Like many who suffer from similar health conditions in Singapore, 74-year-old retiree Lee Kim Loon has what is called the “three highs” of chronic conditions — high cholesterol, high blood pressure and high blood sugar, which is diabetes. Furthermore, Mr Lee had not taken steps to watch his weight or exercise, and smoking heavily did not help make things any better.
When Mr Lee first found multiple black patches on his lower limbs, he did not think too much of them and waited to see if they would recover over time. It was only when a family friend, who is a physician, pointed out that his condition looked severe, that he went to the emergency department at Changi General Hospital, where doctors assessed that he needed to be warded.
The doctors soon found the reason for his black patches — he had blocked arteries from his thighs to his toes, which restricted blood flow and had resulted in gangrene. He had to undergo a surgery to open up the blood vessels and remove the dead tissues on his feet. However, as the infection was already too deep and extensive, two toes — one on each foot — had to be amputated.
Mr Lee with vascular surgeon Dr Derek Ho (middle) and Senior Nurse Clinician Cheng Shu Hua.
Mr Lee was referred to the Wound Healing Centre, located at the Medical Centre of Changi General Hospital, for further management. He has been going for reviews at the Centre about three times a week with vascular and plastic surgeons, as well as to regularly change his wound dressing. He has now also taken proactive steps to lose weight and quit smoking so that he can resume his daily activities.
DIABETES — THE MOST COMMON RISK FACTOR OF CHRONIC WOUNDS
Mr Lee Kim Loon is one of the many patients with diabetes whose chronic condition will give rise to the development of chronic wounds from diabetic peripheral neuropathy, arterial insufficiency or peripheral vascular disease.
While most people can recover quickly from a cut or scratch on the skin, patients with significant risk factors such as diabetes will need to exercise extra caution in preventing wounds around their lower limbs, especially the feet and toes area.
For these patients, a small scratch can be infected easily and develop into a chronic wound. They also may not feel pain when a wound is inflicted due to reduced sensation in the nerves from diabetes. Patients and caregivers thus need to examine the feet regularly for any wounds.
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