The mother of all toe stubs

Kraken · Post by **Kraken** » Thu Sep 05, 2019 10:45 pm

About five weeks ago my brother-in-law stubbed his toe on a door threshold at home. And by "stubbed," I mean he nearly ripped two toes clean off. Doctors said the bones were crushed and his foot was unlikely to heal due to his diabetes. Amputation was proposed. At one point they were talking about taking his leg up to the knee. Since that advice came from a surgeon, he demurred.

Things got better, and he went to rehab. They figured two weeks to teach him how to walk again. After a few days he had a diabetic...episode? attack? flareup? whatever it's called when diabetes goes south. Back to the hospital.

Things got better and he was scheduled to go back to rehab when they detected cardiac fibrillation. Drugs failed to stabilize his heart. Electricity was used, and helped some. There was talk of a pacemaker.

Things got worse. His lungs filled with fluid, as happens when the heart doesn't do its job. Soon, an infection was detected.

Things got a lot worse. Infection turned into sepsis. He was intubated, sedated, and sent to critical care. After consulting with a doctor friend of ours -- because one cannot get straight talk from the hospital staff, or even find out who's in charge -- Wife caught the first possible flight to Lansing, unsure if he would still be alive when she landed and steeling herself for the decision to remove his breathing tube if he was. Her other brother arrived from FL half a day later.

Just when you'd think things couldn't get much worse, things got worse. His kidneys began to fail and he needed dialysis. At this point we actually considered it a positive sign that they still wanted to treat him and nobody was suggesting pulling the plug.

And that's where things stand now, three days later. He's in "critical stable" condition, meaning things stopped getting worse but aren't getting any better. His odds of dying are much higher than the odds of recovering, but nobody's actually ruling that out, so his treatment goes on. If it were my brother, I'd be tempted to put him out of his misery...probably a good thing I don't have a brother. Wife's family are not the kind of people who ever discuss death and dying, so nobody knows what his wishes would be. Drugged unconscious and intubated, he can't say.

If you're the praying sort, please hit up your deity for whatever he can do. If you aren't, then send a positive thought his way. His name is Paul. He's "only" 59 years old, and he's a good guy.

Jaymann · Post by **Jaymann** » Thu Sep 05, 2019 11:47 pm

The body is both such a fragile and resilient thing. Best wishes to your BIL. I'm gonna be a lot more careful where I step.

McNutt · Post by **McNutt** » Thu Sep 05, 2019 11:48 pm

Sorry to hear that. I'll be thinking about you guys and hoping for a recovery.

Zenn7 · Post by **Zenn7** » Fri Sep 06, 2019 12:39 am

My wife is diabetic and worries about something like this happening.

Since I had a cousin who was diabetic die in front of his fridge (they think he was going to get something to address his immediate need), I was more concerned about that, until I read this story.

Though I'm more concerned about her asthma doing her in. Had another cousin's daughter die from that. Woke up in the middle of the night with an attack, got it under control, went back to bed, didn't wake up again. Only 12 years old... a memorably sad funeral with all her friends there crying.

Sending positive thoughts to Lansing for your bil. Hoping for a positive resolution or a quick end if it's going that way anyway.

Daehawk · Post by **Daehawk** » Fri Sep 06, 2019 1:10 am

Seems sometimes theres a chain of events that start small and end up costing a life. Its part of life. But it sure as hell doesn't make it any more palatable.

Jeff V · Post by **Jeff V** » Fri Sep 06, 2019 10:04 am

Is he type 1 or type 2 diabetic?

Holman · Post by **Holman** » Fri Sep 06, 2019 10:21 am

What awful news. I'm thinking of your family, Kraken.

Paingod · Post by **Paingod** » Fri Sep 06, 2019 10:32 am

This is just ... horrible. Wow. I'm sorry.

My only "deadly toe" story isn't even mine. A guy I worked with (a brilliant software developer) told me the story of how he was in a crappy hotel room a year before then and the handle popped off the shower and fell on his big toe. It quickly became a purple, swollen toe. Confused, he went to the hospital and they peeled off the nail to discover that he had an infection under there that had hollowed out the area. Apparently this had been going on for some time without him knowing, and the broken shower saved him from whatever was about to happen when it hit his bones. The nail never grew back, and he was left with a cavernous hole on top of his toe. He offered to show me. I declined.

