Each week on the PAD Leg Saver Hotline, hosted by myself and Douglas Salisbury, the conversation is unscripted. Patients join live. Stories unfold organically. Emotions surface without warning. For this recap, we are intentionally walking you through the flow of the conversation as it happened, highlighting the key moments and discussions that matter most. If you notice defined sections, that is deliberate. We are recreating the progression of the dialogue so that even if you did not watch the episode, you can follow how the discussion evolved in real time.
This week’s episode began casually, with weather and check-ins. Within minutes, it evolved into something far more revealing about the state of vascular care in America.
Dawn, who lost her leg to peripheral artery disease, shared that she recently received a flyer in Virginia advertising PAD testing.
“I sat there and laughed. This December will make five years that I lost my leg because of it. And now Virginia is just now having testing for it. That’s five years behind.”
She continued, “Imagine where were you five years ago when I couldn’t walk and you were telling me it was other reasons.”
Five years. A leg. A lifetime of consequences.
The conversation naturally shifted to the PAD Caucus and the ARC Act, legislation that would require early testing for at-risk patients and mandate inline blood flow checks before amputation. Dawn’s story illustrates exactly why that legislation matters.
Healthcare by Zip Code
Dawn described traveling to Massachusetts for care because she feels the quality is significantly better.
“It took me to go to Massachusetts to get my healthcare. That is not fair.”
Each trip costs roughly $400. She can only do it because her Medicare coverage allows interstate access. Many patients do not have that option.
“Why is all this healthcare different everywhere? We’re all the same people. We all have same diseases.”
Her question underscores a systemic issue: limb salvage should not depend on geography.
The Clotting That No One Investigated
Beth then shared her experience. Multiple strokes. Cardiac events. Ongoing vascular disease. Yet she was never referred to hematology for a comprehensive clotting workup until recently.
“They never sent me to hematology, never did any sort of additional clotting work, put the Band-Aid on it and sent me home.”
She lives with chronic heart failure, kidney disease, coronary artery disease, and a stent in her LAD artery. Still, anticoagulation management and clotting risk assessment remained incomplete.
This portion of the discussion highlighted how fragmented care can miss the larger vascular picture.
“Walk, Walk, Walk”: When Symptoms Are Dismissed
Dawn described her former vascular surgeon repeatedly telling her, “Walk, walk, walk. All you have to do is walk.”
Her response was blunt. She physically could not.
“I can’t even get from my car to the Walmart door where I am hysterically in tears having to sit on the floor because both legs have now cramped up to my hips.”
This was not mild discomfort. It was limb-threatening ischemia being minimized.
She also described being awake during a procedure and seeing the plaque removed from her artery.
“It looked like chewing gum… almost like a sticky piece of cheese that’s kind of melted.”
For patients, vascular disease is not abstract. It is visible. It is unforgettable.
What Amputation Actually Means in Daily Life
The most powerful part of the conversation centered not on surgery but on logistics.
“If I have to pee, I have to pre-plan. There’s no waiting for urgency. Or I will pee myself.”
She described hopping to bathroom stalls, avoiding accessible restrooms because they are often unusable, wearing a trash bag to slide down stairs in snow, managing multiple wheelchairs because equipment breaks.
“Do not tell me you understand until you have no leg and you’re in a wheelchair and your car is your legs to get to the corner store.”
These are the daily realities of amputation that rarely make it into clinical discussions.
The Doctor Who Said “Amputate” — And the One Who Didn’t
Anastasia, a dialysis nurse, spent a year and a half in a wheelchair before finding a specialist willing to attempt limb salvage.
“My doctor dismissed me and told me my only answer was amputation.”
She sought another opinion hours away and ultimately saved her legs.
Imagine if she had accepted the first opinion.
PAD Is Not an Old Person’s Disease
The discussion turned toward risk factors and age. Dawn’s 10-year-old daughter has elevated lipoprotein(a), a genetic risk factor.
“It definitely is not an old person’s disease.”
Dawn herself had a heart attack and said, “My pedal pulses, never checked.”
Three in five people who suffer a heart attack have PAD. Yet lower extremity vascular checks remain inconsistent.
Why This Conversation Matters
Following this episode chronologically reveals a pattern. Delayed screening. Fragmented care. Missed clotting disorders. Dismissed symptoms. Premature amputation recommendations. Geographic disparities.
Peripheral artery disease is increasing alongside diabetes and chronic kidney disease. Younger patients are being affected. Women are often dismissed. Stroke survivors are not always receiving full clotting evaluations. Heart attack patients are not routinely screened for PAD.
This recap intentionally follows the natural flow of the discussion because that is how these failures present in real life — layered, compounding, and interconnected.
The full PAD Leg Saver Hotline episode is embedded below. I encourage policymakers, clinicians, hospital administrators, and insurers to listen carefully.
Until we normalize early testing, enforce inline blood flow checks before amputation, require comprehensive clotting workups, and ensure equitable access to advanced limb salvage, these stories will continue.
And they should not have to.
Watch Dawn-Marie and Legendary Harlem Globetrotter Larry “Shorty” Coleman alongside Dr. Bob Tahara and Dr. Andrew Klein, as they share their moment on Capital Hill, raising the voice of the patient during the PAD Caucus relaunch:
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