Case study of diabetic foot rotten foot not healing with high and low blood pressure

  This is a consultation about a female diabetic foot patient in her 70’s. The patient’s blood pressure fluctuates from high to low, reaching 190 on high days and 110 on low days, and now the affected limb is particularly painful and she has been discharged from the hospital.  What should I do about this patient? We still need to start from her main problems: a. Diabetic foot infection is not effectively controlled. Because the doctor in the hospital only simply anti-inflammatory sterilization, the symptoms have not been controlled, the pain is unbearable, which to a certain extent will have a certain stress response to blood pressure. Especially at night, it is difficult to sleep and blood pressure can get out of control. Therefore, one of the immediate problems that the patient needs to solve is early debridement to control foot wound infection and promote wound healing.  Second, he did not respect medical advice and did not take antihypertensive medication on time. The family described that the patient did not take antihypertensive drugs on time, very randomly, taking some when he felt high and not when he did not. He took them on time during the treatment of the wound ulcer in the hospital, but not after he went home. In this case, it is necessary to take antihypertensive drugs under the guidance of a doctor as requested by the doctor.  Third, the treatment was abandoned, only to make the symptoms worse. Because of the lack of control, the hospital recommended amputation, but the family worried about the poor health condition, worried about the wound not healing after removal, the patient could not get off the operating table, did not accept, and went through the discharge procedures, and now “recuperate” at home. You may not understand the diabetic foot, it will only get worse if it is not treated, but the speed of development of different patients is just slow.  In fact, I got the impression that this patient did not take his health seriously and did not know its seriousness. Our doctor told about treatment options, such as the possibility of open conservative treatment with a combination of Chinese and Western medicine, but as far as I know still did not go to the hospital.  As a reminder, the impact of diabetic foot on the body can be big or small, and it depends a lot on the attitude of the patient and the family. Patients who do not receive systematic treatment again can have unimaginable consequences.