operation, the bone in the thigh (femur) is divided about 12-15 centimeters above the knee joint and the muscle and skin closed over the end of the bone with stitches. However, an amputation stump will remain a potentially vulnerable area that requires lifelong care and attention.
Transmetatarsal amputation - an amputation of the distal third of the foot - is most commonly performed for gangrene or non-healing ulcer of the toes. It is indicated, if:
Gangrenous lesions may be due to emboli, atherosclerosis, or diabetic neuropathy.
Below on the left is a photograph of a diabetic foot with a transmetatarsal amputation taken three weeks after surgical intervention (the wound still visible).
The following images contain pictures of long below-knee (B-K) amputation - an amputation of the lower leg between the ankle and the knee (in the distal third of the tibia), also called transtibial amputation. Pictures taken by Wayne Smith, RN in 2000 during his volunteer work at Scheer Memorial Hospital in Banepa, Kavra, Nepal.
PLEASE NOTE:
These photographic images may not be suitable for sensitive people.
The most frequently found alteration is the shortening of the distal diameter of the stump, which assumes a conical form and migrates towards the end of the prosthesis socket. This occurs by the approximation of the fibula behind the tibia due to socket compression, creating pressure points that may cause cutaneous (skin) ulcers and make prosthesis use impracticable.
Pain in the amputation stump Frequent in conventional amputations are also intraosseous circulatory alterations on extremities. They result in a painful amputation stump at lower temperatures.
The loss of foot or leg is not like the loss of one's jewel or money. This type of loss is priceless. It means that you cannot walk or run as before. After amputation of a foot or leg, the body weight of an amputee shifts to the other leg. The resulting wear and tear often leads to problems in the other foot or leg, and in a few years similar problems may develop, necessitating another... amputation. If this degenerative process continues, the results may be fatal. Losing a limb has also a negative psychological impact. It leaves amputees feeling depressed, angry, or alone. They feel that they're no longer whole persons; or fear that others stare at them, or avoid them. Loss of limb can be compared to losing a spouse or a child. The first time you see your body after the surgery will be very disturbing. You may be shocked to look down and see that a part of your body is missing. The trauma is deep and multi-layered. So it is not easy to adjust to the loss. You will have very strong pain after your amputation surgery because the surgeon has cut through skin, muscles, nerves and bone. Your limb will be swollen. Swelling can cause pain and limit movement. After an amputation, the muscles in and around the residual limb shorten. This pulls your joint into a bent position. If it is left like this for long periods of time, it will become difficult to straighten, or even become permanently stuck. Recovery is never a fast process. Each step is difficult: sitting up in bed, then sitting in a wheelchair, standing, then using crutches.
There are significant risks attached to undergoing an amputation, especially if you are elderly and have diabetes and/or narrowing or hardening of the arteries due to vascular disease (atherosclerosis/arteriosclerosis). In this group of patients, the chances of dying in hospital after a major amputation (below or above knee) are somewhere between 10 - 20 percent. In other words, between 1 in 10 and 1 in 5 patients who undergo a major amputation due to atherosclerosis, sometimes in combination with diabetes, will die in hospital. This is why amputation is always a last resort and a surgeon advises a patient to undergo this operation only when it is absolutely necessary. These statistics also mean that 4 out of 5 patients undergoing an amputation will do well. However, 70 percent of amputees having surgery for vascular ischemia - due to atherosclerosis, diabetes, gangrene, Buerger's disease - are dead within 3 years.
Other complications of amputation surgery include:
Immediate post-op limb pain - where skin, nerves, bones, and muscle have been cut; it is exeperienced by everyone after an amputation. Residual limb pain - in the natural limb (stump) after the amputation and may be present long after the surgery as the residual limb is usually more sensitive than other parts of the body. Unfortunately, there is no one method or treatment guaranteed to reduce or eliminate residual limb pain. Sometimes surgery is necessary. Sometimes nothing will help. Phantom sensation or feeling - in the amputated "phantom" limb which has been removed, such as itching, tingling, warmth, cold, pain, cramping, constriction, movement and any other imaginable sensation; it is experienced by almost all amputees. The brain is “remembering” the missing part of the limb, and is still “reporting” its feelings. Phantom pain - in the missing or amputated part of the limb; it varies from person to person - a little annoying, very unpleasant, severe, or disabling; it is different from pain in the residual limb and experienced by about 60–80 percent of amputees. Unfortunately, there is not one single guaranteed treatment to reduce or eliminate phantom pain. In most cases, it disappears within months, though most amputees (as many as 40 percent of them) may still experience phantom pain from time to time. Management of post-amputation pain is a major problem and usually requires professional help; however, our understanding of the way at the brain handles pain and other sensations is still fairly crude.
