Lower limb amputation is one of the most unfavorable case scenarios in diabetes mellitus. But it is not always the only option for diabetic foot patients, even if the disease is quite severe.
In Germany, the Federal Joint Committee has decided that people with diabetic foot syndrome will in future be entitled to an expert second opinion, which is a considerable improvement.
Therapist Dr Dirk Hochlenert, Vice-Chairman of the public association of diabetic foot patients from Cologne, considers this decision important for both patients and the medical community.
According to Dr Hochlenert, it is very important that the second opinion procedure should finally bring the patient in the center of attention:
Knowing that the patient can consult with another specialist, the treating physician will first consider possible alternatives to amputation, Dr Hochlenert hopes.
In his opinion, too many patients unfortunately accept their sole blame for their situation, since they end up straining their leg despite being strongly advised not to do so by their doctor. "But often they can't help it, they end up having to strain the leg," the diabetologist explains.
According to Dr Hochlenert, many doctors, especially those with surgical specialties, are unlikely to be aware of this particular underlying situation.
Similarly, he notes, there is often a lack of understanding of the serious physical and psychological consequences that amputations can have.
That's why he does distinguish between minor and major amputations: "The little toe is also important because it is essential for stabilizing the outer part of the foot." One should not think that all amputations below the ankle level are essentially harmless, he said. "When you amputate, you are always generating new vulnerabilities that often lead to further amputations."
For Dr Hohlenert and his associates, two goals are now at the forefront: on the one hand, those affected need to learn about their right to a second opinion and make sure to claim one. "And it is important that the second opinions are given by true experts."
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