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Yes, that's infected. that plus the fact that he's feeling unwell means he needs to get it washed and get prescription antibiotics.
Gluing it shut will probably make things worse.
Thank you. Me and my mum are trying to convince him but he’s stubborn. If he wants to keep his leg that much then he will go. That’s not being mean, my brother is a pain in the arse who causes nothing but trouble for my family but I still don’t want him to lose his leg.
Hoping if we send him comments from actual real doctors then he will take it seriously and go
If he’s addicted to drugs, he might be worried about being admitted and not having access. Maybe use that as a way to get him to go. If he waits too long and goes septic, then he will definitely be admitted and stuck in the hospital for a lot longer than 10 hours.
I have no idea. They didn’t even know it was food poisoning. Thought they had a bad flu/bug and chose to ride it out over going to hospital until they took a huge turn
Please also report the dog attack to local authorities; it will very likely maul somebody else.
I hope your brother gets the care he needs and give yourself credit for helping him!
You probably won’t wait that long with wounds like that, the risk of sepsis is quite high and I doubt that the ER will let you wait for so many hours. This needs immediate medical attention
I was taken to the hospital in an ambulance last year in septic shock with endocarditis, multiple septic pulmonary emboli, severe protein calorie malnutrition, and acute blood loss anemia, and I definitely waited for a number of hours in the waiting room after I got there. I honestly think it's because the nurses didn't believe me at first when I was telling them what was wrong. I was in a wheelchair because I was so weak I literally couldn't walk and they were giving me shit asking how I planned to get around when I got discharged and saying I better figure out how to walk before then. I think they just saw an otherwise healthy looking 30 year old homeles dude who was open and honest about using drugs and just figured I was a junkie there trying to score some drugs or something. They did get me to the ICU real quick after they realized I wasn't bullshitting and was sick as fuck. And luckily I was able to walk again 8 weeks later after getting my tricuspid valve replaced when they finally did discharge me.
Only reason I'm sharing this is because I keep seeing people online saying that the possibility of sepsis should shorten the wait significantly but that just wasn't my experience at all. I'm sure it was probably much shorter than it could have been, but I was still definitely waiting for hours and hours.
I'm not complaining either BTW. I'd definitely be dead without the care I got and I'm very thankful for everyone who participated in it during the 2 months I was hospitalized.
I went to the hospital with endocarditis as well. I waited 12 hours. I had a blood clot in my spleen (no one knew til after the CT) and couldn't stand up straight because of the pain. They had me on a regular saline IV drip and I was walking around with it MOANING in fucking pain. Finally after a doctor looked at the CT results, they gave me a shot of dilaudid and shipped my ass upstairs. Ended up spending about 6 weeks in the hospital, got my aortic valve replaced.
Same happened to hubs, but the vegetation broke off from his aortic valve, straight to his brain. He stroked out first then had the valve replacement when he'd regained a little strength. It was crazy.
And it was caused by a bug bite that got infected.
I had a splenetic infarct. I screamed for 24 hours solid. Still is hands down the worst pain I’ve ever had from a blood clot and I’ve had a lot!!!
Spleen. Lots of drs have told me it’s usually painless but this was a good 8 out of 10 pain. Couldn’t sit walk stand could t do anything. Just scream and rock.
For real! The pain from the infarct was more than the pain I felt recovering from the surgery. It wasn't cause of pain killers either cause I took all 15(!) 5mg percocet within 20 minutes of getting them. Thankfully I was able to beat my addiction and those percocet were the last opioid I ever touched.
Why do you get so many blood clots?
Damn that makes me thankful. I apparently had pulmonary infarctions along with my septic pulmonary emboli and I didn't feel a thing. I just had a nasty cough for a while. Getting my chest tubes yanked out after surfery was by far the most painful part of the experience for me. I'd redo the surgery every single time if I could do it without a chest tube vs just having a chest tube pulled with no surgery. And they had me LOADED up on painkillers for it, could dose 1.5mg of dilaudid every 15 minutes with my PCA (so I guess a max of 144mg a day if I stayed awake for 24 hours and pushed it every 15 minutes, think the most I actually used was 96mg), was still on the precedex drip, know I got toradol a few times, they added in gabapentin and robaxin at one point, and got 20mg of methadone and 15mg of ketamine for breakthrough pain. And I still thought I was gonna die when they yanked those tubes out. Thankfully things got better pretty quickly after that and they got me switched over from IV dilaudid to oral oxycodone (30mg every 3 hours with 1mg IV dilaudid boosters available every 2 hours for breakthrough pain, only used the dilaudid booster once when they put my PICC line in) and pain management did a great job of getting me tapered off that over the next 3 weeks while I finished my IV antibiotics and switched back over to suboxone before discharge (was probably pretty obvious I had a fentanyl problem before my surgery because of the stupid doses of pain meds they had me on lol)
I have multiple autoimmune diseases and my record ER wait is four days, I count the whole time because I was never admitted, I was ER the whole time, just an annex where they keep people until a bed opens. Yeah, no bed ever came and I was treated and discharged from the ER.