The possibility of walk after an amputation depends on a number of factors. For instance, a below knee amputation gives the patient the best chance of remaining mobile and successfully walking post-operatively with an artificial leg (prosthesis); 80 percent of below knee amputees will walk. You more likely will walk after your amputation, if
It can take between 6 and 12 months for full rehabilitation potential to be reached. Most patients undergoing minor amputation (toe or foot) are able to walk after surgery virtually normally. For the majority of elderly patients with a lower limb amputation the most important aspect is to walk again. Usually, rehabilitation from an amputation in an elderly person is a difficult process. Unfortuanately, only 40 percent of above knee amputees walk. The factors which make it unlikely a patient will walk after their amputation include:
Over half of the elderly patients who undergo a below or above knee amputation never use artificial legs effectively. In order to remain mobile after an amputation the majority of patients need the help of a wheelchair - especially those, who are very elderly or have had other serious illnesses, such as heart disease or stroke.
Based upon the professional evaluation of medical doctors and an experienced lifecare planner, a convincing proof of an appropriate lifecare plan for the survivor of a below the knee amputation of the leg requires a combination of:
The estimated costs listed below are in addition to:
Please note that the following estimation while comprehensive, is not complete and requires further personalized consideration necessary in every case and to provide for special medical needs.
In this specific example, estimated annual median cost for goods and services in 2003 dollars is approximately $105,000.00 for Northern California.
Also surgery (read: amputation) has its limitations. In some cases it cannot be performed as it may put patient's life at even greater risk! Then, such condition is being qualified as... hopeless. "We're sorry, but nothing else can be done," vascular surgeons keep telling relatives of patients'. And this is true - but only from the medical point of view. What makes gangrene, especially its "dry" version, responsive to the nutritional method is the fact that this type of gangrene involves the resultant obstruction only of the arterial blood supply without interference to the venous return. In other words, in dry gangrene the blood flow (circulation) is only partially impaired and the other part (venous system) is still functioning, or ready to function. Therefore, it is able to cooperate by supporting any attempt to restore internally faulty circulation, especially in its arterial part. The other factor making dry gangrene highly responsive to the nutritional method is the fact that this disease is characterized by a gradual progression>. In other words, due to relatively slow development of gangrene, there is enough time to support the body nutritionally in order to restore partially impaired circulation - in this case, to unclog arterial blockages. These two factors - the partial impairment of the blood flow and the gradual progression of the disease - have been commonly overlooked, not to say ignored, by standard medical treatments of gangrene.
One of the natural, non-amputation methods to effectively treat dry foot gangrene is the nutritional revasculatization. Its first and foremost goal is to improve and - over a period of time - restore the impaired circulation in the areas wounded by vascular ischemia (decreased blood flow) - the most common cause of foot ulcers and/or gangrene. The process of natural revascularization can be triggered with an application of nutritional - natural and essential - factors that - when presented in specific ratios and amounts - are able to correct longer standing deficiencies and imbalances which are known to contribute to the circulatory problems. As opposed to standard medical methods of treating vascular ischemia, the nutritional revascularization helps to reduce the impact of factors that created the buildup of atherosclerotic plaque in the arteries.
Simply put, Gangrene Clear-G Formula works to improve and/or restore circulation. And improved circulation allows the body to heal itself. What could be better than a nutritional supplement fixing the impaired circulation that develops in a diseased body? There have been medical studies on the beneficial effect of nutritional supplementation on the circulatory system; it appears people with poor blood flow do benefit from specialty dietary supplements. Nutritional factors - naturally occurring substances, not drugs whose substances are foreign to the body - are able to boost the body chemistry by
As far as the cardiovascular system is concerned, according to orthomolecular nutrition, if the right building blocks (nutrients) are present in the body - in the right amounts and at the right time - the body will do the rest. In other words, if you want to stop the progression of gangrene due to impaired cirulation you need to get to the root of the problem. By just pulling a dandelion out by its leaves, you are not going to get very far.
