Hello. My name is Soreya. I'm one of the nurses here in A & E. Do you mind if I call
you Libby? Oh hello. That's fine. I see from your notes that you have a cut on your foot.
Is that right? Yes, that's right. I've got a cut on my little toe. On my right foot.
OK. Can you tell me a bit about what happened?
How did you get the cut? Sure. Look I wouldn't have worried except that
I'm a diabetic. I am usually so careful. I went to the beach with some friends and
we were walking a bit too close to the rocks. I slipped on a rock and cut my foot.
I see. When did you cut yourself? It was yesterday. I was at the beach in the morning.
I cut my foot just before lunch I tried to clean the cat in salt water and I put on a band-aid as well. I thought that would be enough.
Can you tell me a bit more about what happened this morning? Well, when I woke
up I noticed that my toe was red and swollen. It just didn't look right. That's
why I came here. I am worried now that the cut is infected.
You did the right thing coming to hospital as soon as possible.
It's very important for diabetics to seek medical help quickly if they have a cut
or a wound. Wound infections can develop quickly if you are not careful. Yes, I thought so.
The problem is that it isn't painful. If I hadn't checked my toe this
morning I would never have known that there was a problem. Yes, it can be very difficult.
It's always important to be careful if you have an injury. If you
have high blood sugar levels it can damage the nerves in your feet.
That's the reason why you might lose some feeling in your toes and you might not
be able to feel any pain. You should check your feet every day for any small
cuts to prevent infections from developing. I know. I'm usually very
careful with my feet. This morning I started getting worried about my toe
especially when I saw how red it was. I even looked it up on the internet!
There's another thing I was reading about diabetic amputations.
Now I'm terrified in case I end up losing my toe.
They won't do that, will they? I understand that you're very worried but it's best
to wait and talk to the doctor about that. You will have a surgical
consultation this afternoon. The surgical consultant is a specialist doctor who
will explain any surgery you might need to have. Amputations are only needed if a
diabetic infection doesn't heal. You came to hospital promptly so we can treat the
infection quickly. I know it is difficult but you will have to wait until this
afternoon and have a chat with the specialist. Oh OK. I see. So you're
saying that it might not be necessary? That's right. I know it's very worrying
for you at the moment but I'm afraid that I can't give you any more
information about surgery until you speak to the specialist. However, I can
explain what will happen now. The first thing is that you will have some IV antibiotics
to clear up any infection. IV just means 'in the vein'. The antibiotics
are very strong so we give them through the drip in your arm. they can get into
your bloodstream more quickly then. OK. Someone just put a drip in my arm.
That's what it's for, is it? Yes. We'll give you IV antibiotics for a couple of days.
It's important to treat the infection as soon as possible. The next thing is to
look at the cut and do the dressing. I'll clean the wound and put on a new
dressing then I'll put on a bandage to hold the dressing in place. I'll give you
a special boot to use when you are walking. It will protect your toe from
being knocked. So, I shouldn't use a bandaid to cover the cut? No. It would be
better to use the special dressings that I'll give you to take home. When you go
home you should change the dressing every 2 days. I can show you how to do
the dressing and I'll give you some dressings to take home with you. If you
can't manage it yourself, I can make arrangements for the community nurse to
come and do it for you. I see. If you show me how to do the dressing I'll see if I
can manage. Ah.. you said something about a boot? Sorry I forgot what you said.
That's all right. It is a lot to take in. What I said was that I would change your
dressing and then give you a protective boot to wear. The boot has a soft lining
so your foot is protected from anything that is sharp. You need to wear it until
your toe has healed completely.
OK. I understand now. Is there anything else I need to do? No, not at the moment.
I'll show you how to do the dressing now. I also have a leaflet here for you about
foot care for diabetics. It will explain some of the things I have been talking about.
If you have any questions after you read it just let me know. OK.
Yes, thank you that would be very helpful.