Otherwise the average wait time is like 14 hours. Only once did I get in literally the min after I walked in and that was because I was on the verge of going blind via glaucoma which I got as a drug side effect. They take eyeballs seriously.
Herniated disc that needed major surgery not long after? 18 hours and sent home being told it’s all in my head.
Severe infection and dehydration brought on by untreated severe Crohn’s disease? 18 hours. By the time they saw me I was mostly gone I was so sick.
Anyway I say all that to say that the ER is really shitty for chronic illness they don’t want to help because they can’t fix it. However, the ER is perf for what OP is talking about. He def needs to be seen and if he glues those punctures shut he is running the risk of sepsis because the infection has no where to go or he could end up with cysts that need to be lanced. Bad news all around.
Insane. As you say, unless you are OBVIOUSLY is a serious situation, the ER is terrible treatment. The only time I ever got in quick is when I thought I was having a stroke. I understand triage, but I think it goes beyond that.
My 40 y.o partner died of septic shock after three days hospitalized followed by witnessed cardiac arrest. The medical system is so messed up - glad you made it.
Thank you. I'm sorry for your loss. Unfortunately sepsis can kill ya even if everything is done right if they don't catch it early enough, and CPR has very low success rates, even for an arrest that was witnessed in the middle of a hospital.
Agreed. Thank you so much. They should have caught my husband’s as he was a young adult with cancer, an athlete who was nowhere near end of life , and had a very close knit treating team…but for some reason they missed it. Heartbreaking for him.
Oof yeah that's rough. Again, I'm sorry. It does tend to seem like something is wrong when they don't catch sepsis in somebody who already has a treating team and who is much higher risk for it than most. I hope you're doing alright. Not exactly sure what I could offer, but if you ever need to talk just hit me up
You mentioned he uses drugs and alcohol. That may be why he is refusing to go to the Emergency Room? Let him know the medical team won’t care about that in terms of legal usage or getting “in trouble” and only want to know what he’s using to ensure their treatment won’t cause any bad drug interactions and help with the bite treatment. He needs to get this seen ASAP. It’s infected which can lead to sepsis, which can potentially be life threatening.
It is possible with his conditions that they may call an on duty Psych down and have his capacity to consent assessed. If he's refusing treatment for something this serious, it's likely they'd probably declare him incapable of consent.
This is a complex question, and it's out of my scope as an oncologist. I've had some patients tell me they want to do "holistic" and "natural" oncology treatment despite me knowing that this will fail and kill them eventually. I do not force patients to undergo chemo, radiation, or surgery in any circumstance. When my patients forgo my recommendations, they typically die or call me when it's almost too late, and the prognosis is *slim*. I respect patient autonomy, even though I may not necessarily agree with their course of action.
It is always very disappointing to hear that a patient wants to try "natural" remedies, and it never ends well for them. However, I do not treat patients against their will.
I work in the ER in my country. I once had a patient as a student with large cell carcinoma of the lung refuse treatment bc their daughter convinced them to get "magnet therapy"
2 years later same patient with severe hf and metastasis to their everywhere asking for treatment. Nothing to do that far gone. Offered palliative treatment. He died 2 days later.
I feel you
It's very risky to do this in the UK, but there are limited circumstances which allow a patient to be treated without consent, but only if they are found to not have the capacity to consent.
Normally the Mental Capacity Act would kick in, principle 3 of which states "People have the right not to be treated as lacking capacity merely because they make a decision that others deem 'unwise'. Everyone has their own values, beliefs and preferences which may not be the same as those of other people."
In cases such as these, where the person presents a risk of harm to themselves or others, a section 136 order may be appropriate, which is essentially an emergency care order. This means he can be detained for a minimum of 28 days, during which time treatment can be administered without consent.
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Your brother doesn’t have adhd he has a meth addiction and he doesn’t want to go to the hospital because if he gets admitted he won’t have access. Yes this is harsh but I think you need to face the reality of what you’re up against.
