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Open foot sores due to poor blood circulation

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Posted 5/9/2012 3:43 AM (GMT 0)
Due to poor blood circulation, my DH (RA sufferer) struggles with open sores on his right foot (2yrs already!)

There is an open sore on the side of the foot (next to the little toe) and now (wet)cracks appear on the big toe.

My question: Our pharmacist suggested that I keep the sore plugged with Acroban and gauze. What about the tiny cracks on the big toe? Acroban or mercurochrome? Oh my, in the centre of the heel, I notice a wart. Of course there is NO cushioning under his feet anymore - he experiences lots of pain everyday and find it difficult to walk. Yes, he is with good doctors. BUT with poor blood circulation, anti-biotics don't do the job anymore! They told him 2yrs back they did what they could and that he must go home and see for how long he can tolerate the pain! Does that mean - PAIN - then gangrene - then amputation? We are over the shock (amputation) and know that amputation can happen any time in future.

My(DW) immediate worry is to keep infection from these open sores - any suggestions, PLEASE - thank you! 

Posted 5/9/2012 2:47 PM (GMT 0)
I would find another doctor, maybe foot doctor or doctor that deals with circulation issues. I'm sorry, but that just does not like normal advice to give to someone! I also don't think that is RA related. I've not heard of anyone with RA developing open sores, or having circulation issues. Even those who are diabetic and have foot issues, aren't sent home to *deal* with the issue! I'm so sorry for your husband.
Posted 5/10/2012 2:52 AM (GMT 0)
momto3 - 'I also don't think that is RA related' - READ MORE . . .

http://www.everydayhealth.com/rheumatoid-arthritis/rheumatoid-arthritis-and-heart-attack-risk.aspx

So sad - NO news/info re RA are good! I didn't sleep well last night - I am really upset about DH's open sores.

Just as it looked like the wounds are healing, it cracked open again. WITH terrible pain - ouch,man my heart is aching!

Part of the pain in the foot is a bone that the ortopedic surgeon is supposed to remove - now doctor refuses to do the op seeing that there is NO blood circulation. RA is severe in his feet for a long time already. Had op on 5 toes few years back. No pain with them anymore. This current open sore started with an infected corn - we were in and out at doctor's rooms and hospital (many,many times) to get this wound clean. That time it took 9months to close - slowly it started to open again. The size of the wound is like two peas together. I am glad to say that the cracks on the big toe is starting to close.

I used Bactroban and paraffien gauze. (please excuse the wrong spelling in my post - it should read Bactroban NOT acroban!-oops) AND if my English sounds 'odd' - it is not our native tongue - we speak Afrikaans (like Dutch)

17 months ago he had a leg (vein) bypass - both legs have severe hardening of the arteries!

I will do my utmost best to keep infection from these foot sores.

I am thinking of you all - love

(thanks for your replies)

 

Posted 5/11/2012 12:42 AM (GMT 0)
Again I am so sorry to hear of your husbands pain with his feet. It is possible it is caused by RA, but if I were having that much difficulty to the point of having open sores/infections my rheumy would be in alarm mode! If it has been caused by RA, it has gotten completely out of hand and your poor husband's RA has been left to get out of control, it should not have reached this point. I have heard of the increased heart attack risk in the article that you posted, but never ever the foot issue that your husband is dealing with. Again, I am so sorry and I hope you get some help for him.
Posted 5/11/2012 6:45 AM (GMT 0)
 

Bless his heart and you too since you are doing so much to ease his pain and are helping to adapt things for him which is important and caring.  That means so much.  I'm glad he is able to continue doing some activities that he enjoys.

I hadn't heard of patients just with RA getting sores/ulcers on their feet either.  One more unwanted complication to look forward to.  I've been trying successfully so far, to not get cracks and sores on my feet due to Diabetes.  Has your husband ever had a OGTT for Diabetes?

I had read that many RA drugs should be stopped in order for wounds and infections to heal properly.

I agree with Mom.  Your husbands' Dr. should have been more aggressive in preventing/treating your husbands sores, if he saw them in time.

I'm also hoping that someone can do something to help him with his foot problems.  Best wishes to you  both.