I can't imagine, though, the suffering going on with your brother-in-law. I don't even know how to process stubbing a toe so hard that your foot breaks apart... let alone everything after. Just ... horrible.

Isgrimnur · Post by **Isgrimnur** » Fri Sep 06, 2019 10:42 am

Sorry to hear it, Kraken.

Maybe time to get myself some foot guards. I've already shattered both my pinky toes.

LordMortis · Post by **LordMortis** » Fri Sep 06, 2019 10:46 am

Wow. I stubbed a toe that took months to heal and turned the outside half of my left foot purple unto my lower leg. I can only assume jammed in to my foot and fracture foot bones of some sort and then I'm no longer in my 20s... or 30s.... and nearly out'my 40s... I guess I should feel lucky, though the amount of time it took to heal the crazy way my body elected to heal should probably be yet another diabetes watch event. I get blood and urine tested every year as I am fat fat fat but nothing comes back, so that's something, I guess.

Daehawk · Post by **Daehawk** » Fri Sep 06, 2019 10:48 am

I think the only time Ive ever really stubbed my toe badly was when I first moved here to this home. Her parents had...and I still have....a fancy couch that has a wood support leg right in the middle front. I stubbed my toe / foot there about 3 or 4 times in the late 80s early 90s and I learned my lesson. Even today when I go near that couch my first thought is that support leg. Makes my toe hurt thinking about it.

Jaymann · Post by **Jaymann** » Fri Sep 06, 2019 10:54 am

I remember many years ago I was just starting my shift as a cook in a restaurant, when I dropped a massive cutting board on my big toe. I just gutted it out and finished my shift. Went home and drank a bottle of brandy to dull the pain. Ah to be young again.

Anonymous Bosch · Post by **Anonymous Bosch** » Fri Sep 06, 2019 11:26 am

Jeff V wrote: ↑Fri Sep 06, 2019 10:04 am Is he type 1 or type 2 diabetic?

I doubt it makes much difference. From the sounds of it, the poor fellow's various afflictions were likely brought about by acute or chronic complications of poorly-controlled diabetes (i.e. poor circulation, neuropathy, kidney damage, and probably diabetic retinopathy etc.) moreso than the stubbed toe.

Pyperkub · Post by **Pyperkub** » Fri Sep 06, 2019 11:27 am

Kraken, I sincerely hope everything goes well and your brother-in-law is able to make a full recovery. That is horrifying.

I remember as a kid riding my bike barefoot and my foot slipping into the spokes and cutting a big gash in my toe. It was right before I was supposed to be doing Punt, Pass, and Kick back in the 70's and I was devastated.

When my Dad passed unexpectedly, I was in the hospital and the Doctors were telling me to pull the plug the same day he was suddenly hospitalized. One of my best friends who used to go to 49er games with my Dad and I was helping me, and he reminded me of my dad, and how he loved telling stories, and how much he would love telling this one if he made it. I told the Dr's no, that they should try to keep him alive, but the next episode did it. That pressure from the doctors, as well as all the family calls I was making to keep everyone up to date was unbelievable, and I'm so glad that it didn't get to the point where I had to make the other decision.

The other thing is that it ended up as a double-whammy. My dad had already bought into the Florida retirement community where my grandmother (his mother) was living and was preparing to move out there, and she was so devastated at outliving her eldest son (my grandfather had passed a couple of years prior) that she went downhill from there and passed a few months later.

Kraken · Post by **Kraken** » Fri Sep 06, 2019 11:36 am

Jeff V wrote: ↑Fri Sep 06, 2019 10:04 am Is he type 1 or type 2 diabetic?

I want to say...Type 2. That's the adult-onset variety, yes?

