Case Studies 27 : Infected Diabetic Wound
Case of infected diabetic wound.
This is a case of 57 yrs old man with
pale, wrinkled & emaciated face, having D. M since 25 yrs,diabetic gangrene of left foot since 2 yrs & diabetic nephropathy since 1 month.
His Sr. Creatinine level was 1.5 mg. % & Blood Urea 52 mg%
He told me that, he had some minute injury to his left foot 3 yrs back. But because of uncontrolled B.S.L. even after taking prolonged allopathic medication (i.e. Antibiotic & daily dressings) wound was not healing & had gradually became gangrenous. So, allopaths advised him amputation of 2nd toe of his left foot.
Then even after amputation of the second toe of left foot (done in Sep 2001) amputated wound was not healing properly.
(It was a non-healing, severely infected, oozing & foul smelling, gangrenous, unhealthy wound.) He came to me with such a critical condition During consulting I observed that, he was sitting with
stooped shoulders with distended belly.
HE ALSO HAD
Breathlessness with cough since 7-8 months
< Ascending
< Exertion
Oedema over both limbs Rt - Lt with
marked redness of oedematous parts Intermittent fever with chills & weakness.
Moderate ascites & bilateral pleural effusion. Along with this Patient was thirsty with burning and sour eructation He had
rumbling in the abdomen < early morning, at about 4 am Unsatisfactory mucoid, reddish stools
Desire - eggs, pungent, spicy, fried foodAversion - sweets
Thermally -
Hot
AFTER INQUIRING ABOUT HIS NATURE, I FOUND
l Patient was a mild yielding and industrious person with loud speech
l He was interested in travelling
l Worried because of business loss
l Desired company
From all the above information and after considering totality, I reached the similimum -
SULPHUR - 30 I advised him admission in the hospital for observation & further study & treatment of the case. But patient refused admission because of his personal problems.
After about a month, the patient came with crucial condition where there was heavy bilateral oedema over both limbs; he could scarcely move the limbs. Oedematous swelling was stony hard & due to such heavy oedema, his pyjama can't be pulled upwards, his bony prominences couldn't be marked. & there was burning over the oedematous region. Along with this, the patient had severe cough with breathlessness < Lying on back > bending forward
Patient was restless & sleepless due to cough & oedema,
HIS COMPLAINTS IN DETAIL WERE AS FOLLOWS :
l Bilateral oedema over both limbs since 7-8 months
Appearance of oedematous swelling : Reddish with burning
l Breathlessness with cough since 7-8 months < ascending > rest
-
Non-healing, oozing, foul smelling, gangrenous wound over left foot since 2 yrs.
-
Fever on & off since 20 days with rigors, heart & sweating
-
H/O Pneumonia 15 yrs back
-
H/O D. M. since 25 yrs
-
H/O mild hepatic enlargement with moderate as cites with bilateral pleural effusion.
-
H/O Typhoid in CH.
GENERALS :
Desire :
Eggs, Pungent, spicy, vegetables, fried food, sour
Aversion : Sweet
Food < : Toor dal <acidity.
Thirst : Thirsty
Stomach : Acidity with heartburn & sore vomiting
Abdomen : Rumbling in abdomen in early morning at about 4a.m
Stool : Unsatisfactory stools. Has to go 3-4 times to pass stool were mucoid & slight
reddish colored.
Habit : P/H/O Habit of cigarette smoking &chewing Ghutakha .
TELL ME ABOUT YOUR NATURE
I am a mild, adjusting person. I don't want to trouble others. Generally I keep everything to myself I like enjoying and travelling.
About education : 11th science
TELL ME EXACTLY SINCE HOW LONG YOU ARE DIABETIC ?
I am diabetic since age of 28, just a year after my marriage.
H/O conflicts with wife
TELL ME ABOUT YOUR HOBBIES / INTERESTS?
I am very much interested in sports specially cricket & badminton. I enjoy travelling. I like to be busy all time, specially in my business.
WHEN DO YOU GET TENSED?
Since last 3 yrs, I am quite worried about my health.
H/O financial loss, thinking over that matter, makes me tensed.
TELL ME ABOUT YOUR BUSINESS?
I am having hardware manufacturing business which is in partnership with my brother. I am also having my own business.
WHEN DO YOU GET ANGRY?
Generally, I don't get angry easily. I am mild person. But if anything happens against my wish, it made me irritable.
AS PER TO MY OBSERVATION :
He is mild, yielding person with loud speech.
REACTION:
After receiving a single dose of the medicine gradual improvement started. His cough & breathlessness gradually decreased.
Oedema also started declining with obvious bony prominences. The non - healing, oozing wound started healing & meanwhile the dose of insulin which was previously about 40 units daily was also tapered gradually & now
the patient is on 5 units of insulin daily.
After about a month at the time of discharge, wound had almost become dry & due to disappearance of ascites & oedema of the limbs, the
patient's weight was reduced to about 7-8 kg.
His cough & breathlessness almost vanished with improvement in General condition of the patient. (Thirst & appetite improved). The patient was fresh & comfortable.