So now Harry is at his podiatrist's office that afternoon in the exam room. The physician is alarmed by what she sees because when she last saw Harry, he was problem free and anticipating his participation in his grandson's wedding. The physician has a difficult time explaining to Harry that he needs to be admitted to the hospital for IV antibiotic administration as well as advanced imaging studies. Quite possibly, due to the severity of the infection, Harry may need to stay for a few days to have this infection surgically treated. Of course, the physician relates that if prolonged, Harry may miss his grandson's wedding.



It is important to note that all diabetic foot infections must be evaluated by a physician, no matter how minor or trivial it may seem to the patient. Misdiagnosing yourself can lead to serious repercussions involving your foot. It could even prove fatal if left untreated. Home treatment without physician evaluation is not an option in diabetics for any level of infection.

The next morning, Harry is visited in the hospital by his podiatrist. Harry has been on IV antibiotics since his arrival in the emergency room, but he has seen no change in the condition of his right foot. In fact, Harry has now lost his appetite and complains of some episodes of nausea. The physician carefully explains the situation to Harry. He has a severe infection involving his right foot. This infection is severe enough and has progressed enough that he will need to go to the operating room to remove the infected tissue and attempt to washout the bacteria present. The x-ray has shown no changes but the MRI has suggested evidence of possible osteomyelitis, a bone infection, in his right foot.

That evening, Harry goes to the operating room where his podiatrist debrides the infected and dead tissue. She also washes out the wound to try and reduce the bacterial load present. She also cultures the wound to help influence the correct antibiotic choice. Lastly, she takes a small piece of bone to be sent to the pathologist to check to see if there is microscopic evidence of an infection.

After three days, the cultures return with exact bacteria identified. This is important because now the best antibiotic can be chosen to fight that particular bacterium. Harry is still in the hospital, and although he feels better and his right foot has improved, he's about to hear the dreaded word that all diabetics hear ?amputation.? Harry's physician tells him that he needs to have part of his foot amputated because the bone sample has come back positive for infection.

Harry has now come to a fork in the road. He can have the amputation and get back on his feet quickly, possibly in time for his grandson's upcoming wedding. Or he can elect to continue IV antibiotics only for up to six weeks, which carries a less than 5% success rate to eliminate bacteria once seeded in bone. Reluctantly, Harry agrees to the amputation. He is discharged from the hospital three days later, having spent a total of ten days there. He is able to attend his grandson's wedding, although he is not wearing his rental shoes and he is not dancing. But he is able to appreciate the fact that he could have lost his leg had he not been properly cared for. Harry is thankful for all of these things, and he now visually inspects his feet everyday. More importantly, Harry is now well educated concerning his disease and he has taken measures to combat any problems that may develop in his future.