Persistent Hyperglycemia on the Neurons of Aaron’s Left Foot

Pressure ulcers, pressure sours, deep cuts, and pressure wounds were also caused by hypertension. Tissue fractures can be easy to treat, but if left untreated, they can lead to complications such as joint damage, cellulitis, and sepsis. Wounds require sufficient oxygen circulation to recover, but hypertension slows the healing process (Harrison, 2015). Slow wound healing is compounded by elevated blood pressure, diabetes, anemia, old age, and chronic lung disease. Hypertension contributes to or prevents wound healing by medicine used to treat hypertension. Chronic hyperglycemia forms part of diabetes condition characteristics but toxicity is the primary cause of diabetes complications. The symptom shows up several years after the illness began. Glucose toxicity shows a clinical condition where diabetes control is poor as hyperglycemia diminishes β-cell insulin secretion capacity. Consequently, the increased insulin resistance enhances hyperglycemia (Harrison, 2015). The vicious cycle finally results in β-cell incapacity to secrete insulin. Chronic hyperglycemia causes serious injuries to body organs due to declined neutrophils and causes infections. Neutrophils are the first cells to arrive at the wound as they try to against invasion by the organism. Neutrophil eliminates microorganism and avoids further inflammation. In diabetes, the apoptosis and inflammation were interrupted.

In Aaron’s case, the untreated hyperglycemia caused a long-term complication. The feet problem escalated due to poor blood and damaged nerves leading to serious infection and the ultimate amputation. Diabetes mellitus complicated the problem and wound healing process (Harrison, 2015). Aaron’s body had reduced the tensile strength of the wound compared to their controls. The situation suggests deposition or defective matrix production. The diminished perfusion as a result of peripheral neuropathy contributed to the impairment wound healing. Poor glygemic controls and decreased sensory function of the nerves caused by peripheral neuropathy contributing to healing impairment.

Aaron’s Risk for the Development of Stroke

Diabetes patients are at higher risk of developing a higher chance of stroke or heart attack. The diabetic have certain conditions such as high cholesterol and high blood pressure that increase the chance of having stroke or heart disease. High blood pressure from diabetes damages the blood vessel and the nervous system controlling blood and heart vessels. The prolonged diabetes condition increases the chances of developing a heart disease.

Aaron did not adhere to the dietary instructions leading to increased risk. Smoking is one of the factors that could contribute to increased risks of contracting the heart disease in diabetic patients. Patients are advised not to smoke as diabetes and smoking narrows down the blood vessels. Smoking increases chances of contracting lung disease. Damaged blood vessels in the legs increase the chance of ulcers, lower leg infections leading to amputation.

Aaron has a higher body mass index that is a clear indication of abnormal cholesterol levels. The fat manufacture in the liver finds its way into the blood system. The LDL cholesterol is bad in the body and causes clogging and building up of blood vessels. The higher levels of LDL chorestral increase the risk of developing stroke. Another fat found in blood, triglycerides could possible play part in increasing the risk of heart disease if the levels exceed the recommended levels. The clinicians need to manage Aaron’s blood glucose cholesterol and blood pressure.

Aaron was diagnosed with hypertension where the heart was forced to pump blood at a higher rate. The high blood pressure strains the heart rate and causes damage to blood vessels. Ultimately, the patients tend to be of higher risk of developing eye problems, kidney problems, stroke or heart attack. Aaron is likely to suffer from Hemorrhagic stroke due to the weakened vessel. According to Harrison (2015), stroke occurs in two types that include aneurysms and arteriovenous malformations (AVMs). Uncontrolled hypertension is the cause of hemorrhagic stroke.

Pain Experienced after Amputation

Aaron will experience phantom limb pain after amputation. The ongoing painful sensation comes from the wound. After the removal of the limb, the nerve ending at the amputated limb continue to send pain signals to the brain (Margolis et al., 2005). The memory interprets the signal as pain. Pathophysiology of phantom pain is not fully understood but begins with changes from the periphery altering the afferent input that the brain and spinal cord receive. Consequently, it leads to central reorganization and changes contributing to phantom pain development.

The stump pain begins immediately after the surgery. The sensational pain comes from various experiences such as itching, pressure, burning and twisting. The pain is common to all amputees but the length of the pain differs from one patient to the other. The stump pain lasts from seconds or become acute nonciceptive pain that lasts for several weeks as the wound continue to heal. During the first few months the pain in Aaron will diminish but will continue experiencing some sensations for years.

The patients suffer from anxiety often alternating with depression. In general, the patient may suffer from silent rumination, inability to sleep, irritability, social withdrawal. The intense sensitivity and phantom limb pain and the fear of negative attitude towards amputees and disabilities create psychological pain to the patient.

References

Harrison, T. R., Kasper, D. L., Fauci, A. S., Hauser, S. L., Longo, D. L., Jameson, J. L., & Loscalzo, J. (2015). Harrison’s principles of internal medicine. New York: McGraw-Hill Education.

Margolis, D. J., Allen-Taylor, L., Hoffstad, O., & Berlin, J. A. (January 01, 2005). Diabetic neuropathic foot ulcers and amputation. Wound Repair and Regeneration, 13(3), 230-236.