This little piggy

I have never been a ‘good’ diabetic. Compliance with rules is just not in my nature. I was
diagnosed in 1967, at the age of 18, after I had gone into hospital
for a relatively minor surgery. Two weeks after that diagnosis, I was
launched back into the world, scared and not completely sure of what
came next. The nurses had taught me all about doing injections, and I
had a shiny glass syringe and a box of one-time use needles. I also
had a diet booklet from the dietician, prescribing a 2,000 calorie
diet. Two thousand calories? Come on, I was a teenager. I ate 2,000
calories for breakfast.

Diabetes ended my plans for a military career, but I had finishing high school and getting
into University to worry about, so I took my 16 units of Lente
insulin daily, avoided sweets and did pretty much what I wanted. In
those days we couldn’t test for blood sugar, so we had to test for
urine sugar until the 90s. My tests always showed 4% or higher, the
highest a test could go. I saw my GPs mostly, although once in a
while they would send me to hospital for “stabilization.”

In my thirties I went through a period of heavy drinking. I don’t know if it’s coincidence,
but it was at this time I lost the sight in my left eye. I went back
and forth between the right eye and the left eye for a few years, but
was blind in both eyes for only a week. I recovered most of my
eyesight through laser and a couple of actual eye surgeries, and a
very, very good ophthalmologist. This cost me a job, as my company
decided “your position is no longer required.” Yeah.

Skip ahead a few years, and I’m in my fifties, now equipped with human insulin and a blood
glucose meter. My blood glucose management is better, but still not
good. In around 2005, I had my first foot infection. It involved my
left big toe and first toe, and they turned black. Due to the good
offices of the surgeon my GP sent me to, These toes recovered nicely,
and in six months or so looked as if they had never had a problem.

For several years I had recurring infections in toes on both feet. The usual course of events
was that my toe or toes would turn black, and after antibiotics and
frequent dressing changes they would slowly recover. I quickly knew
all of the staff at the wound clinic by their first names, and they
treated me wonderfully, and still do today.

So, at this point I had racked up neuropathy, nephropathy, retinopathy, cataracts, heart
disease, a strange condition that gives me vertical double vision,
mild liver and kidney problems, and arthritis. That last one may not
be due to diabetes, as it runs in my family. Oh! Oddly enough, I
suffer from depression, although I am medicated and able to hold it
at bay, but I don’t smile much.

My last toe problem occurred in 2013 on a trip, at Heathrow airport. I was travelling
with my daughter who was on a business trip to Paris and London. She
noticed blood on the floor when I came out of the bathroom in the
morning. My right big toenail had become detached, and we dealt with
it with some bandaids my daughter had, and bought some supplies when
we got to Paris. I limped through the rest of the trip, and got back
to the wound clinic, where the doctor saved me again.

I continued to go to the wound clinic monthly for medical pedicures. They handed that job off
to a podiatrist who shares office space with the clinic. At one of
these pedicures, in March this year, the podiatrist discovered a
sore on the end of my middle right toe.

So now it was back to the wound clinic for antibiotics and dressing changes. After two months,
I brought up the possibility of an amputation, as we seemed to be
getting nowhere with the toe. Furthermore, I was having considerable
pain from the toe. The doctor wanted to wait awhile, but in June
X-rays revealed that the bones in the toe were fully infected. So we
agreed on an amputation, and set the following Wednesday, June 22, as
the date.

I had thought the process of amputation would require some fanfare – a hospital stay,
hospital food, pretty nurses, all that. However, it was done in the
clinic, on the same cot I lie on for dressing changes or pedicures.
The doctor took off the dressing, wiped the toe down and gave me some
local anaesthetic. Then, while we chatted back and forth, he
cheerfully removed the toe. No pain, no fuss. I saw the toe go into a
specimen jar, and called out, “Wait, wait! I’ve changed my mind!”

The doctor said, “Ya want me to put it back? Too late!” and we all had a laugh. They are
used to me at the clinic. In a matter of minutes the wound was
bandaged, and I walked out of the clinic with a note to come back at
7:30 the following morning. I had walked into the clinic at 7:25, and
walked out at 7:50, less one toe, but the pain from the toe was gone,
and stayed gone.