Posted 5/12/2012 3:30 AM (GMT 0)
MsOuchie - read more 'unwanted' complications re RA in arteries and organs.

http://www.sharecare.com/question/how-ra-impact-internal-organs

http://www.medicalnewstoday.com/articles/189281.php
Dh's sees his rheumy 3x py and always sends him for tests (long list) On top of all his meds, he now gets testosterone injection every 2wks.

The cracks on the big toe looks better but I still need to put dressing on - cracks are not completely gone. But the sore on the side of the foot is deep. We are now at a stage that we can only take one day at a time.

At last - these last few weeks - he is starting to ask me to get him things - either from the garage or whatever. NEVER in his life he ordered me around BUT I told him I've got time and I've got feet - I can do the walking for him. Like last night he asked me to get him some water to drink. Now he is coming right! I am always around him so he needs not to shout for my attention. He always 'take off' over weekends, but this coming week I will see to it that he slows down a bit more.

He is painting the outside of the house - but I think it is time for serious talking - I'll see if I can convince him not to do any painting for at least a week. He must get off that foot now. Hold thumbs with me that he will listen! Wish the weather would become so bad that it keeps him inside! - but,oh my - our part of South Africa has this unusual droughts for many years now. H'm, I think I've got it set in my mind now - I am going to lock him inside!

Cheers everyone - have a nice weekend!

Posted 5/12/2012 9:37 AM (GMT 0)
I have Ra and I have problems with open sores on my feet too! My pcp suggested that it was possibly a fungal infection-my rheumy issending me to a dermatologist. In the meantime Iuse a fungal based medication like tinacton for the toes and ib between them, then I use a liquid anti fungal on the other areas. Yhe liquid dries with a clear film over the ares. Has your husband been seen by wound care? Also for wounds that are slow healing he could do hyperbaric therapy. My doctor has stressed the importance of keeping my foot sores clean and dry so I cchange socks 3 times a day and if I have to keep them bandaged aI change that 3 times a day as well. But see if they refer him to wound care center. Hope yhis helps. Prayers for you and your family'
Posted 5/12/2012 1:36 PM (GMT 0)
Hi butternutsquash - (h'm, made butternut soup yesterday - we love it! you like butternutsquash too?) Your info re dermatologist/fungal ointment, I am sure, will help. Will let you know what doctors says)

Ja, both of us has an appointment the beginning of June with our dermatologist - good thing you are talking about your foot sores.
I'll tell Dh to show it to doctor - and Yes, we've been to wound care - 2yrs back when these sores started - was in and out there for weeks. DH is developing RA psoriasis on both arms. (more meds!?!)
Eventually the sores healed but the main problem still is that there is NO blood circulation. That means the sores (I think) is now here to stay!?! ouch, and it is so painful. The pain is also due to the little toe bone (RA) that is supposed to be removed. Orthopedic surgeon says he is not going to operate - with no blood it won't be successful.
So I had a serious talk with him early this morning - and he is listening. NO work (on his feet) for the whole of next week and then by Monday (next week) if the open sore is not getting any better - another week of resting for him! This time I can see he is listening.
Thank you for the prayers, buttercup - I do care alot for ALL chronically ill persons. I know and I can see how HARD it is for you guys to get up and stay hopeful. Bless you all. Love, DW