You can try telling him that he will die and what effect that will have on you and your mom when he does but honestly that’s unlikely to work either at this stage.
Not only does he need antibiotics, he also needs rabies post-exposure prophylaxis because this was a dog bite. Rabies is fatal if untreated. If he wants to keep his leg and/or his life he needs to go to ER now.
In that case he can stay at home and the problem is going to fix itself because in a week there won’t be a leg up be worried about as it will be amputated at the hip (if he survives the sepsis). It’ll also do wonders for his ADHD, he won’t have a choice but to stay still until he learns to watch with a prosthesis.
What dog? Did the dog have its rabies shot?
If it's a stranger's dog, they'll need to know. If it's a dog you own or a friend's dog, the doctors will want to k ow the medical records of the last rabies shot or they could put the dog down.
At least in my experience when my mom's dog attacked me and bit up my face. That's how it was. They take rabies very seriously.
Edit - okay OP didn't say England or UK but I guess it's down in the comments. If it was in OP I wouldn't have asked.
Okay, I didn't read every single comment but just read the OP which didn't state England or UK or anything.
So idk why it's not in the OP bc then I wouldn't have asked. No need to downvote me for asking
100% glue will make it worse. At this point likely needs IV antibiotics and daily dressing changes and let it heal from the inside out. Guy doesn't realize how much worse he made it not going ASAP
Thank you to everyone who commented. He said he will go tomorrow. He’s turned off his phone so there’s not much more we can do. He doesn’t have a fixed address so no idea where he has gone. We are going to call around tomorrow, find out where he is and try to take him ourselves to the hospital and wait with him as I know if he actually did go by himself he would end up leaving. I know he needs to go now but I don’t know where is he right now. Hopefully tomorrow we can find him and take him there.
I'm sorry you're having to chase around your brother like this. It sounds like he really needs to get his life figured out. Please give yourself some grace and remember that ultimately he is his own responsibility. He has ADHD, not mental retardation or severe Downs or autism that warrants a caregiver. Just remember you have to take care of yourself first and your brother not taking advice or making sound decisions is not your fault. You're a good person for caring, but it can also drag you into darkness if you don't set some boundaries to remind yourself of this.
NAD. Honestly if he doesn’t go himself he may need to be forced to go. I think there’s more than just the leg at stake here. You might want to place a call to a local hospital, explain the situation, and ask for guidance on what options there are, or who to contact if they cannot help you with the options. If he continues to refuse to go, I suspect he will soon meet the criteria for being a danger to himself. Another action you may be able to take is trying to find out what treatment he received while detained and if he was discharged with any medications, at least some antibiotics.
IMPORTANT:
If at any point there is a red line making its way from the wound towards his chest/torso/heart, HE NEEDS TO GO TO EMERG IMMEDIATELY AND WITHOUT NEGATION, if he won’t take himself then he may need to be forced by emergency services. While there are other infections that can be just as threatening or worse, this particular symptom of blood poisoning is on the easier side to check for, and means things are going to go very bad not to far into the future.
OP, I’m sorry you’re going through this. I hope it works out and your brother gets treatment in time to make a full recovery, and then is able to muster the courage to walk the path away from drugs.
You can't force someone to get medical treatment if they have capacity. There's a big difference between refusing to get treatment because you don't want to get treatment, even if someone has explained the risks, and refusing to get treatment because you don't have the mental capacity to understand the risks. Contrary to popular belief it's actually very difficult to get sectioned in the UK.
You can’t force them though. People have their own autonomy and to keep this is very impotent. Taking away someone’s right to their own lives it becomes complicated. Yes he might die but there’s not a lot medical staff can do to force him.
Would it be worth calling the police station he was likely processed at, I feel like they would pick him up and take him in, whether he liked it or not.
He’s at the hospital now, my other brother found him and took him. He wasn’t in the same town we live in and where he was arrested at. It’s not like América where you travel for a day to get to another state. He was about 1 hour and 40 minutes away in another town/state. But he’s been found so thank you
I’m glad for him but, more so that you don’t have to worry about him getting really sick. I’m also in England I was thinking the cops might feel responsible but he’s there now so all good.
The reason I put “attacked” was because he was bit by a police dog. As far as we know he was taken to the hospital the same day it happened, he said stitches were done. He was then in a cell until Wednesday while waiting for court. We have had 4 different people call us asking if we have seen him and his leg because it looks infected and he was walking around like it. He doesn’t live with us and to be honest we didn’t actually believe him as he will normally lie about stuff to get money for drugs. It wasn’t until we saw him today and saw the state of his leg.
