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Need second opinion on origin and treatment of dry gangrene

Posted by fkonis @fkonis, Jan 5 5:10pm

Hi,

I have been through every specialty department in Albany Medical Center. The only department that has offered treatment has been rheumatology.

While I believe my symptoms are being treated to the best that can be done here but nobody is able to deliver a root cause for my condition.

I need a fresh look from the outside.

I am a 59 year old M who is went in for post hospital follow up. Seen inpatient for digital ischemia. Right hand critical digital ischemia. 2nd–4th digits. Abnormal arterial duplex with Doppler. Reveals moderate disease in first and fifth digits, and severe disease in 2nd–4th digits. Denies Raynaud's phenomenon. Tobacco use. Stopped on 12/6. aB2GP neg. Suspected Buerger's. Received IV prostacyclin for 7 days with improvement.

Thank you,
Frank

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kayabbott | @kayabbott | Jan 6 6:52am

This is not among my autoimmune diseases, but my read is that yours is associated with inadequate oxygen/circulation to your hands. Tobacco smoking results in lower oxygen and vasoconstriction. Are your feet also impacted? Did your doctors indicate how long it would be after stopping smoking for the ischemia to improve? Did they use hyperbaric oxygen (higher pressure sends more O2 to extremities) or exercises to increase oxygen delivery? The following links are also to give some background info to others on this forum. https://www.nejm.org/doi/abs/10.1056/NEJM195404292501701 https://pubmed.ncbi.nlm.nih.gov/26523153/ https://www.sciencedirect.com/topics/neuroscience/prostacyclin#:~:text=Prostacyclin%20is%20produced%20by%20endothelial,effects%20of%20about%2030%20minutes. This refers to O2 after an allergic response, but does give some background info: https://www.jacionline.org/article/S0091-6749(08)03137-0/fulltext https://www.sciencedirect.com/science/article/abs/pii/036350239490216X

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robertwills | @robertwills | 6 days ago

It appears they are saying tobacco use may have been the cause.

Many people associate tobacco with issues with damage to the lungs. This is true but what many don't know is that tobacco can, and often does, severely damage other systems, particularly the circulatory system.

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