Along with my family and friends we came up with a bunch of jokes about only being able to
count to 19, having difficulty playing “This little piggy.” After
all, do you drop the one that had roast beef, or the one that had
none, or go to the fourth toe and say “This little piggy had tofu,”
because then the next little piggy wouldn’t want any, and could go
“Wee, wee…” oh, never mind!

All jokes aside, it isn’t easy to give up a toe. It seems like a small thing, and I recognized
the necessity, but when it got down to the crunch, I felt saddened. I
have known for fifty years that something like this could happen.
Thank God that I have made it this far without going blind, as has
happened to people I know. I also know people who have lost legs.
Some of those have subsequently lost their lives, so I know it could
be worse, and could get worse. But as I mentioned, I suffer from
depression, and am beginning to do a lot of sitting around with time
to think.

The wound appears to be healing well, and it seems by mid August it will be healed. This
should allow me to return to my activities such as woodwork,
swimming, walking and maybe even riding my bicycle, but two weeks ago
the doctor showed me X-rays that show the second toe is infected in
the bone, and therefore must go, too. So, the piggy that stayed at
home is to be evicted.

This did not improve my mood. It puts my recovery off until late September, and cancels any
thoughts I may have had of doing much this summer. I spent a week
with my daughter recently, and had to do my own dressing changes,
which is something I am unwilling to repeat. I should be able to
dance at my daughter’s wedding on October 1 if nothing else goes
awry. I thought at one time that removing the toe would be the end of
the problem for now, but of course that is not true. I now have to
deal with the possibility of losing half a foot, and after that, half
my lower leg.

I try not to sit around dwelling on the problem or its infinite possibilities. There are
things I can do, and I do them. I am trying to be careful about my
bgs, and waiting for the day when the doctor says, “There, Roger!
You’re all healed. You don’t have to come back here any more.” That
will be the best present I could have.

I said at the outset that I have not been a ‘good’ diabetic, but I’m still here after 50 years.
I know I have done things wrong during the course of this whole
thing, and I don’t need to hear about it. The thing a diabetic
doesn’t need to hear when faced with complications is, “You could
have prevented this if…” This is just my experience of losing a
toe. Whether you see it as inspiration or cautionary tale is up to
you. I hope you have gained something from it.

Just before submitting this, I saw the doctor at the clinic, and he thinks my second toe may
get better, so we are holding off removing it until it gets a chance
to improve. So, the second piggy has a stay of execution. We’ll wait
and see.

Roger N. Tulk (Roger212)


Roger, here’s to wishing you improved control :champagne:, along with retention of your remaining digits (and limbs)!

The “Wait, I changed my mind!” part made me laugh. (Last time I removed a toe, the patient was under general anesthesia and thereby unable to provide witty commentary.) :frowning:

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Thanks, Dr. Cain. I expect to be OK eventually, but I’ve had to take the oxygen-free climb of Everest off my bucket list.

Did you know that Everest is not Earth’s tallest mountain? It’s the highest above sea level, but not the tallest from base to summit.

Please, Roger, just call me Rose. Or “Dr. Mom”, which is what my daughters call me when they don’t agree with what I’ve said. :grimacing:

David, oh God of Everything Trivia-Related, what pray tell is the tallest mountain from base to peak? (I could have googled the answer in the time it took to type this post! :thinking:)

Mauna Loa

I would have, but I didn’t know your first name. And I wasn’t really going to climb Everest.

No $h1t?!?

Would’ve gotten that one wrong at trivia night! :thinking:

Bet you could if you really wanted to, even with only 9 toes! :wink:

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Roger, I enjoyed reading your post, especially seeing your sense of humor. I encourage you to maintain your good spirits and to enjoy your life as much as possible. I was diagnosed with T1 in 1969 while in college. I was discharged from Reserve Officer’s Training Corps the day before I was to be commissioned. I had a job for the summer and was able to go to grad school that fall. I dropped out after one quarter and began working for the U.S. Navy. I’ve been doing similar work now as a government employee and since 2002, as a contractor with the government. My complications have included some neuropathy and long-term toenail fungus but no amputations or serious vision loss. I get tears in my retinas which my ophthalmologist who specializes in treating diabetics fixes with a laser. The best thing that I’ve experienced in my 47 years as a diabetic was meeting a Diabetes Education Nurse who taught me how to count carbs and adjusted my pump to give me basal rates and ratios that help me maintain reasonably good blood glucose levels. I’m 69 now and would like to live long enough and be healthy enough to benefit from further improvements in diabetes management technology or, God willing, a cure. I pray for your continuing good health and spirits!

