# Ankle protection suggestions please?



## grizzlyj (Oct 14, 2008)

Hi folks.

I'm wondering if anyone can help me?

My Dad has developed an abscess on the back of his heel, on the achilles, now about the size of a 2p coin, open to the tendon 

It started out as a small nick, but due to other issues resulting in poor circulation, and him being his own worse enemy, its just been getting bigger over the last 4 months. He had been putting Manuka honey on it, visiting his GP, nurses etc for keeping an eye and keeping it clean, and last week had 3 stents put in.

The biggest day to day problem however is sleeping. Painkillers mean he can ignore pressure on the wound while they're working, but he'll wake up when they wear off. And to my mind any pressure won't help it closing up? During the day he won't put his feet up for the same reason.

So, does anyone know of something that can be strapped up to perhaps the calf and foot leaving the back of the heal clear? Padding that will stay in place all night, lift the heel clear of the bedsheet, easily put on but won't move while sleeping?

His neighbour was a nurse, and she rigged up a piece of roof guttering with appropriate padding, taped in place and worked really well until it moved. That could be improved, but he's decided that it will now never work so a "new" idea is required!

Not very MH'y, but you folks are knowledgeable so here's hoping!

Any input greatly appreciated

Jason


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## ChrisandJohn (Feb 3, 2008)

I can't think of a night time solution yet but I wonder if one of those large exercise balls would help with putting his feet up during the day?

I have one, about 65 cm diameter, and it's great as a footstool. It could perhaps be used supporting the legs and knees, with ankles hanging over not in contact.

I got mine in

Clas Ohlson

scroll down to find it, £9.99

Chris


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## cabby (May 14, 2005)

I assume that it is a double size bed, so I would suggest a rolled blanket across the lower part of the bed, or if not enough a rolled rug,or even a duvay.dont forget to tape it around.
On a single bed a bolster should do the trick.
Oh by the way to stop it moving put it under the base sheet.

cabby


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## ardgour (Mar 22, 2008)

Had similar problems when my dad had one of those external fixator cage things on his leg with wires going through into the bone.
How about a large piece of firm foam (may need 2 and wedge shaped would be better with the thin end under his thighs) under both legs from thigh to lower calf so he is effectively sleeping with his legs raised a few inches. You can put them under a sheet so they are more comfortable. That way nothing has to be strapped to the leg so can't fall off and he can move from side to side without a problem. Also it won't put too much pressure on the legs and hinder his circulation.
Us old nurses have rigged up all sorts of gizmo's in our time  

Chris


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## ched999uk (Jan 31, 2011)

How about a kids arm band. The blow up ones that are used to learn to swim? That way it could be inflated enough to lift off his ankle but not enough to constrict his leg?


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## grizzlyj (Oct 14, 2008)

Thank you so much for your replies!

I've bought him a stool supposedly designed for the job, as well as tried all sorts of pillows and cushions, but he reckons everything just puts that little bit of pressure on it and is too much for him. 

One step beyond Ardgours suggestion could be to lift all of him except his feet up two inches maybe on a shortened mattress topper, which is almost the same as getting him to dangle his legs off the bottom of his bed a little?! Getting him actually try anything is the hardest bit!

Thank you again


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## camallison (Jul 15, 2009)

Just tell him that if he doesn't try out these things, the alternative is amputation below the knee when it gets too bad. Cruel, but the "threat" worked with my 86 year-old father-in-law. Now he claims the final solution that we used was his idea ......... doesn't bother me as long as he keeps that leg up and lets it heal.

Colin


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## grizzlyj (Oct 14, 2008)

Hi Colin and thank you.

Unfortunately he was told amputation would be the most likely outcome until the various Drs decided on trying stents first, and he thought that since the foot being removed would provide relief it would have its upsides?!?


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## bulawayolass (Jul 27, 2010)

We use the following to keep pressure off areas on animals hope the following makes sense if not l will try and post some photos of what l mean in stages

Get a bandage (k band the old fashioned type but not WOW) about 5 to 7cm width (ask chemist)

Decide how big the area is l tend to go for 7cm then fold it lengthways in half to double the bulkiness. 

