"All of this belongs to the following:
http://www.circulatorboot.com/casehistory/case198.html"
E presented in the Circulator Boot Clinic on Tuesday, March 3rd, 1998 with a oral temperature of 100.2 degrees F (37.9 degrees C). He had previously been seen in our diabetic office in 1979 when he was found to have diabetic retinopathy and peripheral neuropathy. He was introduced to home blood glucose testing and a multidose insulin program. In 1983, his insurance program led him to a family practice where he continued our insulin program with little change. He returned now concerned he needed the help of specialist. He had left work the previous Friday having worn new shoes all day. His foot was swollen. He thought he had flu because of nausea and vomiting. He stayed in bed from Friday until Tuesday when he presented with the foot shown below. After a culture was taken, his foot was infiltrated with gentamicin and vancomycin and he was given a Mini-Boot treatment. Immediate hospitalization was advised. His HMO physician, a new doctor to our hospital, preferred he report first to his office. On seeing the patient the doctor admitted him to the hospital and asked for consultants from infection disease and general surgery. Intravenous Unisyn and oral Levaquin were ordered along with vascular studies, foot x-rays and a bone scan. The latter two studies were negative. The vascular laboratory technician was unable to find any palpable pulses in the legs, but found pseudohypertension (ABI 1.72) at the ankles. The pulse volume in the left foot was significantly reduced.
Pictures are in order of latest to earliest onset of disease.
Later,
Hannah
"Future RNFA, CRNA, ARNP, DnP, Ch.M, BSN, MSN"
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