I very much enjoyed your tale, too, Roger. I was born in '67 and dx’d in '75. I grew up during the time of urine tests and never really knowing exactly what my blood sugar was doing…and also usually always had that lovely dark brown poop-colored result (4+) which yeah, always meant “Oh, $h!t!”. Thankfully, I’ve been spared too many complications by this time, at 40+ years as a t1d. I thought it was pretty crazy that I had just posted on my blog about the in’s and out’s of keeping glucagon handy since it often ends up unused, expired and thrown out and I have a really hard time justifying that $50 being tossed in the can until… that unexpected serious low while on the highway with nowhere to turn, limited sugar-supply and the feeling that I’m about to die. ARGH!! It’s one of my bigger gripes with diabetes and the (un)affordability of the necessaries. You can check it out here if you’re interested::: And PLEASE comment with how you handle this dilemma!! I’m really always grappling with this lately as my hypo-unawareness has put me in these situations more often. Thanks for sharing!!

Hi Roger - I am not sure what to say, except thank you for sharing your experience and I am sorry that you’ve gone through all of this! I think “compliance” should be a swear word – I think that ALL of us do the best that we can with where we are and what we have. I’m sorry for the toe that’s gone and sending healing thoughts to all the rest that are still there, especially the one that is working hard to get better (pointer toe?!). All my best - Jessica (type 1 for 24 years)

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Right back atcha, Tinman. I worked for the Government for the last 22 years of my work life.Good place to be, as they were very tolerant and helpful with my needs as a diabetic who had more medical appointments in a year than most people do in a lifetime. Stay the course, and I hope and pray that things will continue to go well for you.

Geannie, I get lots of warning when a low is starting, and I have found carrying candy, or more recently Dex4 tablets, has always been sufficient to handle any low bg problem. Thank you for your comments on my article.

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Jessica, you’re welcome. I often think that if an angel came down from Heaven and told me I could have anything I wanted, I would ask to never have been a diabetic. Of course, that’s when I would find that I joined the Army, went to Cyprus on a peacekeeping mission and got killed by a sniper. So maybe I’ll keep the diabetes. Anyway, it the big toe is an analogue for the thumb, then the one next to it must be the index toe. Best wishes for a long and happyt life.


Roger, wow, what a good question. Would you wish the diabetes away? Would I? I am just home after a wonderful night out with my kids and husband and friends, watching the sun set over the ocean and enjoying great conversation. I have such a good life, but yes, I would wish away the diabetes. It casts such a pall over my entire life – my entire outlook – that I wonder what things would look like without it. But. It’s here and it’s not going away, so I will enjoy the kids and the husband and the conversation and live life as it has to be lived with the D. xoxo to you - Jessica


After almost 42 years with diabetes, I now have hypo-unawareness, so I don’t get any symptoms most of the time. Even more reason I should carry the kit, I guess. I’m about to convince myself I need to suck it up & start keeping one with me. I’ve had too many close calls in the past several months. I don’t want to wake up one day wishing I’d had one with me & unable to recover or worse. :confounded::worried:

I’m a couple week from turning 50, and T1 since almost age 7. I was lucky with a set of parents that were extreme in their approach to good care and keeping up with the latest on diabetic care. I suffered a little from my middle ages as I tried a few times to ignore this, but came around to good senses and now wear a pump and monitor full time.

Anyway, as an early Type 1, I guess I was lucky in a sense to have a friend who was diagnosed within days of my own. He unfortunately did not have parents of the same caliber, and totally ignored his problems. He was dead in a few short years. This played hell on my mind and kept me from taking similar routes. Needless to say, that was one of my biggest mental pushes to try to do my best and keep in line on control. Not perfect, but still was never totally gone from my conscience that control was needed.

I feel fortunate that the few complications I’ve had, including minor foot issues, frozen shoulders, and weight gain from good control (yeah, watch out for that…) But it’s good to hear from others that have issue are not afraid to share in their suffering and triumphs. It’s a hard road. Good to hear you’ve pushed through and continue to fight.

Thanks for your insights.


@Roger212 just told us in the chat room he will unfortunately be losing 2 more toes soon. Let’s keep him in our thoughts and prayers.