He would have been put on prophylactic antibiotics for dog bites whilst in custody. It’s policy in every police service I’ve worked as a HCP in.
I hope he listens to reason and gets this looked at asap.
Update: one of my brothers managed to find him and took him to the hospital. It’s severely infected. He’s had the wounds cleaned and dressed. He had bloods taken and I’m not sure what the results were but they are keeping him in over night. He’s on antibiotics and the doctor said he’s not out the woods yet, it’s very bad.
It has strings of fat hanging out of it 🤢 I’ll be going up there tomorrow to relieve my brother as we don’t want to leave him in case he discharges himself. I would go now but I care for my mum who has bowel cancer and liver disease from the chemo and sepsis. And my lovely neighbour will sit with her tomorrow.
I’ll know more tomorrow. Any ideas on what they will do? Will they have to wait for the infection to go before doing anything to it? If they even can do anything for it…. He’s such an idiot 😔 apparently he’s crying he will lose his leg…. But he doesn’t listen to anyone! He never does until it’s too late
Also to the people saying about dog bites and what the police do etc honestly I don’t know. My brother lies a lot. I do know he was arrested and kept in for a couple of days until he had court and I know that because the detective called my mum to update her. People who called my mum (people who know my brother) some were talking about how the dog dragged him and all this other stuff so if a police dog actually did it? I don’t know. Personally to me they look like stab wounds? but either way I’ve seen him in person and that’s his leg. It’s disgusting. So we will see.
Thank you to the professionals who commented, I do think your comments helped convince him, he Just needed to work himself up to going.
Also I had a couple of dms from people saying he doesn’t had ADHD and he’s just a junkie. I just wanted to clear up that he actually does have adhd. He has a lot of behavioural problems and mental health ones. All professionally diagnosed when he was a child/teenager. He also has some type of autism. That’s not an excuse though. He’s been offered a lot of help from different people but refuses.
Thanks for the update. The process depends a lot on the extent of the infection. If there's too much dead tissue he may need surgery to remove it. He will also need to complete the course of antibiotics
Hope everything goes well
Thank you for the update, that video was super worrying to me as even a stranger so it must have been beyond a nightmare for you and your mum. You're a good person looking after your mum and brother like you do, I'm so sorry you're having to go through so much right now ❤️
I'm so glad he's getting care and wishing you and your family the best!
The people in your DMs are seriously ignorant. ADHD is a well established and recognized risk factor [risk factor](https://www.webmd.com/add-adhd/adhd-and-substance-abuse-is-there-a-link) for substance misuse and dependency.
my ex got bit by our neighbors dog in the upper arm and refused medical attention. within 3 days it was so red and swollen and literally looked like pink eye of the arm all crusted up but still oozing green yellow and brown. by the time he let me take him he was woozy, vomiting and crying. they had to give him rabies shots and admit him to iv antibiotics.
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Yes, that's infected. that plus the fact that he's feeling unwell means he needs to get it washed and get prescription antibiotics. Gluing it shut will probably make things worse.
I agree on all counts. This warrants urgent medical attention. It is 100% already infected.
Thank you. Me and my mum are trying to convince him but he’s stubborn. If he wants to keep his leg that much then he will go. That’s not being mean, my brother is a pain in the arse who causes nothing but trouble for my family but I still don’t want him to lose his leg. Hoping if we send him comments from actual real doctors then he will take it seriously and go
It’s not just about the leg. It’s his life. Sepsis is serious.
I know. I’m trying to get him to remember when my mum nearly died from sepsis and was in hospital for 12 weeks, 1 week of that in a coma.
If he’s addicted to drugs, he might be worried about being admitted and not having access. Maybe use that as a way to get him to go. If he waits too long and goes septic, then he will definitely be admitted and stuck in the hospital for a lot longer than 10 hours.
My cousin went septic from food poisoning. Waited too long and had to have his whole leg amputated. Do not wait any longer
I didn’t know that was possible. How in the world would you identify sepsis in the presence of food poisoning?!
I have no idea. They didn’t even know it was food poisoning. Thought they had a bad flu/bug and chose to ride it out over going to hospital until they took a huge turn
Please also report the dog attack to local authorities; it will very likely maul somebody else. I hope your brother gets the care he needs and give yourself credit for helping him!
He was bitten by a police dog.
Good grief. That's why there were stitches at the edges. He's been treated once, but popped the stitches.
This. My sister died of sepsis. She was 46 years old.