Then wrap it around your fingers (or other base if it needs to be bigger) to build it up into a nice circular shape

When thick enough remove from fingers or whatever base is & wind the rest of the bandage (or a second one) through the middle up then down all the way around your circle to make a nice solid doughnut to stop it unwinding. 

Tie off end with a loose knot or wrap a bit of tape over the end.

You then end up with a nice padded ring dressing to the size you want

Put the hole over wound and tape or a bandage to hold in place.

Added some photos below to help explain as l was confusing myself!


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## bulawayolass (Jul 27, 2010)

Photos may help not neat but took seconds l only used a 5cm bandage but gives and idea of what l mean


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## clubman (Sep 3, 2007)

*ulcer*

As above was roughly my idea, but when I had this on my ankle, I made a giant corn plaster ! Cut a hole the size you need to surround the wound out of firm as you can find foam, or more than one layer of thinner stuff. You can the tape it right round your leg with preferably micropore tape. The relief in bed was tremendous. A neater version can be made for daytime for the amazing amount of times you knock or scrape an area you never thought about before. You can even sit with crossed ankles again.....wonderful. Good luck with it. Pam W.


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## jncrowe (Feb 14, 2009)

*help*

Most problems of ulcers failing to heal in the lower limbs are caused by bad circulation 
The problem is that to increase the circulation the limb needs to be elevated( ideally to the height of the heart ) 
But the increase in circulation also increases the pain its a vicious circle When the leg is lowered the pain sensation is less but the pain is actually a good sign that the blood is reaching the affected area
I could never persuade my mother to keep her leg raised she developed gangrene and had a femero~popliteal bypass which was dreadfull she was cut from groin to knee and a vein eased out and then cut from knee to ankle and the vein replanted 
so she then had a cut from groin to ankle which they didnt sew up !!! obviously because of the amount of swelling which ensued
It was ghastly her leg looked like an anatomical diagram you could see all the tendons and muscles etc I stood over her for weeks demanding that everyone wash their hands, wear gloves, etc
One doctor actually cried out "OH my GOD they've not sewn it up !!" which did not instill great confidence in either of us He went very white and had to sit down and i gave him a drink of mums water !!
Back to the subject I had read a lot about infection precautions and treatments for ulcers and asked the Doctor about Manuka honey and he said it wasnt available on prescription and over the counter products may not be sterile etc etc
However when my DOG got an ulcer on her leg guess what the VET prescribed her "manuka honey" 
somethings wrong somewhere when vets give better care than doctors
One thing that really helped with the healing was TeaTree oil When the district nurses cleaned the wound I would put five drops of it in the gallipot that they were using for the saline soloution cleanser Not one trace of infection in the wound and the nurses said it had healed spectacularly well 
So well in fact that they have used it on other peoples ulcers to good effect
I hope your dads ok 
All the very best
Cath


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## bulawayolass (Jul 27, 2010)

Proper vets buy medical grade manuka honey that has been prepared for medical use they also do manuka honey impregnated dressings and a whole host of other wound treatments
Advancis Medical based in Kirby-in-Ashfield Nottingham 01623 751500

Comment on proper vets is cause a lot just buy a jar and use that despite the fact that the processing destroys the medical properties of it. I always make a point of informing them of that as soon as l see the good old jar in the draw or about to be used... of course the comment is it is cheaper...duh wonder why :x

You may also want to look at some of the "old fashioned" poultices as a kid l had 2 ulcers that wouldnt heal after about 8mths my mum started think if memory serves bread poultices and they healed up fast, also check out garlic, worth getting an old medical book and checking them out.


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## patnles (Oct 26, 2006)

District nurses have been using honey impregnated dressings for at least 7 years. I worked as a senior HCA with the district nurses and spent 70% of my time dressing leg ulcers
Whilst I was away last year I had an infected ingrown toe nail. I only had dry dressings with me so used sugar. See this 
I was quite impressed with the results. It healed in 3 days.
Lesley

Edit: to repair link


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## grizzlyj (Oct 14, 2008)

Hiya

Thank you so much for all the replies!