This all-natural combination of 80 nutrients and phytonutrients (plant nutrients) not only keeps your blood flow to the affected limbs in check (as drugs do), but actually helps your body rebuild the organs and systems that control blood circulation - without side effects. No wonder, our proprietary Gangrene Clear-G Formula can produce results that doctors have rarely seen before, even with hard-core prescription drugs. And, unlike pharmaceutical drugs, it is very body-friendly.
In other words, Gangrene Clear-G Formula does not "destroy" gangrene! It helps the body to eliminate its cause, namely, to stop the progression of gangrene through improving and, over a period of time, restoring impaired blood circulation that is known to contribute to gangrene. In our clinical experience, Gangrene Clear-G Formula does that in a way of:
As you can see, the Gangrene Clear-G Formula consists only of the natural factors vital to the cardiovascular system and present in specific ratios and amounts in order to correct longer standing deficiencies and imbalances that are known to contribute to the common circulatory health problems. This superior dietary supplement has mitigative, preventive and protecting properties. However, there is no one "miracle" ingredient in the Gangrene Clear-G Formula. It is a special and unique, orthomolecular combination of all of ingredients that helps to accelerate the inner self-healing effect. In many individuals, our Gangrene Clear-G Formula has also been able to:
And there appears to be no harm in taking the Gangrene Clear-G Formula.
Dear ReverseGangrene.com, First, let me thank you for the unique way you created your web site. It was very easy to find and your words were sincerely understood. I’m living proof that gangrene can be reversed. In April 2005, I was in a hospital bed, and about an hour away from a scheduled amputation of the fifth toe of my right foot. Right from the hospital bed I called your toll- free number and asked you if it was possible to reverse gangrene even though I was told earlier that morning that bones in my toe were also infected, and the answer was “yes.” I declined the amputation, and two days after taking Gangrene Clearing Formula, the gangrene portion of my toe began to fuse with the non-gangrene area. The rest is history. My toe is healed and the infection is completely gone. No one can believe it. Many are calling it a miracle, especially since the doctors at one of the most well known university medical centers told me that an amputation was the only remedy. Day after day as I changed the dressing on my toe, I was amazed to observe steadily growing white healthy tissue. Eventually the gangrene of the affected part came off and the remaining part of the toe healed nicely. I’m happy to have saved most of my toe, in light of the fact that the surgeons wanted to amputate it all the way up to the metatarsal bone in my foot. I must admit that it took courage and close to five months for a complete healing, but it was well worth it. The most important thing here is that the gangrene was REVERSED! Your Formula specifically targeted the problem and is very potent. It really works!!!!! I might add that you were always available to me for personal support. Also, my sugar is now under control without insulin. Thank you! Thank you! Thank you!
Denis Wedge
Therefore, it is important for you, or someone you love or hold dear, to be decisive about what you want to do about your condition, rather than to be vague or unsure. The consequences of your indecisiveness could be detrimental...
At Full of Health Inc., we hope that you will give the nutritional approach serious consideration; it can help you get and keep gangrene in your feet or legs under control without humiliating surgery.
Think, feel and act positive. Be more concerned with what is right than with who is right. All-in-all, gangrene is a serious, life-threatening condition!
By sharing this information, you can discomfit those who desperately want to believe that conventional medicine has all the answers worth considering. We hope everyone with a relative or friend with diabetes or atherosclerosis effecting the brain, legs or heart, will at least open the door to them to alternatives. The nutritional approach to gangrene is for you - if you have courage, good will and persistence, and are not afraid to take your health into your own hands. As opposed to amputation, the nutritional gangrene control is something you can do on your own - and get results.
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back to web version ReverseGangrene.com © 2000-2008 Reverse Gangrene. com: Foot Gangrene Controlled Naturally With Gangrene Clear-G Formula. Stop the Progression of Gangrene: Avoid Toe, Foot or Leg Amputation. All rights reserved worldwide. This document may not be copied in part or full without express written permission from the publisher. The information on gangrene and nutrition provided herein is a general overview on this topic and may not apply to everyone, therefore, it should not be used for diagnosis or treatment of any medical condition. While reasonable effort has been made to ensure the accuracy of the information on reversing diabetic and non-diabetic dry gangrene naturally, Full of Health, Inc. assumes no responsibility for errors or omissions, or for damages resulting from use of the foot gangrene information herein. |