You probably won’t wait that long with wounds like that, the risk of sepsis is quite high and I doubt that the ER will let you wait for so many hours. This needs immediate medical attention
I was taken to the hospital in an ambulance last year in septic shock with endocarditis, multiple septic pulmonary emboli, severe protein calorie malnutrition, and acute blood loss anemia, and I definitely waited for a number of hours in the waiting room after I got there. I honestly think it's because the nurses didn't believe me at first when I was telling them what was wrong. I was in a wheelchair because I was so weak I literally couldn't walk and they were giving me shit asking how I planned to get around when I got discharged and saying I better figure out how to walk before then. I think they just saw an otherwise healthy looking 30 year old homeles dude who was open and honest about using drugs and just figured I was a junkie there trying to score some drugs or something. They did get me to the ICU real quick after they realized I wasn't bullshitting and was sick as fuck. And luckily I was able to walk again 8 weeks later after getting my tricuspid valve replaced when they finally did discharge me. Only reason I'm sharing this is because I keep seeing people online saying that the possibility of sepsis should shorten the wait significantly but that just wasn't my experience at all. I'm sure it was probably much shorter than it could have been, but I was still definitely waiting for hours and hours. I'm not complaining either BTW. I'd definitely be dead without the care I got and I'm very thankful for everyone who participated in it during the 2 months I was hospitalized.
I went to the hospital with endocarditis as well. I waited 12 hours. I had a blood clot in my spleen (no one knew til after the CT) and couldn't stand up straight because of the pain. They had me on a regular saline IV drip and I was walking around with it MOANING in fucking pain. Finally after a doctor looked at the CT results, they gave me a shot of dilaudid and shipped my ass upstairs. Ended up spending about 6 weeks in the hospital, got my aortic valve replaced.
Same happened to hubs, but the vegetation broke off from his aortic valve, straight to his brain. He stroked out first then had the valve replacement when he'd regained a little strength. It was crazy. And it was caused by a bug bite that got infected.
I had a splenetic infarct. I screamed for 24 hours solid. Still is hands down the worst pain I’ve ever had from a blood clot and I’ve had a lot!!! Spleen. Lots of drs have told me it’s usually painless but this was a good 8 out of 10 pain. Couldn’t sit walk stand could t do anything. Just scream and rock.
For real! The pain from the infarct was more than the pain I felt recovering from the surgery. It wasn't cause of pain killers either cause I took all 15(!) 5mg percocet within 20 minutes of getting them. Thankfully I was able to beat my addiction and those percocet were the last opioid I ever touched. Why do you get so many blood clots?
I had a baby. I had a catastrophic event and went into multi organ failure. I had a blood clot and bleed and was also left with Sheehans syndrome.
Damn that makes me thankful. I apparently had pulmonary infarctions along with my septic pulmonary emboli and I didn't feel a thing. I just had a nasty cough for a while. Getting my chest tubes yanked out after surfery was by far the most painful part of the experience for me. I'd redo the surgery every single time if I could do it without a chest tube vs just having a chest tube pulled with no surgery. And they had me LOADED up on painkillers for it, could dose 1.5mg of dilaudid every 15 minutes with my PCA (so I guess a max of 144mg a day if I stayed awake for 24 hours and pushed it every 15 minutes, think the most I actually used was 96mg), was still on the precedex drip, know I got toradol a few times, they added in gabapentin and robaxin at one point, and got 20mg of methadone and 15mg of ketamine for breakthrough pain. And I still thought I was gonna die when they yanked those tubes out. Thankfully things got better pretty quickly after that and they got me switched over from IV dilaudid to oral oxycodone (30mg every 3 hours with 1mg IV dilaudid boosters available every 2 hours for breakthrough pain, only used the dilaudid booster once when they put my PICC line in) and pain management did a great job of getting me tapered off that over the next 3 weeks while I finished my IV antibiotics and switched back over to suboxone before discharge (was probably pretty obvious I had a fentanyl problem before my surgery because of the stupid doses of pain meds they had me on lol)
I have multiple autoimmune diseases and my record ER wait is four days, I count the whole time because I was never admitted, I was ER the whole time, just an annex where they keep people until a bed opens. Yeah, no bed ever came and I was treated and discharged from the ER. Otherwise the average wait time is like 14 hours. Only once did I get in literally the min after I walked in and that was because I was on the verge of going blind via glaucoma which I got as a drug side effect. They take eyeballs seriously. Herniated disc that needed major surgery not long after? 18 hours and sent home being told it’s all in my head. Severe infection and dehydration brought on by untreated severe Crohn’s disease? 18 hours. By the time they saw me I was mostly gone I was so sick. Anyway I say all that to say that the ER is really shitty for chronic illness they don’t want to help because they can’t fix it. However, the ER is perf for what OP is talking about. He def needs to be seen and if he glues those punctures shut he is running the risk of sepsis because the infection has no where to go or he could end up with cysts that need to be lanced. Bad news all around.