The doctor friend that I mentioned before speculates that Paul might have injured his foot in the first place due to lack of feeling in his extremities. Most diabetics don't control their disease well, and uncontrolled diabetes ravages one's whole body. Millions of Americans don't even know they're diabetic and it can do serious damage by the time symptoms become obvious. "Complications of diabetes" was the cause on my dad's death certificate, and he went down in a similar cascading fashion.

Nobody in his family even knew that Paul was diabetic until this happened. He weighs >300 lbs (or did before this lengthy hospitalization), eats a poor diet, and doesn't exercise, so that wasn't exactly surprising.

No status change as of this morning.

Drazzil · Post by **Drazzil** » Fri Sep 06, 2019 11:38 am

Thoughts sent Kracken. My right small toe has been jammed so many times it will no longer bend and healed at the wrong angle.

Kraken · Post by **Kraken** » Fri Sep 06, 2019 11:45 am

Wife says he is very slightly improved this morning, so that's nice.

Smoove_B · Post by **Smoove_B** » Fri Sep 06, 2019 1:07 pm

Wow. That was not the story I was expecting. Hopefully you get more good news. 59 is too young to be suffering that much.

Z-Corn · Post by **Z-Corn** » Fri Sep 06, 2019 5:36 pm

Sorry to hear this. Sending positive vibes!

Enough · Post by **Enough** » Fri Sep 06, 2019 5:45 pm

Yikes, what a saga. I hope things improve soon for your family!

Holman · Post by **Holman** » Fri Sep 06, 2019 6:05 pm

Diabetes is a bastard.

My dad has been dealing with it for years, and according to his doctors he has managed it absolutely flawlessly, doing everything right. Nevertheless, he recently got a diagnosis of something wrong with his pancreas and his gall bladder. Thankfully neither seems to be cancer, but the gall bladder is coming out and the pancreas is still kind of a mystery.

His father died of diabetic complications. So far I show no sign, but I won't be surprised if someday I get the news.

Archinerd · Post by **Archinerd** » Sat Sep 07, 2019 9:24 pm

Damn, the thread title didn't prepare me for that.
Sounds like he's hanging in there for the time being, hope the good news continues.

Kraken · Post by **Kraken** » Sat Sep 07, 2019 10:15 pm

Thank you. Today's report showed continued minor improvement. I won't turn cartwheels unless he comes off the respirator. It is common for people in his situation to cycle up and down more than once on the way to recovery or death, and we still expect the latter.

Wife and her (other) brother found Paul's house (their childhood home) to be uninhabitable, as they had been warned that it was. Overstuffed with junk, it hadn't been cleaned in...well, let's say that cleaning never rose to the top of Paul's activity list. They spent a few days throwing stuff away and hired cleaners to revive the kitchen and bathroom tomorrow, after which time they'll consider moving in and ending their motel charges -- that's especially important now that it looks like this might take weeks, or even longer, but Wife won't do it until she's sure there are no mice or roaches. Next they're going to see if his car is salvageable so they can turn in one of their rentals. It too is full of trash, filthy, and hasn't been maintained in years. IDK if it's safe or reliable, but it probably runs and is registered and insured.

They knew he was living the life of a bachelor slob, but didn't realize how far he had sunk.

Meanwhile, they're looking into getting guardianship and executor powers, if only for as long as he is unresponsive. He hasn't worked in years and has been living off his 401k; nobody knows how much money is left, but bills gotta be paid, and it's a safe bet that the hospital will get it all in the end. Fortunately he has always lived frugally, so there isn't much to cover beyond utilities, taxes, and insurance.

Kraken · Post by **Kraken** » Wed Sep 18, 2019 9:59 pm

Paul continued to do better than expected for a couple of weeks. Heart and blood pressure normalized, kidneys got flushed, sepsis cured. Some of the IVs came out and sedation got reduced. He was responsive. Talk of moving him to rehab started up again. He still wasn't breathing on his own and he was still in critical care, but everything was moving in the right direction. Long-term care strategies were floated. Wife was thinking about coming home soon.

