Thick Blood, Thin Margins: How Hemoconcentration Sabotages Diabetic Foot Healing

Dr. G explains hemoconcentration — when low plasma volume makes blood thicker — and why it matters for diabetic foot care. The episode covers how dehydration, diuretics, hyperglycemia, and immobility raise hematocrit and BUN/Cr ratio, reducing microvascular perfusion, slowing wound healing, increasing infection and clot risk, and sometimes causing pre-renal azotemia.

Learn how to recognize hemoconcentration (elevated hemoglobin/hematocrit, high BUN/Cr), prevent it with hydration, glucose control, and mobility, and why reversing it can restore perfusion and improve outcomes for non-healing diabetic ulcers.

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Royal Wounds: Queen Victoria’s Case and the Calf Pump

This episode uses Queen Victoria as a clinical mirror to explain how immobility leads to venous hypertension, edema, skin breakdown, and chronic venous leg ulcers. It covers the classic triad—venous h...

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Royal Wounds: King George III, Stress Biology, and Diabetic Foot Healing

This episode examines King George III's documented episodes of severe mental illness and modern re-evaluation (bipolar disorder vs porphyria), then connects the biology of stress—HPA axis, cortisol, a...

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Royal Wounds: How Louis XIV's Anal Fistula Changed Surgery

This episode explores King Louis XIV's chronic infections, his catastrophic anal abscess and fistula, and the brutal pre-anesthesia surgery that ultimately saved him and advanced surgical practice acr...

30 Joulu 202518min

Royal Wounds Episode 2: Napoleon, Boots and the Truth About Pressure Ulcers

Dr. G explores how unrelieved pressure — not just diabetes or infection — can destroy tissue, using Napoleon Bonaparte’s chronic foot pain, stiff military boots, and relentless marching as a historica...

30 Joulu 202516min