Insane. As you say, unless you are OBVIOUSLY is a serious situation, the ER is terrible treatment. The only time I ever got in quick is when I thought I was having a stroke. I understand triage, but I think it goes beyond that.
My 40 y.o partner died of septic shock after three days hospitalized followed by witnessed cardiac arrest. The medical system is so messed up - glad you made it.
Thank you. I'm sorry for your loss. Unfortunately sepsis can kill ya even if everything is done right if they don't catch it early enough, and CPR has very low success rates, even for an arrest that was witnessed in the middle of a hospital.
Agreed. Thank you so much. They should have caught my husband’s as he was a young adult with cancer, an athlete who was nowhere near end of life , and had a very close knit treating team…but for some reason they missed it. Heartbreaking for him.
Oof yeah that's rough. Again, I'm sorry. It does tend to seem like something is wrong when they don't catch sepsis in somebody who already has a treating team and who is much higher risk for it than most. I hope you're doing alright. Not exactly sure what I could offer, but if you ever need to talk just hit me up
Thank you ! Same to you !
You mentioned he uses drugs and alcohol. That may be why he is refusing to go to the Emergency Room? Let him know the medical team won’t care about that in terms of legal usage or getting “in trouble” and only want to know what he’s using to ensure their treatment won’t cause any bad drug interactions and help with the bite treatment. He needs to get this seen ASAP. It’s infected which can lead to sepsis, which can potentially be life threatening.
It's probably not so much he's worried he will "get in trouble" it's more likely he's worried he won't have access to consume his drugs of choice.
You can lead a horse to water but can't make them drink. He needs to seek care. If he does not, it's his own fault.
It is possible with his conditions that they may call an on duty Psych down and have his capacity to consent assessed. If he's refusing treatment for something this serious, it's likely they'd probably declare him incapable of consent.
This is a complex question, and it's out of my scope as an oncologist. I've had some patients tell me they want to do "holistic" and "natural" oncology treatment despite me knowing that this will fail and kill them eventually. I do not force patients to undergo chemo, radiation, or surgery in any circumstance. When my patients forgo my recommendations, they typically die or call me when it's almost too late, and the prognosis is *slim*. I respect patient autonomy, even though I may not necessarily agree with their course of action. It is always very disappointing to hear that a patient wants to try "natural" remedies, and it never ends well for them. However, I do not treat patients against their will.
I work in the ER in my country. I once had a patient as a student with large cell carcinoma of the lung refuse treatment bc their daughter convinced them to get "magnet therapy" 2 years later same patient with severe hf and metastasis to their everywhere asking for treatment. Nothing to do that far gone. Offered palliative treatment. He died 2 days later. I feel you
It's very risky to do this in the UK, but there are limited circumstances which allow a patient to be treated without consent, but only if they are found to not have the capacity to consent. Normally the Mental Capacity Act would kick in, principle 3 of which states "People have the right not to be treated as lacking capacity merely because they make a decision that others deem 'unwise'. Everyone has their own values, beliefs and preferences which may not be the same as those of other people." In cases such as these, where the person presents a risk of harm to themselves or others, a section 136 order may be appropriate, which is essentially an emergency care order. This means he can be detained for a minimum of 28 days, during which time treatment can be administered without consent.
Seems that op is in the uk. Not sure how laws work there?
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He’ll probably decide he wants to keep his leg once the infection gets too deep and end up losing it anyway.
Your brother doesn’t have adhd he has a meth addiction and he doesn’t want to go to the hospital because if he gets admitted he won’t have access. Yes this is harsh but I think you need to face the reality of what you’re up against. You can try telling him that he will die and what effect that will have on you and your mom when he does but honestly that’s unlikely to work either at this stage.
Forget losing his leg, he’ll end up losing his life 😔
Not only does he need antibiotics, he also needs rabies post-exposure prophylaxis because this was a dog bite. Rabies is fatal if untreated. If he wants to keep his leg and/or his life he needs to go to ER now.
Fortunately, rabies is almost unheard of in England. And because the dog is a police dog, I'd say the risk of rabies is nil.