The past tense is a giveaway. Yesterday his heart stopped -- three times -- once for 16 minutes (they stop trying at 20). After the third time they said they wouldn't resuscitate him if he coded again. He didn't, and has been static with a weak heartbeat in the 24 hours since then, but nobody's talking about recovery anymore. They did some brain scans tonight to see how he weathered the heart stoppages. Odds are strong that the decision to "move him to palliative care" -- which I guess is how the kids say "pull the plug" now -- will have to be made tonight or tomorrow.

He beat expectations and struggled back once, and nobody can swear that he won't do it again...but nobody's betting on it. The brain scans will determine if he's even still in there.

Daehawk · Post by **Daehawk** » Wed Sep 18, 2019 10:20 pm

Strange how things can cascade downward so badly so fast. Believe me I know. Modern medicine is still so damn primitive. And in many cases useless. Sorry about your BIL.

McNutt · Post by **McNutt** » Wed Sep 18, 2019 11:23 pm

I'm very sorry to hear that. Thoughts are with you.

Kraken · Post by **Kraken** » Wed Sep 18, 2019 11:56 pm

Daehawk wrote: ↑Wed Sep 18, 2019 10:20 pm Strange how things can cascade downward so badly so fast. Believe me I know. Modern medicine is still so damn primitive. And in many cases useless. Sorry about your BIL.

People are still so damned mortal. Rallying before the end is common, as you know; I tried not to get too optimistic while he was still in critical care. But hope crept in anyway.

Well. Not going to talk about him in the past tense yet.

Paingod · Post by **Paingod** » Thu Sep 19, 2019 12:22 pm

I'm sorry to hear things have turned for the worse.

Our bodies are wildly complex machines, and I often wonder if we'll ever master the art of keeping them running.

Kraken · Post by **Kraken** » Sat Sep 21, 2019 3:32 pm

And he's gone. Slipped away quietly half an hour after the last line was removed, well-doped on morphine, with his brother and sister at his side. He never regained consciousness, and with the amount of brain damage he had incurred that's good.

RIP, Paul. I didn't know you very well, considering that I knew you for 40 years, but I always enjoyed your company and we saw eye-to-eye on most things that matter. You were a good man who will be missed.

McNutt · Post by **McNutt** » Sat Sep 21, 2019 3:51 pm

Sorry for your loss.

Smoove_B · Post by **Smoove_B** » Sat Sep 21, 2019 4:16 pm

That's terrible and I'm sorry for your family's loss.

Z-Corn · Post by **Z-Corn** » Sat Sep 21, 2019 4:55 pm

Oh that's a bummer. I'm keeping you guys in mind.

Daehawk · Post by **Daehawk** » Sat Sep 21, 2019 5:23 pm

Im very sorry Kraken. Ive feared this outcome each time Ive seen the post updated.

Jaymann · Post by **Jaymann** » Sat Sep 21, 2019 5:52 pm

Sorry man. At least he didn't suffer.

Holman · Post by **Holman** » Sat Sep 21, 2019 5:53 pm

My condolences. RIP.

Daehawk · Post by **Daehawk** » Sat Sep 21, 2019 7:06 pm

And all this started with a toe stub. Shows how deadly diabetes is and some people dont think of it that way. When I first moved here a friend of my mother n laws down the street her husband had it. Something happened to his feet and he had to lose his legs so far up. I think he got sores on them and didn't have them checked. Was in a wheelchair for the last remaining years of his life.

Kraken · Post by **Kraken** » Sat Sep 21, 2019 8:32 pm

My dad died in a similar way. He'd been sick for years with neurological symptoms, including chronic pain, and was diagnosed with various best-guesses (including Lou Gehrig's disease, at one point). Ultimately he went through the same kind of cascading organ failure as Paul, and died when we removed life support. His death certificate read "complications of diabetes." Huh. Yes, he'd been diabetic for ages, but diabetes was never even mentioned as part of everything else he was suffering, much less the underlying cause.

He went into the hospital about a month after my first cat died. Paul went in shortly after Gus died.

Anyway, diabetes: not to be trifled with.

mori · Post by **mori** » Sat Sep 21, 2019 8:44 pm

My condolences.

Zenn7 · Post by **Zenn7** » Sat Sep 21, 2019 9:09 pm

Eek... hope no more of your cats die!

My condolences to you and your wife.