renal NEMC

I found this week to be a real challenge. I had a 40 year old man that has end stage renal disease has Type I Diabetes Mellitus and was not on insulin. Apparently he was non compliant with his diet, and medications. He was blind, has just had an amputation due to gangrene setting in from having a toenail removed a couple weeks ago. His skin was purpleon all extremities and had small lesions. He has a stage III ulcer on his sacral area and had 3 kinds of insulin and about 17 other scheduled meds. His Creatine was about 7 and his BUN was 103. My heart broke for this man. I wanted to really take care of him but he was in so much pain it was a challenge to just move him. I was able to get everything done (thank you Beverly for your help) eventually but as i mentioned earlier it was a real challenge. Situations like these really make you stop and count your blessings! It was a great learning experience.