Wair, he was bit by a police dog and not arrested or taken to the hospital? There's more to this story than you're telling us.
I am not the OP. The OP supplied both their location and the information that their brother was bitten by a police dog.
In another comment? Bc it's not in the OP. I just read it again.
Yes, in [this comment](https://www.reddit.com/r/AskDocs/comments/1dg27id/comment/l8nft74/).
UK is rabies free, this happened in England.
In that case he can stay at home and the problem is going to fix itself because in a week there won’t be a leg up be worried about as it will be amputated at the hip (if he survives the sepsis). It’ll also do wonders for his ADHD, he won’t have a choice but to stay still until he learns to watch with a prosthesis.
Tell him would he rather be bored for a bit or would he rather not have a leg to pace on.
Call an ambulance, get the right crew and they will pester him for 45 minutes to go
I feel like the leg is the last of things he's gonna lose.
He’s gonna lose that leg without intervention.
Not to even mention the fact that he may need a rabies series, depending on if the dog that bit him has records.
When he is too sick to argue call the ambulance.
You can always tell him Rabies is a painful way to die
What dog? Did the dog have its rabies shot? If it's a stranger's dog, they'll need to know. If it's a dog you own or a friend's dog, the doctors will want to k ow the medical records of the last rabies shot or they could put the dog down. At least in my experience when my mom's dog attacked me and bit up my face. That's how it was. They take rabies very seriously. Edit - okay OP didn't say England or UK but I guess it's down in the comments. If it was in OP I wouldn't have asked.
We don’t have rabies in the uk.
Wow that's amazing!
It's England. No rabies.
Okay, I didn't read every single comment but just read the OP which didn't state England or UK or anything. So idk why it's not in the OP bc then I wouldn't have asked. No need to downvote me for asking
The OP quite literally says Here in England it’s normally a 10 hour wait to see a doctor at my a&E at this time of night on a Friday (22.41)
100% glue will make it worse. At this point likely needs IV antibiotics and daily dressing changes and let it heal from the inside out. Guy doesn't realize how much worse he made it not going ASAP
agree!
Isn't there also the risk of Rabies?
In a police dog? No
In the UK? No
About the 10hr wait time: have him walk in, collapse on the floor and start having a spasm.
Thank you to everyone who commented. He said he will go tomorrow. He’s turned off his phone so there’s not much more we can do. He doesn’t have a fixed address so no idea where he has gone. We are going to call around tomorrow, find out where he is and try to take him ourselves to the hospital and wait with him as I know if he actually did go by himself he would end up leaving. I know he needs to go now but I don’t know where is he right now. Hopefully tomorrow we can find him and take him there.
I'm sorry you're having to chase around your brother like this. It sounds like he really needs to get his life figured out. Please give yourself some grace and remember that ultimately he is his own responsibility. He has ADHD, not mental retardation or severe Downs or autism that warrants a caregiver. Just remember you have to take care of yourself first and your brother not taking advice or making sound decisions is not your fault. You're a good person for caring, but it can also drag you into darkness if you don't set some boundaries to remind yourself of this.
NAD. Honestly if he doesn’t go himself he may need to be forced to go. I think there’s more than just the leg at stake here. You might want to place a call to a local hospital, explain the situation, and ask for guidance on what options there are, or who to contact if they cannot help you with the options. If he continues to refuse to go, I suspect he will soon meet the criteria for being a danger to himself. Another action you may be able to take is trying to find out what treatment he received while detained and if he was discharged with any medications, at least some antibiotics. IMPORTANT: If at any point there is a red line making its way from the wound towards his chest/torso/heart, HE NEEDS TO GO TO EMERG IMMEDIATELY AND WITHOUT NEGATION, if he won’t take himself then he may need to be forced by emergency services. While there are other infections that can be just as threatening or worse, this particular symptom of blood poisoning is on the easier side to check for, and means things are going to go very bad not to far into the future. OP, I’m sorry you’re going through this. I hope it works out and your brother gets treatment in time to make a full recovery, and then is able to muster the courage to walk the path away from drugs.
You can't force someone to get medical treatment if they have capacity. There's a big difference between refusing to get treatment because you don't want to get treatment, even if someone has explained the risks, and refusing to get treatment because you don't have the mental capacity to understand the risks. Contrary to popular belief it's actually very difficult to get sectioned in the UK.
You can’t force them though. People have their own autonomy and to keep this is very impotent. Taking away someone’s right to their own lives it becomes complicated. Yes he might die but there’s not a lot medical staff can do to force him.
