04/06/2025
"My foot rotted away overnight"…
The story of Don Ramiro and the truth behind his necrosis
Don Ramiro is 65 years old.
He has been diabetic for over 20 years.
He was never consistent with his check-ups, but he used to say he felt "pretty good, all things considered."
He took his medication "when he remembered," walked little, and wore the same worn-out shoes for years.
One day, he arrived at the emergency room limping, with a pale face and eyes full of distress.
—“Doctor, my foot is rotting. Last night it was fine… and today I woke up with a black toe.”
He was convinced that his left foot had necrosed “overnight.”
But the reality was very different.
When we removed his sock, the picture was clear:
Dry necrosis in all his toes and part of his left leg.
Black, hard skin, with no blood flow.
And around it... a poorly cared venous ulcer, with inflamed edges, purulent discharge, and signs of chronic infection.
We listened to him, reassured him… and told him the truth:
That didn’t happen overnight.
Necrosis doesn’t appear suddenly, as if by magic.
It’s the result of weeks or months of poor circulation, progressive damage, and neglect.
In his case, there were two enemies working together:
🔸 Poorly controlled diabetes, which damages nerves (neuropathy) and blood vessels (microangiopathy), reducing sensation and blood flow.
🔸 Chronic venous insufficiency, which caused swelling, poor tissue oxygenation, and persistent ulcers.
What happened was that he didn’t feel the pain or see the damage in time.
And while he slept each night, his foot was slowly deteriorating.
Until one day, the tissue simply couldn’t withstand it anymore.
And it died.
We had to perform surgical debridement and then a partial amputation.
But this time, Don Ramiro changed.
He understood that the body speaks, even if sometimes silently.
Now he comes to his check-ups.
His blood glucose is monitored.
He cares for his feet every day.
And every time he tells his story, he repeats the phrase that left a mark on him most:
—“It didn’t rot overnight… it died little by little, and I didn’t realize it.”
Medical message:
Traumatic lesions, necrosis, and amputations in diabetic and venous insufficiency patients do not happen suddenly.
They are the consequence of progressive vascular damage, undetected infections, and lack of sensation.
The key is prevention, glycemic control, and constant foot monitoring.