Butternut, so you use anti fungal liquid/meds - something special that you use to wash the feet with?
(Okay, so this is not going to be 'pretty' - shall I send you guys a pic of this foot of DH's?)
Posted 5/12/2012 7:25 PM (GMT 0)
I just use soap and water at home. I work 12 hour shifts at the hospital so when I.'m there I swab the down with alcohol. I' m not very knowledgeable about htperbsric chambers but I do know that ee use it for our chronic wound patients, and it has done wonders for them. Its what they use for scuba divers that ascend to fast and get the bends. It increases the amount of oxygen in your blood therefore improving circulation. Could be an avenue you'd like to investigate further! I am still in shock about how horrible his foot sounds. Is the bed of the wound wet, with a lot of drainage? Does it have an odor? If its draining what color is it? I agree w/ mayfloeer that he needs to have it swabbed to see what type of bacteria you're dealing with. There are some amazing products for wounds these days. Some changed daily, some as far as a week. Without knowing what the wound is growing, it could end up a wild goose chase. I hope ya'll get some answers soon.
Posted 5/12/2012 7:33 PM (GMT 0)
I looked at dh med list. How long has he been on the prednisone? As we age ee produce less collagen and the skin thins. Adding prednisone into the mix and well....it can cause a lot of skin tears. How deep is it do you think.? There's always the route of wound vac. But hopefully when you see the doctor they'll be able to answer your questions and give you a treatment plan. Is dh having swelling issues in his feet and ankles?
Posted 5/13/2012 2:24 AM (GMT 0)
Okay - it is 3.30am - just suddenly woke up at 2am - more than usual things on my mind. The open wounds, to keep infection away and on top of that my aunt passed away and the funeral is tomorrow - family is arriving today - will see them at the funeral, all the talking, etc - AND I don't like 'gatherings'! I am a creative artist and like to be quiet and by myself. Now you know me!?!
Anyway, what I want to say IS: . . . Butternut, Mayflower - you guys are SO right. DH is also awake. I printed him your replies and talked for few secs - we will phone rheumy - we must get the correct treatment for these wounds.
Ja, his skin is VERY thin. Yesterday our tiny budgie bird sat on his arm and one can see blood under the skin where budgie's feet landed. One place is actually bleeding!
DH is on prednisone for 15yrs now.
Butternut - yes, not at the moment, but he had ankle swellings (thank goodness that is better now) and just the other day had an op on the knee to drain the water. Much better now.
So - Monday morning we start with the doctors again!!! Our life is simple - in other words, there is no stress if I need to take him to drs or hospital for care. And fortunately the days are getting cooler now. Our hot summer days is very tiring.
Thanks a million for your caring advice - it all helps DH - to help him think what to do next , eases his worries - which is VERY important in any chronically ill person's life. Not a good thing to be ignored.
Butternut - yes, the wound is wet.
GoodDay all.
Posted 5/13/2012 5:49 AM (GMT 0)
There is medicatedmaterial (cant think of the nsme right now) that you can pack the wound with. I am really praying for both of you. I hope you get some answers and correct treatments. Good luck!
Posted 5/14/2012 3:19 AM (GMT 0)
To view DH's RA foot -
In the pics you will notice that the two toes next to the little toe is shortened. Had op to remove the joints that caused pain. All better now. On the other foot, 3 toes were shortened.

Click on . . .
VIEW IMAGE (at the bottom of this window)
(Photobucket will open - Username = CrohnsDisease password = 6mp3asa)
Click on . . .
ALBUMS
On the right hand side in the Sub Albums windows, CLICK ON
Andre RA foot May 2012
VIEW IMAGE
Posted 5/19/2012 1:09 AM (GMT 0)
Dh is in hospital - septic arthritis in his right wrist. He is receiving antibiotics via a drip and I am happy to say that the open foot sores are looking much better - thank goodness for that. The arm is stil swolen and very red. Hopefully he will be back home early next week. Drs discussed amputation with Dh and explained to him that he is going to have both legs amputated one day. Not necessary right now, but we must get prepared. First thing we want to do when Dh gets out of hospital is to apply for a  Disabled Parking Permit. Then to look at a smallish, easy to handle, wheelchair. Prior to this septic arthritis, Dh was not very keen on getting a Parking Permit, but I think he is going to change his mind about that now.

This time I was VERY upset to hear about possible amputation - this is a wake-up call to us - slowly but surely we must bring changes to our house for when he one day comes home in a wheelchair! We will take it day by day - I also will have to do more of the admin work - I don't even know how to use an ATM - don't know how he pays the accounts, etc.

Back to school for me!

Posted 5/19/2012 1:36 AM (GMT 0)
Best eishes. Its always hard to get bad news no matter how "prepared" you think you are. I think he's a very lucky man to have you!
Posted 6/15/2012 6:03 AM (GMT 0)
DH is back from hospital - BTK amputation was done last week Friday.

He is recovering well but is very weak and has no appetite. It will all come right eventually.

He is glad it is all over - specially not having that terrible foot pain anymore.

Drs are all happy with his recovery.

GoodDay

 

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