Waiting It out (Case Study) (Case Study‪)‬

AW is a fifty-nine-year-old male who is being readmitted to the hospital one week after his discharge due to gangrene of three right toes and both of his heels. He denies having any pain. He was originally admitted for blood clots in his lower extremities and was treated and sent back to the nursing home where he lives. He is relatively uneducated and not particularly well-spoken, yet he converses appropriately, still attends nursing home functions, and is able to recall details of the past and present. Upon return to the hospital, he accurately reported his medical history of multiple strokes, type II diabetes, a four-vessel coronary artery bypass surgery, and neurosyphilis. He further states that he has been using a wheelchair for the last year or so, since his last stroke. The vascular surgeons evaluate his arterial flow and determine that he is not a candidate for bypass grafting. They recommend a right above-the-knee and a left heel amputation because his arterial flow will not be sufficient to heal or maintain viable tissue, and infection will likely follow.