Dad reckons that any padding under his leg to elevate the heal clear of pressure from the bed/sofa/stool means his foot droops. The droop scrunches up the damaged area on the heel causing a lot of pain so therefore he says nothing along these lines will work. I knew there was a reason I was trying to find a means to hold his ankle in place but I'd forgotton why! So I think he needs a plaster cast with a hole at the back of the heel, or something like, but I also think whatever is suggested he'll complain about.

The honey he has is just a jar with quite a high UMF number to it but it is just off some supermarket shelf.

Advancis Medical helpfully suggested by bulawayolass also have a webshop

http://www.advancis.co.uk/honey_shop/

They don't give any idea of the UMF number though that other websites proudly boast of though?

Thanks all!


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## bulawayolass (Jul 27, 2010)

Forget that you still end up with fancy names and the correct properties destroyed. 

The medical grade is the correct one it is all down to processing the processing destroys the correct part of the honey. Avancis dont need to boast they produce the correct item. The other websites are using a lot of fancy marketing to try and justify their product all the words dont change medical and and non grade.


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## grizzlyj (Oct 14, 2008)

Hi folks

My Dad was given the info regarding medical grade honey, but insisted that the jar he had from Waitrose(?) was fine. A bit of further prodding suggested he get the Advancis honey via his GP on prescription. Still no, because his GP said they don't supply that particular type. He didn't ask/insist for anything else though. I could have got it for him, but until he can be bothered to try, or just ask, I feel its his choice, as with so many other things with him. 

Since his stents were put in 23/02 the circulation greatly improved to his foot, and the hole shrunk from 3"x3" to about 2"square. A few days ago the area around the wound became inflamed, so back to the GP yesterday but not much done. But the level of pain was too much overnight, he got to see his specialist a few hours ago, and will have his achilles removed this evening. So no driving being the least of his future issues, at the age of 66. Off to visit now.


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## rosalan (Aug 24, 2009)

I am not being funny but has your local hospital tried maggots?
Although it sounds medieval, they are used medicinally in some hospitals to remove any unhealthy tissue and promote healing.
My sister-in-law was prescribed this treatment, could not cope with the idea and lost her lower leg.
Alan


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## aldra (Jul 2, 2009)

A little worried that he is visiting his Gp and district nurse to monitor the ulcer

Has he discussed with them the problems he is having at night

Also natural remedy's may work well but should not be mixed with conventional treatment

If he is concerned ask for a specialist referral
to check and advise

Aldra


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## grizzlyj (Oct 14, 2008)

Thank you both 

There doesn't seem to be very much unhealthy tissue to be removed, and what there is comes off with a type of dressing the nurse sometimes puts on when she doesn't use one with honey.

The pot of honey Dad's been using is weeks if not months old, but there isn't apparently any infection in the wound.

When he went in (to the same ward) for stents they had to postpone the op when they realised he is on warfarin. He filled it out when checked in, but it required him to point it out the next day for them to take that fact on board and act accordingly. Last night the same thing again, op booked for 7pm last night but now postponed until today or tomorrow, they're still not sure, for the warfarin to leave his system beforehand.

The specialist who did the stents 3 weeks ago said yesterday that once theres a problem in the achilles tissue it will never heal so has to come out, but that was true at the time of the stents too so why not do both then? Dad doesn't seem too upset though, pleased he's out of pain while in hospital I'd imagine.

I'll have to find out if the throttle pedal can be moved over for his left foot without changing cars perhaps.

Jason


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## Penquin (Oct 15, 2007)

grizzlyj said:


> I'll have to find out if the throttle pedal can be moved over for his left foot without changing cars perhaps.


If he loses the ability to use his foot he may well be elgibile for DLA the mobility component and may be able to have the foot pedal supplemented by a hand operated lever.

Bear in mind he would also need assistance with braking as it is his right foot. Such modifications need specific advice and guidance and the Disabled Motoring Organisation may well be a good start.

http://www.disabledmotoring.org/

Hope that helps,

Dave


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## grizzlyj (Oct 14, 2008)

Since his car is an auto anyway, I'd imagine he can just use his good left foot for both instead right for both as before?

Thank you for the link, I'll have a look 

Cheers

Jason


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## MrsW (Feb 8, 2009)

He will need quite a bit of practise before he can safely change feet and drive without getting into problems. I guess it should be possible in an automatic.


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