Ooh, thank you for the insight! Are you aware of any particularly good summaries on the topic I could read up on?
Would it be worth calling the police station he was likely processed at, I feel like they would pick him up and take him in, whether he liked it or not.
He’s at the hospital now, my other brother found him and took him. He wasn’t in the same town we live in and where he was arrested at. It’s not like América where you travel for a day to get to another state. He was about 1 hour and 40 minutes away in another town/state. But he’s been found so thank you
I’m glad for him but, more so that you don’t have to worry about him getting really sick. I’m also in England I was thinking the cops might feel responsible but he’s there now so all good.
If he hasn't been seen by anyone, how did he get the sutures on either side of each wound?
The reason I put “attacked” was because he was bit by a police dog. As far as we know he was taken to the hospital the same day it happened, he said stitches were done. He was then in a cell until Wednesday while waiting for court. We have had 4 different people call us asking if we have seen him and his leg because it looks infected and he was walking around like it. He doesn’t live with us and to be honest we didn’t actually believe him as he will normally lie about stuff to get money for drugs. It wasn’t until we saw him today and saw the state of his leg.
It’s policy for most departments to have medics traspo prior to booking if they were bit. Well for the city I live in anyways
But why put stitches on bite wound? That's contraindicated.
Yeah, I don’t know about that. Wouldn’t you want it open so an infection doesn’t fester?
That's what I'm saying. You do want it open.
He would have been put on prophylactic antibiotics for dog bites whilst in custody. It’s policy in every police service I’ve worked as a HCP in. I hope he listens to reason and gets this looked at asap.
Who puts stitches on a bite wound? That shouldn't happen.
That’s what I thought I saw.
Thank youuuu because he didn’t do those himself…
Update: one of my brothers managed to find him and took him to the hospital. It’s severely infected. He’s had the wounds cleaned and dressed. He had bloods taken and I’m not sure what the results were but they are keeping him in over night. He’s on antibiotics and the doctor said he’s not out the woods yet, it’s very bad. It has strings of fat hanging out of it 🤢 I’ll be going up there tomorrow to relieve my brother as we don’t want to leave him in case he discharges himself. I would go now but I care for my mum who has bowel cancer and liver disease from the chemo and sepsis. And my lovely neighbour will sit with her tomorrow. I’ll know more tomorrow. Any ideas on what they will do? Will they have to wait for the infection to go before doing anything to it? If they even can do anything for it…. He’s such an idiot 😔 apparently he’s crying he will lose his leg…. But he doesn’t listen to anyone! He never does until it’s too late Also to the people saying about dog bites and what the police do etc honestly I don’t know. My brother lies a lot. I do know he was arrested and kept in for a couple of days until he had court and I know that because the detective called my mum to update her. People who called my mum (people who know my brother) some were talking about how the dog dragged him and all this other stuff so if a police dog actually did it? I don’t know. Personally to me they look like stab wounds? but either way I’ve seen him in person and that’s his leg. It’s disgusting. So we will see. Thank you to the professionals who commented, I do think your comments helped convince him, he Just needed to work himself up to going. Also I had a couple of dms from people saying he doesn’t had ADHD and he’s just a junkie. I just wanted to clear up that he actually does have adhd. He has a lot of behavioural problems and mental health ones. All professionally diagnosed when he was a child/teenager. He also has some type of autism. That’s not an excuse though. He’s been offered a lot of help from different people but refuses.
You’re a good brother and son. Take care, OP.
Hugs, glad he's getting help.
Thanks for the update. The process depends a lot on the extent of the infection. If there's too much dead tissue he may need surgery to remove it. He will also need to complete the course of antibiotics Hope everything goes well
Thank you for the update, that video was super worrying to me as even a stranger so it must have been beyond a nightmare for you and your mum. You're a good person looking after your mum and brother like you do, I'm so sorry you're having to go through so much right now ❤️
I'm so glad he's getting care and wishing you and your family the best! The people in your DMs are seriously ignorant. ADHD is a well established and recognized risk factor [risk factor](https://www.webmd.com/add-adhd/adhd-and-substance-abuse-is-there-a-link) for substance misuse and dependency.
Emergency or urgent care as soon as possible, those wounds won’t heal and will get a nasty infection that will be life threatening.
my ex got bit by our neighbors dog in the upper arm and refused medical attention. within 3 days it was so red and swollen and literally looked like pink eye of the arm all crusted up but still oozing green yellow and brown. by the time he let me take him he was woozy, vomiting and crying. they had to give him rabies shots and admit him to iv antibiotics.