Toe Bro: It's happening tomorrow, you have-- you do have an appointment.
Patient: An appointment with doctor Paul, he's vein-- hes, uh, vein specialist, you know?
So he's going to do-- I don't know if he's going to do tomorrow or next day.
TB: Did any-- did anyone who is dressing the foot say anything to you about the blackness?
P: It comes on the-- when doctor comes, these are nurses guys he sent [inaudible], what do they know?
TB: No, they know a lot but--
P: They know something, I'm not saying they don't know.
[inaudible] about the hospital again? [laughs] This is the only way, is it?
TB: I-- I think so because this isn't-- this is not looking good.
P: I know. TB: It looks like gangrene to me.
P: I don't want to go to hospital right now.
I have a miserable 2 weeks down there.
TB: I know... So the foot was extremely swollen and red, right?
P: Well, is not bad--
TB: No, no. Before, before.
P: Oh, yeah it was very bad. I was very bad.
TB: Very swollen. P: Dark.
TB: All the toes were dark.
P: At the time, yeah. In front of the-- at about here, know what I mean?
TB: Yes.
P: It's not dark, is it? Is it dark now? What is it?
TB: It's-- it's still dark red.
P: Yeah, it is. TB: But the-- you have 2 toes that are turning black.
P: Which one, though? Small one?
TB: We have this-- P: Oh, so that one. TB: --and this one.
P: Is it wounded there? That's one also. TB: Yeah, there's a wound on there too.
There's a wound here.
P: Sugar's going down but I guess it's too late.
TB: It is... you know, this is very hard and...
so this is a tough part for us.
P: Yeah.
TB: Doesn't smell very good.
P: I know.
TB: It's-- it's-- it's definitely infected.
Are you taking any antibiotics right now? Did anyone give you antibiotics?
P: No, no, no. It's a hospital.They give you pills, blood, that's what they did.
TB: So this is the issue - you do have an appointment tomorrow with a vein specialist?
P: Yeah, with the-- with the-- the veins.
TB: Okay. I know your foots gonna be bandaged up tomorrow.
P: Hm?
TB: Your foot is going to be bandaged cause the nurses are coming later today, right?
P: After I finish with you, I call.
TB: You need-- P: [inaudible]--
TB: Yes. P: --and put the bandage.
TB: This isn't gonna do much because if the-- P: I know that...
TB: You know, you're smart guy. You know that if the circulation is no good,
it's just gonna get worse.
P: The hospital [inaudible] already. They see. TB: But is the problem this is--
this could possibly be leading to the amputation-- P: They do something in the hospital, yeah.
TB: I know, I know. P: The toe, you mean,
is that right? TB: The toe.
And could be worse because now you have a wound on the back of your heel as well.
P: Yeah, on there, is it right or the side?
Is it big wound or small wound?
TB: It's still a big wound.
P: Hm, I can't see there right now.
TB: It's ha-- I know it's hard to see but there is a wound and I think it's when you were in the hospital for two weeks,
all the pressure on the back of your heel.
P: Yeah, they-- they know about that in the hospital. Was there when they went to hospital.
TB: ...Yeah, I'm just taking a look because there's another wound starting on the tip of your toe here.
P: Yeah, that's the one you said, is that right?
TB: But this is-- this toe's not looking too good.
P: Yeah, I know, there's no going back--[inaudible] TB: I feel for you, this is no good.
P: I can see it no good, I know.
TB: [sighs] This is the issue - when we see something like this at this stage and the wounds even the side
wound is getting a little bit dark, the circulation we know is no good.
P: Circulation, yeah.
TB: This is-- this is all leading to signs of amputation.
So...
P: You see.
TB: I know-- I know you want us to take care of the nails and I'll do that but tomorrow you have to show your doctor.
P: Oh, yeah, I go to see that. TB: The vein specialist your toes.
P: Yeah, I go to see that, it is very important.
TB: Because, if you don't, this will continue to spread and then we have to take more of the foot.
P: Is go to see it now.
TB: You have to show him because these 2 toes look completely done.
P: Is that right?
TB: This one for sure.
P: I know, doesn't look good, does it?
TB: Doesn't look too good, unfortunately.
But you said the pain that you're getting is only at night?
P: Not yesterday, the day before but you know what?
I think the lemon juice-- lemon-- the tea.
TB: Mhm-hm.
P: The-- the acid in it, I think is what did it, you know? I have the whole night painful to take, you know?
TB: But it's very-- it's very common at night because you are sitting flat that the blood flow is even worse.
P: But last night was good.
TB: Okay, lets--
P: I couldn't-- I couldn't take it anymore.
TB: So I'm just gonna see the other toe. So this is the one where you had a wound for a long time.
What happened to this one? You had to cut first?
P: No, last time was that. I went for "hybra"-- "hyberic."
TB: Yes. P: And that's how--
TB: You went for hyperbaric treat-- how many treatments did you have to do to heal this toe?
P: Oh, it takes about 2-- 2 months, I forgot to remember, 2 years ago.
TB: Yeah. And finally that one's all healed.
P: It is, yes. TB: Well, we--
P: But that's what I did there, I don't know. TB: But we can see the skins very dry.
P: Yeah, which one? The bottom? TB: Yeah. The ankles. Very, very dry.
P: The ankles, is bottom, is heel. [inaudible] but I can walk.
TB: So... [sighs] yeah, you know what? The problem is I have...
we have to get you on some sort of antibiotic because--
P: I know, I got to see doctor tomorrow.
TB: I'm gonna write you a prescription.
P: You write it.
TB: You talk to the doctor because if we don't control the infection - there is an infection here -
it goes inside the body.
P: You think will-- will-- helps, antibiotic?
TB: Yes.
P: So why they don't give it to me the hospital then?
TB: Because, again, I guess you might have been cleared to go because of the circulation but now we do have a wound,
we do have poor circulation, the toes aren't gonna heal well but there is an infection, we don't want that infection
to go into the bone or into the blood and make it worse so I'm gonna write you a prescription.
But tomorrow you have to speak with the specialist.
If you don't see the specia-- P: I got to--[inaudible]
TB: But this is one thing that's important - if you're not seeing the specialist tomorrow,
you have to go right to the hospital.
P: I go to see him.
TB: Okay.
P: That's why I got an appointment with him.
TB: Okay.
So I'm just gonna take another look at the toe.
P: I go to see him tomorrow.
TB: Yeah, it's black, it's hard.
P: I can't see it that good, I know that, it's very bad.
TB: So this is what we're gonna do - I'm gonna try to take care of these nails.
P: Take what you can.
TB: I'm gonna dress up some foot.
P: Okay.
TB: I'm gonna write you a note to give to the doctor tomorrow and plus a prescription, okay?
P: Okay, sure. TB: Okay.
P: I got some bandage here.
TB: I have more bandages, don't worry. [laughs]
P: I don't know, I have to make sure-- TB: That's nice of you but I got some-- that's good.
P: I don't wear-- I bought a new socks also there.
TB: Yeah.
P: Okay? So--
TB: Okay. P: Put them in.
TB: Okay, I will.
P: See what you can do about that. TB: Okay.